If private equity sized up your business.
Pozen, Robert C
2007-11-01
As the dust settles on the recent frenzy of private equity deals (including transactions topping $20 billion), what lessons can companies glean? Directors and executives of public companies may now be slightly less fearful of imminent takeover, yet the pressure remains: They face shareholders who wonder why they aren't getting private-equity-level returns. Rather than dismiss the value private equity has created as manipulated or aberrant, public company leaders should recognize the disciplined management that often underlies it. Pozen, a longtime leader in the financial services industry, finds that in the aftermath of buyouts, companies undergo five major thrusts of reform. These translate into five key questions that directors should pose to senior management: Have we left too much cash on our balance sheet instead of raising our cash dividends or buying back shares? Do we have the optimal capital structure, with the lowest weighted after-tax cost of total capital, including debt and equity? Do we have an operating plan that will significantly increase shareholder value, with specific metrics to monitor performance? Are the compensation rewards for our top executives tied closely enough to increases in shareholder value, with real penalties for nonperformance? Finally, does our board have enough industry experts who have made the time commitments and been given the financial incentives necessary to maximize shareholder value? The era of private equity is far from over - the top funds have become very large and are likely to play an influential role in future market cycles. Boards that ask these questions, and act on them, won't just beat the takeover artists to the punch. They will build stronger businesses.
Creating Teacher Incentives for School Excellence and Equity
ERIC Educational Resources Information Center
Berry, Barnett; Eckert, Jon
2012-01-01
Ensuring that all students in America's public schools are taught by good teachers is an educational and moral imperative. Teacher incentive proposals are rarely grounded on what high-quality research indicates are the kinds of teacher incentives that lead to school excellence and equity. Few of the current approaches to creating teacher…
Rethinking Equity--There Are Alternatives.
ERIC Educational Resources Information Center
Picus, Lawrence O.
1998-01-01
Defines "equity" in terms of three concepts (horizontal equity, vertical equity, and fiscal neutrality), summarizes school finance litigation history, and presents alternative distribution formats to improve student achievement. Enhancing equity and efficiency requires reallocation of existing resources, incentives for improved performance, a more…
Honda, Ayako
2015-02-04
There are large gaps in the literature relating to the implementation of user fee policy and fee exemption measures for the poor, particularly on how such schemes are implemented and why many have not produced expected outcomes. In October 2003, Madagascar instituted a user fee exemption policy which established "equity funds" at public health centres, and used medicine sales revenue to subsidise the cost of medicine for the poor. This study examines the policy design and implementation process of the equity fund in Madagascar in an attempt to explore factors influencing the poor equity outcomes of the scheme. This study applied an agency-incentive framework to investigate the equity fund policy design and implementation practices. It analysed agency relationships established during implementation; examined incentive structures given to the agency relationships in the policy design; and considered how incentive structures were shaped and how agents responded in practice. The study employed a case-study approach with in-depth analysis of three equity fund cases in Madagascar's Boeny region. Policy design problems, triggering implementation problems, caused poor equity performance. These problems were compounded by the re-direction of policy objectives by health administrators and strong involvement of the administrators in the implementation of policy. The source of the policy design and implementation failure was identified as a set of principal-agent problems concerning: monitoring mechanisms; facility-based fund management; and the nature and level of community participation. These factors all contributed to the financial performance of the fund receiving greater attention than its ability to financially protect the poor. The ability of exemption policies to protect the poor from user fees can be found in the details of the policy design and implementation; and implications of the policy design and implementation in a specific context determine whether a policy can realise its objectives. The equity fund experience in Madagascar, which illustrates the challenges of beneficiary identification, casts doubts on the application of the 'targeting' approach in health financing and raises issues to be considered in universal health policy formulation. The agency framework provides a useful lens through which to examine policy process issues.
Executive pay trends and golden parachute tax: a collision on the horizon.
Johnson, David G
2004-01-01
Ironically, many corporations will likely discover that tying equity-based executive compensation more closely to performance will cost millions of dollars when there is a merger or acquisition. The reason: Internal Revenue Code Section 280G, which is designed to discourage "excess" parachute payments, often assesses a significantly higher toll on performance-based compensation than on time-vested equity payments. There is no magic remedy, but advance planning can often help mitigate the impact. This article describes the dilemma and suggests several approaches to the challenge.
ERIC Educational Resources Information Center
Clarke, John R.
The current approach to promoting educational equity in universities in Australia is substantially flawed. Through the "equity framework," the Australian university community sector has been compelled to involvement with educational equity through government pressure that has included financial incentives and legislation. Six groups have…
Incentives and provider payment methods.
Barnum, H; Kutzin, J; Saxenian, H
1995-01-01
The mode of payment creates powerful incentives affecting provider behavior and the efficiency, equity and quality outcomes of health finance reforms. This article examines provider incentives as well as administrative costs, and institutional conditions for successful implementation associated with provider payment alternatives. The alternatives considered are budget reforms, capitation, fee-for-service, and case-based reimbursement. We conclude that competition, whether through a regulated private sector or within a public system, has the potential to improve the performance of any payment method. All methods generate both adverse and beneficial incentives. Systems with mixed forms of provider payment can provide tradeoffs to offset the disadvantages of individual modes. Low-income countries should avoid complex payment systems requiring higher levels of institutional development.
Payments for Ecosystem Services for watershed water resource allocations
NASA Astrophysics Data System (ADS)
Fu, Yicheng; Zhang, Jian; Zhang, Chunling; Zang, Wenbin; Guo, Wenxian; Qian, Zhan; Liu, Laisheng; Zhao, Jinyong; Feng, Jian
2018-01-01
Watershed water resource allocation focuses on concrete aspects of the sustainable management of Ecosystem Services (ES) that are related to water and examines the possibility of implementing Payment for Ecosystem Services (PES) for water ES. PES can be executed to satisfy both economic and environmental objectives and demands. Considering the importance of calculating PES schemes at the social equity and cooperative game (CG) levels, to quantitatively solve multi-objective problems, a water resources allocation model and multi-objective optimization are provided. The model consists of three modules that address the following processes: ① social equity mechanisms used to study water consumer associations, ② an optimal decision-making process based on variable intervals and CG theory, and ③ the use of Shapley values of CGs for profit maximization. The effectiveness of the proposed methodology for realizing sustainable development was examined. First, an optimization model with water allocation objective was developed based on sustainable water resources allocation framework that maximizes the net benefit of water use. Then, to meet water quality requirements, PES cost was estimated using trade-off curves among different pollution emission concentration permissions. Finally, to achieve equity and supply sufficient incentives for water resources protection, CG theory approaches were utilized to reallocate PES benefits. The potential of the developed model was examined by its application to a case study in the Yongding River watershed of China. Approximately 128 Mm3 of water flowed from the upper reach (Shanxi and Hebei Provinces) sections of the Yongding River to the lower reach (Beijing) in 2013. According to the calculated results, Beijing should pay USD6.31 M (¥39.03 M) for water-related ES to Shanxi and Hebei Provinces. The results reveal that the proposed methodology is an available tool that can be used for sustainable development with resolving PES amounts among different regions under social and environmental constraints by considering the characteristics of social equity and CGs.
Healthcare payment incentives: a comparative analysis of reforms in Taiwan, South Korea and China.
Eggleston, Karen; Hsieh, Chee-Ruey
2004-01-01
Payment incentives to both consumers and providers have significant consequences for the equity and efficiency of a healthcare system, and have recently come to the fore in health policy reforms. This review first discusses the economic rationale for the apparent international convergence toward payment systems with mixed demand- and supply-side cost sharing. The recent payment reforms undertaken in Taiwan, South Korea and China are then summarised. Available evidence clearly indicates that payment incentives matter, and, in particular, that supply-side cost sharing can improve efficiency without undermining equity. Further study and monitoring of health service quality and risk selection is warranted.
Returns on equity to not-for-profit hospitals: theory and implementation.
Conrad, D A
1984-01-01
It is argued that not-for-profit hospitals can be assumed to generate a return on equity capital due, in principle, to competition in the final product market for hospital services and in the capital market. Practical difficulties in identifying claimants to the net income of the firm, as well as the incentive problems of cost-based reimbursement, suggest that a competitive pricing approach is likely to be the appropriate means to provide a reasonable return on equity for the not-for-profit and the for-profit hospital. Implications of the analysis for the correct discount rate in investment decisions are outlined. PMID:6724955
Section 1603 Treasury Grant Expiration. Industry Insight on Financing and Market Implications
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mendelsohn, Michael; Harper, John
In the wake of the 2008-2009 financial crises, tax equity investors largely withdrew from the market, resulting in stagnation of project development. In response, Congress established the Treasury grant program pursuant to Section 1603 of the American Recovery and Reinvestment Act (Section 1603 Program) to offer a cash payment in lieu of a production and investment tax credit. This study addresses the likely project financing and market impacts from the expiration of the Section 1603 Program. The authors assembled an array of insights offered by financial executives active in the renewable energy (RE) market during conference panel discussions and inmore » presentations, direct interviews, and email correspondences. This analysis found that the Section 1603 Program alleviated the need to monetize the tax credit incentives through specialized investors, helped lower the transaction and financing costs associated with renewable electricity projects, and generally supported an extensive build-out of renewable power generation capacity. With the expiration of the Section 1603 Program, smaller or less-established renewable power developers will have more difficulty attracting needed financial capital and completing their projects, development of projects relying on newer or 'innovative' technologies will likely slow as traditional tax equity investors are known to be highly averse to technology risk in the projects they fund, and, finally, projects relying on tax equity may be more expensive to develop due to higher transaction costs and potentially higher yields required to attract tax equity.« less
Section 1603 Treasury Grant Expiration: Industry Insight on Financing and Market Implications
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mendelsohn, M.; Harper, J.
In the wake of the 2008-2009 financial crises, tax equity investors largely withdrew from the market, resulting in stagnation of project development. In response, Congress established the Treasury grant program pursuant to Section 1603 of the American Recovery and Reinvestment Act (..Section..1603 Program) to offer a cash payment in lieu of a production and investment tax credit. This study addresses the likely project financing and market impacts from the expiration of the ..Section..1603 Program. The authors assembled an array of insights offered by financial executives active in the renewable energy (RE) market during conference panel discussions and in presentations, directmore » interviews, and email correspondences. This analysis found that the ..Section..1603 Program alleviated the need to monetize the tax credit incentives through specialized investors, helped lower the transaction and financing costs associated with renewable electricity projects, and generally supported an extensive build-out of renewable power generation capacity. With the expiration of the ..Section..1603 Program, smaller or less-established renewable power developers will have more difficulty attracting needed financial capital and completing their projects, development of projects relying on newer or 'innovative' technologies will likely slow as traditional tax equity investors are known to be highly averse to technology risk in the projects they fund, and, finally, projects relying on tax equity may be more expensive to develop due to higher transaction costs and potentially higher yields required to attract tax equity.« less
Mosquera, Paola; Alzate, Juan Pablo; Pottie, Kevin; Welch, Vivian; Akl, Elie A; Jull, Janet; Lang, Eddy; Katikireddi, Srinivasa Vittal; Morton, Rachel; Thabane, Lehana; Shea, Bev; Stein, Airton T; Singh, Jasvinder; Florez, Ivan D; Guyatt, Gordon; Schünemann, Holger; Tugwell, Peter
2017-01-01
Abstract The availability of evidence-based guidelines does not ensure their implementation and use in clinical practice or policy making. Inequities in health have been defined as those inequalities within or between populations that are avoidable, unnecessary and also unjust and unfair. Evidence-based clinical practice and public health guidelines (‘guidelines’) can be used to target health inequities experienced by disadvantaged populations, although guidelines may unintentionally increase health inequities. For this reason, there is a need for evidence-based clinical practice and public health guidelines to intentionally target health inequities experienced by disadvantaged populations. Current guideline development processes do not include steps for planned implementation of equity-focused guidelines. This article describes nine steps that provide guidance for consideration of equity during guideline implementation. A critical appraisal of the literature followed by a process to build expert consensus was undertaken to define how to include consideration of equity issues during the specific GRADE guideline development process. Using a case study from Colombia we describe nine steps that were used to implement equity-focused GRADE recommendations: (1) identification of disadvantaged groups, (2) quantification of current health inequities, (3) development of equity-sensitive recommendations, (4) identification of key actors for implementation of equity-focused recommendations, (5) identification of barriers and facilitators to the implementation of equity-focused recommendations, (6) development of an equity strategy to be included in the implementation plan, (7) assessment of resources and incentives, (8) development of a communication strategy to support an equity focus and (9) development of monitoring and evaluation strategies. This case study can be used as model for implementing clinical practice guidelines, taking into account equity issues during guideline development and implementation. PMID:29029068
Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-25
... equity options transaction fees for members executing facilitation orders pursuant to Exchange Rule 1064... waiver to members executing facilitation orders pursuant to Exchange Rule 1064 to cabinet trade equity...
Participatory development of incentives to coexist with jaguars and pumas.
Amit, Ronit; Jacobson, Susan K
2018-01-22
Reducing costs and increasing benefits for rural communities coexisting with large carnivores is necessary for conservation of jaguar (Panthera onca) and puma (Puma concolor). To design acceptable incentives, stakeholders must be involved in the process. We conducted an innovative, structured, group communication process based on a Delphi technique as a template for identifying potential incentives. Community workshops with 133 members of 7 communities and surveys with 25 multidisciplinary experts from government, nongovernmental organizations, and academia provided iterative data to design a plan of incentives through 4 rounds of discussion. The final product integrated 862 ideas into 6 types of incentives: organization of communities, mechanisms for improved dialogue, citizen technical assistance, green labeling for community products, payment for the ecosystem service of biodiversity, and an assessment of financial alternatives. We used quantitative and qualitative techniques to indicate support for decisions about the design of incentives, which reduced researcher subjectivity. The diverse incentives developed and the cooperation from multiple stakeholders resulted in an incentive plan that integrated issues of governance, equity, and social norms. © 2018 Society for Conservation Biology.
ERIC Educational Resources Information Center
Mintrop, Rick; Ordenes, Miguel
2017-01-01
Mindful of the withering of high-stakes accountability and disappointing data from pay for performance evaluations in the US, we ask why management by extrinsic incentives and organizational goal setting may have been far less powerful than designers of accountability and extrinsic incentive systems had expected. We explore how…
Solar thermal power generation in India: effect of potential incentives on unit cost of electricity
NASA Astrophysics Data System (ADS)
Sharma, Chandan; Sharma, Ashish K.; Mullick, Subhash C.; Kandpal, Tara C.
2017-09-01
For large-scale dissemination of solar thermal power plants, in countries identified with huge potential, governments are offering various incentives. In an attempt towards studying the effectiveness of various incentives in reducing the levelised cost of electricity (LCOE) delivered by solar thermal power plants in India, this paper presents simple mathematical frameworks that facilitate the determination of the required level of an incentive so as to ensure that the LCOE is within a pre-specified limit. For example, for a 50 MW solar thermal power plant at Barmer (Rajasthan), LCOE of Rs. 9.75 per kWh can be achieved by providing 6.3% viability gap funding or an interest subsidy of 3% or provision of 32% investment tax credits to the equity investor or provision of production tax credits to the equity investor at the rate of Rs. 0.81 per kWh for first 10 years of operation of a plant.
Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-10
.... First, the Exchange proposes to eliminate the first and third qualification requirements for Tier 4... Pilot Issues, plus executed ADV of Retail Orders of 0.3% of U.S. Equity Market Share Posted and Executed... and Non-Penny Pilot Issues Plus executed ADV of Retail Orders of 0.3% ADV of U.S. Equity Market Share...
ERIC Educational Resources Information Center
Hayden, F. Gregory
1980-01-01
By algebraically defining a school finance structure as a total budget system, partial derivatives can be used to find the kinds of rewards, incentives, and distributions the structure defines for individual districts and among districts. Equity concerns can also be answered. (Author/IRT)
The Energy Economics of Financial Structuring for Renewable Energy Projects
NASA Astrophysics Data System (ADS)
Rana, Vishwajeet
2011-12-01
This dissertation focuses on the various financial structuring options for the renewable energy sector. The projects in this sector are capital-intensive to build but have relatively low operating costs in the long run when compared to traditional energy resources. The large initial capital requirements tend to discourage investors. To encourage renewable investments the government needs to provide financial incentives. Since these projects ultimately generate returns, the government's monetary incentives go to the sponsors and tax equity investors who build and operate such projects and invest capital in them. These incentives are usually in the form of ITCs, PTCs and accelerated depreciation benefits. Also, in some parts of the world, carbon credits are another form of incentive for the sponsors and equity investors to invest in such turnkey projects. The relative importance of these various considerations, however, differs from sponsor to sponsor, investor to investor and from project to project. This study focuses mainly on the US market, the federal tax benefits and incentives provided by the government. This study focuses on the energy economics that are used for project decision-making and parties involved in the transaction as: Project Developer/Sponsor, Tax equity investor, Debt investor, Energy buyer and Tax regulator. The study fulfils the knowledge gap in the decision making process that takes advantage of tax monetization in traditional after-tax analysis for renewable energy projects if the sponsors do not have the tax capacity to realize the total benefits of the project. A case-study for a wind farm, using newly emerging financial structures, validates the hypothesis that these renewable energy sources can meet energy industry economic criteria. The case study also helps to validate the following hypotheses: a) The greater a sponsor's tax appetite, the tower the sponsor's equity dilution. b) The use of leverage increases the cost of equity financing and the financing fee. c) Capital contributions by the sponsor are not relevant to the rate of return (IRR) over the life of the project. Overall conclusion is that financial structures can have a major impact on renewable energy, meeting energy demand in an economic manner. At the end, the dissertation lays down the foundation for future research that can be conducted in this field. Key Words: Renewable energy investments, structured finance, financial structuring
Causey, Kayla B; Bjorklund, David F
2014-11-01
Prospective memory (PM) is remembering to perform an action in the future and is crucial to achieving goal-directed activities in everyday life. Doing so requires that an intention is encoded, retained during a delay interval, and retrieved at the appropriate time of execution. We examined PM ability in preschool children by manipulating factors related to agency and incentive. We further explored how metacognition, executive functioning, and theory of mind-factors known to account for individual differences in PM-influenced performance on these PM tasks. A sample of 31 preschool children were asked to carry out a delayed intention or to remind an adult to carry out an intention that was of high or low incentive to the children. Findings indicated that individual differences in theory of mind were related to individual differences in preschoolers' performance on low-incentive PM tasks, independent of executive functioning contributions, whereas individual differences in executive functioning were related to performance on the high-incentive tasks. These findings suggest that changes in theory of mind and executive functioning are important to consider in models of PM and that different PM tasks (e.g., high vs. low incentive) may involve different cognitive requirements for young children. Copyright © 2014 Elsevier Inc. All rights reserved.
Incentives, equity and the Able Chooser Problem.
Grill, Kalle
2017-03-01
Health incentive schemes aim to produce healthier behaviours in target populations. They may do so both by making incentivised options more salient and by making them less costly. Changes in costs only result in healthier behaviour if the individual rationally assesses the cost change and acts accordingly. Not all people do this well. Those who fail to respond rationally to incentives will typically include those who are least able to make prudent choices more generally. This group will typically include the least advantaged more generally, since disadvantage inhibits one's effective ability to choose well and since poor choices tend to cause or aggravate disadvantage. Therefore, within the target population, health benefits to the better off may come at the cost of aggravated inequity. This is one instance of a problem I name the Able Chooser Problem, previously emphasised by Richard Arneson in relation to coercive paternalism. I describe and discuss this problem by distinguishing between policy options and their effects on the choice situation of individuals. Both positive and negative incentives, as well as mandates that are less than perfectly effective, require some sort of rational deliberation and action and so face the Able Chooser Problem. In contrast, effective restriction of what options are physically available, as well as choice context design that makes some options more salient or appealing, does not demand rational agency. These considerations provide an equity-based argument for preferring smart design of our choice and living environment to incentives and mandates. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-28
... Amending NYSE Amex Equities Rule 1000 Regarding Order Size Eligible for Automatic Execution June 22, 2010... Equities Rule 1000 regarding order size eligible for automatic execution. The text of the proposed rule... 1. Purpose The Exchange proposes to amend Rule 1000 to state that the order size eligible for...
School Desegregation and Federal Inducement: Lessons from the Emergency School Aid Act of 1972
ERIC Educational Resources Information Center
Hodge, Emily M.
2018-01-01
This study uses the example of the Emergency School Aid Act of 1972, a federal desegregation incentive program, to discuss the benefits and challenges of equity-oriented incentives. This study applies theories of policy instruments and the social construction of target populations to congressional records, archival program materials, and other…
Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-08
... routing certain equity and index option Customer orders to away markets for execution. \\3\\ For a complete..., 2009) (SR-Phlx-2009-32). The instant proposed fees will apply only to option orders entered into, and... and executing certain Customer orders in equity and index options to away markets. In May 2009, the...
ERIC Educational Resources Information Center
Chiang, Hanley; Wellington, Alison; Hallgren, Kristin; Speroni, Cecilia; Herrmann, Mariesa; Glazerman, Steven; Constantine, Jill
2015-01-01
Recent efforts to attract and retain effective educators and to improve teaching practices have focused on reforming evaluation and compensation systems for teachers and principals. In 2006, Congress established the Teacher Incentive Fund (TIF), which provides grants to support performance-based compensation systems for teachers and principals in…
Ways to Evaluate the Success of Your Teacher Incentive Fund Project in Meeting TIF Goals
ERIC Educational Resources Information Center
Milanowski, Anthony; Finster, Matthew
2016-01-01
This brief outlines some simple methods that Teacher Incentive Fund grants could add to their local evaluations to find out how well they are promoting attainment of the four overall TIF goals. The methods described in this brief can help grantees determine if they are moving toward improving effectiveness, student achievement, and equity.…
ERIC Educational Resources Information Center
Chiang, Hanley; Speroni, Cecilia; Herrmann, Mariesa; Hallgren, Kristin; Burkander, Paul; Wellington, Alison
2017-01-01
The Teacher Incentive Fund (TIF) provides grants to support performance-based compensation systems for teachers and principals in high-need schools. The study measures the impact of pay-for-performance bonuses as part of a comprehensive compensation system within a large, multisite random assignment study design. The treatment schools were to…
ERIC Educational Resources Information Center
Max, Jeffrey; Constantine, Jill; Wellington, Alison; Hallgren, Kristin; Glazerman, Steven; Chiang, Hanley; Speroni, Cecilia
2014-01-01
The Teacher Incentive Fund (TIF) provides grants to support performance-based compensation systems for teachers and principals in high-need schools. The study measures the impact of pay-for-performance bonuses as part of a comprehensive compensation system within a large, multisite random assignment study design. The treatment schools were to…
Can Profit Policy and Contract Incentives Improve Defense Contract Outcomes?
2009-02-01
required by investors. The weighted average cost of capital ( WACC ) is the standard financial statistic that weights the returns demanded by investors that...hold equity and investors that hold debt.6 Like FCFROIC, WACC is expressed as a percentage. Consequently, it is possible to compare these two...contractors include Lockheed, Raytheon, Northrop Grumman, and General Dynamics. 6 Mathematically, WACC = Debt/(Debt + Equity) × Debt Cost × (1-Tax Rate
Chib, Vikram S.; De Martino, Benedetto; Shimojo, Shinsuke; O'Doherty, John P.
2012-01-01
Summary Employers often make payment contingent on performance in order to motivate workers. We used fMRI with a novel incentivized skill task to examine the neural processes underlying behavioral responses to performance-based pay. We found that individuals' performance increased with increasing incentives; however, very high incentive levels led to the paradoxical consequence of worse performance. Between initial incentive presentation and task execution, striatal activity rapidly switched between activation and deactivation in response to increasing incentives. Critically, decrements in performance and striatal deactivations were directly predicted by an independent measure of behavioral loss aversion. These results suggest that incentives associated with successful task performance are initially encoded as a potential gain; however, when actually performing a task, individuals encode the potential loss that would arise from failure. PMID:22578508
1995-11-01
based on established and incentive for Delta compliance. functioning replacement wetlands. Perhaps the most compelling reason given for why The permit...developed mitigation plans powerful incentive for ventures to carefully site, for the Cricket Creek site in accordance with the plan, and execute the...Opportunity. Lev, Esther (with field assistance by Peter Zika ) for the Lane County Council of Governments, 1988 (revised 1990), Preliminary Inventory of
Hindu-Muslim Violence in India: A National and State-Level Study
2014-09-01
clubs, sports clubs, festival organizations, trade unions, and cadre-based political parties.”25 Varshney argues that it is these groups that... tourism sectors by offering subsidies as well as fiscal and policy incentives to attract businesses to the state.37 Likewise, in 2007, Kerala also...Kerala’s tourism sector and agricultural sectors have become near equal contributors of 9% to the state’s GDP. India Brand Equity Foundation, Kerala State
Sharma, Radha R; Sharma, Neha P
2015-01-01
The study is aimed at assessing the role of perceived gender equity and locus of control in employee well-being at the workplace and ascertaining if work engagement mediates between perceived gender equity, locus of control, and employee well-being (measured through optimism, general satisfaction with life and work, and executive burnout). Adopting a personal survey method data was collected from 373 managers (both males and females) from the public and private sectors representing manufacturing and service industry in India. The study bridges the knowledge gap by operationalizing the construct of perceived gender equity and studying its role in the work engagement and employee well-being. Conceptualization of the well-being in an unconventional way covering both the positive and the negative aspects extends the understanding of the emerging concept of well-being. It has practical implications for talent management and work engagement besides promoting gender equity at the workplace for employee well-being. It opens vistas for the gender based theory and cross cultural research on gender equity.
Sharma, Radha R.; Sharma, Neha P.
2015-01-01
The study is aimed at assessing the role of perceived gender equity and locus of control in employee well-being at the workplace and ascertaining if work engagement mediates between perceived gender equity, locus of control, and employee well-being (measured through optimism, general satisfaction with life and work, and executive burnout). Adopting a personal survey method data was collected from 373 managers (both males and females) from the public and private sectors representing manufacturing and service industry in India. The study bridges the knowledge gap by operationalizing the construct of perceived gender equity and studying its role in the work engagement and employee well-being. Conceptualization of the well-being in an unconventional way covering both the positive and the negative aspects extends the understanding of the emerging concept of well-being. It has practical implications for talent management and work engagement besides promoting gender equity at the workplace for employee well-being. It opens vistas for the gender based theory and cross cultural research on gender equity. PMID:26500566
Public preferences over efficiency, equity and autonomy in vaccination policy: an empirical study.
Luyten, Jeroen; Dorgali, Veronica; Hens, Niel; Beutels, Philippe
2013-01-01
Vaccination programs increasingly have to comply with standards of evidence-based decision making. However, such a framework tends to ignore social and ethical sensitivities, risking policy choices that lack crucial public support. Research is needed under which circumstances and to which extent equity and autonomy should prevail over effectiveness and cost-effectiveness in matters of infectious disease prevention. We report on a study investigating public preferences over various vaccination policy options, based on a population survey held in Flanders, Belgium (N = 1049) between March and July 2011. We found (1) that public support varied considerably between policies that were equally efficient in preventing disease but differed according to target group or incentives to improve uptake and (2) that preferences over the use of legal compulsion, financial accountability or the offering of rewards appear to be driven by individuals' social orientation. Copyright © 2012 Elsevier Ltd. All rights reserved.
Lluch, Maria; Kanavos, Panos
2010-05-01
In this paper, we focus on regulatory restrictions on Community Pharmacies and whether these have an impact on efficiency, access and equity and thus in the delivery of services community pharmacists provide to patients. Primary data collection through semi-structured interviews and secondary data collection through literature review have been used with a particular focus on Spain (a country where Community Pharmacy is strictly regulated) and the UK (a country where Community Pharmacy is considered liberalised by EU standards). The findings indicate that improved pharmacy operational efficiency is the result of appropriate incentive structures, ownership liberalisation and OTC price freedom as is the case in the UK. Equity and access seem to be better achieved by establishing geographic, demographic or needs-based criteria to open new pharmacies (as is the case in Spain). In sum, there are useful lessons for both countries: the UK could look into the policies applied in Spain that increase access and equity whilst Spain could adopt some of the policies from the UK to increase efficiency in the system. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.
Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-13
...-Transaction Fees for Executions Against a Public Quotation in an OTC Equity Security April 8, 2011. On... disclose on its website any fees imposed against its published quotation in any OTC Equity Security...
5 CFR 575.103 - Eligible categories of employees.
Code of Federal Regulations, 2010 CFR
2010-01-01
... INCENTIVES Recruitment Incentives § 575.103 Eligible categories of employees. (a) Except as provided in § 575.104, an Executive agency may pay a recruitment incentive to an employee appointed or placed in the... § 575.104, a legislative agency may pay a recruitment incentive to an employee appointed or placed in a...
DOT National Transportation Integrated Search
2002-01-01
This is the first Conditions and Performance Report that begins to capture the effects of investment in highways, bridges and transit undertaken since the enactment of the Transportation Equity Act for the 21st Century (TEA-21) in 1998. Based on data...
Disparities in long-term care: building equity into market-based reforms.
Konetzka, R Tamara; Werner, Rachel M
2009-10-01
A growing body of evidence documents pervasive racial, ethnic, and class disparities in long-term care in the United States. At the same time, major quality improvement initiatives are being implemented that rely on market-based incentives, many of which may have the unintended consequence of exacerbating disparities. We review existing evidence on disparities in the use and quality of long-term care services, analyze current market-based policy initiatives in terms of their potential to ameliorate or exacerbate these disparities, and suggest policies and policy modifications that may help decrease disparities. We find that racial disparities in the use of formal long-term care have decreased over time. Disparities in quality of care are more consistently documented and appear to be related to racial and socioeconomic segregation of long-term care facilities as opposed to within-provider discrimination. Market-based incentives policies should explicitly incorporate the goal of mitigating the potential unintended consequence of increased disparities.
Laurie T, Martin; Linnea Warren, May; Sarah, Weilant; Joie D, Acosta; Anita, Chandra
2018-01-01
In 2013, the Robert Wood Johnson Foundation embarked on a pioneering effort to advance a Culture of Health. This report focuses on two questions that are central to understanding how individuals and sectors think about health and are motivated to promote it: How can the commonly understood concepts of cultural identity (e.g., ethnic or religious; lesbian, gay, bisexual, transgender plus; military) and organizational culture be harnessed to develop a Culture of Health? How can incentives be used to promote individual health and engage investors and leaders within organizations or governments to promote health and well-being broadly? This study draws on 43 one-hour semistructured interviews that RAND researchers conducted with stakeholders whose work focused on cultural alignment, incentives, or both to learn how organizations are addressing and leveraging culture and incentives to promote health and well-being, as well as to identify facilitators, barriers, potential best practices, and lessons learned. Key findings include the following: Equity is often addressed in silos, which impedes progress toward a unified goal of health equity for all; members of specific cultural groups need to be given a voice in health-related activities; systems are built around prevailing cultural norms, making it challenging for those working with specific cultures to make cultural adaptations; and not all incentives are monetary. Recommendations include institutionalizing practices that ensure ongoing input from marginalized populations, identifying ways to help smaller organizations overcome structural inequalities, and institutionalizing health promotion efforts in sectors other than public health or health care to sustain collaborative efforts.
Corporate incentives for promoting safety belt use : rationale, guidelines, and examples
DOT National Transportation Integrated Search
1982-10-01
This manual was designed to teach the corporate executive successful strategies for implementing and evaluating a successful industry-based program to motivate employee safety belt use. A rationale is given for the general approach; and specific guid...
Women Chief Executives and Their Approaches towards Equity in American Universities.
ERIC Educational Resources Information Center
Lindsay, Beverly
1999-01-01
Semistructured interviews with four African-American women serving as university president or provost examined their qualifications, past mentors, racial or gender factors affecting their position, career impediments, experiences with nonsupportive supervisors, reasons for scarcity of African-American women administrators, educational equity and…
Multi-Cultural Issues In Mental Health Services: Strategies Towards Equity.
ERIC Educational Resources Information Center
California State Dept. of Health, Sacramento.
While California has evolved the elements of a strong and responsive mental health service delivery system based on a statutory partnership among the executive office, local jurisdictions, and citizens, many groups of persons in need of mental health services remain underserved. Such is the plight of the racial/ethnic minority people, whose…
Employee incentives in the healthcare industry.
McKinnies, Richard C; Collins, Sandra K; Collins, Kevin S
2008-01-01
*Employee incentives are an important part of a radiology department's ability to attract and maintain employees. For incentive programs to be successful, radiology managers must diligently look for the incentives that motivate each particular employee. *The types of incentives being used frequently in the field of healthcare vary between technical, managerial, and executive positions. The process of identifying the right employee incentive for each group of individuals may be challenging, but if the result is a more productive and satisfied group of employees, the process is worth the effort.
Balancing incentives in the compensation contracts of nonprofit hospital CEOs.
Preyra, C; Pink, G
2001-07-01
Given the considerable insight into corporate governance achieved through studies of executive compensation in proprietary firms it is surprising that executive contracting in nonprofit organizations remains largely unexplored. In this paper, we use the multitask principal agent model of Holmström and Milgrom [The Journal of Law, Economics and Organization 7 (1991) (Suppl.) 24] to argue that nonprofit hospitals represent an optimal response to information asymmetries between managers and boards. For a board with multidimensional objectives, the agency problem is getting top executives to distribute their efforts across all dimensions of the hospital's mission. The nonprofit form is preferred because the absence of high powered incentives such as share ownership reduces executives' incentives to place undue emphasis on improving financial performance at the expense of important but less observable tasks. Using newly available compensation data we test the model by comparing the conditional distributions of earnings for industrial and nonprofit hospital CEOs in Ontario. Our best estimates are that CEOs in publicly traded firms earn twice as much on average as those in similarly sized nonprofit hospitals but bear roughly eight times the income variance. Estimates of the associated degree of risk aversion are well within conventional bounds and are consistent with the trade-off between insurance and incentives predicted by the theory.
Creating the Business Case for Achieving Health Equity.
Chin, Marshall H
2016-07-01
Health care organizations have increasingly acknowledged the presence of health care disparities across race/ethnicity and socioeconomic status, but significantly fewer have made health equity for diverse patients a true priority. Lack of financial incentives is a major barrier to achieving health equity. To create a business case for equity, governmental and private payors can: 1) Require health care organizations to report clinical performance data stratified by race, ethnicity, and socioeconomic status. 2) Incentivize preventive care and primary care. Implement more aggressive shared savings plans, update physician relative value unit fee schedules, and encourage partnerships across clinical and non-clinical sectors. 3) Incentivize the reduction of health disparities with equity accountability measures in payment programs. 4) Align equity accountability measures across public and private payors. 5) Assist safety-net organizations. Provide adequate Medicaid reimbursement, risk-adjust clinical performance scores for sociodemographic characteristics of patients, provide support for quality improvement efforts, and calibrate cuts to Disproportionate Share Hospital (DSH) payments to the pace of health insurance expansion. 6) Conduct demonstration projects to test payment and delivery system reform interventions to reduce disparities. Commitment to social justice is essential to achieve health equity, but insufficient without a strong business case that makes interventions financially feasible.
Negotiating roadblocks to IDS-physician equity joint ventures.
Dubow, S F; Benoff, M
1998-09-01
Integrated delivery systems (IDSs) may find that forming an equity joint venture relationship with a physician group practice is the best way to integrate physicians into their networks. IDSs have a choice between two basic equity structures: affiliated group practice, in which a management services organization (MSO) handles all practice management infrastructure and the physician group is a physician-only organization; and integrated group practice, in which the physician group encompasses both the physician practice and the administrative infrastructure. The choice of equity structure and how it should be implemented hinge on several legal issues, including the existence of a corporate-practice-of-medicine statute in the IDS's state, compliance with the Federal antikickback statute and Stark laws, and various issues regarding the IDS's tax-exempt status. IDSs also should consider pragmatic issues, particularly those associated with aligning the economic incentives of the two partners.
Can Economic Analysis Contribute to Disease Elimination and Eradication? A Systematic Review.
Sicuri, Elisa; Evans, David B; Tediosi, Fabrizio
2015-01-01
Infectious diseases elimination and eradication have become important areas of focus for global health and countries. Due to the substantial up-front investments required to eliminate and eradicate, and the overall shortage of resources for health, economic analysis can inform decision making on whether elimination/eradication makes economic sense and on the costs and benefits of alternative strategies. In order to draw lessons for current and future initiatives, we review the economic literature that has addressed questions related to the elimination and eradication of infectious diseases focusing on: why, how and for whom? A systematic review was performed by searching economic literature (cost-benefit, cost-effectiveness and economic impact analyses) on elimination/eradication of infectious diseases published from 1980 to 2013 from three large bibliographic databases: one general (SCOPUS), one bio-medical (MEDLINE/PUBMED) and one economic (IDEAS/REPEC). A total of 690 non-duplicate papers were identified from which only 43 met the inclusion criteria. In addition, only one paper focusing on equity issues, the "for whom?" question, was found. The literature relating to "why?" is the largest, much of it focusing on how much it would cost. A more limited literature estimates the benefits in terms of impact on economic growth with mixed results. The question of how to eradicate or eliminate was informed by an economic literature highlighting that there will be opportunities for individuals and countries to free-ride and that forms of incentives and/or disincentives will be needed. This requires government involvement at country level and global coordination. While there is little doubt that eliminating infectious diseases will eventually improve equity, it will only happen if active steps to promote equity are followed on the path to elimination and eradication. The largest part of the literature has focused on costs and economic benefits of elimination/eradication. To a lesser extent, challenges associated with achieving elimination/eradication and ensuring equity have also been explored. Although elimination and eradication are, for some diseases, good investments compared with control, countries' incentives to eliminate do not always align with the global good and the most efficient elimination strategies may not prioritize the poorest populations. For any infectious disease, policy-makers will need to consider realigning contrasting incentives between the individual countries and the global community and to assure that the process towards elimination/eradication considers equity.
Målqvist, Mats; Yuan, Beibei; Trygg, Nadja; Selling, Katarina; Thomsen, Sarah
2013-01-01
Targeted interventions to improve maternal and child health is suggested as a feasible and sometimes even necessary strategy to reduce inequity. The objective of this systematic review was to gather the evidence of the effectiveness of targeted interventions to improve equity in MDG 4 and 5 outcomes. We identified primary studies in all languages by searching nine health and social databases, including grey literature and dissertations. Studies evaluating the effect of an intervention tailored to address a structural determinant of inequity in maternal and child health were included. Thus general interventions targeting disadvantaged populations were excluded. Outcome measures were limited to indicators proposed for Millennium Development Goals 4 and 5. We identified 18 articles, whereof 15 evaluated various incentive programs, two evaluated a targeted policy intervention, and only one study evaluated an intervention addressing a cultural custom. Meta-analyses of the effectiveness of incentives programs showed a pooled effect size of RR 1.66 (95% CI 1.43-1.93) for antenatal care attendance (four studies with 2,476 participants) and RR 2.37 (95% CI 1.38-4.07) for health facility delivery (five studies with 25,625 participants). Meta-analyses were not performed for any of the other outcomes due to scarcity of studies. The targeted interventions aiming to improve maternal and child health are mainly limited to addressing economic disparities through various incentive schemes like conditional cash transfers and voucher schemes. This is a feasible strategy to reduce inequity based on income. More innovative action-oriented research is needed to speed up progress in maternal and child survival among the most disadvantaged populations through interventions targeting the underlying structural determinants of inequity.
Driessen, Julia; Olson, Zachary D; Jamison, Dean T; Verguet, Stéphane
2015-08-01
Vaccination coverage rates often mask wide variation in access, uptake, and cost of providing vaccination. Financial incentives have been effective at creating demand for social services in a variety of settings. Using methods of extended cost-effectiveness analysis, we compare the health and economic implications of three different vaccine delivery strategies for measles vaccination in Ethiopia: i) routine immunization, ii) routine immunization with financial incentives, and iii) mass campaigns, known as supplemental immunization activities (SIAs). We examine annual birth cohorts of almost 3,000,000 births over a ten year period, exploring variation in these outcomes based on economic status to understand how various options may improve equity. SIAs naturally achieve higher levels of vaccine coverage, but at higher costs. Routine immunization combined with financial incentives bolsters demand among more economically vulnerable households. The relative appeal of routine immunization with financial incentives and SIAs will depend on the policy environment, including short-term financial limitations, time horizons, and the types of outcomes that are desired. While the impact of financial incentives has been more thoroughly studied in other policy arenas, such as education, consideration of this approach alongside standard vaccination models such as SIAs is timely given the dialog around measles eradication. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Analysis of alternative strategies for energy conservation in new buildings
NASA Astrophysics Data System (ADS)
Fang, J. M.; Tawil, J.
1980-12-01
The policy instruments considered include: greater reliance on market forces; research and development; information, education and demonstration programs; tax incentives and sanctions; mortgage and finance programs; and regulations and standards. The analysis starts with an explanation of the barriers to energy conservation in the residential and commercial sectors. Individual policy instruments are described and evaluated with respect to energy conservation, economic efficiency, equity, political impacts, and implementation and other transitional impacts. Five possible strategies are identified: (1) increased reliance on the market place; (2) energy consumption tax and supply subsidies; (3) Building Energy Performance Standards (BEPS) with no sanctions and no incentives; (4) BEPS with sanctions and incentives (price control); and (5) BEPS with sanctions and incentives (no price controls). A comparative analysis is performed. Elements are proposed for inclusion in a comprehensive strategy for conservation in new buildings.
Clayton, Byron C.
2015-01-01
Successful corporate acquisitions require its managers to achieve substantial performance improvements in order to sufficiently cover acquisition premiums, the expected return of debt and equity investors, and the additional resources needed to capture synergies and accelerate growth. Acquirers understand that achieving the performance improvements necessary to cover these costs and create value for investors will most likely require a significant effort from mergers and acquisitions (M&A) management teams. This understanding drives the common and longstanding practice of offering hefty performance incentive packages to key managers, assuming that financial incentives will induce in-role and extra-role behaviors that drive organizational change and growth. The present study debunks the assumptions of this common M&A practice, providing quantitative evidence that shared vision and autonomous motivation are far more effective drivers of managerial performance than financial incentives. PMID:25610406
Clayton, Byron C
2014-01-01
Successful corporate acquisitions require its managers to achieve substantial performance improvements in order to sufficiently cover acquisition premiums, the expected return of debt and equity investors, and the additional resources needed to capture synergies and accelerate growth. Acquirers understand that achieving the performance improvements necessary to cover these costs and create value for investors will most likely require a significant effort from mergers and acquisitions (M&A) management teams. This understanding drives the common and longstanding practice of offering hefty performance incentive packages to key managers, assuming that financial incentives will induce in-role and extra-role behaviors that drive organizational change and growth. The present study debunks the assumptions of this common M&A practice, providing quantitative evidence that shared vision and autonomous motivation are far more effective drivers of managerial performance than financial incentives.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Eriksson, Leif G.; Dials, George E.; George, Critz H.
2013-07-01
In February 2009, the Obama Administration announced it would abandon USA's only candidate SNF/HLW-disposal facility since 1987. In 2010, all related activities were stopped and the Blue Ribbon Commission on America's Nuclear Future was established 'to recommend a new strategy for managing the back end of the nuclear fuel cycle', which it did in January 2012, emphasizing eight key elements. However, Key Element 1, 'A new, consent-based approach to siting future nuclear facilities', is qualitative/indeterminate rather than quantitative/measurable. It is thus highly-susceptible to semantic permutations that could extend rather than, as intended, expedite the siting of future nuclear facilities unlessmore » it also defines: a) Whose consent is needed?; and b) What constitutes consent? The following 'generic', radiation-risk- and societal-equity-based criteria address these questions: 1. Identify areas affected by projected radiation and other health risks from: a. The proposed nuclear facility (facility stakeholders); and b. The related nuclear-materials-transportation routes (transportation stakeholders); then 2. Surround each stakeholder area with a buffer zone and use this enlarged foot print to identify: a. Stakeholder hosts; and b. Areas not hosting any stakeholder category (interested parties). 3. Define 'consent-based' as being at least 60 percent of the 'population' in the respective stakeholder category and apply this yardstick to both 'in favor' and 'against' votes. Although criteria 1 and 2 also need facility-based definitions to make Key Element 1 measurable, the described siting approach, augmented by related facility-host incentives, would expedite the schedule and reduce the cost for achieving Key Elements 4-6 and 8, politics permitting. (authors)« less
Sandra, Dasha A; Otto, A Ross
2018-03-01
While psychological, economic, and neuroscientific accounts of behavior broadly maintain that people minimize expenditure of cognitive effort, empirical work reveals how reward incentives can mobilize increased cognitive effort expenditure. Recent theories posit that the decision to expend effort is governed, in part, by a cost-benefit tradeoff whereby the potential benefits of mental effort can offset the perceived costs of effort exertion. Taking an individual differences approach, the present study examined whether one's executive function capacity, as measured by Stroop interference, predicts the extent to which reward incentives reduce switch costs in a task-switching paradigm, which indexes additional expenditure of cognitive effort. In accordance with the predictions of a cost-benefit account of effort, we found that a low executive function capacity-and, relatedly, a low intrinsic motivation to expend effort (measured by Need for Cognition)-predicted larger increase in cognitive effort expenditure in response to monetary reward incentives, while individuals with greater executive function capacity-and greater intrinsic motivation to expend effort-were less responsive to reward incentives. These findings suggest that an individual's cost-benefit tradeoff is constrained by the perceived costs of exerting cognitive effort. Copyright © 2017 Elsevier B.V. All rights reserved.
Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-25
... costs that the Exchange incurs for routing and executing orders in equity options to various away... routing orders to away markets plus the away market's transaction fee. The Exchange assesses a $0.04 per... addition to the actual transaction fee or rebate paid by the away market. The fixed Routing Fee is based on...
Financing Opportunities for Renewable Energy Development in Alaska
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ardani, K.; Hillman, D.; Busche, S.
2013-04-01
This technical report provides an overview of existing and potential financing structures for renewable energy project development in Alaska with a focus on four primary sources of project funding: government financed or supported (the most commonly used structure in Alaska today), developer equity capital, commercial debt, and third-party tax-equity investment. While privately funded options currently have limited application in Alaska, their implementation is theoretically possible based on successful execution in similar circumstances elsewhere. This report concludes that while tax status is a key consideration in determining appropriate financing structure, there are opportunities for both taxable and tax-exempt entities to participatemore » in renewable energy project development.« less
The Role Of Nonprofit Hospitals In Identifying And Addressing Health Inequities In Cities.
Carroll-Scott, Amy; Henson, Rosie Mae; Kolker, Jennifer; Purtle, Jonathan
2017-06-01
For nonprofit hospitals to maintain their tax-exempt status, the Affordable Care Act requires them to conduct a community health needs assessment, in which they evaluate the health needs of the community they serve, and to create an implementation strategy, in which they propose ways to address these needs. We explored the extent to which nonprofit urban hospitals identified equity among the health needs of their communities and proposed health equity strategies to address this need. We conducted a content analysis of publicly available community health needs assessments and implementation strategies from 179 hospitals in twenty-eight US cities in the period August-December 2016. All of the needs assessments included at least one implicit health equity term (such as disparities , disadvantage , poor , or minorities ), while 65 percent included at least one explicit health equity term ( equity , health equity , inequity , or health inequity ). Thirty-five percent of implementation strategies included one or more explicit health equity terms, but only 9 percent included an explicit activity to promote health equity. While needs assessment reporting requirements have the potential to encourage urban nonprofit hospitals to address health inequities in their communities, hospitals need incentives and additional capacity to invest in strategies that address the underlying structural social and economic conditions that cause health inequities. Project HOPE—The People-to-People Health Foundation, Inc.
28 CFR 0.143 - Incentive Award Program.
Code of Federal Regulations, 2010 CFR
2010-07-01
....143 Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE... Justice Programs, the Director of the Executive Office for U.S. Attorneys, the Director of the Executive Office for U.S. Trustees, the Director of the Executive Office for Immigration Review, and the Director...
Value rules: senior management incentives in the post-option era.
Ericson, Richard
2004-01-01
Big changes are in the news and on boardroom agendas. This is a good time for many companies to step back and think fundamentally about how senior management incentives are structured and how these programs should be redesigned for better business results. This article describes the main problems with current incentive structures. It then shows how "value rules" can help employers make better use of incentive plans and create a real stake in business units' long-term results, so that the overall structure of executive incentives consistently encourages value creation for shareholders.
Federal Register 2010, 2011, 2012, 2013, 2014
2011-01-14
... system,\\3\\ for routing standardized equity and index option Customer and Professional orders to away... No. 59995 (May 28, 2009), 74 FR 26750 (June 3, 2009) (SR-Phlx-2009-32). The instant proposed fees... costs that the Exchange incurs for routing and executing Customer and Professional orders in equity and...
Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-10
... system,\\3\\ for routing standardized equity and index option customer and professional orders to away... No. 59995 (May 28, 2009), 74 FR 26750 (June 3, 2009) (SR-Phlx-2009-32). The instant proposed fees... and executing customer and professional orders in equity and index options to away markets. In May...
Federal Register 2010, 2011, 2012, 2013, 2014
2012-10-09
... Physical Copper Trust Pursuant To NYSE Arca Equities Rule 8.201 October 2, 2012. On April 2, 2012, NYSE... Copper Trust (``Trust'') pursuant to NYSE Arca Equities Rule 8.201. The proposed rule change was..., Director of Purchasing, Encore Wire Corporation; Ron Beal, Executive Vice President, Tubes Division, Luvata...
ERIC Educational Resources Information Center
Balajee, Sonali S.; Todd, Joshua
2018-01-01
Equity, diversity, and inclusion are frequently on the lips of higher education professionals yet we struggle to infuse these concepts throughout the academy as evidenced in challenges recruiting faculty of color, graduating students of color, and hostile environments reported by students. The authors posit that this is because, to date, most…
ERIC Educational Resources Information Center
Glazerman, Steven; Protik, Ali; Teh, Bing-ru; Bruch, Julie; Max, Jeffrey
2013-01-01
One way to improve struggling schools' access to effective teachers is to use selective transfer incentives. Such incentives offer bonuses for the highest-performing teachers to move into schools serving the most disadvantaged students. In this report, we provide evidence from a randomized experiment that tested whether such a policy intervention…
Analysis of Project Finance | Energy Analysis | NREL
project finance is complex, requiring knowledge of federal tax credits, state-level incentives, renewable and in lieu of the 30% federal investment tax credit, as follows: Less-established renewable power that lack extensive operational track records may be slowed because many tax equity investors are seen
Housing for Moderate Income Households.
ERIC Educational Resources Information Center
Brannigan, Vincent M.; Meeks, Carol B.
1991-01-01
Describes equity leasing, a program that enables people to acquire housing without an up-front investment but with an incentive to maintain and improve the property. Under this proposal, lessees would acquire a leasehold interest in a house and own the right to use the property for a continuously extended lease term. (JOW)
Rewarding safe behavior: strategies for change.
Fell-Carlson, Deborah
2004-12-01
Effective, sustainable safety incentives are integrated into a performance management system designed to encourage long term behavior change. Effective incentive program design integrates the fundamental considerations of compensation (i.e., valence, instrumentality, expectancy, equity) with behavior change theory in the context of a strong merit based performance management system. Clear expectations are established and communicated from the time applicants apply for the position. Feedback and social recognition are leveraged and used as rewards, in addition to financial incentives built into the compensation system and offered periodically as short term incentives. Rewards are tied to specific objectives intended to influence specific behaviors. Objectives are designed to challenge employees, providing opportunities to grow and enhance their sense of belonging. Safety contests and other awareness activities are most effective when used to focus safety improvement efforts on specific behaviors or processes, for a predetermined period of time, in the context of a comprehensive safety system. Safety incentive programs designed around injury outcomes can result in unintended, and undesirable, consequences. Safety performance can be leveraged by integrating safety into corporate cultural indicators. Symbols of safety remind employees of corporate safety goals and objectives (e.g., posted safety goals and integrating safety into corporate mission and vision). Rites and ceremonies provide opportunities for social recognition and feedback and demonstrate safety is a corporate value. Feedback opportunities, rewards, and social recognition all provide content for corporate legends, those stories embellished over time, that punctuate the overall system of organizational norms, and provide examples of the organizational safety culture in action.
The National Shipbuilding Research Program Executive Summary Robotics in Shipbuilding Workshop
1981-01-01
based on technoeconomic analysis and consideration environment. of working c-c-2 (3) The conceptual designs were based on application of commercial...results of our study. We identified shipbuilding tasks that should be performed by industrial robots based on technoeconomic and working-life incentives...is the TV image of the illuminated workplaces. The image is analyzed by the computer. The analysis includes noise rejection and fitting of straight
Federal Register 2010, 2011, 2012, 2013, 2014
2013-10-02
.... As such, marketing fee programs,\\7\\ and customer posting incentive programs,\\8\\ are based on... its current Priority Customer Rebate Program (the ``Program'') until October 31, 2013.\\3\\ The Program... Priority Customer \\6\\ order transmitted by that Member which is executed on the Exchange in all multiply...
Fairness and Ethical Considerations in Pay for Performance in NSPS
2008-03-17
of performance. A 1998 Woodward study of eighteen organizations that developed alternative personnel systems for hiring, promoting, compensating...equity were the key values underlying the design and execution of their human resources management systems.35 Woodward found that the values of...leadership, time management, etc. 22 Amanda Olsen, The Value of Web-Based Training, available from http://www.amandaolsen.com/ Docs/White%20Paper
Can Economic Analysis Contribute to Disease Elimination and Eradication? A Systematic Review
Sicuri, Elisa; Evans, David B.; Tediosi, Fabrizio
2015-01-01
Background Infectious diseases elimination and eradication have become important areas of focus for global health and countries. Due to the substantial up-front investments required to eliminate and eradicate, and the overall shortage of resources for health, economic analysis can inform decision making on whether elimination/eradication makes economic sense and on the costs and benefits of alternative strategies. In order to draw lessons for current and future initiatives, we review the economic literature that has addressed questions related to the elimination and eradication of infectious diseases focusing on: why, how and for whom? Methods A systematic review was performed by searching economic literature (cost-benefit, cost-effectiveness and economic impact analyses) on elimination/eradication of infectious diseases published from 1980 to 2013 from three large bibliographic databases: one general (SCOPUS), one bio-medical (MEDLINE/PUBMED) and one economic (IDEAS/REPEC). Results A total of 690 non-duplicate papers were identified from which only 43 met the inclusion criteria. In addition, only one paper focusing on equity issues, the “for whom?” question, was found. The literature relating to “why?” is the largest, much of it focusing on how much it would cost. A more limited literature estimates the benefits in terms of impact on economic growth with mixed results. The question of how to eradicate or eliminate was informed by an economic literature highlighting that there will be opportunities for individuals and countries to free-ride and that forms of incentives and/or disincentives will be needed. This requires government involvement at country level and global coordination. While there is little doubt that eliminating infectious diseases will eventually improve equity, it will only happen if active steps to promote equity are followed on the path to elimination and eradication. Conclusion The largest part of the literature has focused on costs and economic benefits of elimination/eradication. To a lesser extent, challenges associated with achieving elimination/eradication and ensuring equity have also been explored. Although elimination and eradication are, for some diseases, good investments compared with control, countries’ incentives to eliminate do not always align with the global good and the most efficient elimination strategies may not prioritize the poorest populations. For any infectious disease, policy-makers will need to consider realigning contrasting incentives between the individual countries and the global community and to assure that the process towards elimination/eradication considers equity. PMID:26070135
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-30
... II system,\\3\\ for routing standardized equity and index option customer orders to away markets for... 28, 2009), 74 FR 26750 (June 3, 2009) (SR-Phlx-2009-32). The instant proposed fees will apply only to... change is to recoup costs that the Exchange incurs for routing and executing customer orders in equity...
A decade of change: the emerging role of the CFO.
Gauss, J W
1991-05-01
The average senior financial executive today in a hospital or corporate healthcare setting is a 42-year-old male who has a master's degree or at least some postgraduate education and who has been in his position for six years, according to a 1991 national survey of healthcare chief financial officers (CFOs). The individual has the title of CFO, earns $82,100, and last year received incentive compensation amounting to 12.3 percent of base salary. He aspires to a higher position, although not necessarily the job of chief executive officer.
29 CFR 541.101 - Business owner.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 29 Labor 3 2012-07-01 2012-07-01 false Business owner. 541.101 Section 541.101 Labor Regulations... Executive Employees § 541.101 Business owner. The term “employee employed in a bona fide executive capacity... equity interest in the enterprise in which the employee is employed, regardless of whether the business...
29 CFR 541.101 - Business owner.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 29 Labor 3 2011-07-01 2011-07-01 false Business owner. 541.101 Section 541.101 Labor Regulations... Executive Employees § 541.101 Business owner. The term “employee employed in a bona fide executive capacity... equity interest in the enterprise in which the employee is employed, regardless of whether the business...
29 CFR 541.101 - Business owner.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 29 Labor 3 2013-07-01 2013-07-01 false Business owner. 541.101 Section 541.101 Labor Regulations... Executive Employees § 541.101 Business owner. The term “employee employed in a bona fide executive capacity... equity interest in the enterprise in which the employee is employed, regardless of whether the business...
29 CFR 541.101 - Business owner.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 29 Labor 3 2014-07-01 2014-07-01 false Business owner. 541.101 Section 541.101 Labor Regulations... Executive Employees § 541.101 Business owner. The term “employee employed in a bona fide executive capacity... equity interest in the enterprise in which the employee is employed, regardless of whether the business...
29 CFR 541.101 - Business owner.
Code of Federal Regulations, 2010 CFR
2010-07-01
... equity interest in the enterprise in which the employee is employed, regardless of whether the business... 29 Labor 3 2010-07-01 2010-07-01 false Business owner. 541.101 Section 541.101 Labor Regulations... Executive Employees § 541.101 Business owner. The term “employee employed in a bona fide executive capacity...
Incentives for solar energy in industry
NASA Astrophysics Data System (ADS)
Bergeron, K. D.
1981-05-01
Several issues are analyzed on the effects that government subsidies and other incentives have on the use of solar energy in industry, as well as on other capital-intensive alternative energy supplies. Discounted cash flow analysis is used to compare tax deductions for fuel expenses with tax credits for capital investments for energy. The result is a simple expression for tax equity. The effects that market penetration of solar energy has on conventional energy prices are analyzed with a free market model. It is shown that net costs of a subsidy program to the society can be significantly reduced by price. Several government loan guarantee concepts are evaluated as incentives that may not require direct outlays of government funds; their relative effectiveness in achieving loan leverage through project financing, and their cost and practicality, are discussed.
Federal Register 2010, 2011, 2012, 2013, 2014
2012-10-18
...] simultaneously trade different asset classes within a single strategy. Phlx also notes that cash equities and... asset classes, Phlx is introducing a pricing incentive to encourage market participants that are active... equitable allocation of reasonable dues, fees and other charges among members and issuers and other persons...
The Political Meaning of Quality.
ERIC Educational Resources Information Center
Mingle, James R.
1989-01-01
Quality as a political goal for public higher education is discussed, and its fuller acceptance at the state over the federal level is noted. Federal policy is driven by values associated with access, need, and equity. State leaders are using a rhetoric of quality and excellence, incentives for high achievement, rigor, and merit. One reason the…
Economics and ethics in mental health care: traditions and trade-offs.
Chisholm, Daniel; Stewart, Alan
1998-07-01
BACKGROUND: Both economic and ethical perspectives are exerting increasing influence at all levels of mental health policy and practice; yet there is little consensus on how these two different perspectives are to be reconciled or explicitly incorporated into decision-making. AIM: This review article is directed towards a fuller understanding of the complex trade-offs and compromises that are or may be made by clinicians, managers and policy-makers alike in the context of mental health care planning and delivery. METHOD: We briefly outline a number of key principles of health care economics and ethics, and then focus on the particular incentives and trade-offs that are raised by these principles at three levels of the mental health system: government and society; purchasers and providers; and users and carers. RESULTS: At the level of government and society, we find (economically influenced) attempts to reform mental health care offset by concerns revolving around access to care: whether society is prepared to forgo economic benefits in exchange for improved equity depends to a considerable extent on the prevailing ethical paradigm. The implementation of these reforms at the level of purchasers and providers has helped to focus attention on evaluation and prioritization, but has also introduced "perverse incentives" such as cost-shifting and cream-skimming, which can impede access to or continuity of appropriate care for mentally ill people. Finally, we detect opportunities for moral hazard and other forms of strategic behaviour that are thrown up by the nature of the carer:user relationship in mental health care. CONCLUSION: We conclude by highlighting the need to move towards a more open, accountable and evidence-based mental health care system. Acknowledgement of and progress towards these three requirements will not deliver ideal levels of efficiency or equity, but will foster a greater understanding of the relevance of ethical considerations to mental health policies and strategies that are often influenced strongly or solely by economic arguments, whilst also demonstrating that equity must come at a price.
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2012-04-25
... Change Amending NYSE Arca Equities Rule 7.31 To Specify How the Immediate-or-Cancel Time-in-Force... Change The Exchange proposes to amend NYSE Arca Equities Rule 7.31 to specify how the immediate-or-cancel... part as soon as such order is received, and the portion not so executed is to be treated as cancelled...
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2012-11-16
... pricing for NASDAQ members using the NASDAQ Options Market (``NOM''), NASDAQ's facility for executing and... recoup costs that the Exchange incurs for routing and executing certain orders in equity options to the International Securities Exchange, LLC (``ISE''). The Exchange's Pricing Schedule at Chapter XV, Section 2(4...
Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-29
... inquiries and investigations. The current approach of requiring members to report the reference time instead... proposing amendments to the equity trade reporting rules relating to reporting (i) an additional time field for specified trades, (ii) execution time in milliseconds, (iii) reversals, (iv) trades executed on...
Two decades of reforms. Appraisal of the financial reforms in the Russian public healthcare sector.
Gordeev, Vladimir S; Pavlova, Milena; Groot, Wim
2011-10-01
This paper reviews the empirical evidence on the outcomes of the financial reforms in the Russian public healthcare sector. A systematic literature review identified 37 relevant publications that presented empirical evidence on changes in quality, equity, efficiency and sustainability in public healthcare provision due to the Russian public healthcare financial reforms. Evidence suggests that there are substantial inter-regional inequalities across income groups both in terms of financing and access to public healthcare services. There are large efficiency differences between regions, along with inter-regional variations in payment and reimbursement mechanisms. Informal and quasi-formal payments deteriorate access to public healthcare services and undermine the overall financing sustainability. The public healthcare sector is still underfinanced, although the implementation of health insurance gave some premises for future increases of efficiency. Overall, the available empirical data are not sufficient for an evidence-based evaluation of the reforms. More studies on the quality, equity, efficiency and sustainability impact of the reforms are needed. Future reforms should focus on the implementation of cost-efficiency and cost-control mechanisms; provide incentives for better allocation and distribution of resources; tackle problems in equity in access and financing; implement a system of quality controls; and stimulate healthy competition between insurance companies. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Hungary: Reform of Social Policy and Expenditures. A World Bank Country Study.
ERIC Educational Resources Information Center
World Bank, Washington, DC.
This study evaluates the overall social policy system of Hungary and proposes reforms aimed at strengthening its role as a defense against poverty, raising the quality and equity of social programs, ensuring financial sustainability of the system, and restoring incentives (in particular relating to demand and supply for labor) suitable to a market…
Welch, Vivian; Jull, J; Petkovic, J; Armstrong, R; Boyer, Y; Cuervo, L G; Edwards, Sjl; Lydiatt, A; Gough, D; Grimshaw, J; Kristjansson, E; Mbuagbaw, L; McGowan, J; Moher, D; Pantoja, T; Petticrew, M; Pottie, K; Rader, T; Shea, B; Taljaard, M; Waters, E; Weijer, C; Wells, G A; White, H; Whitehead, M; Tugwell, P
2015-10-21
Health equity concerns the absence of avoidable and unfair differences in health. Randomized controlled trials (RCTs) can provide evidence about the impact of an intervention on health equity for specific disadvantaged populations or in general populations; this is important for equity-focused decision-making. Previous work has identified a lack of adequate reporting guidelines for assessing health equity in RCTs. The objective of this study is to develop guidelines to improve the reporting of health equity considerations in RCTs, as an extension of the Consolidated Standards of Reporting Trials (CONSORT). A six-phase study using integrated knowledge translation governed by a study executive and advisory board will assemble empirical evidence to inform the CONSORT-equity extension. To create the guideline, the following steps are proposed: (1) develop a conceptual framework for identifying "equity-relevant trials," (2) assess empirical evidence regarding reporting of equity-relevant trials, (3) consult with global methods and content experts on how to improve reporting of health equity in RCTs, (4) collect broad feedback and prioritize items needed to improve reporting of health equity in RCTs, (5) establish consensus on the CONSORT-equity extension: the guideline for equity-relevant trials, and (6) broadly disseminate and implement the CONSORT-equity extension. This work will be relevant to a broad range of RCTs addressing questions of effectiveness for strategies to improve practice and policy in the areas of social determinants of health, clinical care, health systems, public health, and international development, where health and/or access to health care is a primary outcome. The outcomes include a reporting guideline (CONSORT-equity extension) for equity-relevant RCTs and a knowledge translation strategy to broadly encourage its uptake and use by journal editors, authors, and funding agencies.
Alternative Fuels Data Center: State Alternative Fuel and Advanced Vehicle
2016, the number of new state-level legislative, executive, private, and utility activities related to , new utility and private incentives focused almost entirely on electricity. In previous years, natural gas was also a strong focus area for states. In 2016, however, the volume of new state incentives
Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-09
... fee cap would eliminate the incentive for market participants to effect such executions on the... discriminatory because it would apply equally to all market participants and because the remaining Strategy... elimination of the $750 fee cap would eliminate the incentive for market participants to effect such...
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2010-06-25
... prices. See Exchange Rule 1079. FLEX Options are a trademark of the Chicago Board Options Exchange. While... transactions executed pursuant to Exchange Rule 1079 (``FLEX equity options''). The Exchange believes that the... options transactions executed pursuant to Exchange Rule 1079. \\11\\ 15 U.S.C. 78f(b). \\12\\ 15 U.S.C. 78f(b...
Klein, E S; Barbier, M R; Watson, J R
2017-08-01
Understanding how and when cooperative human behaviour forms in common-pool resource systems is critical to illuminating social-ecological systems and designing governance institutions that promote sustainable resource use. Before assessing the full complexity of social dynamics, it is essential to understand, concretely and mechanistically, how resource dynamics and human actions interact to create incentives and pay-offs for social behaviours. Here, we investigated how such incentives for information sharing are affected by spatial dynamics and management in a common-pool resource system. Using interviews with fishermen to inform an agent-based model, we reveal generic mechanisms through which, for a given ecological setting characterized by the spatial dynamics of the resource, the two 'human factors' of information sharing and management may heterogeneously impact various members of a group for whom theory would otherwise predict the same strategy. When users can deplete the resource, these interactions are further affected by the management approach. Finally, we discuss the implications of alternative motivations, such as equity among fishermen and consistency of the fleet's output. Our results indicate that resource spatial dynamics, form of management and level of depletion can interact to alter the sociality of people in common-pool resource systems, providing necessary insight for future study of strategic decision processes.
Klein, Eran; Karlawish, Jason
2010-01-01
There is growing interest in using patient-directed incentives to change health-related behaviors. Advocates of incentive programs have proposed an ambitious research agenda for moving patient incentive programs forward. Older adults may pose a challenge to such a research agenda. The cognitive and psychological features of this population, in particular, age-related changes in emotional regulation, executive function and cognitive capacities, and a preference for collaborative decision-making raise questions about the suitability of these programs, particularly the structure of current financial incentives, to older adults. Differences in decision-making in older adults need to be accounted for in the design and implementation of financial incentive programs. Financial incentive programs tailored to characteristics of older adult populations may be more likely to improve the lives of older persons and the economic success of programs that serve them. PMID:20863335
Every employee an owner. Really.
Rosen, Corey; Case, John; Staubus, Martin
2005-06-01
Surveys indicate that when new rules on expensing stock options take effect, many companies are likely to limit the number of employees who can receive equity compensation. But companies that reserve equity for executives are bound to suffer in the long run. Study after study proves that broad-based ownership, when done right, leads to higher productivity, lower workforce turnover, better recruits, and bigger profits. "Done right" is the key. Here are the four most important factors in implementing a broad-based employee equity plan: A significant portion of the workforce--generally, most of the full-time people--must hold equity; employees must think the amounts they hold can significantly improve their financial prospects; managerial practices and policies must reinforce the plan; and employees must feel a true sense of company ownership. Those factors add up to an ownership culture in which employees' interests are aligned with the company's. The result is a workforce that is loyal, cooperative, and willing to go above and beyond to make the organization successful. A wide variety of companies have recorded exceptional business performance with the help of employee-ownership programs supported by management policies. The authors examine two: Science Applications International, a research and development contractor, and Scot Forge, which shapes metal and other materials for industrial machinery. At both companies, every employee with a year or so of service holds equity, and employees who stay on can accumulate a comfortable nest egg. Management's sharing of financial information reinforces workers' sense of ownership. So does the expectation that employees will accept the responsibilities of ownership. Workers with an ownership stake internalize their responsibilities and feel they have an obligation not only to management but to one another.
ERIC Educational Resources Information Center
Wellington, Alison; Chiang, Hanley; Hallgren, Kristin; Speroni, Cecilia; Herrmann, Mariesa; Burkander, Paul
2016-01-01
Research indicates that effective teachers are critical to raising student achievement. However, there is little evidence about the best ways to improve teacher effectiveness, or how schools that serve the students most in need can attract and retain effective teachers. Traditional salary schedules, which pay teachers based on their years of…
ERIC Educational Resources Information Center
Glazerman, Steven; Protik, Ali; Teh, Bing-ru; Bruch, Julie; Seftor, Neil
2012-01-01
This report describes the implementation and intermediate impacts of an intervention designed to provide incentives for a school district's highest-performing teachers to work in its lowest-achieving schools. The report is part of a larger study in which random assignment was used to form two equivalent groups of classrooms organized into teacher…
ERIC Educational Resources Information Center
Springer, Matthew G.; Hamilton, Laura; McCaffrey, Daniel F.; Ballou, Dale; Le, Vi-Nhuan; Pepper, Matthew; Lockwood, J. R.; Stecher, Brian M.
2013-01-01
The Project on Incentives in Teaching (POINT) was a three-year study conducted in the Metropolitan Nashville School System from 2006-07 through 2008-09, in which middle school mathematics teachers voluntarily participated in a controlled experiment to assess the effect of financial rewards for teachers whose students showed unusually large gains…
Equity in access to maternal and child health services in five developing countries: what works.
Talukder, M D Noorunnabi; Rob, Ubaidur
2010-01-01
People living in rural areas are yet to have equitable access to maternal and child health services in many developing countries. This article examines selected health service delivery models that improved access to services in five developing countries. The article is based on the review of background papers on Bangladesh, Pakistan, Cambodia, Ghana, and Tanzania, prepared as part of a multi-country study on health systems and maternal and child health. Findings suggest that equity in access to health services largely depends on a system that ensures a combination of facility-based service delivery and outreach services with a functioning referral network. A key factor is the availability of health workforce at the community level. Community-based deployment of service providers or recruitment and training of community health workers is critical in enhancing service coverage and linking local populations to a health facility. Incentive is necessary to keep community health workers' interest in providing services. However, health workforce alone cannot ensure good health outcomes. They must be embedded in a functioning service delivery network to transform structural inputs into outcomes. Moreover, local-level health systems should have the ability to allocate resources in strategic ways addressing the pressing health needs of the people.
Scarborough, Jane; Eliott, Jaklin; Miller, Emma; Aylward, Paul
2015-04-01
To suggest ways of increasing the cohesiveness of national primary healthcare strategies and hepatitis C strategies, with the aim of ensuring that all these strategies include ways to address barriers and facilitators to access to primary healthcare and equity for people with hepatitis C. A critical review was conducted of the first national Primary Healthcare System Strategy and Health Workforce Strategy with the concurrent Hepatitis C Strategy. Content relating to provision of healthcare in private general practice was examined, focussing on issues around access and equity. In all strategies, achieving access to care and equity was framed around providing sufficient medical practitioners for particular locations. Equity statements were present in all policies but only the Hepatitis C Strategy identified discrimination as a barrier to equity. Approaches detailed in the Primary Healthcare System Strategy and Health Workforce Strategy regarding current resource allocation, needs assessment and general practitioner incentives were limited to groups defined within these documents and may not identify or meet the needs of people with hepatitis C. Actions in the primary healthcare system and health workforce strategies should be extended to additional groups beyond those listed as priority groups within the strategies. Future hepatitis C strategies should outline appropriate, detailed needs assessment methodologies and specify how actions in the broad strategies can be applied to benefit the primary healthcare needs of people with hepatitis C.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bolinger, Mark
This report compares the relative costs, benefits, and implications of capturing the value of renewable energy tax benefits in these three different ways – applying them against outside income , carrying them forward in time until they can be fully absorbed internally, or monetizing them through third-party tax equity investors – to see which method is most competitive under various scenarios. It finds that under current law and late-2013 market conditions, monetization makes sense for all but the most tax-efficient project sponsors. In other words, for most project sponsors, bringing in third-party tax equity currently provides net benefits to amore » project.« less
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-05
... and safety effects, distributive impacts, and equity). Executive Order 13563 emphasizes the importance... part of order issuance. This change will ultimately help improve the management, and promotion of...
ERIC Educational Resources Information Center
Holland, Barbara A.; Berdahl, Robert O.
This paper presents data from a 1989 survey of 48 state higher education executive officers regarding the use of fiscal enhancement programs as a strategy to influence higher education performance. The paper reports on the purposes and objectives most often funded through specific incentives, and on the key advantages and disadvantages of this…
Niederman, Richard; Trescher, Anna-Lena; Listl, Stefan
2017-01-01
Despite significant financial, training, and program investments, US children’s caries experience and inequities continued to increase over the last 20 years. We posit that (1) dental insurance payment systems are not aligned with the current best evidence, exacerbating inequities, and (2) system redesign could meet health care’s triple aim and reduce children’s caries by 80%. On the basis of 2013 to 2016 Medicaid and private payment rates and the caries prevention literature, we find that effective preventive interventions are either (1) consistently compensated less than ineffective interventions or (2) not compensated at all. This economic and clinical misalignment may account for underuse of effective caries prevention and subsequent overuse of restorative care. We propose universal school-based comprehensive caries prevention to address this misalignment. Preliminary modeling suggests that universal caries prevention could eliminate 80% of children’s caries and cost less than one fifth of current Medicaid children’s oral health spending. If implemented with bundled payments based on cycle of care and measurable outcomes, there would be an alignment of incentives, best evidence, care, and outcomes. Such a program would meet the Healthy People Oral Health goals for children, as well as health care’s triple aim. PMID:28661798
78 FR 40630 - International Traffic in Arms Regulations: Canadian Firearms Components Exemption
Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-08
... substantial direct effects on the States, on the relationship between the national government and the States... impacts, and equity). These executive orders stress the importance of quantifying both costs and benefits...
Odeyemi, Isaac Ao; Nixon, John
2013-01-01
Social and national health insurance schemes are being introduced in many developing countries in moving towards universal health care. However, gaps in coverage are common and can only be met by out-of-pocket payments, general taxation, or private health insurance (PHI). This study provides an overview of PHI in different health care systems and discusses factors that affect its uptake and equity. A representative sample of countries was identified (United States, United Kingdom, The Netherlands, France, Australia, and Latvia) that illustrates the principal forms and roles of PHI. Literature describing each country's health care system was used to summarize how PHI is utilized and the factors that affect its uptake and equity. In the United States, PHI is a primary source of funding in conjunction with tax-based programs to support vulnerable groups; in the UK and Latvia, PHI is used in a supplementary role to universal tax-based systems; in France and Latvia, complementary PHI is utilized to cover gaps in public funding; in The Netherlands, PHI is supplementary to statutory private and social health insurance; in Australia, the government incentivizes the uptake of complementary PHI through tax rebates and penalties. The uptake of PHI is influenced by age, income, education, health care system typology, and the incentives or disincentives applied by governments. The effect on equity can either be positive or negative depending on the type of PHI adopted and its role within the wider health care system. PHI has many manifestations depending on the type of health care system used and its role within that system. This study has illustrated its common applications and the factors that affect its uptake and equity in different health care systems. The results are anticipated to be helpful in informing how developing countries may utilize PHI to meet the aim of achieving universal health care.
Hartzler, Bryan; Rabun, Carl
2013-01-01
Treatment community reluctance toward contingency management (CM) may be better understood by eliciting views of its feasibility, effectiveness, and transportability when social vs. financial incentives are utilized. This mixed method study involved individual staff interviews representing three personnel tiers (an executive, clinical supervisor, and two front-line clinicians) at 16 opiate treatment programs. Interviews included Likert ratings of feasibility, effectiveness, and transportability of each incentive type, and content analysis of corresponding interviewee narrative. Multi-level modeling analyses indicated that social incentives were perceived more feasible, more effective, and more transportable than financial incentives, with results pervading personnel tier. Content analysis suggested the more positive perception of social incentives was most often due to expected logistical advantages, positive impacts on patient quality-of-life, and philosophical congruence among staff. Weaker perception of financial incentives was most often influenced by concerns about costs, patient dissatisfaction, and staff philosophical incongruence. Implications for CM dissemination are discussed. PMID:23506780
ERIC Educational Resources Information Center
Springer, Matthew G.; Lewis, Jessica L.; Ehlert, Mark W.; Podgursky, Michael J.; Crader, Gary D.; Taylor, Lori L.; Gronberg, Timothy J.; Jansen, Dennis W.; Lopez, Omar S.; Stuit, David A.
2010-01-01
District Awards for Teacher Excellence (D.A.T.E.) is a state-funded program in Texas that provides grants to districts for the implementation of locally-designed incentive pay plans. All districts in the state are eligible to receive grants, but participation is voluntary. D.A.T.E. incentive pay plans were first implemented in Texas districts…
Can Profit Policy and Contract Incentives Improve Defense Contract Outcomes?
2008-10-01
a metric that estimates the returns required by investors. The weighted average cost of capital ( WACC ) is the standard financial statistic that...weights the returns demanded by investors that hold equity and investors that hold debt.6 Like FCFROIC, WACC is expressed as a percentage. Consequently...previous year. 5 These defense prime contractors include Lockheed, Raytheon, Northrop Grumman, and General Dynamics. 6 Mathematically, WACC = Debt/(Debt
The Impact of New Execution Venues on European Equity Markets' Liquidity - The Case of Chi-X
NASA Astrophysics Data System (ADS)
Chlistalla, Michael; Lutat, Marco
With the Markets in Financial Instruments Directive in effect since November 2007, new trading venues have emerged in European equities trading, among them Chi-X. This paper analyzes the impact of this new market entrant on the home market as well as on consolidated liquidity of French blue chip equities, newly tradable on Chi-X. Our findings suggest that owing to this new competition the home market’s liquidity has enhanced. This is apparently due to the battle for order flow which results in narrower spreads and increased market depth. These results imply that overall liquidity in a virtually consolidated order book is in the French case higher than without the new competitor.
Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-15
... facility for executing and routing standardized equity and index options. The Exchange also proposes a... using the Financial Information Exchange (``FIX'') protocol. The Exchange also proposes to define the...
78 FR 47179 - Amendment to the International Traffic in Arms Regulations: Libya and UNSCR 2095
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2013-08-05
... 13132 This rulemaking will not have substantial direct effects on the States, on the relationship... and safety effects, distributed impacts, and equity). These executive orders stress the importance of...
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2011-03-01
... techniques of other forms of information technology, e.g., permitting electronic submission of responses..., Equity Size, Prior History with HUD Loans and prior sales participation. By executing the Qualification...
Customer-centered brand management.
Rust, Roland T; Zeithaml, Valarie A; Lemon, Katherine N
2004-09-01
Most executives today agree that their efforts should be focused on growing the lifetime value of their customers. Yet few companies have come to terms with the implications of that idea for their marketing management. Oldsmobile, for example, enjoyed outstanding brand equity with many customers through the 1980s. But as the century wore further on, the people who loved the Olds got downright old. So why did General Motors spend so many years and so much money trying to reposition and refurbish the tired,tarnished brand? Why didn't GM managers instead move younger buyers along a path of less resistance, toward another of the brands in GM's stable--or even launch a wholly new brand geared to their tastes? Catering to new customers, even at the expense of the brand, would surely have been the path to profits. The reason, argue the authors, is that in large consumer-goods companies like General Motors, brands are the raison d'etre. They are the focus of decision making and the basis of accountability. But this overwhelming focus on growing brand equity is inconsistent with the goal of growing customer equity. Drawing on a wide range of current examples, the authors offer seven tactics that will put brands in the service of growing customer equity. These include replacing traditional brand managers with a new position--the customer segment manager; targeting brands to as narrow an audience as possible; developing the capability and the mind-set to hand off customers from one brand to another within the company; and changing the way brand equity is measured by basing calculations on individual, rather than average, customer data.
Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-09
... the incentive for market participants to effect such executions on the Exchange. This would also be... Change To Amend the NYSE Amex Options Fee Schedule To Remove Dividend Spreads From the List of Strategy... (``Fee Schedule'') to remove dividend spreads from the list of strategy executions for which fee caps...
Anzman-Frasca, Stephanie; Folta, Sara C; Glenn, Meaghan E; Jones-Mueller, Anita; Lynskey, Vanessa M; Patel, Anjali A; Tse, Lisa L; Lopez, Nanette V
2017-04-01
Assess parents', children's, and restaurant executives' perspectives on children's meals in restaurants. Cross-sectional. Parents and children completed predominantly quantitative surveys at 4 quick- and full-service restaurant locations. Telephone interviews were conducted with executives representing additional restaurants. Parents (n = 59) and their first- through fourth-grade children (n = 58); executives (n = 4). Parent/child perspectives on child meal selection and toy incentives in restaurants; executives' views on kids' meals and barriers to supplying healthier kids' meals. Frequencies, thematic analysis. A total of 63% of children ordered from children's menus, 8% of whom ordered healthier kids' meals. Half of parents reported that children determined their own orders. Taste was the most common reason for children's meal choices. Most (76%) children reported visiting the restaurant previously; 64% of them placed their usual order. Parents' views on toy incentives were mixed. Themes from executive interviews highlighted factors driving children's menu offerings, including children's habits and preferences and the need to use preexisting pantry items. Executives described menu changes as driven by profitability, consumer demand, regulation, and corporate social responsibility. Findings can inform the development of restaurant interventions that are effective in promoting healthier eating and are acceptable to parents, children, and restaurant personnel. Copyright © 2016 Society for Nutrition Education and Behavior. All rights reserved.
Rudasingwa, Martin; Uwizeye, Marie Rose
2017-01-01
Performance-based financing (PBF) was first implemented in Burundi in 2006 as a pilot programme in three provinces and was rolled out nationwide in 2010. PBF is a reform approach to improve the quality, quantity, and equity of health services and aims at achieving universal health coverage. It focuses on how to best motivate health practitioners. To elicit physicians' and nurses' experiences and views on how PBF influenced and helped them in healthcare delivery. A qualitative cross-sectional study was carried out among frontline health workers such as physicians and nurses. The data was gathered through individual face-to-face, in-depth, semi-structured interviews with 6 physicians and 30 nurses from February to March 2011 in three hospitals in Gitega Province. A simple framework approach and thematic analysis using a combination of manual technique and MAXQDA software guided the analysis of the interview data. Overall, the interviewees felt that the PBF scheme had provided positive motivation to improve the quality of care, mainly in the structures and process of care. The utilization of health services and the relationship between health practitioners and patients also improved. The salary top-ups were recognized as the most significant impetus to increase effort in improving the quality of care. The small and sometimes delayed financial incentives paid to physicians and nurses were criticized. The findings of this study also indicate that the positive interaction between performance-based incentive schemes and other health policies is crucial in achieving comprehensive improvement in healthcare delivery. PBF has the potential to motivate medical staff to improve healthcare provision. The views of medical staff and the context of the area of implementation have to be taken into consideration when designing and implementing PBF schemes.
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2012-07-10
... evolution of the equities markets away from manual executions and manual enforcement of rules toward an... Exchange's current market structure and to reflect rapidly changing market technology and the development...
Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-27
..., distributive impacts, and equity). Executive Order 13563 emphasizes the importance of quantifying both costs... Regulations System. Therefore, 48 CFR part 232 is amended as follows: PART 232--CONTRACT FINANCING 0 1. The...
Quadrennial Review of Military Compensation (5th). Executive Summary.
1984-01-01
COMBINATION Any proposed legislation to modify the current retire- ment system by reducing retired pay must stress the absolute requirement that a form of...Hazardous Duty Incentive Pays: — Parachute Duty — Flight Deck Duty -- Demolition Duty — Toxic Fuels and — Experimental Stress Duty Propellants — Non...3) Experimental Stress Duty Pay - an incentive for performance of hazardous duty while participating in acceleration/ deceleration testing, thermal
Plan demographics, participants' saving behavior, and target-date fund investments.
Park, Youngkyun
2009-05-01
This analysis explores (1) whether plan demographic characteristics would affect individual participant contribution rates and target-date fund investments and (2) equity glide paths for participants in relation to plan demographics by considering target replacement income and its success rate. PLAN DEMOGRAPHIC CHARACTERISTICS IN PARTICIPANT CONTRIBUTION RATES: This study finds empirical evidence that 401(k) plan participants' contribution rates differ by plan demographics based on participants' income and/or tenure. In particular, participants in 401(k) plans dominated by those with low income and short tenure tend to contribute less than those in plans dominated by participants with high income and long tenure. Future research will explore how participant contribution behavior may also be influenced by incentives provided by employers through matching formulae. PLAN DEMOGRAPHIC CHARACTERISTICS IN TARGET-DATE FUND INVESTMENTS: The study also finds empirical evidence that participants' investments in target-date funds with different equity allocations differ by plan demographics based on participants' income and/or tenure. In particular, target-date fund users with 90 percent or more of their account balances in target-date funds who are in 401(k) plans dominated by low-income and short-tenure participants tend to hold target-date funds with lower equity allocations, compared with their counterparts in plans dominated by high-income and long-tenure participants. Future research will focus on the extent to which these characteristics might influence the selection of target-date funds by plan sponsors. EQUITY GLIDE PATHS: Several stylized equity glide paths as well as alternative asset allocations are compared for participants at various starting ages to demonstrate the interaction between plan demographics and equity glide paths/asset allocations in terms of success rates in meeting various replacement income targets. The equity glide path/asset allocation providing the highest success rate at a particular replacement rate target will vary with the assumed starting date of the participant (see Figure 17). Given the highly stylized nature of the simulations in this Issue Brief it is important to note that the results are not intended to provide a single equity glide path solution in relation to plan demographics. Instead, they serve as a framework to be considered when plan sponsors make a selection concerning which target-date funds to include in their plan. IMPORTANCE OF PARTICIPANT CONTRIBUTION RATES: This analysis finds that although target-date funds with different equity glide paths affect the retirement income replacement success rate, participant contribution rates corresponding to different plan demographic characteristics have a stronger impact. AUTO FEATURES OF THE PPA: This Issue Brief provides a stylized study using observed contribution rates as of the 2007 plan year. However, with the passage of the Pension Protection Act of 2006 and its likely impact on plan design in the future (increased utilization of automatic enrollment and automatic contribution escalations), it is likely that contribution rates among the participants may become more homogenous. In such a scenario, it may be more likely that a single equity glide path would meet a wide range of demographic profiles.
Tole, Lise
2010-06-01
After an initial burst of enthusiasm in the 1990 s, community-based forest management (CBFM) is increasingly being viewed with a critical eye. Evidence suggests that many programs have failed to promote their stated objectives of sustainability, efficiency, equity, democratic participation and poverty reduction. A large volume of academic literature now exists on CBFM, examining both the success and failure of such initiatives in a wide variety of countries. Through analysis of key themes, concepts and issues in CBFM, this article provides a review of CBFM initiatives in tropical developing countries for policymakers, practitioners and planners wishing to gain an understanding of this wide-ranging, interdisciplinary academic literature. The article identifies key institutions and incentives that appear to significantly affect the success or failure of CBFM initiatives. In particular, it reports that consideration of institutional and socioeconomic factors along with personal characteristics of key stakeholders such as beliefs, attitudes, financial resources and skills are important determinants of CBFM outcomes. However, local incentive structures also appear to be important. There is increasing recognition in the literature of the need to consider the conditions under which local politicians entrusted with carrying out CBFM initiatives will deem it worthwhile to invest their scarce time and resources on environmental governance.
NASA Astrophysics Data System (ADS)
Tole, Lise
2010-06-01
After an initial burst of enthusiasm in the 1990s, community-based forest management (CBFM) is increasingly being viewed with a critical eye. Evidence suggests that many programs have failed to promote their stated objectives of sustainability, efficiency, equity, democratic participation and poverty reduction. A large volume of academic literature now exists on CBFM, examining both the success and failure of such initiatives in a wide variety of countries. Through analysis of key themes, concepts and issues in CBFM, this article provides a review of CBFM initiatives in tropical developing countries for policymakers, practitioners and planners wishing to gain an understanding of this wide-ranging, interdisciplinary academic literature. The article identifies key institutions and incentives that appear to significantly affect the success or failure of CBFM initiatives. In particular, it reports that consideration of institutional and socioeconomic factors along with personal characteristics of key stakeholders such as beliefs, attitudes, financial resources and skills are important determinants of CBFM outcomes. However, local incentive structures also appear to be important. There is increasing recognition in the literature of the need to consider the conditions under which local politicians entrusted with carrying out CBFM initiatives will deem it worthwhile to invest their scarce time and resources on environmental governance.
Xpey' Relational Environments: an analytic framework for conceptualizing Indigenous health equity.
Kent, Alexandra; Loppie, Charlotte; Carriere, Jeannine; MacDonald, Marjorie; Pauly, Bernie
2017-12-01
Both health equity research and Indigenous health research are driven by the goal of promoting equitable health outcomes among marginalized and underserved populations. However, the two fields often operate independently, without collaboration. As a result, Indigenous populations are underrepresented in health equity research relative to the disproportionate burden of health inequities they experience. In this methodological article, we present Xpey' Relational Environments, an analytic framework that maps some of the barriers and facilitators to health equity for Indigenous peoples. Health equity research needs to include a focus on Indigenous populations and Indigenized methodologies, a shift that could fill gaps in knowledge with the potential to contribute to 'closing the gap' in Indigenous health. With this in mind, the Equity Lens in Public Health (ELPH) research program adopted the Xpey' Relational Environments framework to add a focus on Indigenous populations to our research on the prioritization and implementation of health equity. The analytic framework introduced an Indigenized health equity lens to our methodology, which facilitated the identification of social, structural and systemic determinants of Indigenous health. To test the framework, we conducted a pilot case study of one of British Columbia's regional health authorities, which included a review of core policies and plans as well as interviews and focus groups with frontline staff, managers and senior executives. ELPH's application of Xpey' Relational Environments serves as an example of the analytic framework's utility for exploring and conceptualizing Indigenous health equity in BC's public health system. Future applications of the framework should be embedded in Indigenous research methodologies.
ERIC Educational Resources Information Center
Carroll, Barry J.
A study identified motivations and disincentives for business philanthropy among 101 small and medium-sized corporations operating nationwide, as revealed through interviews conducted with their executives from March through August 1984. Discussions identified several principal incentives to encourage corporate support of community services and…
Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-12
... facility for executing and routing standardized equity and index options, to amend Routing Fees. While... other persons using any facility or system which NASDAQ operates or controls, and is not designed to...
Federal Register 2010, 2011, 2012, 2013, 2014
2012-09-17
... routing and executing certain orders in equity options to NOM, specifically, options on Facebook, Inc... Reference Room, 100 F Street NE., Washington, DC 20549, on official business days between the hours of 10:00...
State of Texas regional ITS architectures : El Paso region, executive summary
DOT National Transportation Integrated Search
2003-10-27
The Federal Highway Administration (FHWA) issued a final rule to implement Section 5206(e) of the Transportation Equity Act for the 21st Century (TEA-21) in January of 2001. This final rule requires that Intelligent Transportation System (ITS) projec...
Dovis, Sebastiaan; Van der Oord, Saskia; Wiers, Reinout W; Prins, Pier J M
2012-07-01
Visual-spatial Working Memory (WM) is the most impaired executive function in children with Attention-Deficit/Hyperactivity Disorder (ADHD). Some suggest that deficits in executive functioning are caused by motivational deficits. However, there are no studies that investigate the effects of motivation on the visual-spatial WM of children with- and without ADHD. Studies examining this in executive functions other than WM, show inconsistent results. These inconsistencies may be related to differences in the reinforcement used. The effects of different reinforcers on WM performance were investigated in 30 children with ADHD and 31 non-ADHD controls. A visual-spatial WM task was administered in four reinforcement conditions: Feedback-only, 1 euro, 10 euros, and a computer-game version of the task. In the Feedback-only condition, children with ADHD performed worse on the WM measure than controls. Although incentives significantly improved the WM performance of children with ADHD, even the strongest incentives (10 euros and Gaming) were unable to normalize their performance. Feedback-only provided sufficient reinforcement for controls to reach optimal performance, while children with ADHD required extra reinforcement. Only children with ADHD showed a decrease in performance over time. Importantly, the strongest incentives (10 euros and Gaming) normalized persistence of performance in these children, whereas 1 euro had no such effect. Both executive and motivational deficits give rise to visual-spatial WM deficits in ADHD. Problems with task-persistence in ADHD result from motivational deficits. In ADHD-reinforcement studies and clinical practice (e.g., assessment), reinforcement intensity can be a confounding factor and should be taken into account. Gaming can be a cost-effective way to maximize performance in ADHD.
State of Texas ITS architectures and deployment plans : San Angelo region, executive summary
DOT National Transportation Integrated Search
2004-11-12
The Federal Highway Administration (FHWA) issued a final rule to implement Section 5206(e) of the Transportation Equity Act for the 21st Century (TEA-21) in January of 2001. This final rule requires that Intelligent Transportation System (ITS) projec...
State of Texas ITS architectures and deployment plans : Brazos Valley region, executive summary
DOT National Transportation Integrated Search
2004-04-30
The Federal Highway Administration (FHWA) issued a final rule to implement Section 5206(e) of the Transportation Equity Act for the 21st Century (TEA-21) in January of 2001. This final rule requires that Intelligent Transportation System (ITS) projec...
State of Texas ITS architectures and deployment plans : Corpus Christi region, executive summary
DOT National Transportation Integrated Search
2003-04-28
The Federal Highway Administration (FHWA) issued a final rule to implement Section 5206(e) of the Transportation Equity Act for the 21st Century (TEA-21) in January of 2001. This final rule requires that Intelligent Transportation System (ITS) projec...
State of Texas ITS architectures and deployment plans : Tyler region, executive summary
DOT National Transportation Integrated Search
2003-07-16
The Federal Highway Administration (FHWA) issued a final rule to implement Section 5206(e) of the Transportation Equity Act for the 21st Century (TEA-21) in January of 2001. This final rule requires that Intelligent Transportation System (ITS) projec...
State of Texas ITS architectures and deployment plans : Atlanta region, executive summary
DOT National Transportation Integrated Search
2003-11-07
The Federal Highway Administration (FHWA) issued a final rule to implement Section 5206(e) of the Transportation Equity Act for the 21st Century (TEA-21) in January of 2001. This final rule requires that Intelligent Transportation System (ITS) projec...
State of Texas ITS architectures and deployment plans : Beaumont Region, executive summary
DOT National Transportation Integrated Search
2003-12-29
The Federal Highway Administration (FHWA) issued a final rule to implement Section 5206(e) of the Transportation Equity Act for the 21st Century (TEA-21) in January of 2001. This final rule requires that Intelligent Transportation System (ITS) projec...
State of Texas ITS architectures and deployment plans : Lubbock region, executive summary
DOT National Transportation Integrated Search
2005-02-28
The Federal Highway Administration (FHWA) issued a final rule to implement Section 5206(e) of the Transportation Equity Act for the 21st Century (TEA-21) in January of 2001. This final rule requires that Intelligent Transportation System (ITS) projec...
State of Texas ITS architectures and deployment plans : Paris region, executive summary
DOT National Transportation Integrated Search
2005-05-31
The Federal Highway Administration (FHWA) issued a final rule to implement Section 5206(e) of the Transportation Equity Act for the 21st Century (TEA-21) in January of 2001. This final rule requires that Intelligent Transportation System (ITS) projec...
State of Texas ITS architectures and deployment plans : Childress region, executive summary
DOT National Transportation Integrated Search
2003-08-22
The Federal Highway Administration (FHWA) issued a final rule to implement Section 5206(e) of the Transportation Equity Act for the 21st Century (TEA-21) in January of 2001. This final rule requires that Intelligent Transportation System (ITS) projec...
State of Texas ITS architectures and deployment plans : Del Rio region, executive summary
DOT National Transportation Integrated Search
2004-02-27
The Federal Highway Administration (FHWA) issued a final rule to implement Section 5206(e) of the Transportation Equity Act for the 21st Century (TEA-21) in January of 2001. This final rule requires that Intelligent Transportation System (ITS) projec...
State of Texas ITS architectures and deployment plans : Laredo region, executive summary
DOT National Transportation Integrated Search
2003-06-20
The Federal Highway Administration (FHWA) issued a final rule to implement Section 5206(e) of the Transportation Equity Act for the 21st Century (TEA-21) in January of 2001. This final rule requires that Intelligent Transportation System (ITS) projec...
State of Texas ITS architectures and deployment plans : Wichita Falls region, executive summary
DOT National Transportation Integrated Search
2005-01-14
The Federal Highway Administration (FHWA) issued a final rule to implement Section 5206(e) of the Transportation Equity Act for the 21st Century (TEA-21) in January of 2001. This final rule requires that Intelligent Transportation System (ITS) projec...
Betancourt, Joseph R; Tan-McGrory, Aswita; Kenst, Karey S; Phan, Thuy Hoai; Lopez, Lenny
2017-06-01
Leaders of health care organizations need to be prepared to improve quality and achieve equity in today's health care environment characterized by a focus on achieving value and addressing disparities in a diverse population. To help address this need, the Disparities Solutions Center at Massachusetts General Hospital launched the Disparities Leadership Program in 2007. The leadership program is an ongoing, year-long, executive education initiative that trains leaders from hospitals, health plans, and health centers to improve quality and eliminate racial and ethnic disparities in health care. Feedback from participating organizations demonstrates that health care leaders seem to possess knowledge about what disparities are and about what should be done to eliminate them. Data collection, performance measurement, and multifaceted interventions remain the tools of the trade. However, the barriers to success are lack of leadership buy-in, organizational prioritization, energy, and execution, which can be addressed through organizational change management strategies. Project HOPE—The People-to-People Health Foundation, Inc.
A Review of Wind Project Financing Structures in the USA
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bolinger, Mark A; Harper, John; Karcher, Matthew
2008-09-24
The rapid pace of wind power development in the U.S. over the last decade has outstripped the ability of most project developers to provide adequate equity capital and make efficient use of project-related tax benefits. In response, the sector has created novel project financing structures that feature varying combinations of equity capital from project developers and third-party tax-oriented investors, and in some cases commercial debt. While their origins stem from variations in the financial capacity and business objectives of wind project developers, as well as the risk tolerances and objectives of equity and debt providers, each structure is, at itsmore » core, designed to manage project risk and allocate federal tax incentives to those entities that can use them most efficiently. This article surveys the six principal financing structures through which most new utility-scale wind projects (excluding utility-owned projects) in the U.S. have been financed from 1999 to the present. These structures include simple balance-sheet finance, several varieties of all-equity special allocation partnership 'flip' structures, and two leveraged structures. In addition to describing each structure's mechanics, the article also discusses its rationale for use, the types of investors that find it appealing and why, and its relative frequency of use in the market. The article concludes with a generalized summary of how a developer might choose one structure over another.« less
38 CFR 36.4209 - Reporting requirements.
Code of Federal Regulations, 2011 CFR
2011-07-01
... and Department of Veterans Affairs regulations. (A) If the assumption is approved and the transfer of... of the executed deed, bill of sale, transfer of equity agreement, and/or assumption agreement as... disapproval decision. If the application for assumption is approved and the transfer of the security is...
DOT National Transportation Integrated Search
2003-07-23
The Federal Highway Administration (FHWA) issued a final rule to implement Section 5206(e) of the Transportation Equity Act for the 21st Century (TEA-21) in January of 2001. This final rule requires that Intelligent Transportation System (ITS) projec...
78 FR 52467 - Title I-Improving the Academic Achievement of the Disadvantaged
Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-23
... Orders 12866 and 13563 Regulatory Impact Analysis Under Executive Order 12866, the Secretary must... or planned by another agency; (3) Materially alter the budgetary impacts of entitlement grants, user... advantages; distributive impacts; and equity); (4) To the extent feasible, specify performance objectives...
ERIC Educational Resources Information Center
Wharton, Clifton R., Jr.
1991-01-01
The chief executive officer of the Teachers' Insurance and Annuities Fund-College Retirement Equities Fund (TIAA-CREF) discusses the current widespread concern over retirement issues in general and the ending of mandatory retirement ages for college faculty. Changes in TIAA-CREF policies and practices affecting range and coverage of retirement…
ERIC Educational Resources Information Center
Rosen, Gerald H.; Perrin, Robert
1992-01-01
The Teachers Insurance and Annuities Association's (TIAA) College Retirement and Equity Fund is criticized for its low returns and its chief executive officer's recent salary raise. It is said to be in need of additional regulation and policyholder involvement. A TIAA vice president responds that the analysis given is inaccurate and misleading.…
California Makes the Case for Pay Equity.
ERIC Educational Resources Information Center
Turner, Anne M.
2002-01-01
Discusses results of a California Library Association study that investigated library employees' salaries as compared to salaries of employees in comparable public jobs. Highlights include reasons for unfair library employee compensation; comparisons of support staff supervisor salaries and executive salaries; and how to use the data to improve…
State of Texas ITS architectures and deployment plans : West Central Texas region, executive summary
DOT National Transportation Integrated Search
2004-09-17
The Federal Highway Administration (FHWA) issued a final rule to implement Section 5206(e) of the Transportation Equity Act for the 21st Century (TEA-21) in January of 2001. This final rule requires that Intelligent Transportation System (ITS) projec...
Incentives to promote family planning
Heil, Sarah H.; Gaalema, Diann E.; Herrmann, Evan S.
2012-01-01
Objective Over the past 60 years, population control has become an increasingly urgent issue worldwide as a growing population strains already limited resources. The use of financial incentives to promote family planning is an innovative approach that has potential to make a contribution to efforts to better manage population growth. This report reviews eight studies that examined the effect of incentives on family planning. Method Published studies that tested the impact of incentives to promote some aspect of family planning and included an appropriate control or comparison condition were reviewed. Results Incentives have been used to promote attendance at contraceptive education sessions, adoption and continuation of contraceptive methods, sterilization, and to limit family size. All but one of the eight studies reviewed reported positive outcomes, but weaknesses in study design and execution limit the strength of the conclusions that can be drawn. Conclusion Review of this literature suggests that family planning behaviors, like other behaviors, are sensitive to incentives. Given the tremendous need for efficacious interventions in global efforts to manage population growth, further research on this topic using more rigorous experimental methods is warranted. PMID:22743293
Results from the first 4 years of pay for performance.
DeVore, Susan D
2010-01-01
Some of the lessons hospitals that have participated in the Hospital Quality Incentive Demonstration project have learned include: the need to tie in quality-of-care initiatives to the organization's strategic plan and to incentive plans for all employees, from executives on down; the value in allowing hospital physicians to "own" quality improvement initiatives; the importance of making results of the initiative available to all staff; the benefit of creating best-practice teams to address improvements in specific clinical areas.
17 CFR 200.80a - Appendix A-Documentary materials available to the public.
Code of Federal Regulations, 2010 CFR
2010-04-01
..., directors and principal stockholders of issuers having listed equity securities; and changes in such... executed by financial institution authorizing representative to serve as officer or director of holding... securities filed by officers and directors of registered public utility holding companies, and changes in...
The Evolution, Development, and Future of Affirmative Action in Government.
ERIC Educational Resources Information Center
Davis, James Edward
This thesis discusses the evolution, development, and future of affirmative action in government. Executive Order 11246 formally created affirmative action in 1965 as a remedy for underuse of minorities and women in the workplace and classroom. Many private businesses believe government organizations promote diversity and social equity. Many local…
Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-10
... evolution of the equities markets away from manual executions and manual enforcement of rules toward an... technology and the development of automated systems. \\5\\ 15 U.S.C. 78f(b). \\6\\ 15 U.S.C. 78f(b)(4). B. Self...
The Supervision and Career Advancement of Women in Community College Administration
ERIC Educational Resources Information Center
Donohue-Mendoza, Michelle
2012-01-01
This study explores the specific issue of supervision as an important administrative gate keeping function that facilitates or impedes women's career advancement, and promotes gender equity at the executive leadership level in community colleges. The very nature of supervision mirrors the historical purpose of higher education, employee learning…
An incentive-based distributed mechanism for scheduling divisible loads in tree networks
DOE Office of Scientific and Technical Information (OSTI.GOV)
Carroll, T. E.; Grosu, D.
The underlying assumption of Divisible Load Scheduling (DLS) theory is that the pro-cessors composing the network are obedient, i.e., they do not “cheat” the scheduling algorithm. This assumption is unrealistic if the processors are owned by autonomous, self-interested organizations that have no a priori motivation for cooperation and they will manipulate the algorithm if it is beneficial to do so. In this paper, we address this issue by designing a distributed mechanism for scheduling divisible loads in tree net-works, called DLS-T, which provides incentives to processors for reporting their true processing capacity and executing their assigned load at full processingmore » capacity. We prove that the DLS-T mechanism computes the optimal allocation in an ex post Nash equilibrium. Finally, we simulate and study the mechanism under various network structures and processor parameters.« less
Labudda, Kirsten; Woermann, Friedrich G; Mertens, Markus; Pohlmann-Eden, Bernd; Markowitsch, Hans J; Brand, Matthias
2008-06-01
Recent functional neuroimaging and lesion studies demonstrate the involvement of the orbitofrontal/ventromedial prefrontal cortex as a key structure in decision making processes. This region seems to be particularly crucial when contingencies between options and consequences are unknown but have to be learned by the use of feedback following previous decisions (decision making under ambiguity). However, little is known about the neural correlates of decision making under risk conditions in which information about probabilities and potential outcomes is given. In the present study, we used functional magnetic resonance imaging to measure blood-oxygenation-level-dependent (BOLD) responses in 12 subjects during a decision making task. This task provided explicit information about probabilities and associated potential incentives. The responses were compared to BOLD signals in a control condition without information about incentives. In contrast to previous decision making studies, we completely removed the outcome phase following a decision to exclude the potential influence of feedback previously received on current decisions. The results indicate that the integration of information about probabilities and incentives leads to activations within the dorsolateral prefrontal cortex, the posterior parietal lobe, the anterior cingulate and the right lingual gyrus. We assume that this pattern of activation is due to the involvement of executive functions, conflict detection mechanisms and arithmetic operations during the deliberation phase of decisional processes that are based on explicit information.
Rudasingwa, Martin; Uwizeye, Marie Rose
2017-01-01
ABSTRACT Background: Performance-based financing (PBF) was first implemented in Burundi in 2006 as a pilot programme in three provinces and was rolled out nationwide in 2010. PBF is a reform approach to improve the quality, quantity, and equity of health services and aims at achieving universal health coverage. It focuses on how to best motivate health practitioners. Objective: To elicit physicians’ and nurses’ experiences and views on how PBF influenced and helped them in healthcare delivery. Methods: A qualitative cross-sectional study was carried out among frontline health workers such as physicians and nurses. The data was gathered through individual face-to-face, in-depth, semi-structured interviews with 6 physicians and 30 nurses from February to March 2011 in three hospitals in Gitega Province. A simple framework approach and thematic analysis using a combination of manual technique and MAXQDA software guided the analysis of the interview data. Results: Overall, the interviewees felt that the PBF scheme had provided positive motivation to improve the quality of care, mainly in the structures and process of care. The utilization of health services and the relationship between health practitioners and patients also improved. The salary top-ups were recognized as the most significant impetus to increase effort in improving the quality of care. The small and sometimes delayed financial incentives paid to physicians and nurses were criticized. The findings of this study also indicate that the positive interaction between performance-based incentive schemes and other health policies is crucial in achieving comprehensive improvement in healthcare delivery. Conclusions: PBF has the potential to motivate medical staff to improve healthcare provision. The views of medical staff and the context of the area of implementation have to be taken into consideration when designing and implementing PBF schemes. PMID:28452651
Semiannual Report to the Congress, October 1, 2011 - March 31, 2012
2012-03-31
0013-ALM Follow-up Audit of Rotor Blades 11/08/2011 USAAA A-2012-0015- FFM Controls Over the Incentive Program in the Indiana Army National Guard...Financial Statements 11/02/2011 USAAA A-2012-0022- FFM Army Executive Dining Facility Fund Financial Statements, Office of the Administrative Assistant to...the Secretary of the Army 12/06/2011 USAAA A-2012-0023- FFM Army Executive Dining Facility Fund Internal Controls, Office of the Administrative
Female Superintendents, Barriers, and the Struggle for Equity.
ERIC Educational Resources Information Center
McCreight, Carolyn
This report examines the status of female superintendents in the United States. Women comprise 70 percent of all teachers in the United States, but men continue to dominate educational administration, particularly the superintendency. A 1999 survey revealed that females hold 20 percent of top school-executive positions and that there remain many…
Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-16
... Proposed Rule Change Relating to Penny Pilot Options and Non-Penny Pilot Options May 10, 2013. Pursuant to... ``Options Pricing,'' at Section 2 governing pricing for NASDAQ members using the NASDAQ Options Market (``NOM''), NASDAQ's facility for executing and routing standardized equity and index options...
Educational Equity and the Fiscal Incidence of Public Education.
ERIC Educational Resources Information Center
McDonald, M. Brian
1980-01-01
Individual student data have been developed for both public education benefits (expenditures) and costs (taxes paid) for a sample of senior high school students. The results indicate a redistributive pattern that is propoor, pro-Black (for high income Blacks), and promale. Available from Executive Director, NTA-TIA, 21 East State Street, Columbus,…
Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-28
... indirect cost is expressly unallowable under a cost principle in the FAR, or an executive agency supplement... economic, environmental, public health and safety effects, distributive impacts, and equity). E.O. 13563... have a significant economic impact on a substantial number of small entities within the meaning of the...
Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-30
... fees for routing options to away markets. While these amendments are effective upon filing, the... recoup costs the Exchange incurs for routing and executing certain orders in equity options to away... plus the away market transaction fee as noted below. Today, the Exchange calculates Routing Fees by...
Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-15
... Exchange incurs for routing and executing certain orders in equity options to away markets. The Exchange proposes to amend Routing Fees for the following away markets: BATS Exchange, Inc. (``BATS''), BOX Options... NASDAQ OMX PHLX LLC (``Phlx''). These away markets amended their transaction fees and the Exchange...
ThinkForward: Evaluation Report and Executive Summary
ERIC Educational Resources Information Center
Demack, Sean; McCaig, Colin; Wolstenholme, Claire; Stevens, Anna; Fumagalli, Laura
2016-01-01
ThinkForward is a coaching programme, developed by Impetus Private Equity Foundation, which is designed to support secondary school pupils. ThinkForward is targeted at pupils who have been identified as being at high risk of not being in education, employment or training (NEET) following the completion of compulsory education. Coaches are assigned…
ERIC Educational Resources Information Center
Rosenberg, Judith H.
These instructional materials focus on federal laws and executive orders that prohibit sex discrimination in employment and education. The materials consist of the following: (1) a list of some of the legislation covered; (2) a list of relevant materials and resources; (3) a list of 14 instructional activities, each described by one or a few…
Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-09
... general matter, the changes will result in fee increases and rebate reductions that reflect the persistent... the orders of institutional investors are executed in dark pools. Securities Exchange Act Release No... trading and un- displayed, or ``dark,'' liquidity. See also Mary L. Schapiro, Strengthening Our Equity...
Federal Register 2010, 2011, 2012, 2013, 2014
2011-01-07
... institutional investors are executed in dark pools. Securities Exchange Act Release No. 61358 (January 14, 2010...- displayed, or ``dark,'' liquidity. See also Mary L. Schapiro, Strengthening Our Equity Market Structure... Web site)(comments of Commission Chairman on what she viewed as a troubling trend of reduced...
Support to the Safe Motherhood Programme in Nepal: an integrated approach.
Barker, Carol E; Bird, Cherry E; Pradhan, Ajit; Shakya, Ganga
2007-11-01
Evidence gathered from 1997 to 2006 indicates progress in reducing maternal mortality in Nepal, but public health services are still constrained by resource and staff shortages, especially in rural areas. The five-year Support to the Safe Motherhood Programme builds on the experience of the Nepal Safer Motherhood Project (1997-2004). It is working with the Government of Nepal to build capacity to institute a minimum package of essential maternity services, linking evidence-based policy development with health system strengthening. It has supported long-term planning, working towards skilled attendance at every birth, safe blood supplies, staff training, building management capacity, improving monitoring systems and use of process indicators, promoting dialogue between women and providers on quality of care, and increasing equity and access at district level. An incentives scheme finances transport costs to a health facility for all pregnant women and incentives to health workers attending deliveries, with free services and subsidies to facilities in the poorest 25 districts. Despite bureaucracy, frequent transfer of key government staff and political instability, there has been progress in policy development, and public health sector expenditure has increased. For the future, a human resources strategy with career paths that encourage skilled staff to stay in the government service is key.
Tong, Allison; Chapman, Jeremy R; Wong, Germaine; Craig, Jonathan C
2014-10-01
The shortage of donors for organ transplantation has stimulated debate on financial incentives for living kidney donors. This study aims to describe the range of attitudes and opinions of transplant physicians on financial reimbursement, compensation, and incentives in living kidney donation. Qualitative study. 110 transplant nephrologists and surgeons from 12 countries across 43 transplantation units in Europe, Australasia, and North America. Face-to-face semistructured interviews were conducted. Transcripts were thematically analyzed. We identified 7 major themes. Prioritizing the removal of disincentives for living kidney donors was largely deemed acceptable. By contrast, provision of financial incentives raised concerns about undermining benevolence, compromising human dignity and value, and traversing market forces. Some contended that financial incentives potentially were legitimate if regulated, arguing that this would maximize utility in transplantation, but most also acknowledged the difficulty and that operational feasibility of a regulated system of financial incentivization may be limited. Participants were English speaking and from Western high-income countries; therefore, the transferability of our findings may be limited. Transplantation specialists believed that minimizing disincentives would support equity and justice in living kidney donation. Direct financial incentivization for living kidney donors, even in the context of a regulated market, was regarded by most as unjustified because of the potential moral consequences and uncertain feasibility. Removing financial disincentives and safeguarding the intrinsic volunteerism, value, and meaning of donation were viewed to uphold integrity in living kidney donation. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Zhang, Chun-Yu; Hashimoto, Hideki
2015-01-01
Background: China has achieved universal health insurance coverage. This study examined how patients and hospitals react to the different designs of the plans and to monitoring of patients by the local authority in the Chinese multiple health security schemes. Methods: The sample for analysis consisted of 1006 orthopedic inpatients who were admitted between January and December 2011 at a tertiary teaching hospital located in Beijing. We conducted general linear regression analyses to investigate whether medical expenditure and length of stay differed according to the different incentives. Results: Patients under plans with lower copayment rates consumed significantly more medication compared with those under plans with higher copayment rates. Under plans with an annual ceiling for insurance coverage, patients spent significantly more in the second half of the year than in the first half of the year. The length of stay was shorter among patients when there were government monitoring and a penalty to the hospital service provider. Conclusions: Our results indicate that the different designs and monitoring of the health security systems in China cause opportunistic behavior by patients and providers. Reformation is necessary to reduce those incentives, and improve equity and efficiency in healthcare use. PMID:25698195
Zhang, Chun-Yu; Hashimoto, Hideki
2015-03-05
China has achieved universal health insurance coverage. This study examined how patients and hospitals react to the different designs of the plans and to monitoring of patients by the local authority in the Chinese multiple health security schemes. The sample for analysis consisted of 1006 orthopedic inpatients who were admitted between January and December 2011 at a tertiary teaching hospital located in Beijing. We conducted general linear regression analyses to investigate whether medical expenditure and length of stay differed according to the different incentives. Patients under plans with lower copayment rates consumed significantly more medication compared with those under plans with higher copayment rates. Under plans with an annual ceiling for insurance coverage, patients spent significantly more in the second half of the year than in the first half of the year. The length of stay was shorter among patients when there were government monitoring and a penalty to the hospital service provider. Our results indicate that the different designs and monitoring of the health security systems in China cause opportunistic behavior by patients and providers. Reformation is necessary to reduce those incentives, and improve equity and efficiency in healthcare use.
Managerial Ownership in Nursing Homes: Staffing, Quality, and Financial Performance.
Huang, Sean Shenghsiu; Bowblis, John R
2017-06-20
Ownership of nursing homes (NHs) has primarily focused broadly on differences between for-profit (FP), nonprofit (NFP), and government-operated facilities. Yet, among FPs, the understanding of detailed ownership structures at individual NHs is rather limited. Particularly, NH administrators may hold significant equity interests in their facilities, leading to heterogeneous financial incentives and NH outcomes. Through the principal-agent theory, this article studies how managerial ownership of individual facilities affects NH outcomes. We use a unique panel dataset of Ohio NHs (2005-2010) to empirically examine the relationship between managerial equity ownership and NH staffing, quality, and financial performance. We identify facility administrators as owner-managers if they have more than 5% of the equity stakes or are relatives of the owners. The statistical analysis is based on the pooled ordinary least squares and NH-fixed effect models. We find that owner-managed NHs are associated with higher nursing staff levels compared to other FP NHs. Surprisingly, despite higher staffing levels, owner-managed NHs are not associated with better quality and we find no statistically significant difference in financial performance between owner-managed and nonowner-managed FP NHs. Our results do not support the principal-agent model and we offer alternative explanations for future research. Our findings provide empirical evidence that NH ownership structures are more nuanced than simply broadly categorizing facilities as FP or NFP, and our results do not fully align with the standard principal-agent model. The role of managerial ownership should be considered in future NH research and policy discussions. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Perspective: POTUS Trump's Executive Orders - Implications for Immigrants and Health Care.
Talamantes, Efrain; Aguilar-Gaxiola, Sergio
2017-01-01
The United States, under new executive orders proposed by its 45th president, may quickly lose its greatness in serving Emma Lazarus' untimely portrait of immigrants and refugees as " the tired, poor and huddled masses yearning to breathe free ." After years of progress in improving health care access to underserved populations, new executive orders threaten our nation's advancements in health equity. Within this perspective, we offer examples on how these actions may result in damaging impacts on patients, families, communities and the health care workforce. We add our voices to a myriad of national leaders who are advocating for the preservation of the Affordable Care Act (ACA) and the protection of immigrants, including Deferred Action for Childhood Arrivals (DACA).
Financialisation in health care: An analysis of private equity fund investments in Turkey.
Eren Vural, Ipek
2017-08-01
The 2007-2008 global financial crisis revived interest in the impacts of financial markets and actors on our social and economic life. Nevertheless, research on health care financialisation remains scant. This article presents findings from research on one modality of financial investments in health care: global private equity funds' investments in private hospitals. Adopting a political economy approach, it analyses the drivers and impacts of the upsurge of global private equity investments in the Turkish private hospital sector amid the global financial crisis. The analysis derives from review of research and archival literature, as well as six in-depth interviews held with owners/executive board directors/general managers of the largest private hospital chains in Turkey and the general partners of their PE investors. The interviewing process took place between January and November 2016. All interviews were conducted by the author in Istanbul. The findings point to a mutually reinforcing relationship between neoliberal policies and financialisation processes in health care. The article shows that neoliberal healthcare reforms, introduced under consecutive Justice and Development Party (JDP) governments in Turkey, have been important precursors of private equity investments in healthcare services. These private equity investments, in turn, intensified and broadened the process of marketisation in health care services. Four impacts are identified, through which private equity investments hasten the marketisation of health care services. These relate to the impacts of private equity investments on a) advancing the process of chain formation by large hospital groups, b) spreading financial imperatives into the operations of private hospitals c) fostering internationalisation of capital, and d) augmenting inequities in access to health care services and standards. Copyright © 2017 Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
Petersen, Mary Louise
1980-01-01
Ten important goals for trustees during the 1980s include: long-range planning; educational diversity; public relations; self-regulation; selection of chief executive officers; role of policy making; fully informed governing boards; facing crises; use of incentives to reach institutional goals; and keeping the individual campus as the…
26 CFR 1.809-10 - Computation of equity base.
Code of Federal Regulations, 2013 CFR
2013-04-01
... 26 Internal Revenue 8 2013-04-01 2013-04-01 false Computation of equity base. 1.809-10 Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Gain and Loss from Operations § 1.809-10 Computation of equity base. (a) In general. For purposes of section 809, the equity base of a life insurance company includes the...
26 CFR 1.809-10 - Computation of equity base.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 26 Internal Revenue 8 2011-04-01 2011-04-01 false Computation of equity base. 1.809-10 Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Gain and Loss from Operations § 1.809-10 Computation of equity base. (a) In general. For purposes of section 809, the equity base of a life insurance company includes the...
26 CFR 1.809-10 - Computation of equity base.
Code of Federal Regulations, 2012 CFR
2012-04-01
... 26 Internal Revenue 8 2012-04-01 2012-04-01 false Computation of equity base. 1.809-10 Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Gain and Loss from Operations § 1.809-10 Computation of equity base. (a) In general. For purposes of section 809, the equity base of a life insurance company includes the...
26 CFR 1.809-10 - Computation of equity base.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 26 Internal Revenue 8 2010-04-01 2010-04-01 false Computation of equity base. 1.809-10 Section 1... (CONTINUED) INCOME TAXES Gain and Loss from Operations § 1.809-10 Computation of equity base. (a) In general. For purposes of section 809, the equity base of a life insurance company includes the amount of any...
Where the Girls Are: The Facts about Gender Equity in Education. Executive Summary
ERIC Educational Resources Information Center
Corbett, Christianne; Hill, Catherine; St. Rose, Andresse
2008-01-01
This document summarizes the full report, which presents a comprehensive look at girls' educational achievement during the past 35 years, paying special attention to the relationship between girls' and boys' progress. Analyses of results from national standardized tests such as the National Assessment of Educational Progress (NAEP) and the SAT and…
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The Investment Case for Education and Equity. Executive Summary
ERIC Educational Resources Information Center
UNICEF, 2015
2015-01-01
Education is a human right. The Convention on the Rights of the Child and the Universal Declaration of Human Rights recognize the essential role education plays in human and social development. As stated in article 26 of the Declaration, "Everyone has the right to education. Education shall be free, at least in the elementary and fundamental…
Flores, Walter
2010-01-01
Governance refers to decision-making processes in which power relationships and actors and institutions' particular interests converge. Situations of consensus and conflict are inherent to such processes. Furthermore, decision-making happens within a framework of ethical principles, motivations and incentives which could be explicit or implicit. Health systems in most Latin-American and Caribbean countries take the principles of equity, solidarity, social participation and the right to health as their guiding principles; such principles must thus rule governance processes. However, this is not always the case and this is where the importance of investigating governance in health systems lies. Making advances in investigating governance involves conceptual and methodological implications. Clarifying and integrating normative and analytical approaches is relevant at conceptual level as both are necessary for an approach seeking to investigate and understand social phenomena's complexity. In relation to methodological level, there is a need to expand the range of variables, sources of information and indicators for studying decision-making aimed to greater equity, health citizenship and public policy efficiency.
Cui, Dan; Liu, Xinliang; Hawkey, Peter; Li, Hao; Wang, Quan; Mao, Zongfu; Sun, Jing
2017-12-01
We analyzed China's current use of and microbial resistance to antibiotics, and possible means of reducing antimicrobial resistance. Interventions like executive orders within clinical settings and educational approach with vertical approaches rather than an integrated strategy to curb the use of antimicrobials remain limited. An underlying problem is the system of incentives that has resulted in the intensification of inappropriate use by health professionals and patients. There is an urgent need to explore the relationship between financial and non-financial incentives for providers and patients, to eliminate inappropriate incentives. China's national health reforms have created an opportunity to contain inappropriate use of antibiotics through more comprehensive and integrated strategies. Containment of microbial resistance may be achieved by strengthening surveillance at national, regional and hospital levels; eliminating detrimental incentives within the health system; and changing prescribing behaviors to a wider health systems approach, to achieve long-term, equitable and sustainable results and coordinate stakeholders' actions through transparent sharing of information.
Perspective: POTUS Trump’s Executive Orders – Implications for Immigrants and Health Care
Talamantes, Efrain; Aguilar-Gaxiola, Sergio
2017-01-01
The United States, under new executive orders proposed by its 45th president, may quickly lose its greatness in serving Emma Lazarus’ untimely portrait of immigrants and refugees as “the tired, poor and huddled masses yearning to breathe free.” After years of progress in improving health care access to underserved populations, new executive orders threaten our nation’s advancements in health equity. Within this perspective, we offer examples on how these actions may result in damaging impacts on patients, families, communities and the health care workforce. We add our voices to a myriad of national leaders who are advocating for the preservation of the Affordable Care Act (ACA) and the protection of immigrants, including Deferred Action for Childhood Arrivals (DACA). PMID:28439182
Garg, Pankaj; Nagpal, Jitender
2014-01-01
In the context of inadequate public spending on health care in India (0.9% of the GDP); government liberalized its policies in the form of subsidized lands and tax incentives, resulting in the mushrooming of private hospitals and clinics in India. Paradoxically, a robust framework was not developed for the regulation of these health care providers, resulting in disorganized health sector, inadequate financing models, and lack of prioritization of services, as well as a sub-optimal achievement of the Millennium Development Goals (MDG). We systematically reviewed the evidence base regarding regulation of private hospitals, applicability of private-public mix, state of health insurance and effective policy development for India, while seeking lessons on regulation of private health systems, from South African (a developing country) and Australian (a developed country) health care systems. PMID:24701465
Dishonesty in the name of equity.
Gino, Francesca; Pierce, Lamar
2009-09-01
Under what conditions do people act dishonestly to help or hurt others? We addressed this question by examining the influence of a previously overlooked factor-the beneficiary or victim of dishonest acts. In two experiments, we randomly paired participants and manipulated their wealth levels through an initial lottery. We then observed how inequity between partners influenced the likelihood of one dishonestly helping or hurting the other, while varying the financial incentives for dishonest behavior. The results show that financial self-interest cannot fully explain people's tendency to dishonestly help or hurt others. Rather, such dishonesty is influenced by emotional reactions to wealth-based inequity, even when the dishonesty bears a personal financial cost. Envy evoked by negative inequity led to hurting behavior, whereas guilt induced by positive inequity motivated helping behavior. Finally, inequity between the partner and third parties triggered dishonest helping through empathy with the partner.
[Human resources for health in Chile: the reform's pending challenge].
Méndez, Claudio A
2009-09-01
Omission of human resources from health policy development has been identified as a barrier in the health sector reform's adoption phase. Since 2002, Chile's health care system has been undergoing a transformation based on the principles of health as a human right, equity, solidarity, efficiency, and social participation. While the reform has set forth the redefinition of the medical professions, continuing education, scheduled accreditation, and the introduction of career development incentives, it has not considered management options tailored to the new setting, a human resources strategy that has the consensus of key players and sector policy, or a process for understanding the needs of health care staff and professionals. However, there is still time to undo the shortcomings, in large part because the reform's implementation phase only recently has begun. Overcoming this challenge is in the hands of the experts charged with designing public health strategies and policies.
Who should set CEO pay? The press? Congress? Shareholders?
Brownstein, A R; Panner, M J
1992-01-01
Populist fervor in an election year has transformed executive compensation from a business issue into a political one. Critics, led by Graef Crystal, author of In Search of Excess: The Overcompensation of American Executives, charge that CEOs are ripping off shareholders with their outrageous salaries while running U.S. corporations into the ground. Politicians claim overpaid CEOs are the root cause of the U.S. competitiveness problem. Add a recessionary business climate to the fact that some CEOs earn 130 times more than their lowest paid employees, and you have the makings of a populist rebellion. In a bid to appease voters, Congress is considering several bills that would limit the deductibility of "excessive executive salaries," the SEC has opened the issue to shareholder comment, and the Financial Accounting Standards Board is looking at new accounting standards for granting stock options to executives as part of company compensation schemes. Andrew R. Brownstein and Morris J. Panner say it's time to put the debate back where it belongs--in a business context. The real question is not are executives paid too much, but are shareholders getting their money's worth. Most U.S. corporations use stock compensation to link company long-term performance to executive salaries. And because of the staggering market performance of U.S. corporations in the 1980s, an overwhelming majority of CEOs are actually paid in line with their performance. Rather than cut executive pay, Brownstein and Panner suggest that corporations extend incentive-based compensation plans to all employees, thus narrowing the salary gap and establishing pay for performance at every level of the organization.
Nahuelhual, Laura; Benra, Felipe; Laterra, Pedro; Marin, Sandra; Arriagada, Rodrigo; Jullian, Cristobal
2018-09-01
In developing countries, the protection of biodiversity and ecosystem services (ES) rests on the hands of millions of small landowners that coexist with large properties, in a reality of highly unequal land distribution. Guiding the effective allocation of ES-based incentives in such contexts requires researchers and practitioners to tackle a largely overlooked question: for a given targeted area, will single large farms or several small ones provide the most ES supply? The answer to this question has important implications for conservation planning and rural development alike, which transcend efficiency to involve equity issues. We address this question by proposing and testing ES supply-area relations (ESSARs) around three basic hypothesized models, characterized by constant (model 1), increasing (model 2), and decreasing increments (model 3) of ES supply per unit of area or ES "productivity". Data to explore ESSARs came from 3384 private landholdings located in southern Chile ranging from 0.5ha to over 30,000ha and indicators of four ES (forage, timber, recreation opportunities, and water supply). Forage provision best fit model 3, which suggests that targeting several small farms to provide this ES should be a preferred choice, as compared to a single large farm. Timber provision best fit model 2, suggesting that in this case targeting a single large farm would be a more effective choice. Recreation opportunities best fit model 1, which indicates that several small or a single large farm of a comparable size would be equally effective in delivering this ES. Water provision fit model 1 or model 2 depending on the study site. The results corroborate that ES provision is not independent from property area and therefore understanding ESSARs is a necessary condition for setting conservation incentives that are both efficient (deliver the highest conservation outcome at the least cost) and fair for landowners. Copyright © 2018 Elsevier B.V. All rights reserved.
Value-Based Emergency Management.
Corrigan, Zachary; Winslow, Walter; Miramonti, Charlie; Stephens, Tim
2016-02-01
This article touches on the complex and decentralized network that is the US health care system and how important it is to include emergency management in this network. By aligning the overarching incentives of opposing health care organizations, emergency management can become resilient to up-and-coming changes in reimbursement, staffing, and network ownership. Coalitions must grasp the opportunity created by changes in value-based purchasing and impending Centers for Medicare and Medicaid Services emergency management rules to engage payers, physicians, and executives. Hope and faith in doing good is no longer enough for preparedness and health care coalitions; understanding how physicians are employed and health care is delivered and paid for is now necessary. Incentivizing preparedness through value-based compensation systems will become the new standard for emergency management.
A Private Sector Guide to CETA.
ERIC Educational Resources Information Center
Greenwood, Katy; And Others
Written to provide business executives with examples of Comprehensive Employment and Training Act (CETA) programs that successfully prepare people to be skilled workers, this guide also describes the financial incentives for hiring unemployed and economically disadvantaged persons. In an overview of CETA and Title VII programs, private industry…
Wellness Programs: How Do They Shape Up?
ERIC Educational Resources Information Center
Feuer, Dale
1985-01-01
Presents several case studies that demonstrate the various types of wellness programs at various companies. These include health and fitness assessments for high stress level executives, lectures on health care topics, health improvement clinics, exercise facilities, economic incentives, and mental health programs. The impact of these programs is…
78 FR 72063 - Open Meeting of the Information Security and Privacy Advisory Board
Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-02
... agenda is expected to include the following items: --Cybersecurity Executive Order 13636, Improving Critical Infrastructure Cybersecurity (78 FR 11737, February 19, 2013); Development of New Cybersecurity... Cybersecurity (78 FR 13024, February 26, 2013); Notice of Inquiry (NOI)--Incentives to Adopt Improved...
Louisiana's Achievements for Gender Equity in Vocational Education. Executive Summary 1996-97.
ERIC Educational Resources Information Center
Hargroder, Margaret
Workplace and educational changes related to gender in Louisiana in 1996-97 suggest some progress but a continued need to reduce wide gender gaps in some occupational areas. Workplace data show a closing gender gap, but changes are occurring at different rates for different areas. Women's share of the total labor force continues to rise; wage…
Egypt in Transition: Responding to Social and Political Changes in Executive Education
ERIC Educational Resources Information Center
Wafa, Dina Mohamed
2013-01-01
Egypt witnessed an unexpected uprising on 25 January 2011. People took to the streets demanding their rights to freedom, equity and a better economy, and in only 18 days managed to oust President Mubarak, who had held power for 30 years. The transition period is still ongoing with an unfolding of events creating turbulence in the political, social…
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2013-09-12
... executing certain trades that either add liquidity to or remove liquidity from the Exchange's order book in... adopted its fees, it set its fee levels appropriate to the start-up nature of the Exchange's new equities... to perform at a high level of responsiveness and efficiency. \\5\\ Securities Exchange Act Release No...
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2013-12-17
... fees for routing options to away markets. The text of the proposed rule change is available on the... Exchange incurs for routing and executing certain orders in equity options to away markets. Today, the... assessed. If the away market pays a rebate, the Routing Fee is $0.00 per contract.\\4\\ \\3\\ Including BATS...
ERIC Educational Resources Information Center
Tung, Rosann; Carlo, Vivian Dalila; Colón, Melissa; Del Razo, Jaime L.; Diamond, John B.; Raynor, Alethea Frazier; Graves, Daren; Kuttner, Paul J.; Miranda, Helena; St. Rose, Andresse
2015-01-01
Boston Public Schools (BPS) commissioned companion studies as part of its efforts to address achievement gaps for Black and Latino males. The first study revealed the increasing diversity of Black and Latino males and stark opportunity gaps throughout the system that contribute in large part to wide attainment gaps for these students. We…
Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-01
... prices. See Exchange Rule 1079. FLEX Options are a trademark of the Chicago Board Options Exchange. While... pursuant to Exchange Rule 1079 (``FLEX equity options''). The Exchange believes that the proposed fee... options transactions executed pursuant to Exchange Rule 1079. \\11\\ 15 U.S.C. 78f(b). \\12\\ 15 U.S.C. 78f(b...
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2011-12-14
... Modify Pricing for BX Members Using the NASDAQ OMX BX Equities System December 8, 2011. Pursuant to... of the Proposed Rule Change The Exchange proposes to modify pricing for BX Members using the NASDAQ... above $1. BX has a pricing model under which members are charged for the execution of quotes/orders...
ERIC Educational Resources Information Center
Teo, Thompson S. H.; Tan, Jek Swan
2002-01-01
Describes a study on Internet marketing strategies of business-to-consumer (B2C) firms in Singapore. Results of a survey and hierarchical regression analyses indicate that strategies to attract customers and to relate to customers have significant positive relationships to online brand equity, which is positively related to financial growth.…
Nayroles, Gabrielle; Frybourg, Sandrine; Gabriel, Sylvie; Kornfeld, Åsa; Antoñanzas-Villar, Fernando; Espín, Jaime; Jommi, Claudio; Martini, Nello; de Pouvourville, Gérard; Tolley, Keith; Wasem, Jürgen; Toumi, Mondher
2017-01-01
Background : Many established products (EPs - marketed for eight years or more) are widely used off-label despite little evidence on benefit-risk ratio. This exposes patients to risks related to safety and lack of efficacy, and healthcare providers to liability. Introducing new indications for EPs may represent a high societal value; however, manufacturers rarely invest in R&D for EPs. The objective of this research was to describe incentives and disincentives for developing new indications for EPs in Europe and to investigate consequences of current policies. Methods : Targeted literature search and expert panel meetings. Results : Within the current European-level and national-level regulatory framework there are limited incentives for development of new indications with EPs. Extension of indication normally does not allow the price to be increased or maintained, the market protection period to be extended, or exclusion from a reference price system. New indication frequently triggers re-evaluation, resulting in price erosion, regardless of the level of added value with the new indication. In consequence, manufacturers are more prone to undertake R&D efforts at early to mid-stage of product life cycle rather than with EPs, or to invest in new chemical entities, even in therapeutic areas with broad off-label use. This represents a potentially missed opportunity as developing new indications for EPs offers an alternative to off-label use or lengthy and expensive R&D for new therapies, opens new opportunities for potentially cost-effective treatment alternatives, as well as greater equity in patients' access to treatment options. Conclusion : There are potential benefits from the development of new indications for EPs that are currently not being realized due to a lack of regulatory and pricing incentives in Europe. Incentives for orphan or paediatric drugs have proven to be effective in promoting R&D. Similarly, incentives to promote R&D in EPs should be developed, for the benefit of patients and healthcare systems.
Nayroles, Gabrielle; Frybourg, Sandrine; Gabriel, Sylvie; Kornfeld, Åsa; Antoñanzas-Villar, Fernando; Espín, Jaime; Jommi, Claudio; Martini, Nello; de Pouvourville, Gérard; Tolley, Keith; Wasem, Jürgen; Toumi, Mondher
2017-01-01
ABSTRACT Background: Many established products (EPs – marketed for eight years or more) are widely used off-label despite little evidence on benefit–risk ratio. This exposes patients to risks related to safety and lack of efficacy, and healthcare providers to liability. Introducing new indications for EPs may represent a high societal value; however, manufacturers rarely invest in R&D for EPs. The objective of this research was to describe incentives and disincentives for developing new indications for EPs in Europe and to investigate consequences of current policies. Methods: Targeted literature search and expert panel meetings. Results: Within the current European-level and national-level regulatory framework there are limited incentives for development of new indications with EPs. Extension of indication normally does not allow the price to be increased or maintained, the market protection period to be extended, or exclusion from a reference price system. New indication frequently triggers re-evaluation, resulting in price erosion, regardless of the level of added value with the new indication. In consequence, manufacturers are more prone to undertake R&D efforts at early to mid-stage of product life cycle rather than with EPs, or to invest in new chemical entities, even in therapeutic areas with broad off-label use. This represents a potentially missed opportunity as developing new indications for EPs offers an alternative to off-label use or lengthy and expensive R&D for new therapies, opens new opportunities for potentially cost-effective treatment alternatives, as well as greater equity in patients’ access to treatment options. Conclusion: There are potential benefits from the development of new indications for EPs that are currently not being realized due to a lack of regulatory and pricing incentives in Europe. Incentives for orphan or paediatric drugs have proven to be effective in promoting R&D. Similarly, incentives to promote R&D in EPs should be developed, for the benefit of patients and healthcare systems. PMID:28740616
Kibale forest wild coffee: challenges to market-based conservation in Africa.
Lilieholm, Robert J; Weatherly, W Paul
2010-08-01
Declining rural security and pressures to reduce public-sector expenditures in the late 1990s spurred efforts to develop alternative funding models for Uganda's Kibale National Park (KNP). The Wild Coffee Project, established in 1999 with support from the U.S. Agency for International Development, the World Bank, and the Ford Foundation, sought to develop a market for wild coffee that had been harvested traditionally from areas within today's KNP. The Kibale Forest Foundation, a U.S.-based nonprofit organization, was created to legalize harvests, obtain third-party wild and organic certification, and coordinate management between KNP, the coffee industry, and local communities. Although the project was successful in legalizing, harvesting, and processing the world's first certified wild and organic coffee, efforts to gain entry into the international marketplace failed. Chief among the lessons learned from this project is that for many wild-grown products, the value of "the story"--in both human and conservation terms--is likely to far exceed actual product values. This value differential should be captured through high-value niche markets to avoid low commodity pricing and subsequent pressures to improve financial returns through over harvesting. In addition, local producers should hold significant assets in whatever brands are developed, creating a shared-equity approach that serves social responsibility goals, fosters project sustainability, and ensures a steady stream of positive stories for use in marketing to build brand value. Shared equity--in this case ownership interest in the intellectual property embodied in the brand--provides a second incentive beyond transactional profits that can only be realized if resource conservation is maintained.
The Role of Industry Training Advisory Bodies. Monograph Series No. 2.
ERIC Educational Resources Information Center
Wooden, Mark
Designed to provide a better understanding of how Industry Training Advisory Bodies (ITABs) operate, a study showed whether current arrangements, incentives, and structures are conducive to ITABs always working in the best interests of their constituents: employers. Semi-structured interviews were conducted with chief executive officers (CEOs) of…
School Bus Safety. An AS&U Roundtable.
ERIC Educational Resources Information Center
American School and University, 1985
1985-01-01
A roundtable discussion of the issue of seat belts in school buses features United States Representative Peter H. Kostmayer, who has introduced a bill providing incentive grants to states to adopt and enforce laws requiring the use of seat belts in new school buses; three bus manufacturing executives; and two educators. (MLF)
Do motivational incentives reduce the inhibition deficit in ADHD?
Shanahan, Michelle A; Pennington, Bruce F; Willcutt, Erik W
2008-01-01
The primary goal of this study was to test three competing theories of ADHD: the inhibition theory, the motivational theory, and a dual deficit theory. Previous studies have produced conflicting findings about the effects of incentives on executive processes in ADHD. In the present study of 25 children with ADHD and 30 typically developing controls, motivation was manipulated within the Stop Task. Stop signal reaction time was examined, as well as reaction time, its variability, and the number of errors in the primary choice reaction time task. Overall, the pattern of results supported the inhibition theory over the motivational or dual deficit hypotheses, as main effects of group were found for most key variables (ADHD group was worse), whereas the group by reward interaction predicted by the motivational and dual deficit accounts was not found. Hence, as predicted by the inhibition theory, children with ADHD performed worse than controls irrespective of incentives.
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2012-01-25
... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-66192; File No. SR-NYSEArca-2012-02] Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Order Granting Accelerated Approval of a Proposed Rule Amendments to NYSE Arca Rule 9.4 and NYSE Equities Inc. Rules 5.3(d) and 9.4 Relating to Discretionary Proxy Voting on Executive...
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2012-04-19
... Orders (``MOO Orders''). The text of the proposed rule change is available at the Exchange, www.nyse.com.... Purpose The Exchange proposes to amend NYSE Arca Equities Rule 7.31(t) to provide for LOO and MOO Orders... orders that are only executed within an auction.\\4\\ As proposed, LOO and MOO Orders would be defined...
Social capital from carbon property: creating equity for indigenous people.
Saunders, Lindsay S; Hanbury-Tenison, Robin; Swingland, Ian R
2002-08-15
New incentives for protection and in situ use of forests and the services they provide raise hopes for the reversal of tropical and temperate deforestation. Past management of forests appropriated the rights of forest communities, providing incentives to convert natural forest into financial capital through logging, while destroying the underlying physical property. Carbon trading aims to provide a means to convert the forest property into financial capital, while protecting the physical property of forests, thereby providing new incentives for in situ forest management. The potential for carbon-emission trading as a contributor to these new incentives is tempered by concerns that it is another tool for capitalists to exploit the indigenous communities of the developing world. Estimates of annual emission trading amounting to US $200 billion raise alarm bells about the effect of such trade in the developing world. People are right to be concerned, as the history of exploitation of indigenous people, the appropriation of their rights, the loss of forests and their benefits is well documented. This exploitation resulted in the exclusion of forest communities from the basic tenets for development created by the wealth generated by traded property. However, one virtue of trade is that it can be made subject to constraints. Through international treaties and agreements, trade can be constrained and national governments obliged to observe the rules of trade. The value of tradable carbon credits will be discounted or invalid if they do not meet these criteria, providing all parties with strong incentives to achieve the necessary performance standards relating to both processes and contracts. For carbon trading to develop social capital from natural capital requires the admission of forest communities into the polity and management of forest resources. In this paper we argue for responsible carbon-emission trading based on the clear and appropriate definition of carbon entitlements, with the proviso that trading respects the rights and needs of indigenous people. We adopt this position as emissions trading now seems inevitable and there should be proper rules to control this trade where it affects forests and their inhabitants. It is imperative that the poor and indigenous people are not excluded from these systems. Trading systems and the property systems they depend on need to be more accountable, transparent and inclusive of those features which we propose.
Health equity in humanitarian emergencies: a role for evidence aid.
Pottie, Kevin
2015-02-01
Humanitarian emergencies require a range of planned and coordinated actions: security, healthcare, and, as this article highlights, health equity responses. Health equity is an evidence-based science that aims to address unfair and unjust health inequality outcomes. New approaches are using health equity to guide the development of community programs, equity methods are being used to identify disadvantaged groups that may face health inequities in a humanitarian emergency, and equity is being used to prevent unintended harms and consequences in interventions. Limitations to health equity approaches include acquiring sufficient data to make equity interpretations, integrating disadvantage populations in to the equity approach, and ensuring buy-in from decision-makers. This article uses examples from World Health Organization, Refugee Health Guidelines and Health Impact Assessment to demonstrate the emerging role for health equity in humanitarian emergencies. It is based on a presentation at the Evidence Aid Symposium, on 20 September 2014, at Hyderabad, India. © 2015 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.
Engelmann, Carsten; Grote, Gudela; Geyer, Siegfried; Ametowobla, Dzifa
2017-02-01
Algorithms for surgical operation planning are evidence-based. However, choices sometimes have to be made between medically equal solutions e.g. for staffing of sought-after operations. Such decisions are heavily influenced by micropolitics and power. The article examines the array of highly manipulated processes around operation theatre allocation of convenient time slots or staff, which play out in various ways in all of the world's main regional surgical cultures. Essay supported by empiric data from an ethnographic power-analysis targeted to senior executive surgeons. Operations were categorized into "Interesting" (i.e. career-promoting) and "Uninteresting" (i.e. routine) operations. Fifty nine executives responded. Only one respondent contested the categorization of operations into Interesting and Uninteresting. The two categories were staffed according to significantly different criteria (p < 0.05). These were classified as Rational (e.g. "surgical expertise"), Social (e.g. "equity"), and Political (e.g. "status"). For Interesting operations, Rational criteria were deemed most relevant, while for the Uninteresting operations "equity" was ranked top. Moreover, we found significant differences between surgeons' and external observers' (experienced clerical and nursing staff) assessments of staffing decisions, the latter ranking Political motives higher. Decisions were almost exclusively negotiated among surgeons. 33% of respondents said they used subterfuges such as withholding information, incorrect duration-statements, and barter arrangements to defuse possible conflicts. Operating Lists are not merely the product of rational resource optimization. This article demonstrates the methodic feasibility of academic investigation into the typically tacit micro-political mechanisms in List-making. Developing such research further may potentially concern the practice and outcome of surgery.
Restructuring Primary Health Care Markets in New Zealand: from Welfare Benefits to Insurance Markets
Howell, Bronwyn
2005-01-01
Background New Zealand's Primary Health Care Strategy (NZPHCS) was introduced in 2002. Its features are substantial increases in government funding delivered as capitation payments, and newly-created service-purchasing agencies. The objectives are to reduce health disparities and to improve health outcomes. Analysis The NZPHCS changes New Zealand's publicly-funded primary health care payments from targeted welfare benefits to universal, risk-rated insurance premium subsidies. Patient contributions change from fee-for-service top-ups to insurance premium top-ups, and are collected by service providers who, depending upon their contracts with purchasers, may also be either insurance agents or risk-bearing insurance companies. The change invokes the tensions associated with allocating risk-bearing amongst providers, patients and insurance companies that accompany all insurance-based funding instruments. These include increases in existing incentives for over-consumption and new incentives for insurers to limit their exposure to variations in patient health states by engaging in active patient pool selection. The New Zealand scheme is complex, but closely resembles United States insurance-based, risk-rated managed care schemes. The key difference is that unlike classic managed care models, where provider remuneration is determined by the insurer, the historic right for general practitioners to autonomously set patient charges alters the fiscal incentives normally available to managed care organisations. Consequently, the insurance role is being devolved to individual service providers with very small patient pools, who must recoup the premium top-ups from insured individuals. Premium top-ups are being collected only from those individuals consuming care, in proportion to the number of times care is sought. Co-payments thus constitute perfectly risk-rated premium levies set by inefficiently small insurers, raising questions about the efficiency and equity of a 'universal' insurance system pooling total population demands and costs. The efficacy of using financial incentives to constrain costs and encourage innovation when providers retain the right to arbitrarily recoup costs directly from patients, is also questioned. Results Initial evidence suggests that total costs are higher than initially expected, and prices to some patients have risen substantially under the NZPHCS. Limited competition and NZPHCS governance requirements mean current institutional arrangements are unlikely to facilitate efficiency improvements. System design changes therefore appear indicated. PMID:16144544
Wiysonge, Charles S; Paulsen, Elizabeth; Lewin, Simon; Ciapponi, Agustín; Herrera, Cristian A; Opiyo, Newton; Pantoja, Tomas; Rada, Gabriel; Oxman, Andrew D
2017-09-11
One target of the Sustainable Development Goals is to achieve "universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all". A fundamental concern of governments in striving for this goal is how to finance such a health system. This concern is very relevant for low-income countries. To provide an overview of the evidence from up-to-date systematic reviews about the effects of financial arrangements for health systems in low-income countries. Secondary objectives include identifying needs and priorities for future evaluations and systematic reviews on financial arrangements, and informing refinements in the framework for financial arrangements presented in the overview. We searched Health Systems Evidence in November 2010 and PDQ-Evidence up to 17 December 2016 for systematic reviews. We did not apply any date, language, or publication status limitations in the searches. We included well-conducted systematic reviews of studies that assessed the effects of financial arrangements on patient outcomes (health and health behaviours), the quality or utilisation of healthcare services, resource use, healthcare provider outcomes (such as sick leave), or social outcomes (such as poverty, employment, or financial burden of patients, e.g. out-of-pocket payment, catastrophic disease expenditure) and that were published after April 2005. We excluded reviews with limitations important enough to compromise the reliability of the findings. Two overview authors independently screened reviews, extracted data, and assessed the certainty of evidence using GRADE. We prepared SUPPORT Summaries for eligible reviews, including key messages, 'Summary of findings' tables (using GRADE to assess the certainty of the evidence), and assessments of the relevance of findings to low-income countries. We identified 7272 reviews and included 15 in this overview, on: collection of funds (2 reviews), insurance schemes (1 review), purchasing of services (1 review), recipient incentives (6 reviews), and provider incentives (5 reviews). The reviews were published between 2008 and 2015; focused on 13 subcategories; and reported results from 276 studies: 115 (42%) randomised trials, 11 (4%) non-randomised trials, 23 (8%) controlled before-after studies, 51 (19%) interrupted time series, 9 (3%) repeated measures, and 67 (24%) other non-randomised studies. Forty-three per cent (119/276) of the studies included in the reviews took place in low- and middle-income countries. Collection of funds: the effects of changes in user fees on utilisation and equity are uncertain (very low-certainty evidence). It is also uncertain whether aid delivered under the Paris Principles (ownership, alignment, harmonisation, managing for results, and mutual accountability) improves health outcomes compared to aid delivered without conforming to those principles (very low-certainty evidence). Insurance schemes: community-based health insurance may increase service utilisation (low-certainty evidence), but the effects on health outcomes are uncertain (very low-certainty evidence). It is uncertain whether social health insurance improves utilisation of health services or health outcomes (very low-certainty evidence). Purchasing of services: it is uncertain whether increasing salaries of public sector healthcare workers improves the quantity or quality of their work (very low-certainty evidence). Recipient incentives: recipient incentives may improve adherence to long-term treatments (low-certainty evidence), but it is uncertain whether they improve patient outcomes. One-time recipient incentives probably improve patient return for start or continuation of treatment (moderate-certainty evidence) and may improve return for tuberculosis test readings (low-certainty evidence). However, incentives may not improve completion of tuberculosis prophylaxis, and it is uncertain whether they improve completion of treatment for active tuberculosis. Conditional cash transfer programmes probably lead to an increase in service utilisation (moderate-certainty evidence), but their effects on health outcomes are uncertain. Vouchers may improve health service utilisation (low-certainty evidence), but the effects on health outcomes are uncertain (very low-certainty evidence). Introducing a restrictive cap may decrease use of medicines for symptomatic conditions and overall use of medicines, may decrease insurers' expenditures on medicines (low-certainty evidence), and has uncertain effects on emergency department use, hospitalisations, and use of outpatient care (very low-certainty evidence). Reference pricing, maximum pricing, and index pricing for drugs have mixed effects on drug expenditures by patients and insurers as well as the use of brand and generic drugs. Provider incentives: the effects of provider incentives are uncertain (very low-certainty evidence), including: the effects of provider incentives on the quality of care provided by primary care physicians or outpatient referrals from primary to secondary care, incentives for recruiting and retaining health professionals to serve in remote areas, and the effects of pay-for-performance on provider performance, the utilisation of services, patient outcomes, or resource use in low-income countries. Research based on sound systematic review methods has evaluated numerous financial arrangements relevant to low-income countries, targeting different levels of the health systems and assessing diverse outcomes. However, included reviews rarely reported social outcomes, resource use, equity impacts, or undesirable effects. We also identified gaps in primary research because of uncertainty about applicability of the evidence to low-income countries. Financial arrangements for which the effects are uncertain include external funding (aid), caps and co-payments, pay-for-performance, and provider incentives. Further studies evaluating the effects of these arrangements are needed in low-income countries. Systematic reviews should include all outcomes that are relevant to decision-makers and to people affected by changes in financial arrangements.
Alternative Fuels Data Center: State Alternative Fuel and Advanced Vehicle
2017, the number of new state-level legislative, executive, private, and utility activities related to 2016 (54 total), but in line with previous years. The analysis below provides detail on trends in new (PEVs). Also consistent with recent prior years, new utility and private incentives primarily addressed
Measuring the Effectiveness of the Industrial Modernization Incentives Program (IMIP).
1985-09-01
nebulous to accurately measure. It is of interest to note that if "degree of improved readiness" could be defined and quantified, 100 percent of the...Make the Turtle Run?" Government Executive, Vol 14: 18-21 (October 1982). 19. Kluter, Major Eugene E., USAF. Producing More For Less: A Guide For
Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-08
... proposed rule change reflects a competitive pricing structure designed to incent market participants to... that the above pricing is appropriate since lower rates for Flag H executions are directly correlated... notes that it operates in a highly competitive market in which market participants can readily direct...
Principals' Group Seeks Influence on Incentive Pay
ERIC Educational Resources Information Center
Samuels, Christina A.
2008-01-01
School districts that want to start pay-for-performance programs for school leaders should look beyond high-stakes student tests as the primary measure for awarding bonuses, a position paper released last week by the National Association of Secondary School Principals says. Gerald N. Tirozzi, the executive director of the Reston, Virginia-based…
state executive and the militias commander-in-chief; the governor. This intrinsic dual control feature of our federal system of governance shapes the...ARNG’s values system and officer incentives structure, which in turn effects the prioritization of personnel and training readiness, and influences AC
Confronting the Equity "Learning Problem" through Practitioner Inquiry
ERIC Educational Resources Information Center
Ching, Cheryl D.
2018-01-01
This study examined how participation in an inquiry-based workshop on assessing course syllabi for equity-mindedness and cultural inclusivity fostered community college math faculty learning about racial/ethnic equity and equity-mindedness. Findings show that the workshop prompted reflection on what equity means and how participants' teaching…
Goldman, L Elizabeth; Henderson, Stuart; Dohan, Daniel P; Talavera, Jason A; Dudley, R Adams
2007-01-01
Safety-net hospitals (SNHs) may gain little financial benefit from the rapidly spreading adoption of public reporting and pay-for-performance, but may feel compelled to participate (and bear the costs of data collection) to meet public expectations of transparency and accountability. To better understand the concerns that SNH administrators have regarding public reporting and pay-for-performance, we interviewed 37 executives at randomly selected California SNHs. The main concerns noted by SNH executives were that human and financial resource constraints made it difficult for SNHs to accurately measure their performance. Additionally, some executives felt that market-driven public reporting and pay-for-performance may focus on clinical areas and incentive structures that may not be high-priority clinical areas for SNHs. Executives at SNHs suggested several policy responses to these concerns-such as offering training programs for SNH data collectors-that could be relatively inexpensive and might improve the cost-benefit ratio of public reporting and pay-for-performance programs.
Developing Agency for Equity-Minded Change
ERIC Educational Resources Information Center
Felix, Eric R.; Bensimon, Estela Mara; Hanson, Debbie; Gray, James; Klingsmith, Libby
2015-01-01
This chapter highlights the use of the Equity Scorecard with the Community College of Aurora. The Equity Scorecard is a theory-based strategy that assists community colleges in embedding equity into their institutional norms, practices, and policies.
Phuong, Nguyen Khanh; Oanh, Tran Thi Mai; Phuong, Hoang Thi; Tien, Tran Van; Cashin, Cheryl
2015-01-01
Provider payment arrangements are currently a core concern for Vietnam's health sector and a key lever for expanding effective coverage and improving the efficiency and equity of the health system. This study describes how different provider payment systems are designed and implemented in practice across a sample of provinces and districts in Vietnam. Key informant interviews were conducted with over 100 health policy-makers, purchasers and providers using a structured interview guide. The results of the different payment methods were scored by respondents and assessed against a set of health system performance criteria. Overall, the public health insurance agency, Vietnam Social Security (VSS), is focused on managing expenditures through a complicated set of reimbursement policies and caps, but the incentives for providers are unclear and do not consistently support Vietnam's health system objectives. The results of this study are being used by the Ministry of Health and VSS to reform the provider payment systems to be more consistent with international definitions and good practices and to better support Vietnam's health system objectives.
Milligan, Kevin; Stablie, Mark
2009-05-01
Industrial countries typically provide income transfers to families with young children. Traditionally, these family benefit programs were motivated by distributional concerns--families with children faced higher expenditure needs than other families, and a concern for horizontal equity led to transfers. Throughout the 1990s, however, many countries introduced benefits aimed at improving labor market incentives for mothers with young children. In the United States, the Earned Income Tax Credit (EITC) has played this role, but similar programs exist in Europe, Canada, and elsewhere. Much effort has been expended on evaluating the labor market impact of child benefits. However, less work has examined the impact of these programs on broader outcomes such as the mental and physical health of both the children and the parents, outcomes that follow from the traditional equity motivation for child benefits. In this paper, we review and extend some recent results studying the expansion of family benefits in Canada. In particular, we exploit a change that occurred in the province of Manitoba to highlight the effects of child benefits on both labor supply and family outcomes.
You have more capital than you think.
Merton, Robert C
2005-11-01
Senior executives typically delegate the responsibility for managing a firm's derivatives portfolio to in-house financial experts and the company's financial advisers. That's a strategic blunder, argues this Nobel laureate, because the inventiveness of modern financial markets makes it possible for companies to double or even triple their capacity to invest in their strategic assets and competencies. Risks fall into two categories: either a company adds value by assuming them on behalf of its shareholders or it does not. By hedging or insuring against non-value-adding risks with derivative securities and contracts, thereby removing them from what the author calls the risk balance sheet, managers can release equity capital for assuming more value-adding risk. This is not just a theoretical possibility. One innovation-the interest rate swap, introduced about 20 years ago-has already enabled the banking industry to dramatically increase its capacity for adding value to each dollar of invested equity capital. With the range of derivative instruments growing, there is no reason why other companies could not similarly remove strategic risks, potentially creating billions of dollars in shareholder value. The possibilities are especially important for private companies that have no access to public equity markets and therefore cannot easily increase their equity capital by issuing more shares. The author describes how derivative contracts of various kinds are already being employed strategically to mitigate or eliminate various risks. He also shows how companies can use the risk balance sheet to identify risks they should not bear directly and to determine how much equity capacity they can release for assuming more value-adding risk.
Do Professors Have Customer-Based Brand Equity?
ERIC Educational Resources Information Center
Jillapalli, Ravi K.; Jillapalli, Regina
2014-01-01
This research endeavors to understand whether certain professors have customer-based brand equity (CBBE) in the minds of students. Consequently, the purpose of this study is to conceptualize, develop, and empirically test a model of customer-based professor brand equity. Survey data gathered from 465 undergraduate business students were used to…
Wittich, Christopher M; Daniels, Wendlyn L; West, Colin P; Harris, Ann M; Beebe, Timothy J
2016-01-01
Background Most research on how to enhance response rates in physician surveys has been done using paper surveys. Uncertainties remain regarding how to enhance response rates in Internet-based surveys. Objective To evaluate the impact of a low-cost nonmonetary incentive and paper mail reminders (formal letter and postcard) on response rates in Internet-based physician surveys. Methods We executed a factorial-design randomized experiment while conducting a nationally representative Internet-based physician survey. We invited 3966 physicians (randomly selected from a commercial database of all licensed US physicians) via email to complete an Internet-based survey. We used 2 randomly assigned email messages: one message offered a book upon survey completion, whereas the other did not mention the book but was otherwise identical. All nonrespondents received several email reminders. Some physicians were further assigned at random to receive 1 reminder via paper mail (either a postcard or a letter) or no paper reminder. The primary outcome of this study was the survey response rate. Results Of the 3966 physicians who were invited, 451 (11.4%) responded to at least one survey question and 336 (8.5%) completed the entire survey. Of those who were offered a book, 345/2973 (11.6%) responded compared with 106/993 (10.7%) who were not offered a book (odds ratio 1.10, 95% CI 0.87-1.38, P=.42). Regarding the paper mail reminder, 168/1572 (10.7%) letter recipients, 148/1561 (9.5%) postcard recipients, and 69/767 (9.0%) email-only recipients responded (P=.35). The response rate for those receiving letters or postcards was similar (odds ratio 1.14, 95% CI 0.91-1.44, P=.26). Conclusions Offering a modest nonmonetary incentive and sending a paper reminder did not improve survey response rate. Further research on how to enhance response rates in Internet-based physician surveys is needed. PMID:27637296
Cook, David A; Wittich, Christopher M; Daniels, Wendlyn L; West, Colin P; Harris, Ann M; Beebe, Timothy J
2016-09-16
Most research on how to enhance response rates in physician surveys has been done using paper surveys. Uncertainties remain regarding how to enhance response rates in Internet-based surveys. To evaluate the impact of a low-cost nonmonetary incentive and paper mail reminders (formal letter and postcard) on response rates in Internet-based physician surveys. We executed a factorial-design randomized experiment while conducting a nationally representative Internet-based physician survey. We invited 3966 physicians (randomly selected from a commercial database of all licensed US physicians) via email to complete an Internet-based survey. We used 2 randomly assigned email messages: one message offered a book upon survey completion, whereas the other did not mention the book but was otherwise identical. All nonrespondents received several email reminders. Some physicians were further assigned at random to receive 1 reminder via paper mail (either a postcard or a letter) or no paper reminder. The primary outcome of this study was the survey response rate. Of the 3966 physicians who were invited, 451 (11.4%) responded to at least one survey question and 336 (8.5%) completed the entire survey. Of those who were offered a book, 345/2973 (11.6%) responded compared with 106/993 (10.7%) who were not offered a book (odds ratio 1.10, 95% CI 0.87-1.38, P=.42). Regarding the paper mail reminder, 168/1572 (10.7%) letter recipients, 148/1561 (9.5%) postcard recipients, and 69/767 (9.0%) email-only recipients responded (P=.35). The response rate for those receiving letters or postcards was similar (odds ratio 1.14, 95% CI 0.91-1.44, P=.26). Offering a modest nonmonetary incentive and sending a paper reminder did not improve survey response rate. Further research on how to enhance response rates in Internet-based physician surveys is needed.
How Have States Used Executive Orders to Address Public Health?
Gakh, Maxim; Callahan, Karen; Goodie, Aaliyah; Rutkow, Lainie
2018-06-07
Gubernatorial executive orders (GEOs) are important, yet poorly understood, public health tools. We analyzed health-related GEOs nationwide using a modified legal mapping approach. We searched Westlaw's Netscan Executive Orders database for orders issued between 2008 and 2014. Search terms were generated from the Healthy People 2020 Leading Health Indicators (LHIs). GEOs were screened with data abstracted and analyzed on the basis of LHIs, states, years, and characteristics identified in previous literature. We found differences in GEOs issued per LHI. Of the 303 unique orders, they ranged from 32 to 53 issued per year and 0 to 45 issued per state. Most GEOs managed governmental public health functions, required collaboration, and mandated studying problems. Fewer directly addressed health equity, chronic disease, and resource deployment. Gubernatorial authority and political and institutional factors appear relevant to GEO issuance. GEOs offer means to institute public health policies and should be considered by public health professionals.
Equity impact of interventions and policies to reduce smoking in youth: systematic review.
Brown, Tamara; Platt, Stephen; Amos, Amanda
2014-11-01
A systematic review to assess the equity impact of interventions/policies on youth smoking. Biosis, Cinahl, Cochrane Library, Conference Proceedings Citation Index, Embase, Eric, Medline, Psycinfo, Science Citation Index Expanded, Social Sciences Citation Index and tobacco control experts. Published January 1995 to October 2013. Primary studies of interventions/policies reporting smoking-related outcomes in youth (11-25 years) of lower compared to higher socioeconomic status (SES). References were screened and independently checked. Studies were quality assessed; characteristics and outcomes were extracted. A narrative synthesis by intervention/policy type. Equity impact was assessed as: positive (reduced inequity), neutral (no difference by SES), negative (increased inequity), mixed (equity impact varied) or unclear.Thirty-eight studies of 40 interventions/policies were included: smokefree (12); price/tax (7); mass media campaigns (1); advertising controls (4); access controls (5); school-based programmes (5); multiple policies (3), individual-level cessation support (2), individual-level support for smokefree homes (1). The distribution of equity effects was: 7 positive, 16 neutral, 12 negative, 4 mixed, 1 unclear. All 7 positive equity studies were US-based: price/tax (4), age-of-sales laws (2) and text-messaging cessation support (1). A British school-based intervention (A Stop Smoking in Schools Trial (ASSIST)) showed mixed equity effects (neutral and positive). Most neutral equity studies benefited all SES groups. Very few studies have assessed the equity impact of tobacco control interventions/policies on young people. Price/tax increases had the most consistent positive equity impact. There is a need to strengthen the evidence base for the equity impact of youth tobacco control interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Incentive Funding Meets Incentive-Based Budgeting: Can They Coexist?
ERIC Educational Resources Information Center
Lang, Daniel W.
2016-01-01
Two major developments in the financial management of higher education have occurred more or less contemporaneously: incentive or performance funding on the part of government and incentive-based budgeting on the part of institutions. Both are based on fiscal incentives. Despite their several inherent and interconnected similarities, incentive…
Welch, Vivian A; Akl, Elie A; Pottie, Kevin; Ansari, Mohammed T; Briel, Matthias; Christensen, Robin; Dans, Antonio; Dans, Leonila; Eslava-Schmalbach, Javier; Guyatt, Gordon; Hultcrantz, Monica; Jull, Janet; Katikireddi, Srinivasa Vittal; Lang, Eddy; Matovinovic, Elizabeth; Meerpohl, Joerg J; Morton, Rachael L; Mosdol, Annhild; Murad, M Hassan; Petkovic, Jennifer; Schünemann, Holger; Sharaf, Ravi; Shea, Bev; Singh, Jasvinder A; Solà, Ivan; Stanev, Roger; Stein, Airton; Thabaneii, Lehana; Tonia, Thomy; Tristan, Mario; Vitols, Sigurd; Watine, Joseph; Tugwell, Peter
2017-10-01
The aim of this paper is to describe a conceptual framework for how to consider health equity in the Grading Recommendations Assessment and Development Evidence (GRADE) guideline development process. Consensus-based guidance developed by the GRADE working group members and other methodologists. We developed consensus-based guidance to help address health equity when rating the certainty of synthesized evidence (i.e., quality of evidence). When health inequity is determined to be a concern by stakeholders, we propose five methods for explicitly assessing health equity: (1) include health equity as an outcome; (2) consider patient-important outcomes relevant to health equity; (3) assess differences in the relative effect size of the treatment; (4) assess differences in baseline risk and the differing impacts on absolute effects; and (5) assess indirectness of evidence to disadvantaged populations and/or settings. The most important priority for research on health inequity and guidelines is to identify and document examples where health equity has been considered explicitly in guidelines. Although there is a weak scientific evidence base for assessing health equity, this should not discourage the explicit consideration of how guidelines and recommendations affect the most vulnerable members of society. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
ERIC Educational Resources Information Center
Uebel, Henrik; Albrecht, Bjorn; Asherson, Philip; Borger, Norbert A.; Butler, Louise; Chen, Wai; Christiansen, Hanna; Heise, Alexander; Kuntsi, Jonna; Schafer, Ulrike; Andreou, Penny; Manor, Iris; Marco, Rafaela; Miranda, Ana; Mulligan, Aisling; Oades, Robert D.; van der Meere, Jaap; Faraone, Stephen V.; Rothenberger, Aribert; Banaschewski, Tobias
2010-01-01
Background: Attention-deficit hyperactivity disorder (ADHD) is one of the most common and highly heritable child psychiatric disorders. There is strong evidence that children with ADHD show slower and more variable responses in tasks such as Go/Nogo tapping aspects of executive functions like sustained attention and response control which may be…
Federal Register 2010, 2011, 2012, 2013, 2014
2012-10-11
... reflects a competitive pricing structure designed to incent market participants to direct their order flow... ROUC \\5\\ routing strategy and executes at non-exchange destinations. The pricing of Flag Q is also... qualifying for additional volume tiered pricing. The Exchange offered Members a rebate of $0.0014 per share...
Capa, Rémi L; Bouquet, Cédric A; Dreher, Jean-Claude; Dufour, André
2013-01-01
Motivation is often thought to interact consciously with executive control, although recent studies have indicated that motivation can also be unconscious. To date, however, the effects of unconscious motivation on high-order executive control functions have not been explored. Only a few studies using subliminal stimuli (i.e., those not related to motivation, such as an arrow to prime a response) have reported short-lived effects on high-order executive control functions. Here, building on research on unconscious motivation, in which a behavior of perseverance is induced to attain a goal, we hypothesized that subliminal motivation can have long-lasting effects on executive control processes. We investigated the impact of unconscious/conscious monetary reward incentives on evoked potentials and neural activity dynamics during cued task-switching performance. Participants performed long runs of task-switching. At the beginning of each run, a reward (50 cents or 1 cent) was displayed, either subliminally or supraliminally. Participants earned the reward contingent upon their correct responses to each trial of the run. A higher percentage of runs was achieved with higher (conscious and unconscious) than lower rewards, indicating that unconscious high rewards have long-lasting behavioral effects. Event-related potential (ERP) results indicated that unconscious and conscious rewards influenced preparatory effort in task preparation, as suggested by a greater fronto-central contingent negative variation (CNV) starting at cue-onset. However, a greater parietal P3 associated with better reaction times (RTs) was observed only under conditions of conscious high reward, suggesting a larger amount of working memory invested during task performance. Together, these results indicate that unconscious and conscious motivations are similar at early stages of task-switching preparation but differ during task performance. Copyright © 2012 Elsevier Ltd. All rights reserved.
Kuntsche, S.; Knibbe, R.A.; Kuntsche, E.; Gmel, G.
2011-01-01
Aims To investigate whether differences in gender-income equity at country level explain national differences in the links between alcohol use, and the combination of motherhood and paid labour. Design Cross-sectional data in 16 established market economies participating in the GenACIS study Setting Population surveys Participants 12,454 mothers (aged 24 to 49). Measurements Alcohol use was assessed as the quantity per drinking day. Paid labour, having a partner, gender-income ratio at country level, and the interaction between individual and country characteristics were regressed on alcohol consumed per drinking day using multilevel modelling. Findings Mothers with a partner who were in paid labour reported consuming more alcohol on drinking days than partnered housewives. In countries with high gender-income equity, mothers with a partner who were in paid labour drank less alcohol per occasion, while alcohol use was higher among working partnered mothers living in countries with lower income equity. Conclusion In countries which facilitate working mothers, daily alcohol use decreases as female social roles increase; in contrast, in countries where there are fewer incentives for mothers to remain in work, the protective effect of being a working mother (with partner) on alcohol use is weaker. These data suggest that a country’s investment in measures to improve the compatibility of motherhood and paid labour may reduce women’s alcohol use. PMID:21615581
Ward, Kim; Sanders, David; Leng, Henry; Pollock, Allyson M
2014-07-01
To investigate equity in the geographical distribution of community pharmacies in South Africa and assess whether regulatory reforms have furthered such equity. Data on community pharmacies from the national department of health and the South African pharmacy council were used to analyse the change in community pharmacy ownership and density (number per 10,000 residents) between 1994 and 2012 in all nine provinces and 15 selected districts. In addition, the density of public clinics, alone and with community pharmacies, was calculated and compared with a national benchmark of one clinic per 10,000 residents. Interviews were conducted with nine national experts from the pharmacy sector. Community pharmacies increased in number by 13% between 1994 and 2012--less than the 25% population growth. In 2012, community pharmacy density was higher in urban provinces and was eight times higher in the least deprived districts than in the most deprived ones. Maldistribution persisted despite the growth of corporate community pharmacies. In 2012, only two provinces met the 1 per 10,000 benchmark, although all provinces achieved it when community pharmacies and clinics were combined. Experts expressed concerns that a lack of rural incentives, inappropriate licensing criteria and a shortage of pharmacy workers could undermine access to pharmaceutical services, especially in rural areas. To reduce inequity in the distribution of pharmaceutical services, new policies and legislation are needed to increase the staffing and presence of pharmacies.
Outcome-based and Participation-based Wellness Incentives
Barleen, Nathan A.; Marzec, Mary L.; Boerger, Nicholas L.; Moloney, Daniel P.; Zimmerman, Eric M.; Dobro, Jeff
2017-01-01
Objective: This study examined whether worksite wellness program participation or achievement of health improvement targets differed according to four incentive types (participation-based, hybrid, outcome-based, and no incentive). Methods: The study included individuals who completed biometric health screenings in both 2013 and 2014 and had elevated metrics in 2013 (baseline year). Multivariate logistic regression modeling tested for differences in odds of participation and achievement of health improvement targets between incentive groups; controlling for demographics, employer characteristics, incentive amounts, and other factors. Results: No statistically significant differences between incentive groups occurred for odds of participation or achievement of health improvement target related to body mass index, blood pressure, or nonhigh-density lipoprotein cholesterol. Conclusions: Given the null findings of this study, employers cannot assume that outcome-based incentives will result in either increased program participation or greater achievement of health improvement targets than participation-based incentives. PMID:28146041
Thomopoulos, N; Grant-Muller, S; Tight, M R
2009-11-01
Interest has re-emerged on the issue of how to incorporate equity considerations in the appraisal of transport projects and large road infrastructure projects in particular. This paper offers a way forward in addressing some of the theoretical and practical concerns that have presented difficulties to date in incorporating equity concerns in the appraisal of such projects. Initially an overview of current practice within transport regarding the appraisal of equity considerations in Europe is offered based on an extensive literature review. Acknowledging the value of a framework approach, research towards introducing a theoretical framework is then presented. The proposed framework is based on the well established MCA Analytic Hierarchy Process and is also contrasted with the use of a CBA based approach. The framework outlined here offers an additional support tool to decision makers who will be able to differentiate choices based on their views on specific equity principles and equity types. It also holds the potential to become a valuable tool for evaluators as a result of the option to assess predefined equity perspectives of decision makers against both the project objectives and the estimated project impacts. This framework may also be of further value to evaluators outside transport.
24 CFR 241.1010 - Feasibility letter.
Code of Federal Regulations, 2010 CFR
2010-04-01
... SUPPLEMENTARY FINANCING FOR INSURED PROJECT MORTGAGES Insurance for Equity Loans and Acquisition Loans... Commissioner's estimate of the supportable loan amount, based upon the project's equity in the case of an equity loan and based on the project's purchase price in the case of an acquisition loan, but such...
The Canada Pension Plan's experience with investing its portfolio in equities.
Sarney, M; Preneta, A M
For the past few years, the Canada Pension Plan (CPP) has been investing some of its assets in equities. Without changes, an imbalance between revenues and outlays would exhaust the CPP reserve fund by 2015. Creating an entity that was independent of government was one of several changes the federal and provincial governments enacted to achieve fuller funding. The governments created an independent Investment Board (the CPP Investment Board, or "CPPIB") to oversee the new investments. Because the plan already owned a large government bond portfolio, the CPPIB decided to invest new CPP funds in broad equity indices in March 1999. In 2000, the CPPIB began actively investing a portion of the CPP funds. Key features of that policy and some observations about its implementation include the following: In addition to investing CPP revenues in equities, reform also included contribution rate increases, benefit reductions, and a financing stabilizer. The new investment policy accounted for 25 percent of the total effect of all the reforms. It is premature to know if the investments will achieve their long-term performance objective. The new equity investments are projected by the Chief Actuary, in his most recent Actuarial Report, to earn a 4.5 percent real rate of return on Canadian equity and 5.0 percent real return on foreign equity for a blended real return of 4.65 percent based on an equity mix of 70 percent Canadian and 30 percent non-Canadian. However, it is too early to tell if the equity investments will achieve that goal over the long run. The Investment Board's mandate is to maximize returns. The Investment Board, which oversees the CPP's new investments, has broad discretion to pursue maximum returns on its assets without incurring undue risk of loss while keeping in mind the financial obligations and other assets of the CPP. Furthermore, it has developed into a professional investment organization staffed with private-sector experts in finance and investment. The board is designed to be independent of government. The federal and provincial governments designed the board to operate at arm's length from themselves. The process for selecting directors includes public- and private-sector participation, and the board is in compliance with several sets of governance guidelines for corporations. CPPIB management, with the support of its board of directors, has decided to implement a virtual corporation model involving a small team of senior executives setting strategies for implementation primarily by external professional firms. Consequently, as a virtual corporation, the board currently relies on external fund managers to make investments and vote proxies. Several measures are designed to ensure accountability to the public. The investment legislation subjects the board to overlapping layers of oversight to ensure accountability to the public. The features of this oversight include public meetings in each province as well as quarterly statements and annual reports to Parliament, the federal and provincial finance ministers, and the public. The 10 finance ministers review the CPPIB's mandate and regulations every 3 years, and the CPPIB is subject to a special examination every 6 years by an auditor appointed by the Federal Minister of Finance.
Ong, Katherine S; Kelaher, Margaret; Anderson, Ian; Carter, Rob
2009-01-01
Background Efficiency and equity are both important policy objectives in resource allocation. The discipline of health economics has traditionally focused on maximising efficiency, however addressing inequities in health also requires consideration. Methods to incorporate equity within economic evaluation techniques range from qualitative judgements to quantitative outcomes-based equity weights. Yet, due to definitional uncertainties and other inherent limitations, no method has been universally adopted to date. This paper proposes an alternative cost-based equity weight for use in the economic evaluation of interventions delivered from primary health care services. Methods Equity is defined in terms of 'access' to health services, with the vertical equity objective to achieve 'equitable access for unequal need'. Using the Australian Indigenous population as an illustrative case study, the magnitude of the equity weight is constructed using the ratio of the costs of providing specific interventions via Indigenous primary health care services compared with the costs of the same interventions delivered via mainstream services. Applying this weight to the costs of subsequent interventions deflates the costs of provision via Indigenous health services, and thus makes comparisons with mainstream more equitable when applied during economic evaluation. Results Based on achieving 'equitable access', existing measures of health inequity are suitable for establishing 'need', however the magnitude of health inequity is not necessarily proportional to the magnitude of resources required to redress it. Rather, equitable access may be better measured using appropriate methods of health service delivery for the target group. 'Equity of access' also suggests a focus on the processes of providing equitable health care rather than on outcomes, and therefore supports application of equity weights to the cost side rather than the outcomes side of the economic equation. Conclusion Cost-based weights have the potential to provide a pragmatic method of equity weight construction which is both understandable to policy makers and sensitive to the needs of target groups. It could improve the evidence base for resource allocation decisions, and be generalised to other disadvantaged groups who share similar concepts of equity. Development of this decision-making tool represents a potentially important avenue for further health economics research. PMID:19807930
U.S. Energy Service Company (ESCO) Industry: Recent Market Trends
DOE Office of Scientific and Technical Information (OSTI.GOV)
Stuart, Elizabeth; Larsen, Peter H.; Carvallo, Juan Pablo
This study presents an analysis of the market size, growth projections and industry trends of the U.S. Energy Service Company (ESCO) industry, drawing on information provided by ESCO executives in late 2015. We define ESCOs as energy service companies for whom performance-based contracting is a core business offering. We identified forty-seven firms that met our definition of an ESCO.1 Forty-three of these companies responded to our requests for information, representing a 91% response rate.2 We also report 2014 ESCO industry revenues by market segment, region and business activity type, and for new versus existing customers. Finally, we report on usemore » of tax incentives and financing tools, and incorporation of non-energy benefits into performance-based project economics. We summarize key findings below.« less
ERIC Educational Resources Information Center
Luna, Gaye
1990-01-01
Traces the history of laws and litigation concerning pay equity issues, also referred to as wage equity and comparable worth. Suggests that universities and colleges identify possible problems and take voluntary corrective measures before pay-equity problems arise. (MLF)
Conducting "Good" Equity Research in Mathematics Education: A Question of Methodology
ERIC Educational Resources Information Center
Bullock, Erika C.
2012-01-01
Hostetler (2005) describes "good" education research as that which attends to the well-being of students, teachers, and communities. In this essay, the author proposes measuring equity-based research in mathematics education against Hostetler's standard. She argues that current equity-based research has not adequately addressed the…
Chung, Tammy; Geier, Charles; Luna, Beatriz; Pajtek, Stefan; Terwilliger, Robert; Thatcher, Dawn; Clark, Duncan
2010-01-01
Effective response inhibition is a key component of recovery from addiction. Some research suggests that response inhibition can be enhanced through reward contingencies. We examined the effect of monetary incentive on response inhibition among adolescents with and without substance use disorder (SUD) using a fast event-related fMRI antisaccade reward task. The fMRI task permits investigation of how reward (monetary incentive) might modulate inhibitory control during three task phases: cue presentation (reward or neutral trial), response preparation, and response execution. Adolescents with lifetime SUD (n=12; 100% marijuana use disorder) were gender and age-matched to healthy controls (n=12). Monetary incentive facilitated inhibitory control for SUD adolescents; for healthy controls, the difference in error rate for neutral and reward trials was not significant. There were no significant differences in behavioral performance between groups across reward and neutral trials, however, group differences in regional brain activation were identified. During the response preparation phase of reward trials, SUD adolescents, compared to controls, showed increased activation of prefrontal and oculomotor control (e.g., frontal eye field) areas, brain regions that have been associated with effective response inhibition. Results indicate differences in brain activation between SUD and control youth when preparing to inhibit a prepotent response in the context of reward, and support a possible role for incentives in enhancing response inhibition among youth with SUD. PMID:21115229
Hospital reimbursement incentives: is there a more effective option?--Part II.
Weil, Thomas P
2013-01-01
As discussed in Part I of this article, hospital executives in Canada, Germany, and the United States manage their facilities' resources to maximize the incentives inherent in their respective reimbursement system and thereby increase their bottom line. It was also discussed that an additional supply of available hospitals, physicians, and other services will generate increased utilization. Part II discusses how the Patient Protection and Affordable Care Act of 2010 will eventually fail since it neither controls prices nor utilization (e.g., imaging, procedures, ambulatory surgery, discretionary spending). This article concludes with the discussion of the German multipayer approach with universal access and global budgets that might well be a model for U.S. healthcare in the future. Although the German healthcare system has a number of shortfalls, its paradigm could offer the most appropriate compromise when selecting the economic incentives to reduce the percentage of the U.S. gross domestic product expenditure for healthcare from 17.4% to roughly 12.0%.
Collaborative Inquiry for Equity: Discipline and Discomfort
ERIC Educational Resources Information Center
Winkelman, Peg
2012-01-01
In this study the discipline of collaborative inquiry is employed to prepare aspiring administrators to lead for equity. Educational leadership students are required to conduct a site-based collaborative inquiry resulting in an Equity Plan signature assignment. As they develop their Equity Plans, emerging leaders also participate in a…
The Tensions between Shared Governance and Advancing Educational Equity
ERIC Educational Resources Information Center
Castagno, Angelina E.; Hausman, Charles
2017-01-01
This article examines the relationship between shared governance and one school district's (in)ability to advance educational equity. Specifically, we consider the district's policies, discourse, and practice around equity within the context of site-based management and shared decision making. We suggest that if equity is indeed a major district…
Design and analysis of electricity markets
NASA Astrophysics Data System (ADS)
Sioshansi, Ramteen Mehr
Restructured competitive electricity markets rely on designing market-based mechanisms which can efficiently coordinate the power system and minimize the exercise of market power. This dissertation is a series of essays which develop and analyze models of restructured electricity markets. Chapter 2 studies the incentive properties of a co-optimized market for energy and reserves that pays reserved generators their implied opportunity cost---which is the difference between their stated energy cost and the market-clearing price for energy. By analyzing the market as a competitive direct revelation mechanism we examine the properties of efficient equilibria and demonstrate that generators have incentives to shade their stated costs below actual costs. We further demonstrate that the expected energy payments of our mechanism is less than that in a disjoint market for energy only. Chapter 3 is an empirical validation of a supply function equilibrium (SFE) model. By comparing theoretically optimal supply functions and actual generation offers into the Texas spot balancing market, we show the SFE to fit the actual behavior of the largest generators in market. This not only serves to validate the model, but also demonstrates the extent to which firms exercise market power. Chapters 4 and 5 examine equity, incentive, and efficiency issues in the design of non-convex commitment auctions. We demonstrate that different near-optimal solutions to a central unit commitment problem which have similar-sized optimality gaps will generally yield vastly different energy prices and payoffs to individual generators. Although solving the mixed integer program to optimality will overcome such issues, we show that this relies on achieving optimality of the commitment---which may not be tractable for large-scale problems within the allotted timeframe. We then simulate and compare a competitive benchmark for a market with centralized and self commitment in order to bound the efficiency losses stemming from coordination losses (cost of anarchy) in a decentralized market.
ERIC Educational Resources Information Center
Greenberg, David; Dechausay, Nadine; Fraker, Carolyn
2011-01-01
In 2007, New York City's Center for Economic Opportunity launched Opportunity NYC-Family Rewards, an experimental, privately funded, conditional cash transfer (CCT) program to help families break the cycle of poverty. Family Rewards provided payments to low-income families in six of the city's poorest communities for achieving specific goals…
Ohio's Public Colleges Lure Businesses with the Promise of a Skilled Work Force
ERIC Educational Resources Information Center
Fischer, Karin
2008-01-01
When NetJets, a private aviation company, announced it would keep and expand its operational headquarters in Ohio, Richard T. Santulli, chairman and chief executive, didn't give credit to tax breaks or any of the other incentives states and cities typically use to woo or retain corporations. Instead, he said the critical factor was the state's…
Brown, Tamara; Platt, Stephen; Amos, Amanda
2014-05-01
There is strong evidence about which tobacco control policies reduce smoking. However, their equity impact is uncertain. The aim was to assess the effectiveness of population-level interventions/policies to reduce socioeconomic inequalities in adult smoking. Systematic review of studies of population-level interventions/policies reporting smoking-related outcomes in adults of lower compared to higher socioeconomic status (SES). References were screened and independently checked. Studies were quality assessed. Results are presented in a narrative synthesis. Equity impact was assessed as: positive (reduced inequality), neutral (no difference by SES), negative (increased inequality), mixed (equity impact varied) or unclear. 117 studies of 130 interventions/policies were included: smokefree (44); price/tax (27); mass media campaigns (30); advertising controls (9); cessation support (9); settings-based interventions (7); multiple policies (4). The distribution of equity effects was: 33 positive, 36 neutral, 38 negative, 6 mixed, 17 unclear. Most neutral equity studies benefited all SES groups. Fourteen price/tax studies were equity positive. Voluntary, regional and partial smokefree policies were more likely to be equity negative than national, comprehensive smokefree policies. Mass media campaigns had inconsistent equity effects. Cigarette marketing controls were equity positive or neutral. Targeted national smoking cessation services can be equity positive by achieving higher reach among low SES, compensating for lower quit rates. Few studies have assessed the equity impact of tobacco control policy/interventions. Price/tax increases had the most consistent positive equity impact. More research is needed to strengthen the evidence-base for reducing smoking inequalities and to develop effective equity-orientated tobacco control strategies. Copyright © 2014. Published by Elsevier Ireland Ltd.
Financial arrangements for health systems in low-income countries: an overview of systematic reviews
Wiysonge, Charles S; Paulsen, Elizabeth; Lewin, Simon; Ciapponi, Agustín; Herrera, Cristian A; Opiyo, Newton; Pantoja, Tomas; Rada, Gabriel; Oxman, Andrew D
2017-01-01
Background One target of the Sustainable Development Goals is to achieve "universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all". A fundamental concern of governments in striving for this goal is how to finance such a health system. This concern is very relevant for low-income countries. Objectives To provide an overview of the evidence from up-to-date systematic reviews about the effects of financial arrangements for health systems in low-income countries. Secondary objectives include identifying needs and priorities for future evaluations and systematic reviews on financial arrangements, and informing refinements in the framework for financial arrangements presented in the overview. Methods We searched Health Systems Evidence in November 2010 and PDQ-Evidence up to 17 December 2016 for systematic reviews. We did not apply any date, language, or publication status limitations in the searches. We included well-conducted systematic reviews of studies that assessed the effects of financial arrangements on patient outcomes (health and health behaviours), the quality or utilisation of healthcare services, resource use, healthcare provider outcomes (such as sick leave), or social outcomes (such as poverty, employment, or financial burden of patients, e.g. out-of-pocket payment, catastrophic disease expenditure) and that were published after April 2005. We excluded reviews with limitations important enough to compromise the reliability of the findings. Two overview authors independently screened reviews, extracted data, and assessed the certainty of evidence using GRADE. We prepared SUPPORT Summaries for eligible reviews, including key messages, 'Summary of findings' tables (using GRADE to assess the certainty of the evidence), and assessments of the relevance of findings to low-income countries. Main results We identified 7272 reviews and included 15 in this overview, on: collection of funds (2 reviews), insurance schemes (1 review), purchasing of services (1 review), recipient incentives (6 reviews), and provider incentives (5 reviews). The reviews were published between 2008 and 2015; focused on 13 subcategories; and reported results from 276 studies: 115 (42%) randomised trials, 11 (4%) non-randomised trials, 23 (8%) controlled before-after studies, 51 (19%) interrupted time series, 9 (3%) repeated measures, and 67 (24%) other non-randomised studies. Forty-three per cent (119/276) of the studies included in the reviews took place in low- and middle-income countries. Collection of funds: the effects of changes in user fees on utilisation and equity are uncertain (very low-certainty evidence). It is also uncertain whether aid delivered under the Paris Principles (ownership, alignment, harmonisation, managing for results, and mutual accountability) improves health outcomes compared to aid delivered without conforming to those principles (very low-certainty evidence). Insurance schemes: community-based health insurance may increase service utilisation (low-certainty evidence), but the effects on health outcomes are uncertain (very low-certainty evidence). It is uncertain whether social health insurance improves utilisation of health services or health outcomes (very low-certainty evidence). Purchasing of services: it is uncertain whether increasing salaries of public sector healthcare workers improves the quantity or quality of their work (very low-certainty evidence). Recipient incentives: recipient incentives may improve adherence to long-term treatments (low-certainty evidence), but it is uncertain whether they improve patient outcomes. One-time recipient incentives probably improve patient return for start or continuation of treatment (moderate-certainty evidence) and may improve return for tuberculosis test readings (low-certainty evidence). However, incentives may not improve completion of tuberculosis prophylaxis, and it is uncertain whether they improve completion of treatment for active tuberculosis. Conditional cash transfer programmes probably lead to an increase in service utilisation (moderate-certainty evidence), but their effects on health outcomes are uncertain. Vouchers may improve health service utilisation (low-certainty evidence), but the effects on health outcomes are uncertain (very low-certainty evidence). Introducing a restrictive cap may decrease use of medicines for symptomatic conditions and overall use of medicines, may decrease insurers' expenditures on medicines (low-certainty evidence), and has uncertain effects on emergency department use, hospitalisations, and use of outpatient care (very low-certainty evidence). Reference pricing, maximum pricing, and index pricing for drugs have mixed effects on drug expenditures by patients and insurers as well as the use of brand and generic drugs. Provider incentives: the effects of provider incentives are uncertain (very low-certainty evidence), including: the effects of provider incentives on the quality of care provided by primary care physicians or outpatient referrals from primary to secondary care, incentives for recruiting and retaining health professionals to serve in remote areas, and the effects of pay-for-performance on provider performance, the utilisation of services, patient outcomes, or resource use in low-income countries. Authors' conclusions Research based on sound systematic review methods has evaluated numerous financial arrangements relevant to low-income countries, targeting different levels of the health systems and assessing diverse outcomes. However, included reviews rarely reported social outcomes, resource use, equity impacts, or undesirable effects. We also identified gaps in primary research because of uncertainty about applicability of the evidence to low-income countries. Financial arrangements for which the effects are uncertain include external funding (aid), caps and co-payments, pay-for-performance, and provider incentives. Further studies evaluating the effects of these arrangements are needed in low-income countries. Systematic reviews should include all outcomes that are relevant to decision-makers and to people affected by changes in financial arrangements. Financial arrangements for health systems in low-income countries What is the aim of this overview? The aim of this Cochrane Overview is to provide a broad summary of what is known about the effects of financial arrangements for health systems in low-income countries. This overview is based on 15 systematic reviews. Each of these systematic reviews searched for studies that evaluated different types of financial arrangements within the scope of the review question. The reviews included a total of 276 studies. This overview is one of a series of four Cochrane Overviews that evaluate different health system arrangements. Main results What are the effects of different ways of collecting funds to pay for health services? Two reviews looked for studies that addressed this question and found the following. - The effects of changes in user fees on utilisation and equity are uncertain (very low-certainty evidence). - It is uncertain whether aid delivered under Paris Principles (ownership, alignment, harmonisation, managing for results, and mutual accountability) improves health compared to aid delivered without conforming to those principles (very low-certainty evidence). What are the effects of different types of insurance schemes? One systematic review looked for studies that addressed this question and found the following. - Community-based health insurance may increase people's use of services (low-certainty evidence), but the effects on people's health are uncertain. It is uncertain whether social health insurance increases people's use of services (very low-certainty evidence). What are the effects of different ways of paying for health services? One systematic review looked for studies that addressed this question and found the following. - It is uncertain whether increasing salaries of public sector healthcare workers improves the quantity or quality of their work. What are the effects of different types of financial incentives for recipients of care? Six systematic reviews looked for studies that addressed this question and found the following. - Giving healthcare recipients incentives may improve their adherence to long-term treatments (low-certainty evidence), but it is uncertain whether they improve people's health. - Giving healthcare recipients one-time incentives probably leads more people to return to start or continue treatment for tuberculosis (moderate-certainty evidence). The certainty of the evidence for other types of recipient incentives for tuberculosis is low or very low. - Conditional cash transfer programmes (giving money to recipients of care on the condition that they take a specified action to improve their health) probably increase people's use of services (moderate-certainty evidence), but have mixed effect on people's health. - Vouchers may improve people's use of health services (low-certainty evidence) but have mixed effects on people's health (low-certainty evidence). - A combination of a ceiling and co-insurance probably slightly decreases the overall use of medicines (moderate-certainty evidence) and may increase health service utilisation (low-certainty evidence). The certainty of the evidence for the effects of other combinations of caps, co-insurance, co-payments, and ceilings is low or very low. - Limits on how much insurers pay for different groups of drugs (reference pricing, maximum pricing, and index pricing) have mixed effects on drug expenditures by patients and insurers as well as the use of brand and generic drugs. What are the effects of different types of financial incentives for health workers? Five systematic reviews looked for studies that addressed this question and found the following. - We are uncertain whether pay-for-performance improves health worker performance, people's use of services, people's health, or resource use in low-income countries (very low-certainty evidence). - We are uncertain whether financial incentives for health workers improve the quality of care provided by primary care physicians or outpatient referrals from primary to secondary care (very low-certainty evidence). - There is no rigorous research evaluating incentives (e.g. bursaries or scholarships linked to future practice location, rural allowances) for recruiting health workers to serve in remote areas. It is uncertain whether giving health workers incentives lead more of them to stay in underserved areas (very low-certainty evidence). - No studies assessed the effects of financial interventions on the movement of health workers between public and private organisations in low- and middle-income countries. How up to date is this overview? The overview authors searched for systematic reviews published up to 17 December 2016. PMID:28891235
Income-based equity impacts of congestion pricing
DOT National Transportation Integrated Search
2008-12-01
This equity primer was produced to examine the impacts of congestion pricing on low-income groups, public opinion as expressed by various income groups, and ways to mitigate the equity impacts of congestion pricing
Income-based equity impacts of congestion pricing.
DOT National Transportation Integrated Search
2008-12-01
This equity primer was produced to examine the impacts of congestion pricing on low-income groups, public opinion as expressed by various income groups, and ways to mitigate the equity impacts of congestion pricing.
ERIC Educational Resources Information Center
Merit Systems Protection Board, Washington, DC.
An investigation of the process for career progression in the federal white-collar work force examined the nature and extent of any barriers women may confront in that process. It included data from three sources: U.S. Office of Personnel Management's Central Personnel Data File; 19 focus groups with 144 senior level and senior executive men and…
Bonfrer, Igna; Soeters, Robert; Van de Poel, Ellen; Basenya, Olivier; Longin, Gashubije; van de Looij, Frank; van Doorslaer, Eddy
2014-12-01
Several governments in low- and middle-income countries have adopted performance-based financing to increase health care use and improve the quality of health services. We evaluated the effects of performance-based financing in the central African nation of Burundi by exploiting the staggered rollout of this financing across provinces during 2006-10. We found that performance-based financing increased the share of women delivering their babies in an institution by 22 percentage points, which reflects a relative increase of 36 percent, and the share of women using modern family planning services by 5 percentage points, a relative change of 55 percent. The overall quality score for health care facilities increased by 45 percent during the study period, but performance-based financing was found to have no effect on the quality of care as reported by patients. We did not find strong evidence of differential effects of performance-based financing across socioeconomic groups. The performance-based financing effects on the probability of using care when ill were found to be even smaller for the poor. Our findings suggest that a supply-side intervention such as performance-based financing without accompanying access incentives for poor people is unlikely to improve equity. More research into the cost-effectiveness of performance-based financing and how best to target vulnerable populations is warranted. Project HOPE—The People-to-People Health Foundation, Inc.
Beery, Joshua A; Day, Jennifer E
2015-03-03
Wind energy development is an increasingly popular form of renewable energy infrastructure in rural areas. Communities generally perceive socioeconomic benefits accrue and that community funding structures are preferable to corporate structures, yet lack supporting quantitative data to inform energy policy. This study uses the Everpower wind development, to be located in Midwestern Ohio, as a hypothetical modeling environment to identify and examine socioeconomic impact trends arising from corporate, community and diversified funding structures. Analysis of five National Renewable Energy Laboratory Jobs and Economic Development Impact models incorporating local economic data and review of relevant literature were conducted. The findings suggest that community and diversified funding structures exhibit 40-100% higher socioeconomic impact levels than corporate structures. Prioritization of funding sources and retention of federal tax incentives were identified as key elements. The incorporation of local shares was found to mitigate the negative effects of foreign private equity, local debt financing increased economic output and opportunities for private equity investment were identified. The results provide the groundwork for energy policies focused to maximize socioeconomic impacts while creating opportunities for inclusive economic participation and improved social acceptance levels fundamental to the deployment of renewable energy technology.
Equity in Standards-Based Elementary Mathematics Classrooms. Weaving Gender Equity into Math Reform.
ERIC Educational Resources Information Center
Perez, Christina
This article discusses the issue of equity in standards-based elementary mathematics classrooms. It is argued that while some of the gaps in mathematics achievement have slowly diminished (e.g., differences in mathematics grades and participation rates between girls and boys in K-12 education have decreased), others remain intractable. Other…
Coupling Financial Incentives With Direct Mail in Population-Based Practice.
Slater, Jonathan S; Parks, Michael J; Malone, Michael E; Henly, George A; Nelson, Christina L
2017-02-01
Financial incentives are being used increasingly to encourage a wide array of health behaviors because of their well-established efficacy. However, little is known about how to translate incentive-based strategies to public health practice geared toward improving population-level health, and a dearth of research exists on how individuals respond to incentives through public health communication strategies such as direct mail. This study reports results of a population-based randomized controlled trial testing a direct mail, incentive-based intervention for promoting mammography uptake. The study population was composed of a random sample of Minnesota women enrolled in Medicare fee-for-service and overdue for breast cancer screening. Participants ( N = 18,939) were randomized into three groups: (1) Direct Mail only, (2) Direct Mail plus Incentive, and (3) Control. Both direct mail groups received two mailers with a message about the importance of mammography; however, Mail plus Incentive mailers also offered a $25 incentive for getting a mammogram. Logistic regression analyses measured intervention effects. Results showed the odds for receiving mammography were significantly higher for the Direct Mail plus Incentive group compared with both Direct Mail only and Control groups. The use of incentives also proved to be cost-effective. Additionally, the Direct Mail only group was more likely to receive mammography than the Control group. Findings offer experimental evidence on how the population-based strategy of direct mail coupled with a financial incentive can encourage healthy behavior, as well as how incentive-based programs can be translated into health promotion practice aimed at achieving population-level impact.
The ideal physician entrepreneur.
Bottles, K
2000-01-01
How does the sometimes elusive and high-stakes world of venture capital really work? How can physician executives with innovative ideas or new technologies approach venture capitalists to help them raise capital to form a start-up company? These important questions are explored in this new column on the physician as entrepreneur. The ideal physician executive is described as: (1) an expert in an area that Wall Street perceives as hot; (2) a public speaker who can enthusiastically communicate scientific and business plans to a variety of audiences; (3) a team leader who is willing to share equity in the company with other employees; (4) a recruiter and a motivator; (5) an implementer who can achieve milestones quickly that allow the company to go public as soon as possible; and (6) a realist who does not resent the terms of the typical deal. The lucrative world of the venture capitalists is foreign territory for physician executives and requires a great idea, charisma, risk-taking, connections, patience, and perseverance to navigate it successfully.
Johns, Benjamin; Steinhardt, Laura; Walker, Damian G; Peters, David H; Bishai, David
2013-07-01
Producing services efficiently and equitably are important goals for health systems. Many countries pursue horizontal equity - providing people with the same illnesses equal access to health services - by locating facilities in remote areas. Staff are often paid incentives to work at such facilities. However, there is little evidence on how many fewer people are treated at remote facilities than facilities in more densely settled areas. This research explores if there is an association between the efficiency of health centers in Afghanistan and the remoteness of their location. Survey teams collected data on facility level inputs and outputs at a stratified random sample of 579 health centers in 2005. Quality of care was measured by observing staff interact with patients and determining if staff completed a set of normative patient care tasks. We used seemingly unrelated regression to determine if facilities in remote areas have fewer outpatient visits than other rural facilities. In this analysis, one equation compares the number of outpatient visits to facility inputs, while another compares quality of care to determinants of quality. The results indicate remote facilities have about 13% fewer outpatient visits than non-remote facilities, holding inputs constant. Our analysis suggests that facilities in remote areas are realizing horizontal equity since their clients are receiving comparable quality of care to those at non-remote facilities. However, we find the average labor cost for a visit at a remote facility is $1.44, but only $0.97 at other rural facilities, indicating that a visit in a remote facility would have to be 'worth' 1.49 times a visit at a rural facility for there to be no equity - efficiency trade-off. In determining where to build or staff health centers, this loss of efficiency may be offset by progress toward a social policy objective of providing services to disadvantaged rural populations. Copyright © 2013 Elsevier Ltd. All rights reserved.
Income-based equity weights in healthcare planning and policy.
Herlitz, Anders
2017-08-01
Recent research indicates that there is a gap in life expectancy between the rich and the poor. This raises the question: should we on egalitarian grounds use income-based equity weights when we assess benefits of alternative benevolent interventions, so that health benefits to the poor count for more? This article provides three egalitarian arguments for using income-based equity weights under certain circumstances. If income inequality correlates with inequality in health, we have reason to use income-based equity weights on the ground that health inequality is bad. If income inequality correlates with inequality in opportunity for health, we have reason to use such weights on the ground that inequality in opportunity for health is bad. If income inequality correlates with inequality in well-being, income-based equity weights should be used to mitigate inequality in well-being. Three different ways in which to construe income-based equity weights are introduced and discussed. They can be based on relative income inequality, on income rankings and on capped absolute income. The article does not defend any of these types of weighting schemes, but argues that in order to settle which of these types of weighting scheme to choose, more empirical research is needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
History of the Voluntary Intermodal Sealift Agreement
2002-06-01
reflect executed Voluntary Enrollment Contracts (VEC) for VISA Stages I, II, and III to include basic activation procedures; DOD annual minimums for...provisions; and on-the-shelf basic agreements (such as VISA Intermodal Contingency Contracts (VICC) for Stages I, II, and III). The anticipated...insufficient Program incentives are revised annually, but the basic tenets remain in place. Activation, capacity required to commit and carrier risk clauses
A Neutral Odor May Become a Sexual Incentive through Classical Conditioning in Male Rats
ERIC Educational Resources Information Center
Kvitvik, Inger-Line; Berg, Kristine Marit; Agmo, Anders
2010-01-01
A neutral olfactory stimulus was employed as CS in a series of experiments with a sexually receptive female as UCS and the execution of an intromission as the UCR. Each experimental session lasted until the male ejaculated. The time the experimental subject spent in a zone adjacent to the source of the olfactory stimulus during the 10 s of CS…
Sanders, David; Leng, Henry; Pollock, Allyson M
2014-01-01
Abstract Objective To investigate equity in the geographical distribution of community pharmacies in South Africa and assess whether regulatory reforms have furthered such equity. Methods Data on community pharmacies from the national department of health and the South African pharmacy council were used to analyse the change in community pharmacy ownership and density (number per 10 000 residents) between 1994 and 2012 in all nine provinces and 15 selected districts. In addition, the density of public clinics, alone and with community pharmacies, was calculated and compared with a national benchmark of one clinic per 10 000 residents. Interviews were conducted with nine national experts from the pharmacy sector. Findings Community pharmacies increased in number by 13% between 1994 and 2012 – less than the 25% population growth. In 2012, community pharmacy density was higher in urban provinces and was eight times higher in the least deprived districts than in the most deprived ones. Maldistribution persisted despite the growth of corporate community pharmacies. In 2012, only two provinces met the 1 per 10 000 benchmark, although all provinces achieved it when community pharmacies and clinics were combined. Experts expressed concerns that a lack of rural incentives, inappropriate licensing criteria and a shortage of pharmacy workers could undermine access to pharmaceutical services, especially in rural areas. Conclusion To reduce inequity in the distribution of pharmaceutical services, new policies and legislation are needed to increase the staffing and presence of pharmacies. PMID:25110373
Equity Theory Ratios as Causal Schemas.
Arvanitis, Alexios; Hantzi, Alexandra
2016-01-01
Equity theory approaches justice evaluations based on ratios of exchange inputs to exchange outcomes. Situations are evaluated as just if ratios are equal and unjust if unequal. We suggest that equity ratios serve a more fundamental cognitive function than the evaluation of justice. More particularly, we propose that they serve as causal schemas for exchange outcomes, that is, they assist in determining whether certain outcomes are caused by inputs of other people in the context of an exchange process. Equality or inequality of ratios in this sense points to an exchange process. Indeed, Study 1 shows that different exchange situations, such as disproportional or balanced proportional situations, create perceptions of give-and-take on the basis of equity ratios. Study 2 shows that perceptions of justice are based more on communicatively accepted rules of interaction than equity-based evaluations, thereby offering a distinction between an attribution and an evaluation cognitive process for exchange outcomes.
Equity Theory Ratios as Causal Schemas
Arvanitis, Alexios; Hantzi, Alexandra
2016-01-01
Equity theory approaches justice evaluations based on ratios of exchange inputs to exchange outcomes. Situations are evaluated as just if ratios are equal and unjust if unequal. We suggest that equity ratios serve a more fundamental cognitive function than the evaluation of justice. More particularly, we propose that they serve as causal schemas for exchange outcomes, that is, they assist in determining whether certain outcomes are caused by inputs of other people in the context of an exchange process. Equality or inequality of ratios in this sense points to an exchange process. Indeed, Study 1 shows that different exchange situations, such as disproportional or balanced proportional situations, create perceptions of give-and-take on the basis of equity ratios. Study 2 shows that perceptions of justice are based more on communicatively accepted rules of interaction than equity-based evaluations, thereby offering a distinction between an attribution and an evaluation cognitive process for exchange outcomes. PMID:27594846
Choking under monitoring pressure: being watched by the experimenter reduces executive attention.
Belletier, Clément; Davranche, Karen; Tellier, Idriss S; Dumas, Florence; Vidal, Franck; Hasbroucq, Thierry; Huguet, Pascal
2015-10-01
Performing more poorly given one's skill level ("choking") is likely in situations that offer an incentive if a certain outcome is achieved (outcome pressure) or when one is being watched by others-especially when one's performance is being evaluated (monitoring pressure). According to the choking literature, outcome pressure is associated with reduced executive control of attention, whereas monitoring pressure is associated with increased, yet counterproductive, attention to skill processes. Here, we show the first evidence that monitoring pressure-being watched by the experimenter-may lead individuals with higher working memory to choke on a classic measure of executive control-just the task effect thought to result from outcome pressure. Not only does this finding help refine our understanding of the processes underlying choking under monitoring pressure, but it also leads to a new look at classic audience effects, with an important implication for experimental psychology.
Working under a clinic-level quality incentive: primary care clinicians' perceptions.
Greene, Jessica; Kurtzman, Ellen T; Hibbard, Judith H; Overton, Valerie
2015-01-01
A key consideration in designing pay-for-performance programs is determining what entity the incentive should be awarded to-individual clinicians or to groups of clinicians working in teams. Some argue that team-level incentives, in which clinicians who are part of a team receive the same incentive based on the team's performance, are most effective; others argue for the efficacy of clinician-level incentives. This study examines primary care clinicians' perceptions of a team-based quality incentive awarded at the clinic level. This research was conducted with Fairview Health Services, where 40% of the primary care compensation model was based on clinic-level quality performance. We conducted 48 in-depth interviews to explore clinicians' perceptions of the clinic-level incentive, as well as an online survey of 150 clinicians (response rate 56%) to investigate which entity the clinicians would consider optimal to target for quality incentives. Clinicians reported the strengths of the clinic-based quality incentive were quality improvement for the team and less patient "dumping," or shifting patients with poor outcomes to other clinicians. The weaknesses were clinicians' lack of control and colleagues riding the coattails of higher performers. There were mixed reports on the model's impact on team dynamics. Although clinicians reported greater interaction with colleagues, some described an increase in tension. Most clinicians surveyed (73%) believed that there should be a mix of clinic and individual-level incentives to maintain collaboration and recognize individual performance. The study highlights the important advantages and disadvantages of using incentives based upon clinic-level performance. Future research should test whether hybrid incentives that mix group and individual incentives can maintain some of the best elements of each design while mitigating the negative impacts. © 2015 Annals of Family Medicine, Inc.
Expensing options solves nothing.
Sahlman, William A
2002-12-01
The use of stock options for executive compensation has become a lightning rod for public anger, and it's easy to see why. Many top executives grew hugely rich on the back of the gains they made on their options, profits they've been able to keep even as the value they were supposed to create disappeared. The supposed scam works like this: Current accounting regulations let companies ignore the cost of option grants on their income statements, so they can award valuable option packages without affecting reported earnings. Not charging the cost of the grants supposedly leads to overstated earnings, which purportedly translate into unrealistically high share prices, permitting top executives to realize big gains when they exercise their options. If an accounting anomaly is the problem, then the solution seems obvious: Write off executive share options against the current year's revenues. The trouble is, Sahlman writes, expensing option grants won't give us a more accurate view of earnings, won't add any information not already included in the financial statements, and won't even lead to equal treatment of different forms of executive pay. Far worse, expensing evades the real issue, which is whether compensation (options and other-wise) does what it's supposed to do--namely, help a company recruit, retain, and provide the right people with appropriate performance incentives. Any performance-based compensation system has the potential to encourage cheating. Only ethical management, sensible governance, adequate internal control systems, and comprehensive disclosure will save the investor from disaster. If, Sahlman warns, we pass laws that require the expensing of options, thinking that's fixed the fundamental flaws in corporate America's accounting, we will have missed a golden opportunity to focus on the much more extensive defects in the present system.
Global Equity Gauge Alliance: reflections on early experiences.
McCoy, David; Bambas, Lexi; Acurio, David; Baya, Banza; Bhuiya, Abbas; Chowdhury, A Mushtaque R; Grisurapong, Siriwan; Liu, Yuanli; Ngom, Pierre; Ngulube, Thabale J; Ntuli, Antoinette; Sanders, David; Vega, Jeanette; Shukla, Abhay; Braveman, Paula A
2003-09-01
The paper traces the evolution and working of the Global Equity Gauge Alliance (GEGA) and its efforts to promote health equity. GEGA places health equity squarely within a larger framework of social justice, linking findings on socioeconomic and health inequalities with differentials in power, wealth, and prestige in society. The Alliance's 11 country-level partners, called Equity Gauges, share a common action-based vision and framework called the Equity Gauge Strategy. An Equity Gauge seeks to reduce health inequities through three broad spheres of action, referred to as the 'pillars' of the Equity Gauge Strategy, which define a set of interconnected and overlapping actions. Measuring and tracking the inequalities and interpreting their ethical import are pursued through the Assessment and Monitoring pillar. This information provides an evidence base that can be used in strategic ways for influencing policy-makers through actions in the Advocacy pillar and for supporting grassroots groups and civil society through actions in the Community Empowerment pillar. The paper provides examples of strategies for promoting pro-equity policy and social change and reviews experiences and lessons, both in terms of technical success of interventions and in relation to the conceptual development and refinement of the Equity Gauge Strategy and overall direction of the Alliance. To become most effective in furthering health equity at both national and global levels, the Alliance must now reach out to and involve a wider range of organizations, groups, and actors at both national and international levels. Sustainability of this promising experiment depends, in part, on adequate resources but also on the ability to attract and develop talented leadership.
Zimmerman, Sheryl; Bowers, Barbara J; Cohen, Lauren W; Grabowski, David C; Horn, Susan D; Kemper, Peter
2016-02-01
To synthesize new findings from the THRIVE Research Collaborative (The Research Initiative Valuing Eldercare) related to the Green House (GH) model of nursing home care and broadly consider their implications. Interviews and observations conducted in GH and comparison homes, Minimum Data Set (MDS) assessments, Medicare data, and Online Survey, Certification and Reporting data. Critical integration and interpretation of findings based on primary data collected 2011-2014 in 28 GH homes (from 16 organizations), and 15 comparison nursing home units (from 8 organizations); and secondary data derived from 2005 to 2010 for 72 GH homes (from 15 organizations) and 223 comparison homes. Implementation of the GH model is inconsistent, sometimes differing from design. Among residents of GH homes, adoption lowers hospital readmissions, three MDS measures of poor quality, and Part A/hospice Medicare expenditures. Some evidence suggests the model is associated with lower direct care staff turnover. Recommendations relate to assessing fidelity, monitoring quality, capitalizing opportunities to improve care, incorporating evidence-based practices, including primary care providers, supporting high-performance workforce practices, aligning Medicare financial incentives, promoting equity, informing broad culture change, and conducting future research. © Health Research and Educational Trust.
Electric utility companies and geothermal power
NASA Technical Reports Server (NTRS)
Pivirotto, D. S.
1976-01-01
The requirements of the electric utility industry as the primary potential market for geothermal energy are analyzed, based on a series of structured interviews with utility companies and financial institution executives. The interviews were designed to determine what information and technologies would be required before utilities would make investment decisions in favor of geothermal energy, the time frame in which the information and technologies would have to be available, and the influence of the governmental politics. The paper describes the geothermal resources, electric utility industry, its structure, the forces influencing utility companies, and their relationship to geothermal energy. A strategy for federal stimulation of utility investment in geothermal energy is suggested. Possibilities are discussed for stimulating utility investment through financial incentives, amelioration of institutional barriers, and technological improvements.
Welch, Vivian A; Akl, Elie A; Guyatt, Gordon; Pottie, Kevin; Eslava-Schmalbach, Javier; Ansari, Mohammed T; de Beer, Hans; Briel, Matthias; Dans, Tony; Dans, Inday; Hultcrantz, Monica; Jull, Janet; Katikireddi, Srinivasa Vittal; Meerpohl, Joerg; Morton, Rachael; Mosdol, Annhild; Petkovic, Jennifer; Schünemann, Holger J; Sharaf, Ravi N; Singh, Jasvinder A; Stanev, Roger; Tonia, Thomy; Tristan, Mario; Vitols, Sigurd; Watine, Joseph; Tugwell, Peter
2017-10-01
This article introduces the rationale and methods for explicitly considering health equity in the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology for development of clinical, public health, and health system guidelines. We searched for guideline methodology articles, conceptual articles about health equity, and examples of guidelines that considered health equity explicitly. We held three meetings with GRADE Working Group members and invited comments from the GRADE Working Group listserve. We developed three articles on incorporating equity considerations into the overall approach to guideline development, rating certainty, and assembling the evidence base and evidence to decision and/or recommendation. Clinical and public health guidelines have a role to play in promoting health equity by explicitly considering equity in the process of guideline development. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
Sustainability of quality improvement following removal of pay-for-performance incentives.
Benzer, Justin K; Young, Gary J; Burgess, James F; Baker, Errol; Mohr, David C; Charns, Martin P; Kaboli, Peter J
2014-01-01
Although pay-for-performance (P4P) has become a central strategy for improving quality in US healthcare, questions persist about the effectiveness of these programs. A key question is whether quality improvement that occurs as a result of P4P programs is sustainable, particularly if incentives are removed. To investigate sustainability of performance levels following removal of performance-based incentives. Observational cohort study that capitalized on a P4P program within the Veterans Health Administration (VA) that included adoption and subsequent removal of performance-based incentives for selected inpatient quality measures. The study sample comprised 128 acute care VA hospitals where performance was assessed between 2004 and 2010. VA system managers set annual performance goals in consultation with clinical leaders, and report performance scores to medical centers on a quarterly basis. These scores inform performance-based incentives for facilities and their managers. Bonuses are distributed based on the attainment of these performance goals. Seven quality of care measures for acute coronary syndrome, heart failure, and pneumonia linked to performance-based incentives. Significant improvements in performance were observed for six of seven quality of care measures following adoption of performance-based incentives and were maintained up to the removal of the incentive; subsequently, the observed performance levels were sustained. This is a quasi-experimental study without a comparison group; causal conclusions are limited. The maintenance of performance levels after removal of a performance-based incentive has implications for the implementation of Medicare's value-based purchasing initiative and other P4P programs. Additional research is needed to better understand human and system-level factors that mediate sustainability of performance-based incentives.
Financial incentives for cadaver organ donation: an ethical reappraisal.
Arnold, Robert; Bartlett, Steven; Bernat, James; Colonna, John; Dafoe, Donald; Dubler, Nancy; Gruber, Scott; Kahn, Jeffrey; Luskin, Richard; Nathan, Howard; Orloff, Susan; Prottas, Jeffrey; Shapiro, Robyn; Ricordi, Camillo; Youngner, Stuart; Delmonico, Francis L
2002-04-27
A panel of ethicists, organ procurement organization executives, physicians, and surgeons was convened by the sponsorship of the American Society of Transplant Surgeons to determine whether an ethically acceptable pilot trial could be proposed to provide a financial incentive for a family to consent to the donation of organs from a deceased relative. An ethical methodology was developed that could be applied to any proposal for monetary compensation to elucidate its ethical acceptability. An inverse relationship between financial incentives for increasing the families' consent for cadaver donation that clearly would be ethically acceptable (e.g., a contribution to a charity chosen by the family or a reimbursement for funeral expenses) and those approaches that would more likely increase the rate of donation (e.g., direct payment or tax incentive) was evident. The panel was unanimously opposed to the exchange of money for cadaver donor organs because either a direct payment or tax incentive would violate the ideal standard of altruism in organ donation and unacceptably commercialize the value of human life by commodifying donated organs. However, a majority of the panel members supported reimbursement for funeral expenses or a charitable contribution as an ethically permissible approach. The panel concluded that the concept of the organ as a gift could be sustained by a funeral reimbursement or charitable contribution that conveyed the appreciation of society to the family for their donation. Depending on the amount of reimbursement provided for funeral expenses, this approach could be ethically distinguished from a direct payment, by their intrusion into the realm of altruism and voluntariness. We suggest that a pilot project be conducted to determine whether this kind of a financial incentive would be acceptable to the public and successful in increasing organ donation.
Carlsen, Benedicte; Norheim, Ole Frithjof
2005-01-01
Background The general practitioner in Norway is expected to ensure equity and effectiveness through fair rationing. At the same time, due to recent reforms of the Norwegian health care sector, both the role of economic incentives and patient autonomy have been strengthened. Studies indicate that modern general practitioners, both in Norway and in other countries are uncomfortable with the gatekeeper role, but there is little knowledge about how general practitioners experience rationing in practice. Methods Through focus group interviews with Norwegian general practitioners, we explore physicians' attitudes toward factors of influence on medical decision making and how rationing dilemmas are experienced in everyday practice. Results Four major concerns appeared in the group discussions: The obligation to ration health care, professional autonomy, patient autonomy, and competition. A central finding was that the physicians find rationing difficult because saying no in face to face relations often is felt uncomfortable and in conflict with other important objectives for the general practitioner. Conclusion It is important to understand the association between using economic incentives in the management of health care, increasing patient autonomy, and the willingness among physicians to contribute to efficient, fair and legitimate resource allocation. PMID:16281967
NASA Astrophysics Data System (ADS)
Siregar, K.; Siregar, S. F.
2018-02-01
This research is design employee performance assessment by considering work result of employee based on competency. Relevant competencies are identified according to Spencer’s competence of employees that subsequently processed by Analytical Hierarchy Process (AHP) method. The results of weighting AHP indicate the highest priority order of criteria, there are; concern of customer satisfaction (0.1325), group work (0.1324) and technical expertise (0.0826). The weight of the criteria is used to design the Work Performance Value (WPV) to be used as the basis for calculating the incentive index. The higher incentive index of an employee, the greater amount of incentives was earned. The calculation of incentives is made to four employees of chopsticks production. From employee incentives A, B, C and D, employee D has the highest incentive index and increment of IDR 2,700,675 compared to previous incentive system. The incentive division system based on the Work Performance Values (WPV) of this proposal reflects a real incentive so that the incapacity of incentive can be reduced.
2011-01-01
Background This article considers how health services access and equity documents represent the problem of access to health services and what the effects of that representation might be for lesbian, gay, bisexual and transgender (LGBT) communities. We conducted a critical discourse analysis on selected access and equity documents using a gender-based diversity framework as determined by two objectives: 1) to identify dominant and counter discourses in health services access and equity literature; and 2) to develop understanding of how particular discourses impact the inclusion, or not, of LGBT communities in health services access and equity frameworks.The analysis was conducted in response to public health and clinical research that has documented barriers to health services access for LGBT communities including institutionalized heterosexism, biphobia, and transphobia, invisibility and lack of health provider knowledge and comfort. The analysis was also conducted as the first step of exploring LGBT access issues in home care services for LGBT populations in Ontario, Canada. Methods A critical discourse analysis of selected health services access and equity documents, using a gender-based diversity framework, was conducted to offer insight into dominant and counter discourses underlying health services access and equity initiatives. Results A continuum of five discourses that characterize the health services access and equity literature were identified including two dominant discourses: 1) multicultural discourse, and 2) diversity discourse; and three counter discourses: 3) social determinants of health (SDOH) discourse; 4) anti-oppression (AOP) discourse; and 5) citizen/social rights discourse. Conclusions The analysis offers a continuum of dominant and counter discourses on health services access and equity as determined from a gender-based diversity perspective. The continuum of discourses offers a framework to identify and redress organizational assumptions about, and ideological commitments to, sexual and gender diversity and health services access and equity. Thus, the continuum of discourses may serve as an important element of a health care organization's access and equity framework for the evaluation of access to good quality care for diverse LGBT populations. More specfically, the analysis offers four important points of consideration in relation to the development of a health services access and equity framework. PMID:21957894
Daley, Andrea E; Macdonnell, Judith A
2011-09-29
This article considers how health services access and equity documents represent the problem of access to health services and what the effects of that representation might be for lesbian, gay, bisexual and transgender (LGBT) communities. We conducted a critical discourse analysis on selected access and equity documents using a gender-based diversity framework as determined by two objectives: 1) to identify dominant and counter discourses in health services access and equity literature; and 2) to develop understanding of how particular discourses impact the inclusion, or not, of LGBT communities in health services access and equity frameworks.The analysis was conducted in response to public health and clinical research that has documented barriers to health services access for LGBT communities including institutionalized heterosexism, biphobia, and transphobia, invisibility and lack of health provider knowledge and comfort. The analysis was also conducted as the first step of exploring LGBT access issues in home care services for LGBT populations in Ontario, Canada. A critical discourse analysis of selected health services access and equity documents, using a gender-based diversity framework, was conducted to offer insight into dominant and counter discourses underlying health services access and equity initiatives. A continuum of five discourses that characterize the health services access and equity literature were identified including two dominant discourses: 1) multicultural discourse, and 2) diversity discourse; and three counter discourses: 3) social determinants of health (SDOH) discourse; 4) anti-oppression (AOP) discourse; and 5) citizen/social rights discourse. The analysis offers a continuum of dominant and counter discourses on health services access and equity as determined from a gender-based diversity perspective. The continuum of discourses offers a framework to identify and redress organizational assumptions about, and ideological commitments to, sexual and gender diversity and health services access and equity. Thus, the continuum of discourses may serve as an important element of a health care organization's access and equity framework for the evaluation of access to good quality care for diverse LGBT populations. More specfically, the analysis offers four important points of consideration in relation to the development of a health services access and equity framework.
Challenges in developing physician leadership and management.
Guthrie, M B
1999-01-01
Many of the issues confronting healthcare organizations require physician involvement and understanding, and the physician executive is a tool to achieving physician participation. Physician leaders can become the mediators between physicians and organizational management, minimizing miscommunication and maximizing agreement and understanding. Yet few doctors seem willing to stand up and speak positively for the plans and proposals that will move the institution forward, and healthcare executives are often frustrated by physician leadership that fails to articulate and implement the vision and objectives of the organization. Understanding physician leadership and exploring the challenges in managing and leading physicians require an understanding of the physician mindset--a completely different mindset than that of the typical healthcare executive. Beginning with a discussion of the unique situation faced by physicians in leadership positions, this article attempts to define the obstacles faced by both the physician and the executive in developing the role of physician executive. After reviewing the opportunities open to physician executives for improving leadership ability, the author presents the essential characteristics and core skills for effective leadership. The second half of the article suggests ways in which an organization can reemphasize physician leadership development within an organization from selection of potential candidates to creating training and networking opportunities and offering appropriate incentives.
1999-03-01
these kinds of sources: Industry standards Other commercial or military customers LMI specification summaries Contractor’s in-house data Section...government and industry managers to achieve program objectives. • Putting in place for fielded systems additional incentives to reduce operating and...meaning clarifications; an explanation of the roles of Congress, the Executive Branch, and Industry in defense acquisition; and an overview on the
Perfect Storm: Analyzing Strategic Issues Confronting Program Executive Office, Missiles and Space
2007-03-30
question or challenge affecting an organization’s mandates, mission, and values; product or service level and mix ; clients, users, or payers; or...the people are the right mix . This also includes the rewards program that provides motivation and incentives for the achievement of goals. The...visible indicators of organizational success (e.g., exploding Starbucks growth). Outputs can be described in terms of three factors. How successfully
Medicaid case-mix nursing home reimbursement in three states.
Swan, James H; Pickard, Ruth B
2003-01-01
Case-mix nursing facility payment raises issues of access, quality, equity, and cost. Case-mix should better match payment to costs, improve access, and provide incentives to increased staffing and quality of care; but it may also increase costs. This paper reports analysis of Medicaid cost-report data from three case-mix states. Case-mix did not discourage capacity building and was more equitable for providers. Medicaid access declined in one state but increased in another. There were shifts toward greater skilled care in two states, with evidence of greater focus of resources on patient care. Case-mix showed no evidence of cost-constraint and some signs of increased costs. Whether such mixed outcomes are viable in the current era remains to be seen.
A framework for regional primary health care to organise actions to address health inequities.
Freeman, Toby; Javanparast, Sara; Baum, Fran; Ziersch, Anna; Mackean, Tamara
2018-06-01
Regional primary health-care organisations plan, co-ordinate, and fund some primary health-care services in a designated region. This article presents a framework for examining the equity performance of regional primary health-care organisations, and applies it to Australian Medicare Locals (funded from 2011 to 2015). The framework was developed based on theory, literature, and researcher deliberation. Data were drawn from Medicare Local documents, an online survey of 210 senior Medicare Local staff, and interviews with 50 survey respondents. The framework encompassed equity in planning, collection of equity data, community engagement, and strategies to address equity in access, health outcomes, and social determinants of health. When the framework was applied to Medicare Locals, their inclusion of equity as a goal, collection of equity data, community engagement, and actions improving equity of access were strong, but there were gaps in broader advocacy, and strategies to address social determinants of health, and equity in quality of care. The equity framework allows a platform for advancing knowledge and international comparison of the health equity efforts of regional primary health-care organisations.
Towards environmental health equity in health impact assessment: innovations and opportunities.
Buse, Chris G; Lai, Valerie; Cornish, Katie; Parkes, Margot W
2018-06-18
As global environmental change drives inequitable health outcomes, novel health equity assessment methodologies are increasingly required. We review literatures on equity-focused HIA to clarify how equity is informing HIA practice, and to surface innovations for assessing health equity in relation to a range of exposures across geographic and temporal scales. A narrative review of the health equity and HIA literatures analysed English articles published between 2003 and 2017 across PubMed, PubMed Central, Biomed Central and Ovid Medline. Title and abstract reviews of 849 search results yielded 89 articles receiving full text review. Considerations of equity in HIA increased over the last 5 years, but equity continues to be conflated with health disparities rather than their root causes (i.e. inequities). Lessons from six literatures to inform future HIA practice are described: HIA for healthy cities, climate change vulnerability assessment, cumulative health risk assessment, intersectionality-based policy analysis, corporate health impact assessment and global health impact assessment. Academic reporting on incorporating equity in HIA practice has been limited. Nonetheless, significant methodological advancements are being made to examine the health equity implications of multiple environmental exposures.
Pottie, Kevin; Welch, Vivian; Morton, Rachael; Akl, Elie A; Eslava-Schmalbach, Javier H; Katikireddi, Vittal; Singh, Jasvinder; Moja, Lorenzo; Lang, Eddy; Magrini, Nicola; Thabane, Lehana; Stanev, Roger; Matovinovic, Elizabeth; Snellman, Alexandra; Briel, Matthias; Shea, Beverly; Tugwell, Peter; Schunemann, Holger; Guyatt, Gordon; Alonso-Coello, Pablo
2017-10-01
The aim of this paper is to provide detailed guidance on how to incorporate health equity within the GRADE (Grading Recommendations Assessment and Development Evidence) evidence to decision process. We developed this guidance based on the GRADE evidence to decision framework, iteratively reviewing and modifying draft documents, in person discussion of project group members and input from other GRADE members. Considering the impact on health equity may be required, both in general guidelines and guidelines that focus on disadvantaged populations. We suggest two approaches to incorporate equity considerations: (1) assessing the potential impact of interventions on equity and (2) incorporating equity considerations when judging or weighing each of the evidence to decision criteria. We provide guidance and include illustrative examples. Guideline panels should consider the impact of recommendations on health equity with attention to remote and underserviced settings and disadvantaged populations. Guideline panels may wish to incorporate equity judgments across the evidence to decision framework. This is the fourth and final paper in a series about considering equity in the GRADE guideline development process. This series is coming from the GRADE equity subgroup. Copyright © 2017 Elsevier Inc. All rights reserved.
Equity and Leadership: Research-Based Strategies for School Leaders
ERIC Educational Resources Information Center
Ross, John A.; Berger, Marie-Josee
2009-01-01
Principals are required by policy, regulation, legislation and democratic discourse to promote equity of outcomes. This integrated review investigates research on equity issues facing five student groups: special needs students; religious, cultural and racial minorities; groups disadvantaged by socioeconomic status; gender groups; and students…
The five traps of performance measurement.
Likierman, Andrew
2009-10-01
Evaluating a company's performance often entails wading through a thicket of numbers produced by a few simple metrics, writes the author, and senior executives leave measurement to those whose specialty is spreadsheets. To take ownership of performance assessment, those executives should find qualitative, forward-looking measures that will help them avoid five common traps: Measuring against yourself. Find data from outside the company, and reward relative, rather than absolute, performance. Enterprise Rent-A-Car uses a service quality index to measure customers' repeat purchase intentions. Looking backward. Use measures that lead rather than lag the profits in your business. Humana, a health insurer, found that the sickest 10% of its patients account for 80% of its costs; now it offers customers incentives for early screening. Putting your faith in numbers. The soft drinks company Britvic evaluates its executive coaching program not by trying to assign it an ROI number but by tracking participants' careers for a year. Gaming your metrics. The law firm Clifford Chance replaced its single, easy-to-game metric of billable hours with seven criteria on which to base bonuses. Sticking to your numbers too long. Be precise about what you want to assess and explicit about what metrics are assessing it. Such clarity would have helped investors interpret the AAA ratings involved in the financial meltdown. Really good assessment will combine finance managers' relative independence with line managers' expertise.
Public subsidies for employees' contributions to employer-sponsored insurance.
Merlis, M
2001-01-01
Proposals to provide or subsidize health insurance for low-income families must take account of the fact that many workers have access to employer-sponsored insurance (ESI), but decline it because of required employee premium contributions. This article considers a tax credit for the employee share of ESI in the context of a broader program of income-based health insurance tax credits. Helping uninsured workers pay for available ESI could be more cost-effective than subsidizing their coverage in the nongroup market. The credit would also be available to workers who were already covered, both for equity reasons and to reduce the incentives for employers to drop coverage or for workers to shift to subsidized individual plans. One key issue is how to prevent employers from reducing their current health plan contributions to take advantage of the new funding. Other design questions considered by the article include whether workers should be able to choose between ESI and nongroup coverage, whether minimum benefit standards should apply for employer plans, and how to achieve a fair balance in subsidies for group and nongroup coverage.
Sustainability in urban water resources management - some notes from the field
NASA Astrophysics Data System (ADS)
Shuster, W.; Garmestani, A.; Green, O. O.
2014-12-01
Urban development has radically transformed landscapes, and along with it, how our cities and suburbs cycle energy and water. One unfortunate outcome of urbanization is the production of massive volumes of uncontrolled runoff volume. Our civic infrastructure is sometimes marginally capable of handling even dry-weather fluxes without wastewater system overflows, much less the challenges of wet-weather events. The predominance of runoff volume in urban water balance has had serious ramifications for regulatory activity, municipal financial matters, and public health. In the interest of protecting human health and the environment, my group's research has primarily addressed the integration of social equity, economic stabilization, and environmental management to underpin the development of sustainable urban water cycles. In this talk, I will present on: 1) the Shepherd Creek Stormwater Management project wherein an economic incentive was used to recruit citizen stormwater managers and distribute parcel-level, green infrastructure-based stormwater control measures; and 2) our urban soil pedologic-hydrologic assessment protocol that we use as a way of understanding the capacity for urban soils to provide ecosystem services, and in cities representing each of the major soil orders.
Why do people postpone parenthood? Reasons and social policy incentives.
Mills, Melinda; Rindfuss, Ronald R; McDonald, Peter; te Velde, Egbert
2011-01-01
Never before have parents in most Western societies had their first children as late as in recent decades. What are the central reasons for postponement? What is known about the link between the delay of childbearing and social policy incentives to counter these trends? This review engages in a systematic analysis of existing evidence to extract the maximum amount of knowledge about the reasons for birth postponement and the effectiveness of social policy incentives. The review followed the PRISMA procedure, with literature searches conducted in relevant demographic, social science and medical science databases (SocINDEX, Econlit, PopLine, Medline) and located via other sources. The search focused on subjects related to childbearing behaviour, postponement and family policies. National, international and individual-level data sources were also used to present summary statistics. There is clear empirical evidence of the postponement of the first child. Central reasons are the rise of effective contraception, increases in women's education and labour market participation, value changes, gender equity, partnership changes, housing conditions, economic uncertainty and the absence of supportive family policies. Evidence shows that some social policies can be effective in countering postponement. The postponement of first births has implications on the ability of women to conceive and parents to produce additional offspring. Massive postponement is attributed to the clash between the optimal biological period for women to have children with obtaining additional education and building a career. A growing body of literature shows that female employment and childrearing can be combined when the reduction in work-family conflict is facilitated by policy intervention.
Incentive pricing and cost recovery at the basin scale.
Ward, Frank A; Pulido-Velazquez, Manuel
2009-01-01
Incentive pricing programs have potential to promote economically efficient water use patterns and provide a revenue source to compensate for environmental damages. However, incentive pricing may impose disproportionate costs and aggravate poverty where high prices are levied for basic human needs. This paper presents an analysis of a two-tiered water pricing system that sets a low price for subsistence needs, while charging a price equal to marginal cost, including environmental cost, for discretionary uses. This pricing arrangement can promote efficient and sustainable water use patterns, goals set by the European Water Framework Directive, while meeting subsistence needs of poor households. Using data from the Rio Grande Basin of North America, a dynamic nonlinear program, maximizes the basin's total net economic and environmental benefits subject to several hydrological and institutional constraints. Supply costs, environmental costs, and resource costs are integrated in a model of a river basin's hydrology, economics, and institutions. Three programs are compared: (1) Law of the River, in which water allocations and prices are determined by rules governing water transfers; (2) marginal cost pricing, in which households pay the full marginal cost of supplying treated water; (3) two-tiered pricing, in which households' subsistence water needs are priced cheaply, while discretionary uses are priced at efficient levels. Compared to the Law of the River and marginal cost pricing, two-tiered pricing performs well for efficiency and adequately for sustainability and equity. Findings provide a general framework for formulating water pricing programs that promote economically and environmentally efficient water use programs while also addressing other policy goals.
Why do people postpone parenthood? Reasons and social policy incentives
Mills, Melinda; Rindfuss, Ronald R.; McDonald, Peter; te Velde, Egbert
2011-01-01
BACKGROUND Never before have parents in most Western societies had their first children as late as in recent decades. What are the central reasons for postponement? What is known about the link between the delay of childbearing and social policy incentives to counter these trends? This review engages in a systematic analysis of existing evidence to extract the maximum amount of knowledge about the reasons for birth postponement and the effectiveness of social policy incentives. METHODS The review followed the PRISMA procedure, with literature searches conducted in relevant demographic, social science and medical science databases (SocINDEX, Econlit, PopLine, Medline) and located via other sources. The search focused on subjects related to childbearing behaviour, postponement and family policies. National, international and individual-level data sources were also used to present summary statistics. RESULTS There is clear empirical evidence of the postponement of the first child. Central reasons are the rise of effective contraception, increases in women's education and labour market participation, value changes, gender equity, partnership changes, housing conditions, economic uncertainty and the absence of supportive family policies. Evidence shows that some social policies can be effective in countering postponement. CONCLUSIONS The postponement of first births has implications on the ability of women to conceive and parents to produce additional offspring. Massive postponement is attributed to the clash between the optimal biological period for women to have children with obtaining additional education and building a career. A growing body of literature shows that female employment and childrearing can be combined when the reduction in work–family conflict is facilitated by policy intervention. PMID:21652599
Seven Years of Gender Equity: Building California's Workforce.
ERIC Educational Resources Information Center
California Community Colleges, Sacramento. Office of the Chancellor.
Since 1984, the Gender Equity and Civil Rights specialist of the Chancellor's Office of the California Community Colleges (CCC) has led the colleges in the strategic development of statewide and college-based Gender Equity, Single Parent, Displaced Homemaker, and Single Pregnant Woman programs designed to improve access and eliminate barriers to…
What Is Fair? Special Education and Financial Equity.
ERIC Educational Resources Information Center
Parrish, Thomas B.
1995-01-01
Examines equity issues pertaining to special-education students, finance systems, and taxpayers. The major student equity focus is "inclusion." After passage of IDEA, reducing the number of restrictive special-education placements has become a clearly articulated policy objective. There is a movement away from cost-based to census-based…
26 CFR 1.817A-1 - Certain modified guaranteed contracts.
Code of Federal Regulations, 2010 CFR
2010-04-01
..., other equity instruments, or equity-based derivatives. (5) Current market rate for non-equity-indexed... to time with reference to market values for annual statement purposes. Further, an MGC must provide... policyholder upon surrender is usually increased or decreased by a market value adjustment, which is determined...
Educational Equity: Challenges for Educator Effectiveness
ERIC Educational Resources Information Center
Best, Jane; Winslow, Emily
2015-01-01
With increasingly diverse student populations, educational equity is a bigger challenge than ever for public schools across the United States. While federal government, states, and school districts work to identify and address the root causes of equity gaps, efforts are often hampered by a limited body of research-based strategies and approaches…
Countervailing incentives in value-based payment.
Arnold, Daniel R
2017-09-01
Payment reform has been at the forefront of the movement toward higher-value care in the U.S. health care system. A common belief is that volume-based incentives embedded in fee-for-service need to be replaced with value-based payments. While this belief is well-intended, value-based payment also contains perverse incentives. In particular, behavioral economists have identified several features of individual decision making that reverse some of the typical recommendations for inducing desirable behavior through financial incentives. This paper discusses the countervailing incentives associated with four behavioral economic concepts: loss aversion, relative social ranking, inertia or status quo bias, and extrinsic vs. intrinsic motivation. Copyright © 2016 Elsevier Inc. All rights reserved.
Randive, Bharat; San Sebastian, Miguel; De Costa, Ayesha; Lindholm, Lars
2014-12-01
Proportion of women giving birth in health institutions has increased sharply in India since the introduction of cash incentive program, Janani Suraksha Yojana (JSY) in 2005. JSY was intended to benefit disadvantaged population who had poor access to institutional care for childbirth and who bore the brunt of maternal deaths. Increase in institutional deliveries following the implementation of JSY needs to be analysed from an equity perspective. We analysed data from nine Indian states to examine the change in socioeconomic inequality in institutional deliveries five years after the implementation of JSY using the concentration curve and concentration index (CI). The CI was then decomposed in order to understand pathways through which observed inequalities occurred. Disparities in access to emergency obstetric care (EmOC) and in maternal mortality reduction among different socioeconomic groups were also assessed. Slope and relative index of inequality were used to estimate absolute and relative inequalities in maternal mortality ratio (MMR). Results shows that although inequality in access to institutional delivery care persists, it has reduced since the introduction of JSY. Nearly 70% of the present inequality was explained by differences in male literacy, EmOC availability in public facilities and poverty. EmOC in public facilities was grossly unavailable. Compared to richest division in nine states, poorest division has 135 more maternal deaths per 100,000 live births in 2010. While MMR has decreased in all areas since JSY, it has declined four times faster in richest areas compared to the poorest, resulting in increased inequalities. These findings suggest that in order for the cash incentive to succeed in reducing the inequalities in maternal health outcomes, it needs to be supported by the provision of quality health care services including EmOC. Improved targeting of disadvantaged populations for the cash incentive program could be considered. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
Factors associated with independent pharmacy owners' satisfaction with Medicare Part D contracts.
Zhang, Su; Doucette, William R; Urmie, Julie M; Xie, Yang; Brooks, John M
2010-06-01
As Medicare Part D contracts apply pressure on the profitability of independent pharmacies, there is concern about their owners' willingness to sign such contracts. Identifying factors affecting independent pharmacy owners' satisfaction with Medicare Part D contracts could inform policy makers in managing Medicare Part D. (1) To identify influences on independent pharmacy owners' satisfaction with Medicare Part D contracts and (2) to characterize comments made by independent pharmacy owners about Medicare Part D. This cross-sectional study used a mail survey of independent pharmacy owners in 15 states comprising 6 Medicare regions to collect information on their most- and least-favorable Medicare Part D contracts, including satisfaction, contract management activities, market position, pharmacy operation, and specific payment levels on brand and generic drugs. Of the 1649 surveys mailed, 296 surveys were analyzed. The regression models for satisfaction with both the least and the most-favorable Part D contracts were significant (P<0.05). A different set of significant influences on satisfaction was identified for each regression model. For the most-favorable contract, influences were contending and equity. For the least-favorable contract, influences were negotiation, equity, generic rate bonus, and medication therapy management (MTM) payment. About one-third of the survey respondents made at least 1 comment. The most frequent themes in the comments were that Medicare Part D reimbursement rate is too low (28%) and that contracts are offered without negotiation in a "take it or leave it" manner (20%). Equity, contending, negotiation, generic rate bonus, and MTM payments were identified as the influences of independent pharmacy owners' satisfaction toward Medicare Part D contracts. Generic rate bonus and MTM payment provide additional financial incentives to less financially favorable contracts and, in turn, contribute to independent pharmacy owner's satisfaction toward these contracts. Copyright 2010 Elsevier Inc. All rights reserved.
Amo-Adjei, Joshua
2016-01-01
Public-private mix (PPM) can supplement public sector initiatives, including public health. As National Tuberculosis Control Programmes around the world embrace PPM, conforming to the four key principles of partnership values of beneficence, non-maleficence, autonomy, and equity as espoused by the World Health Organization can provide a useful framework to guide successful implementation. This is a qualitative case study of PPM in tuberculosis (TB) control, which utilised a purposive sample of 30 key stakeholders involved in TB control in Ghana. Respondents comprised an equal number of respondents from both the public and private sectors. Semi-structured in-depth interviews (IDI) were conducted with respondents. Data emanating from the IDIs were analysed deductively. Although the respondents' perceptions about beneficence were unanimous, their views about non-maleficence, autonomy, and equity appeared incongruous with the underlying meanings of the PPM values. Underlying the unfavourable perceptions were disruptions in funding, project implementers' failure to follow-up on promised incentives, and private providers lost interest. This was perceived to have negatively affected the smooth implementation of PPM in the country. Going forward, it is imperative that future partnerships are built around utilitarian principles and also adhere to the dictates of agreements, whether they are 'soft' or standard contracts.
Azzopardi-Muscat, Natasha; Schroder-Bäck, Peter; Brand, Helmut
2017-01-01
The Joint Procurement Agreement (JPA) is an innovative instrument for multi-country procurement of medical countermeasures against cross-border health threats. This paper aims to assess its potential performance. A literature review was conducted to identify key features of successful joint procurement programmes. Documentary analysis and a key informants' interview were carried out to analyse the European Union (EU) JPA. Ownership, equity, transparency, stable central financing, standardisation, flexibility and gradual development were identified as important prerequisites for successful establishment of multi-country joint procurement programmes in the literature while security of supply, favourable prices, reduction of operational costs and administrative burden and creation of professional expert networks were identified as desirable outcomes. The EU JPA appears to fulfil the criteria of ownership, transparency, equity, flexibility and gradual development. Standardisation is only partly fulfilled and central EU level financing is not provided. Security of supply is an important outcome for all EU Member States (MS). Price savings, reduction in administrative burden and creation of professional networks may be particularly attractive for the smaller MS. The JPA has the potential to increase health system collaboration and efficiency at EU level provided that the incentives for sustained commitment of larger MS are sufficiently attractive.
Amo-Adjei, Joshua
2016-01-01
Background Public–private mix (PPM) can supplement public sector initiatives, including public health. As National Tuberculosis Control Programmes around the world embrace PPM, conforming to the four key principles of partnership values of beneficence, non-maleficence, autonomy, and equity as espoused by the World Health Organization can provide a useful framework to guide successful implementation. Design This is a qualitative case study of PPM in tuberculosis (TB) control, which utilised a purposive sample of 30 key stakeholders involved in TB control in Ghana. Respondents comprised an equal number of respondents from both the public and private sectors. Semi-structured in-depth interviews (IDI) were conducted with respondents. Data emanating from the IDIs were analysed deductively. Results Although the respondents’ perceptions about beneficence were unanimous, their views about non-maleficence, autonomy, and equity appeared incongruous with the underlying meanings of the PPM values. Underlying the unfavourable perceptions were disruptions in funding, project implementers’ failure to follow-up on promised incentives, and private providers lost interest. This was perceived to have negatively affected the smooth implementation of PPM in the country. Conclusions Going forward, it is imperative that future partnerships are built around utilitarian principles and also adhere to the dictates of agreements, whether they are ‘soft’ or standard contracts. PMID:26739783
Issues in Perspective. Critical Issues Papers 1-17.
ERIC Educational Resources Information Center
Duttweiler, Patricia Cloud
The papers in this collection are based on the document "Perspectives on Performance-Based Incentive Plans" and offer brief overviews of the following critical issues in education: (1) performance-based incentive plans; (2) needed organizational changes; (3) successful and unsuccessful teacher incentive plans; (4) compensation strategies and…
[Informational analysis of global health equity studies based on database of Web of Science].
Zhao, Bo; Cui, Lei; Guo, Yan
2011-06-18
To present the history of global health equity studies and provide reference for the selection of topics of China's health equity study. In this article citations on the subject of health equity from Web of Science (WOS) were analyzed and 60 papers concerned which were cited more than 30 times selected. Through the co-citation cluster analysis combined with the content analysis of the highly-cited papers, this article attempted to cluster them into several significant categories. Then we analyzed their strategic importance in the field of health equity by drawing citation strategic diagrams. Six hot topics in health equity studies were as follows: health service equity, the relationship between health service demand and utilization; definitions of health equity; socioeconomic status and mortality, income distribution and health, and the measurement of health inequity. Income distribution and health was the biggest concern and the measurement of health inequity was of the greatest novelty. Conducting empirical analyses on the effect of social determinants (including socioeconomic status, social network and psychosocial status etc.) on health by means of health equity measurements marks the development trend of health equity study.
Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-13
... sweat equity and volunteer-based homeownership programs for low-income persons and families. This... infrastructure to support sweat equity and volunteer-based homeownership programs for low-income persons and...
Financial incentives for quality in breast cancer care.
Tisnado, Diana M; Rose-Ash, Danielle E; Malin, Jennifer L; Adams, John L; Ganz, Patricia A; Kahn, Katherine L
2008-07-01
To examine the use of financial incentives related to performance on quality measures reported by oncologists and surgeons associated with a population-based cohort of patients with breast cancer in Los Angeles County, California, and to explore the physician and practice characteristics associated with the use of these incentives among breast cancer care providers. Cross-sectional observational study. Physician self-reported financial arrangements from a survey of 348 medical oncologists, radiation oncologists, and surgeons caring for patients with breast cancer in Los Angeles County (response rate, 76%). Physicians were asked whether they were subject to financial incentives for quality (ie, patient satisfaction surveys and adherence to practice guidelines). We examined the prevalence and correlates of incentives and performed multivariate logistic regression analyses to assess predictors of incentives, controlling for other covariates. Twenty percent of respondents reported incentives based on patient satisfaction, and 15% reported incentives based on guideline adherence. The use of incentives for quality in this cohort of oncologists and surgeons was modest and was primarily associated with staff- or group-model health maintenance organization (HMO) settings. In other settings, important predictors were partial physician ownership interest, large practice size, and capitation. Most cancer care providers in Los Angeles County outside of staff- or group-model HMOs are not subject to explicit financial incentives based on quality-of-care measures. Those who are, seem more likely to be associated with large practice settings. New approaches are needed to direct financial incentives for quality toward specialists outside of staff- or group-model HMOs if pay-for-performance programs are to succeed in influencing care.
Welch, Vivian; Petticrew, Mark; Ueffing, Erin; Benkhalti Jandu, Maria; Brand, Kevin; Dhaliwal, Bharbhoor; Kristjansson, Elizabeth; Smylie, Janet; Wells, George Anthony; Tugwell, Peter
2012-01-01
Tackling health inequities both within and between countries remains high on the agenda of international organizations including the World Health Organization and local, regional and national governments. Systematic reviews can be a useful tool to assess effects on equity in health status because they include studies conducted in a variety of settings and populations. This study aims to describe the extent to which the impacts of health interventions on equity in health status are considered in systematic reviews, describe methods used, and assess the implications of their equity related findings for policy, practice and research. We conducted a methodology study of equity assessment in systematic reviews. Two independent reviewers extracted information on the reporting and analysis of impacts of health interventions on equity in health status in a group of 300 systematic reviews collected from all systematic reviews indexed in one month of MEDLINE, using a pre-tested data collection form. Any differences in data extraction were resolved by discussion. Of the 300 systematic reviews, 224 assessed the effectiveness of interventions on health outcomes. Of these 224 reviews, 29 systematic reviews assessed effects on equity in health status using subgroup analysis or targeted analyses of vulnerable populations. Of these, seven conducted subgroup analyses related to health equity which were reported in insufficient detail to judge their credibility. Of these 29 reviews, 18 described implications for policy and practice based on assessment of effects on health equity. The quality and completeness of reporting should be enhanced as a priority, because without this policymakers and practitioners will continue lack the evidence base they need to inform decision-making about health inequity. Furthermore, there is a need to develop methods to systematically consider impacts on equity in health status that is currently lacking in systematic reviews.
NASA Astrophysics Data System (ADS)
Zhao, J.; Cai, X.; Wang, Z.
2009-12-01
It also has been well recognized that market-based systems can have significant advantages over administered systems for water allocation. However there are not many successful water markets around the world yet and administered systems exist commonly in water allocation management practice. This paradox has been under discussion for decades and still calls for attention for both research and practice. This paper explores some insights for the paradox and tries to address why market systems have not been widely implemented for water allocation. Adopting the theory of agent-based system we develop a consistent analytical model to interpret both systems. First we derive some theorems based on the analytical model, with respect to the necessary conditions for economic efficiency of water allocation. Following that the agent-based model is used to illustrate the coherence and difference between administered and market-based systems. The two systems are compared from three aspects: 1) the driving forces acting on the system state, 2) system efficiency, and 3) equity. Regarding economic efficiency, penalty on the violation of water use permits (or rights) under an administered system can lead to system-wide economic efficiency, as well as being acceptable by some agents, which follows the theory of the so-call rational violation. Ideal equity will be realized if penalty equals incentive with an administered system and if transaction costs are zero with a market system. The performances of both agents and the over system are explained with an administered system and market system, respectively. The performances of agents are subject to different mechanisms of interactions between agents under the two systems. The system emergency (i.e., system benefit, equilibrium market price, etc), resulting from the performance at the agent level, reflects the different mechanism of the two systems, the “invisible hand” with the market system and administrative measures (penalty and subsidy) with the administered system. Furthermore, the impact of hydrological uncertainty on the performance of water users under the two systems is analyzed by extending the deterministic model to a stochastic one subject to the uncertainty of water availability. It is found that the system response to hydrologic uncertainty depends on risk management mechanics - sharing risk equally among the agents or by prescribed priorities on some agents. Figure1. Agent formulation and its implications in administered system and market-based system
Cash Incentives and Turnover in Center-Based Child Care Staff
ERIC Educational Resources Information Center
Gable, Sara; Rothrauff, Tanja C.; Thornburg, Kathy R.; Mauzy, Denise
2007-01-01
The current study evaluates the Workforce INcentive Project (WIN), a programmatic effort to increase child care workforce stability in center- and home-based child care providers via the provision of bi-annual cash incentives based on educational attainment. Five hundred and thirteen center-based teaching staff (304 WIN and 209 comparison) and 167…
Equity Goals in Illinois School Finance: 1973-1979.
ERIC Educational Resources Information Center
Hickrod, G. Alan; And Others
This paper uses the year 1972-73 as a base line in evaluating the progress of Illinois toward certain "equity goals." In determining the equity goals, two dimensions are studied--disparity and wealth neutrality. One measure of disparity is the permissible variance in school district expenditures expressed in the coefficient of variation,…
Diminishing musyarakah investment model based on equity
NASA Astrophysics Data System (ADS)
Jaffar, Maheran Mohd; Zain, Shaharir Mohamad; Jemain, Abdul Aziz
2017-11-01
Most of the mudharabah and musyarakah contract funds are involved in debt financing. This does not support the theory that profit sharing contract is better than that of debt financing due to the sharing of risks and ownership of equity. Indeed, it is believed that Islamic banking is a financial model based on equity or musyarakah which emphasis on the sharing of risks, profit and loss in the investment between the investor and entrepreneur. The focus of this paper is to introduce the mathematical model that internalizes diminishing musyarakah, the sharing of profit and equity between entrepreneur and investor. The entrepreneur pays monthly-differed payment to buy out the equity that belongs to the investor (bank) where at the end of the specified period, the entrepreneur owns the business and the investor (bank) exits the joint venture. The model is able to calculate the amount of equity at any time for both parties and hence would be a guide in helping to estimate the value of investment should the entrepreneur or investor exit before the end of the specified period. The model is closer to the Islamic principles for justice and fairness.
Von den Flitterwochen zur distanzierten Partnerschaft. Deutsche Manager in internationalen M&A
NASA Astrophysics Data System (ADS)
Fuchs, Martina; Schalljo, Martin
2017-04-01
Cross-border mergers and acquisitions (M&A) require considerable intercultural openness on the part of the managers involved. A recent wave of takeovers by private equity investors and foreign investors from emerging economies has challenged German executives. In cases of friendly takeovers, as described in this study, managers at first appear to extend a cosmopolitan welcome to the new owners. However, further analysis of structural hermeneutics reveals latent normative professional ethics of managers which lead to practices of distancing, in particular from young investors from China, India, and Russia.
Incentives for college student participation in web-based substance use surveys.
Patrick, Megan E; Singer, Eleanor; Boyd, Carol J; Cranford, James A; McCabe, Sean Esteban
2013-03-01
The purpose of this study was to examine the effects of two incentive conditions (a $10 pre-incentive only vs. a $2 pre-incentive and a $10 promised incentive) on response rates, sample composition, substantive data, and cost-efficiency in a survey of college student substance use and related behaviors. Participants were 3000 randomly-selected college students invited to participate in a survey on substance use. Registrar data on all invitees was used to compare response rates and respondents, and web-based data collection on participants was used to compare substantive findings. Participants randomized to the pre-incentive plus promised incentive condition were more likely to complete the survey and less likely to give partial responses. Subgroup differences by sex, class year, and race were evaluated among complete responders, although only sex differences were significant. Men were more likely to respond in the pre-incentive plus promised incentive condition than the pre-incentive only condition. Substantive data did not differ across incentive structure, although the pre-incentive plus promised incentive condition was more cost-efficient. Survey research on college student populations is warranted to support the most scientifically sound and cost-efficient studies possible. Although substantive data did not differ, altering the incentive structure could yield cost savings with better response rates and more representative samples. Copyright © 2012 Elsevier Ltd. All rights reserved.
Health insurers promoting employee wellness: strategies, program components and results.
Murphy, Brigid M; Schoenman, Julie A; Pirani, Hafiza
2010-01-01
To examine health insurance companies' role in employee wellness. Case studies of eight insurers. Wellness activities in work, clinical, online, and telephonic settings. Senior executives and wellness program leaders from Blue Cross Blue Shield health insurers and from one wellness organization. Telephone interviews with 20 informants. Health insurers were engaged in wellness as part of their mission to promote health and reduce health care costs. Program components included the following: education, health risk assessments, incentives, coaching, environmental consultation, targeted programming, onsite biometric screening, professional support, and full-time wellness staff. Programs relied almost exclusively on positive incentives to encourage participation. Results included participation rates as high as 90%, return on investment ranging from $1.09 to $1.65, and improved health outcomes. Health insurers have expertise in developing, implementing, and marketing health programs and have wide access to employers and their employees' health data. These capabilities make health insurers particularly well equipped to expand the reach of wellness programming to improve the health of many Americans. By coupling members' medical data with wellness-program data, health insurers can better understand an individual's health status to develop and deliver targeted interventions. Through program evaluation, health insurers can also contribute to the limited but growing evidence base on employee wellness programs.
Perlman, David C; Friedmann, Patricia; Horn, Leslie; Nugent, Anne; Schoeb, Veronika; Carey, Jeanne; Salomon, Nadim; Des Jarlais, Don C
2003-09-01
Syringe-exchange programs (SEPs) have proven to be valuable sites to conduct tuberculin skin testing among active injection drug users. Chest x-rays (CXRs) are needed to exclude active tuberculosis prior to initiating treatment for latent tuberculosis infection. Adherence of drug users to referral for off-site chest x-rays has been incomplete. Previous cost modeling demonstrated that a monetary incentive to promote adherence could be justified on the cost basis if it had even a modest effect on adherence. We compared adherence to referral for chest x-rays among injection drug users undergoing syringe exchange-based tuberculosis screening in New York City before and after the implementation of monetary incentives. From 1995 to 1998, there were 119 IDUs referred for CXRs based on tuberculin skin testing at the SEP. From 1999 to 2001, there were 58 IDUs referred for CXRs with a $25 incentive based on adherence. Adherence to CXR referral within 7 days was 46/58 (79%) among individuals who received the monetary incentive versus 17/119 (14%) prior to the implementation of the monetary incentive (P<.0001; odds ratio [OR]=23; 95% confidence interval [CI]=9.5-57). The median time to obtaining a CXR was significantly shorter among those given the incentive than among those referred without the incentive (2 vs. 11 days, P<.0001). In multivariate logistic regression analysis, use of the incentive was highly independently associated with increased adherence (OR=22.9; 95% CI=10-52). Monetary incentives are highly effective in increasing adherence to referral for screening CXRs to exclude active tuberculosis after syringe exchange-based tuberculin skin testing. Prior cost modeling demonstrated that monetary incentives could be justified on the cost basis if they had even a modest effect on adherence. The current data demonstrated that monetary incentives are highly effective at increasing adherence in this setting and therefore are justifiable on a cost basis. When health care interventions for drug users require referral off site, monetary incentives may be particularly valuable in promoting adherence.
42 CFR § 414.1450 - APM incentive payment.
Code of Federal Regulations, 2010 CFR
2017-10-01
... (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Merit-Based Incentive Payment System and Alternative Payment Model Incentive § 414.1450 APM incentive payment. (a) In... 42 Public Health 3 2017-10-01 2017-10-01 false APM incentive payment. § 414.1450 Section § 414...
Equity - some theory and its policy implications
Culyer, A.
2001-01-01
This essay seeks to characterise the essential features of an equitable health care system in terms of the classical Aristotelian concepts of horizontal and vertical equity, the common (but ill-defined) language of "need" and the economic notion of cost-effectiveness as a prelude to identifying some of the more important issues of value that policy-makers will have to decide for themselves; the characteristics of health (and what determines it) that can cause policy to be ineffective (or have undesired consequences); the information base that is required to support a policy directed at securing greater equity, and the kinds of research (theoretical and empirical) that are needed to underpin such a policy. Key Words: Health care systems • equity • horizontal equity • vertical equity • cost-effectiveness PMID:11479360
Stereotype threat can both enhance and impair older adults' memory.
Barber, Sarah J; Mather, Mara
2013-12-01
Negative stereotypes about aging can impair older adults' memory via stereotype threat; however, the mechanisms underlying this phenomenon are unclear. In two experiments, we tested competing predictions derived from two theoretical accounts of stereotype threat: executive-control interference and regulatory fit. Older adults completed a working memory test either under stereotype threat about age-related memory declines or not under such threat. Monetary incentives were manipulated such that recall led to gains or forgetting led to losses. The executive-control-interference account predicts that stereotype threat decreases the availability of executive-control resources and hence should impair working memory performance. The regulatory-fit account predicts that threat induces a prevention focus, which should impair performance when gains are emphasized but improve performance when losses are emphasized. Results were consistent only with the regulatory-fit account. Although stereotype threat significantly impaired older adults' working memory performance when remembering led to gains, it significantly improved performance when forgetting led to losses.
Influence of paper color and a monetary incentive on response rate.
King, Keith A; Vaughan, Jennifer L
2004-10-01
This study examined whether survey response rate differed based on the color of the paper the survey was printed on (blue vs green) and presence of a monetary incentive. A 4-page survey on eating disorders was mailed to Division 1A and 1AA college head athletic trainers (N=223) with half of the surveys on blue paper and half on green paper. Half of the athletic trainers (n = 111) received a $1.00 monetary incentive, and half (n = 112) received no monetary incentive. A total of 166 (71%) athletic trainers returned completed surveys. Response rates did not differ based on survey color but did differ based on presence of a monetary incentive. Athletic trainers who received a monetary incentive were significantly more likely than those who did not to return completed surveys (86% vs 63%, respectively).
Wang, Ping; Lu, Zhengnan; Sun, Jihong
2018-02-08
Background : New energy has become a key trend for global energy industry development. Talent plays a very critical role in the enhancement of new energy enterprise competitiveness. As a key component of talent, managers have been attracting more and more attention. The increase in job performance relies on, to a certain extent, incentive mechanism. Based on the Two-factor Theory, differences in influences and effects of different incentives on management performance have been checked in this paper from an empirical perspective. Methods : This paper selects the middle and low level managers in new energy enterprises as research samples and classifies the managers' performance into task performance, contextual performance and innovation performance. It uses manager performance questionnaires and intrinsic-extrinsic incentive factor questionnaires to investigate and study the effects and then uses Amos software to analyze the inner link between the intrinsic-extrinsic incentives and job performance. Results : Extrinsic incentives affect task performance and innovation performance positively. Intrinsic incentives impose active significant effects on task performance, contextual performance, and innovation performance. The intrinsic incentive plays a more important role than the extrinsic incentive. Conclusions : Both the intrinsic-extrinsic incentives affect manager performance positively and the intrinsic incentive plays a more important role than the extrinsic incentive. Several suggestions to management should be given based on these results.
The future of global health education: training for equity in global health.
Adams, Lisa V; Wagner, Claire M; Nutt, Cameron T; Binagwaho, Agnes
2016-11-21
Among academic institutions in the United States, interest in global health has grown substantially: by the number of students seeking global health opportunities at all stages of training, and by the increase in institutional partnerships and newly established centers, institutes, and initiatives to house global health programs at undergraduate, public health and medical schools. Witnessing this remarkable growth should compel health educators to question whether the training and guidance that we provide to students today is appropriate, and whether it will be applicable in the next decade and beyond. Given that "global health" did not exist as an academic discipline in the United States 20 years ago, what can we expect it will look like 20 years from now and how can we prepare for that future? Most clinicians and trainees today recognize the importance of true partnership and capacity building in both directions for successful international collaborations. The challenge is in the execution of these practices. There are projects around the world where this is occurring and equitable partnerships have been established. Based on our experience and observations of the current landscape of academic global health, we share a perspective on principles of engagement, highlighting instances where partnerships have thrived, and examples of where we, as a global community, have fallen short. As the world moves beyond the charity model of global health (and its colonial roots), it is evident that the issue underlying ethical global health practice is partnership and the pursuit of health equity. Thus, achieving equity in global health education and practice ought to be central to our mission as educators and advisors when preparing trainees for careers in this field. Seeking to eliminate health inequities wherever they are ingrained will reveal the injustices around the globe and in our own cities and towns.
Drug promotional practices in Mumbai: a qualitative study.
Roy, Nobhojit; Madhiwalla, Neha; Pai, Sanjay A
2007-01-01
We conducted a qualitative study to determine the range of promotional practices influencing drug usage in Mumbai. Open-ended interviews were conducted with 15 senior executives in drug companies, 25 chemists and 25 doctors; focus group discussions were held with 36 medical representatives. The study provided a picture of what might be described as an unholy alliance: manufacturers, chemists and doctors conspire to make profits at the expense of consumers and the public's health, even as they negotiate with each other on their respective shares of these profits. Misleading information, incentives and unethical trade practices were identified as methods to increase the prescription and sale of drugs. Medical representatives provide incomplete medical information to influence prescribing practices; they also offer incentives including conference sponsorship. Doctors may also demand incentives, as when doctors' associations threaten to boycott companies that do not comply with their demands for sponsorship. Manufacturers, chemists and medical representatives use various unethical trade practices. Of particular interest was the finding that chemists are major players in this system, providing drug information directly to patients. The study also reinforced our impression that medical representatives are the least powerful of the four groups.
Equity Measurements in School Finance: Indiana, Iowa and Illinois.
ERIC Educational Resources Information Center
Hickrod, G. Alan; And Others
Empirical studies of the school finance reforms of the 1970s have not indicated that equity has been satisfactorily achieved in all cases. The methods of equity analysis used and the data bases analyzed in those studies have differed enough to prevent ready comparison or the formulation of overall assessments of the effects of school finance…
ERIC Educational Resources Information Center
Ham, Sandra; Walker, Erica
This paper describes the Milwaukee Public Schools' involvement in Equity 2000, a standards-based reform initiative to enhance mathematics education and achievement among students of color, thereby increasing their likelihood of college enrollment and completion. The study highlights efforts to support and sustain a key component of Equity 2000:…
Shareowners' Equity at Campbell Soup: How Can Equity Be Negative?
ERIC Educational Resources Information Center
Mohrman, Mary Beth; Stuerke, Pamela S.
2014-01-01
This paper presents an instructional case based on the 2001 annual report of the Campbell Soup Company (CPB). During that year, CPB's shareowners' equity went from a surplus of USD137 million to a deficit of USD247 million. The analysis will allow students to determine that the change resulted from borrowing to purchase treasury stock. Students…
Addicted to discovery: Does the quest for new knowledge hinder practice improvement?
Perl, Harold I
2011-06-01
Despite the billions of dollars spent on health-focused research and the hundreds of billions spent on delivering health services each year, relatively little money and effort are directed toward investigating how best to connect the two. This results in missed opportunities to assure that research findings inform and improve quality across healthcare in general and for addiction prevention and treatment in particular. There is an asymmetrical focus that favors the identification of new interventions and neglects the implementation of science-based knowledge in actual practice. The consequences of that neglect are severe: significantly diminished progress in research on how to implement treatments that could improve the lives of persons with addiction problems, their families, and the rest of society. While the advancement of knowledge regarding effective implementation is lagging, it is clear that existing systemic incentives in the conduct of science inhibit rather than facilitate widespread adoption of evidence-based practices. This commentary proposes three interrelated strategies for improving the implementation process. First, develop scientific tools to understand implementation better, by expanding investigations on the science of implementation and broadening approaches to the design and execution of research. Second, nurture and support a collaborative implementation workforce comprised of scientists and on-the-ground practitioners, with an explicit focus on enhancing appropriate incentives for both. Third, pay closer attention to crafting research that seeks answers that are most relevant to clinicians' actual needs, primarily by ensuring that the anticipated users of the evidence-based practice are full partners in developing the questions right from the start. Published by Elsevier Ltd.
1980-01-01
professionally; increased self - esteem ; and preparation for future growth. The quality of supervision and coaching are critical in an organization. Each...Ther is a wider use of competitive exams for selection, providing an incentive for the officer to prepare for attendance through self -study. Examinations...Development." Journal of Systems Management (August 1977): 16-18. A critical look is given to job-task analysis, self - actualization, and the
Orphan drugs for rare diseases: is it time to revisit their special market access status?
Simoens, Steven; Cassiman, David; Dooms, Marc; Picavet, Eline
2012-07-30
Orphan drugs are intended for diseases with a very low prevalence, and many countries have implemented legislation to support market access of orphan drugs. We argue that it is time to revisit the special market access status of orphan drugs. Indeed, evidence suggests that there is no societal preference for treating rare diseases. Although society appears to assign a greater value to severity of disease, this criterion is equally relevant to many common diseases. Furthermore, the criterion of equity in access to treatment, which underpins orphan drug legislation, puts more value on health improvement in rare diseases than in common diseases and implies that population health is not maximized. Finally, incentives for the development, pricing and reimbursement of orphan drugs have created market failures, including monopolistic prices and the artificial creation of rare diseases. We argue that, instead of awarding special market access status to orphan drugs, there is scope to optimize research and development (R&D) of orphan drugs and to control prices of orphan drugs by means of, for example, patent auctions, advance purchase commitments, pay-as-you-go schemes and dose-modification studies. Governments should consider carefully the right incentive strategy for R&D of orphan drugs in rare diseases.
Ham, C.; Maynard, A.
1994-01-01
The purpose of the present NHS reforms is to introduce a managed market; developing some of the incentives for greater efficiency that are often found in markets while still being able to regulate proceedings to prevent market failures. If government intervenes too much there will be no incentive to improve efficiency and streamline operations: too little intervention may result in some areas having inadequate health service cover or monopoly powers abusing their position. Effective management of the NHS market requires eight core elements: openness of information, control of labour and capital markets, regulation of mergers and takeovers, arbitrating in disputes, protection of unprofitable functions such as research and development, overseeing national provision of health services, protection of basic principles of the NHS, and handling of closures and redundancy. Management of the market would best be performed by the NHS management executive and health authority purchasers acting within a framework set by politicians. Images p846-a p847-a PMID:8167496
IRS proposed "physician recruitment" revenue ruling offers few kernels in search for.
Reaves, C F
1995-07-01
Not to sound corny, but things have really been popping since the Internal Revenue Service (IRS) recently released a proposed revenue ruling regarding the scope of recruitment incentives that may be offered to nonemployee physician members of tax-exempt hospital medical staffs. Commentators have criticized the proposed revenue ruling, however, because it offers little in the way of guidance in all but the most obvious cases of recruitment violations. Nonetheless, the proposed ruling may provide insight that may assist hospitals to prepare permissible recruitment incentives for physicians. The IRS provided a public comment period within which individuals and groups could submit proposals to improve or revise the proposed ruling. However, with or without such comments, clarification of the ruling is called for. "Health Law" is a regular feature of Physician Executive from the Washington, D.C., law firm Epstein Becker & Green. Mark Lutes of the law firm serves as editor of the column.
Incentive contracts for development projects
NASA Astrophysics Data System (ADS)
Finley, David T.; Smith, Byron; DeGroff, B.
2012-09-01
Finding a contract vehicle that balances the concerns of the customer and the contractor in a development project can be difficult. The customer wants a low price and an early delivery, with as few surprises as possible as the project progresses. The contractor wants sufficient cost and schedule to cover risk. Both want to clearly define what each party will provide. Many program offices do not want to award cost plus contracts because their funding sources will not allow it, their boards do not want an open ended commitment, and they feel like they lose financial control of the project. A fixed price incentive contract, with a mutually agreed upon target cost, provides the owner with visibility into the project and input into the execution of the project, encourages both parties to save costs, and stimulates a collaborative atmosphere by aligning the respective interests of customers and contractors.
Food sovereignty, food security and health equity: a meta-narrative mapping exercise
Weiler, Anelyse M.; Hergesheimer, Chris; Brisbois, Ben; Wittman, Hannah; Yassi, Annalee; Spiegel, Jerry M.
2015-01-01
There has been growing policy interest in social justice issues related to both health and food. We sought to understand the state of knowledge on relationships between health equity—i.e. health inequalities that are socially produced—and food systems, where the concepts of ‘food security’ and ‘food sovereignty’ are prominent. We undertook exploratory scoping and mapping stages of a ‘meta-narrative synthesis’ on pathways from global food systems to health equity outcomes. The review was oriented by a conceptual framework delineating eight pathways to health (in)equity through the food system: 1—Multi-Scalar Environmental, Social Context; 2—Occupational Exposures; 3—Environmental Change; 4—Traditional Livelihoods, Cultural Continuity; 5—Intake of Contaminants; 6—Nutrition; 7—Social Determinants of Health and 8—Political, Economic and Regulatory context. The terms ‘food security’ and ‘food sovereignty’ were, respectively, paired with a series of health equity-related terms. Combinations of health equity and food security (1414 citations) greatly outnumbered pairings with food sovereignty (18 citations). Prominent crosscutting themes that were observed included climate change, biotechnology, gender, racialization, indigeneity, poverty, citizenship and HIV as well as institutional barriers to reducing health inequities in the food system. The literature indicates that food sovereignty-based approaches to health in specific contexts, such as advancing healthy school food systems, promoting soil fertility, gender equity and nutrition, and addressing structural racism, can complement the longer-term socio-political restructuring processes that health equity requires. Our conceptual model offers a useful starting point for identifying interventions with strong potential to promote health equity. A research agenda to explore project-based interventions in the food system along these pathways can support the identification of ways to strengthen both food sovereignty and health equity. PMID:25288515
Cost of Equity Estimation in Fuel and Energy Sector Companies Based on CAPM
NASA Astrophysics Data System (ADS)
Kozieł, Diana; Pawłowski, Stanisław; Kustra, Arkadiusz
2018-03-01
The article presents cost of equity estimation of capital groups from the fuel and energy sector, listed at the Warsaw Stock Exchange, based on the Capital Asset Pricing Model (CAPM). The objective of the article was to perform a valuation of equity with the application of CAPM, based on actual financial data and stock exchange data and to carry out a sensitivity analysis of such cost, depending on the financing structure of the entity. The objective of the article formulated in this manner has determined its' structure. It focuses on presentation of substantive analyses related to the core of equity and methods of estimating its' costs, with special attention given to the CAPM. In the practical section, estimation of cost was performed according to the CAPM methodology, based on the example of leading fuel and energy companies, such as Tauron GE and PGE. Simultaneously, sensitivity analysis of such cost was performed depending on the structure of financing the company's operation.
The impact of productivity-based incentives on faculty salary-based compensation.
Miller, Ronald D; Cohen, Neal H
2005-07-01
In industry and academic anesthesia departments, incentives and bonus payments based on productivity are accounting for an increasing proportion of a total compensation. When incentives are primarily based on clinical productivity, the impact on the distribution of total compensation to the faculty is not known. We compared a pure salary-based compensation methodology based entirely on academic rank to salary plus incentives and/or clinical productivity compensation (i.e., billable hours). The change in compensation methodology resulted in two major findings. First, the productivity-based compensation resulted in a large increase in the variability of total compensation among faculty, especially at the Assistant Professor rank. Second, the mean difference in total compensation between Assistant and Full Professors decreased. The authors conclude that this particular incentive plan, primarily directed toward clinical productivity, dramatically changed the distribution of total compensation in favor of junior faculty. Although not analytically investigated, the potential impact of these changes on faculty morale and distribution of faculty activities is discussed.
ERIC Educational Resources Information Center
Bianchini, Julie A.; Dwyer, Hilary A.; Brenner, Mary E.; Wearly, Alayna J.
2015-01-01
We investigated a 2.5-year professional development effort designed to support practicing science and mathematics teachers in understanding equity and enacting equitable practices. Our purpose was to inform the research base on effective equity professional development, toward the goal of better supporting science and mathematics teachers in…
ERIC Educational Resources Information Center
Abu-Ghaida, Dina; Klasen, Stephan
2004-01-01
At the Millennium Summit, the world community pledged to promote gender equality and chose as a specific target the achievement of gender equity in primary and secondary education by the year 2005 in every country of the world. Based on the findings from a growing empirical literature that suggests that gender equity in education promotes economic…
Multicriteria approaches for a private equity fund
NASA Astrophysics Data System (ADS)
Tammer, Christiane; Tannert, Johannes
2012-09-01
We develop a new model for a Private Equity Fund based on stochastic differential equations. In order to find efficient strategies for the fund manager we formulate a multicriteria optimization problem for a Private Equity Fund. Using the e-constraint method we solve this multicriteria optimization problem. Furthermore, a genetic algorithm is applied in order to get an approximation of the efficient frontier.
Marti, Joachim; Bachhuber, Marcus; Feingold, Jordyn; Meads, David; Richards, Michael; Hennessy, Sean
2017-01-01
Objectives Investigate the acceptability of financial incentives for initiating a medically supervised benzodiazepine discontinuation programme among people with long-term benzodiazepine use and to identify programme features that influence willingness to participate. Methods We conducted a discrete choice experiment in which we presented a variety of incentive-based programs to a sample of older adults with long-term benzodiazepine use identified using the outpatient electronic health record of a university-owned health system. We studied four programme variables: incentive amount for initiating the programme, incentive amount for successful benzodiazepine discontinuation, lottery versus certain payment and whether partial payment was given for dose reduction. Respondents reported their willingness to participate in the programmes and additional information was collected on demographics, history of use and anxiety symptoms. Results The overall response rate was 28.4%. Among the 126 respondents, all four programme variables influenced stated preferences. Respondents strongly preferred guaranteed cash-based incentives as opposed to a lottery, and the dollar amount of both the starting and conditional incentives had a substantial impact on choice. Willingness to participate increased with the amount of conditional incentive. Programme participation also varied by gender, duration of use and income. Conclusions Participation in an incentive-based benzodiazepine discontinuation programme might be relatively low, but is modifiable by programme variables including incentive amounts. These results will be helpful to inform the design of future trials of benzodiazepine discontinuation programmes. Further research is needed to assess the financial viability and potential cost-effectiveness of such economic incentives. PMID:28988167
An incentive plan for professional fee collections at an indigent-care teaching hospital.
Stewart, M G; Jones, D B; Garson, A T
2001-11-01
The authors describe the implementation and development of an incentive plan to improve professional fee collections at an indigent-care teaching hospital. They theorized that an incentive plan based on relative value unit (RVU) productivity would increase billings and collections of professional fees. Unique RVU targets were set for individual services based on the number of faculty full-time equivalents and average reported productivity for academic physicians by specialty. The incentive plan was based on the level of expected faculty billings, measured in RVUs, for each department. A "base + incentive" model was used, with the base budget being distributed monthly throughout the year, and the incentive held as a "withhold" to be paid at the year's end only if the billing target in RVUs was met. Additionally, a task force worked with physician billing office and the hospital to improve collections. In the first year after implementation of the system was in place, important increases were noted in total RVU productivity (30.5% over the previous year) and in collections (49.5% over the previous year). Sixteen of 23 departments exceeded their incentive targets, and it was possible to make distributions of professional fees to those departments, to be used within the hospital system to enhance clinical services. Moreover, the plan created an overall positive attitude toward billings and documentation of faculty activities. The authors believe that this kind of incentive plan will be increasingly important for academic faculty working in public hospital systems.
Wang, Ping; Lu, Zhengnan; Sun, Jihong
2018-01-01
Background: New energy has become a key trend for global energy industry development. Talent plays a very critical role in the enhancement of new energy enterprise competitiveness. As a key component of talent, managers have been attracting more and more attention. The increase in job performance relies on, to a certain extent, incentive mechanism. Based on the Two-factor Theory, differences in influences and effects of different incentives on management performance have been checked in this paper from an empirical perspective. Methods: This paper selects the middle and low level managers in new energy enterprises as research samples and classifies the managers’ performance into task performance, contextual performance and innovation performance. It uses manager performance questionnaires and intrinsic-extrinsic incentive factor questionnaires to investigate and study the effects and then uses Amos software to analyze the inner link between the intrinsic-extrinsic incentives and job performance. Results: Extrinsic incentives affect task performance and innovation performance positively. Intrinsic incentives impose active significant effects on task performance, contextual performance, and innovation performance. The intrinsic incentive plays a more important role than the extrinsic incentive. Conclusions: Both the intrinsic-extrinsic incentives affect manager performance positively and the intrinsic incentive plays a more important role than the extrinsic incentive. Several suggestions to management should be given based on these results. PMID:29419730
Get the right mix of bricks & clicks.
Gulati, R; Garino, J
2000-01-01
The bright line that once distinguished the dot-com from the incumbent is rapidly fading. Success in the new economy will go to those who can execute clicks-and-mortar strategies that bridge the physical and virtual worlds. But how executives forge such strategies is under considerable debate. Despite the obvious benefits that integration offers--cross-promotion, shared information, purchasing leverage, distribution economies, and the like--many executives now assume that Internet businesses have to be separate to thrive. They believe that the very nature of traditional business--its protectiveness of current customers, its fear of cannibalization, its general myopia--will smother any Internet initiative. Authors Ranjay Gulati and Jason Garino contend that executives don't have to make an either- or choice when it comes to their clicks-and-mortar strategies. The question isn't, "Should we develop our Internet channel in-house or launch a spin-off?" but rather, "What degree of integration makes sense for our company?" To determine the best level of integration for their companies, executives should examine four business dimensions: brand, management, operations, and equity. Drawing on the experiences of three established retailers--Office Depot, KB Toys, and Rite Aid--the authors show the spectrum of strategies available and discuss the trade-offs involved in each choice. By thinking carefully about which aspects of a business to integrate and which to keep distinct, companies can tailor their clicks-and-mortar strategy to their own particular market and competitive situation, dramatically increasing their odds of e-business success.
On the Path to SunShot: Emerging Opportunities and Challenges in Financing Solar
DOE Office of Scientific and Technical Information (OSTI.GOV)
Feldman, David; Bolinger, Mark
This report analyzes solar financing strategies and their role in achieving the U.S. Department of Energy's SunShot goals. Financing is critical to solar deployment, because the costs of solar technologies are paid up front, while their benefits are realized over decades. Solar financing has been shaped by government solar incentives, particularly federal tax incentives, which have spawned complex tax-equity structures that monetize tax benefits for project sponsors who otherwise could not use them efficiently. Although these structures have helped expand solar deployment, they are relatively costly and inefficient. This has spurred solar stakeholders to develop lower-cost financing solutions such asmore » securitization of solar project portfolios, solar-specific loan products, and methods for incorporating residential solar's value into home values. To move solar further toward an unsubsidized SunShot future, additional financial innovation must occur. Development of a larger, more mature U.S. solar industry will likely increase financial transparency and investor confidence, which in turn will enable simpler, lower-cost financing methods. Utility-scale solar might be financed more like conventional generation assets are today, non-residential solar might be financed more like a new roof, and residential solar might be financed more like an expensive appliance. Assuming a constant, SunShot-level installed photovoltaic (PV) system price, such financing innovations could reduce PV's levelized cost of electricity (LCOE) by an estimated 25%-50% compared with historical financing approaches. These results suggest that financing can adapt to changing conditions and might ease the transition away from a reliance on tax incentives while driving solar's LCOE toward the SunShot goals.« less
Food sovereignty, food security and health equity: a meta-narrative mapping exercise.
Weiler, Anelyse M; Hergesheimer, Chris; Brisbois, Ben; Wittman, Hannah; Yassi, Annalee; Spiegel, Jerry M
2015-10-01
There has been growing policy interest in social justice issues related to both health and food. We sought to understand the state of knowledge on relationships between health equity--i.e. health inequalities that are socially produced--and food systems, where the concepts of 'food security' and 'food sovereignty' are prominent. We undertook exploratory scoping and mapping stages of a 'meta-narrative synthesis' on pathways from global food systems to health equity outcomes. The review was oriented by a conceptual framework delineating eight pathways to health (in)equity through the food system: 1--Multi-Scalar Environmental, Social Context; 2--Occupational Exposures; 3--Environmental Change; 4--Traditional Livelihoods, Cultural Continuity; 5--Intake of Contaminants; 6--Nutrition; 7--Social Determinants of Health and 8--Political, Economic and Regulatory context. The terms 'food security' and 'food sovereignty' were, respectively, paired with a series of health equity-related terms. Combinations of health equity and food security (1414 citations) greatly outnumbered pairings with food sovereignty (18 citations). Prominent crosscutting themes that were observed included climate change, biotechnology, gender, racialization, indigeneity, poverty, citizenship and HIV as well as institutional barriers to reducing health inequities in the food system. The literature indicates that food sovereignty-based approaches to health in specific contexts, such as advancing healthy school food systems, promoting soil fertility, gender equity and nutrition, and addressing structural racism, can complement the longer-term socio-political restructuring processes that health equity requires. Our conceptual model offers a useful starting point for identifying interventions with strong potential to promote health equity. A research agenda to explore project-based interventions in the food system along these pathways can support the identification of ways to strengthen both food sovereignty and health equity. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.
Welch, Vivian; Petticrew, Mark; Ueffing, Erin; Benkhalti Jandu, Maria; Brand, Kevin; Dhaliwal, Bharbhoor; Kristjansson, Elizabeth; Smylie, Janet; Wells, George Anthony; Tugwell, Peter
2012-01-01
Introduction Tackling health inequities both within and between countries remains high on the agenda of international organizations including the World Health Organization and local, regional and national governments. Systematic reviews can be a useful tool to assess effects on equity in health status because they include studies conducted in a variety of settings and populations. This study aims to describe the extent to which the impacts of health interventions on equity in health status are considered in systematic reviews, describe methods used, and assess the implications of their equity related findings for policy, practice and research. Methods We conducted a methodology study of equity assessment in systematic reviews. Two independent reviewers extracted information on the reporting and analysis of impacts of health interventions on equity in health status in a group of 300 systematic reviews collected from all systematic reviews indexed in one month of MEDLINE, using a pre-tested data collection form. Any differences in data extraction were resolved by discussion. Results Of the 300 systematic reviews, 224 assessed the effectiveness of interventions on health outcomes. Of these 224 reviews, 29 systematic reviews assessed effects on equity in health status using subgroup analysis or targeted analyses of vulnerable populations. Of these, seven conducted subgroup analyses related to health equity which were reported in insufficient detail to judge their credibility. Of these 29 reviews, 18 described implications for policy and practice based on assessment of effects on health equity. Conclusion The quality and completeness of reporting should be enhanced as a priority, because without this policymakers and practitioners will continue lack the evidence base they need to inform decision-making about health inequity. Furthermore, there is a need to develop methods to systematically consider impacts on equity in health status that is currently lacking in systematic reviews. PMID:22427804
ERIC Educational Resources Information Center
Kaimal, Girija; Jordan, Will J.
2016-01-01
Context: Policymakers have increasingly advocated for incentive-based approaches for improving urban schools. Purpose of the study: Few studies have examined the implementation of incentive based approaches in the urban charter school context. This paper presents research findings from a 4-year longitudinal study of the implementation of a…
ERIC Educational Resources Information Center
Florida State Legislature, Tallahassee. Office of Program Policy Analysis and Government Accountability.
This report addresses the Florida Community College System's (FCCS) performance based on measures established by the General Appropriations Act. Discussed are: (1) FCCS' performance on the measures used in the performance-based budgeting (PBB) incentive fund; (2) improvements that can be made to the PBB incentive fund; and (3) changes to community…
ERIC Educational Resources Information Center
Wickramasinghe, Vathsala; Dabere, Sampath
2012-01-01
The objective of the study is to investigate the effect of performance-based financial incentives on work performance. The study hypothesized that the design features of performance-based financial incentive schemes themselves may influence individuals' work performance. For the study, survey methodology was used and 93 technical-level employees…
Use of the Equity Implementation Model to Review Clinical System Implementation Efforts
Lauer, Thomas W.; Joshi, Kailash; Browdy, Thomas
2000-01-01
This paper presents the equity implementation model (EIM) in the context of a case that describes the implementation of a medical scheduling system. The model is based on equity theory, a well-established theory in the social sciences that has been tested in hundreds of experimental and field studies. The predictions of equity theory have been supported in organizational, societal, family, and other social settings. Thus, the EIM helps provide a theory-based understanding for collecting and reviewing users' reactions to, and acceptance or rejection of, a new technology or system. The case study (implementation of a patient scheduling and appointment setting system in a large health maintenance organization) illustrates how the EIM can be used to examine users' reactions to the implementation of a new system. PMID:10641966
Kamb, M L; Rhodes, F; Hoxworth, T; Rogers, J; Lentz, A; Kent, C; MacGowen, R; Peterman, T A
1998-08-01
We studied the effect of small monetary incentives and non-monetary incentives of similar value on enrollment and participation in clinic based HIV/STD prevention counselling. We examined incident STDs to try to assess whether participants offered money may be less motivated to change risky behaviours than those offered other incentives. Patients from five US STD clinics were invited to enroll in a multisession risk reduction counselling intervention and, based on their enrollment date, were offered either $15 for each additional session or non-monetary incentives worth $15. The two incentive groups were compared on participants' enrollment, completion of intervention sessions, and new STDs over the 24 months after enrollment. Of 648 patients offered money, 198 (31%) enrolled compared with 160 (23%) of 696 patients offered other incentives (p = 0.002). Enrollees in the two incentive groups had similar baseline characteristics, including condom use. Of the 198 participants offered money, 109 (55%) completed all sessions compared with 59 (37%) of the participants offered other incentives (p < 0.0001). Comparing those offered money with those offered other incentives STD rates were similar after 6, 12, and 24 months. Small monetary incentives enhanced enrollment and participation compared with other incentives of similar value. Regardless of incentive offered, participants had similar post-enrollment STD rates, suggesting that the type of incentive does not adversely affect motivation to change behaviour. Money may be useful in encouraging high risk individuals to participate in and complete counselling or other public health interventions.
Financial incentives for exercise adherence in adults: systematic review and meta-analysis.
Mitchell, Marc S; Goodman, Jack M; Alter, David A; John, Leslie K; Oh, Paul I; Pakosh, Maureen T; Faulkner, Guy E
2013-11-01
Less than 5% of U.S. adults accumulate the required dose of exercise to maintain health. Behavioral economics has stimulated renewed interest in economic-based, population-level health interventions to address this issue. Despite widespread implementation of financial incentive-based public health and workplace wellness policies, the effects of financial incentives on exercise initiation and maintenance in adults remain unclear. A systematic search of 15 electronic databases for RCTs reporting the impact of financial incentives on exercise-related behaviors and outcomes was conducted in June 2012. A meta-analysis of exercise session attendance among included studies was conducted in April 2013. A qualitative analysis was conducted in February 2013 and structured along eight features of financial incentive design. Eleven studies were included (N=1453; ages 18-85 years and 50% female). Pooled results favored the incentive condition (z=3.81, p<0.0001). Incentives also exhibited significant, positive effects on exercise in eight of the 11 included studies. One study determined that incentives can sustain exercise for longer periods (>1 year), and two studies found exercise adherence persisted after the incentive was withdrawn. Promising incentive design feature attributes were noted. Assured, or "sure thing," incentives and objective behavioral assessment in particular appear to moderate incentive effectiveness. Previously sedentary adults responded favorably to incentives 100% of the time (n=4). The effect estimate from the meta-analysis suggests that financial incentives increase exercise session attendance for interventions up to 6 months in duration. Similarly, a simple count of positive (n=8) and null (n=3) effect studies suggests that financial incentives can increase exercise adherence in adults in the short term (<6 months). © 2013 American Journal of Preventive Medicine.
ERIC Educational Resources Information Center
Dieltiens, Veerle; Unterhalter, Elaine; Letsatsi, Setungoane; North, Amy
2009-01-01
Gender equity is one of the foundational principles of the national Department of Education, but there is not a shared understanding of its meaning. Based on interviews conducted in 2008 with officials in the Department of Education, we argue that there are two basic approaches to gender equity. The first, which we term "gender blind",…
Financial Incentives and Physician Practice Participation in Medicare's Value-Based Reforms.
Markovitz, Adam A; Ramsay, Patricia P; Shortell, Stephen M; Ryan, Andrew M
2017-07-26
To evaluate whether greater experience and success with performance incentives among physician practices are related to increased participation in Medicare's voluntary value-based payment reforms. Publicly available data from Medicare's Physician Compare (n = 1,278; January 2012 to November 2013) and nationally representative physician practice data from the National Survey of Physician Organizations 3 (NSPO3; n = 907,538; 2013). We used regression analysis to examine practice-level relationships between prior exposure to performance incentives and participation in key Medicare value-based payment reforms: accountable care organization (ACO) programs, the Physician Quality Reporting System ("Physician Compare"), and the Meaningful Use of Health Information Technology program ("Meaningful Use"). Prior experience and success with financial incentives were measured as (1) the percentage of practices' revenue from financial incentives for quality or efficiency; and (2) practices' exposure to public reporting of quality measures. We linked physician participation data from Medicare's Physician Compare to the NSPO3 survey. There was wide variation in practices' exposure to performance incentives, with 64 percent exposed to financial incentives, 45 percent exposed to public reporting, and 2.2 percent of practice revenue coming from financial incentives. For each percentage-point increase in financial incentives, there was a 0.9 percentage-point increase in the probability of participating in ACOs (standard error [SE], 0.1, p < .001) and a 0.8 percentage-point increase in the probability of participating in Meaningful Use (SE, 0.1, p < .001), controlling for practice characteristics. Financial incentives were not associated with participation in Physician Compare. Among ACO participants, a 1 percentage-point increase in incentives was associated with a 0.7 percentage-point increase in the probability of being "very well" prepared to utilize cost and quality data (SE, 0.1, p < .001). Physicians organizations' prior experience and success with performance incentives were related to participation in Medicare ACO arrangements and participation in the meaningful use criteria but not to participation in Physician Compare. We conclude that Medicare must complement financial incentives with additional efforts to address the needs of practices with less experience with such incentives to promote value-based payment on a broader scale. © Health Research and Educational Trust.
Advancing Efforts to Achieve Health Equity: Equity Metrics for Health Impact Assessment Practice
Heller, Jonathan; Givens, Marjory L.; Yuen, Tina K.; Gould, Solange; Benkhalti Jandu, Maria; Bourcier, Emily; Choi, Tim
2014-01-01
Equity is a core value of Health Impact Assessment (HIA). Many compelling moral, economic, and health arguments exist for prioritizing and incorporating equity considerations in HIA practice. Decision-makers, stakeholders, and HIA practitioners see the value of HIAs in uncovering the impacts of policy and planning decisions on various population subgroups, developing and prioritizing specific actions that promote or protect health equity, and using the process to empower marginalized communities. There have been several HIA frameworks developed to guide the inclusion of equity considerations. However, the field lacks clear indicators for measuring whether an HIA advanced equity. This article describes the development of a set of equity metrics that aim to guide and evaluate progress toward equity in HIA practice. These metrics also intend to further push the field to deepen its practice and commitment to equity in each phase of an HIA. Over the course of a year, the Society of Practitioners of Health Impact Assessment (SOPHIA) Equity Working Group took part in a consensus process to develop these process and outcome metrics. The metrics were piloted, reviewed, and refined based on feedback from reviewers. The Equity Metrics are comprised of 23 measures of equity organized into four outcomes: (1) the HIA process and products focused on equity; (2) the HIA process built the capacity and ability of communities facing health inequities to engage in future HIAs and in decision-making more generally; (3) the HIA resulted in a shift in power benefiting communities facing inequities; and (4) the HIA contributed to changes that reduced health inequities and inequities in the social and environmental determinants of health. The metrics are comprised of a measurement scale, examples of high scoring activities, potential data sources, and example interview questions to gather data and guide evaluators on scoring each metric. PMID:25347193
Dean, Hazel D; Roberts, George W; Bouye, Karen E; Green, Yvonne; McDonald, Marian
2016-01-01
The public health infrastructure required for achieving health equity is multidimensional and complex. The infrastructure should be responsive to current and emerging priorities and capable of providing the foundation for developing, planning, implementing, and evaluating health initiatives. This article discusses these infrastructure requirements by examining how they are operationalized in the organizational infrastructure for promoting health equity at the Centers for Disease Control and Prevention, utilizing the nation's premier public health agency as a lens. Examples from the history of the Centers for Disease Control and Prevention's work in health equity from its centers, institute, and offices are provided to identify those structures and functions that are critical to achieving health equity. Challenges and facilitators to sustaining a health equity organizational infrastructure, as gleaned from the Centers for Disease Control and Prevention's experience, are noted. Finally, we provide additional considerations for expanding and sustaining a health equity infrastructure, which the authors hope will serve as "food for thought" for practitioners in state, tribal, or local health departments, community-based organizations, or nongovernmental organizations striving to create or maintain an impactful infrastructure to achieve health equity.
Marti, Joachim; Bachhuber, Marcus; Feingold, Jordyn; Meads, David; Richards, Michael; Hennessy, Sean
2017-10-06
Investigate the acceptability of financial incentives for initiating a medically supervised benzodiazepine discontinuation programme among people with long-term benzodiazepine use and to identify programme features that influence willingness to participate. We conducted a discrete choice experiment in which we presented a variety of incentive-based programs to a sample of older adults with long-term benzodiazepine use identified using the outpatient electronic health record of a university-owned health system. We studied four programme variables: incentive amount for initiating the programme, incentive amount for successful benzodiazepine discontinuation, lottery versus certain payment and whether partial payment was given for dose reduction. Respondents reported their willingness to participate in the programmes and additional information was collected on demographics, history of use and anxiety symptoms. The overall response rate was 28.4%. Among the 126 respondents, all four programme variables influenced stated preferences. Respondents strongly preferred guaranteed cash-based incentives as opposed to a lottery, and the dollar amount of both the starting and conditional incentives had a substantial impact on choice. Willingness to participate increased with the amount of conditional incentive. Programme participation also varied by gender, duration of use and income. Participation in an incentive-based benzodiazepine discontinuation programme might be relatively low, but is modifiable by programme variables including incentive amounts. These results will be helpful to inform the design of future trials of benzodiazepine discontinuation programmes. Further research is needed to assess the financial viability and potential cost-effectiveness of such economic incentives. © 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.
[Clinical Management: Basics and organization].
Torres, Juan; Mingo, Carlos
2015-01-01
Many strategies have been proposed over the last years to ensure the Health Care System sustainability, mainly after the recent global economic crisis. One of the most attractive approaches is clinical management, which is a way of organizing health care units based on active participation of professionals who receive the transference of responsibilities dispoto achieve the objectives with the mission of ensuring a proper patient centered care, taking into consideration the rational use of resources (Efficiency) For the start up of Health Care structures based on clinical management, it is necessary a previous management culture within the departments involved and the center's executive board. Furthermore, to achieve the objectives proposed various tools must be used, such as evidence based medicine, clinical practice variability analysis, process management, in addition of quality and safety strategies. The units involved have to propose a management plan that will result in a management contract with the center's executive board. This agreement will establish some activity, expense and quality objectives that will be quantifiable through various indicators. Risk transference to the unit must include certain budget allocation and incentive decision capacity. Clinical management must not be employed as a savings tool from the part of macro and meso management. There is not a health care structure based on clinical management that have a general character for all health care organizations, existing a great variability in the adoption of various organizational formulas, so that every center must perform its own analysis and decide the most adequate model. In our country there are many clinical management experiences, although there is a long way to go.
Some problems with pro-competition reforms.
Agich, G J; Begley, C E
1985-01-01
As the search for effective cost-containment policies continues, health care reform along pro-competition lines has gained considerable backing in the United States. By offering market competition to achieve allocational efficiency and vouchers and tax credits to achieve distributional equity, pro-competition reforms appear to satisfy what many believed were incommensurable goals. A critical review of this strategy reveals two practical difficulties, however. The first concerns the ambiguity arising from the proposals' reliance on the concept of equal access to some basic level of health care as its distributional objective and the second concerns the ethical dilemma arising from the proposals' reliance on physicians as rationers of health care. In considering the distributional goal of guaranteeing access to a basic minimum of health care, we argue that, despite its theoretical attractiveness, there exists no acceptable way of determining or justifying its content, and without a clear definition of the basic minimum there is no guarantee that any equity objective will be achieved under the pro-competition strategy. With regard to the use of physicians and other providers as society's gatekeepers, we point out that this role is in direct conflict with traditional responsibilities that patients expect providers to assume. Requiring doctors to ration services in response to market incentives may further erode the trust relationship between physicians and patients, and clearly puts the more seriously ill at a disadvantage.
Franc, Carine; Pierre, Aurélie
2015-02-01
In January 2013, within the framework of a National Inter-professional Agreement (NIA), the French government required all employers (irrespective of the size of their business) to offer private complementary health insurance to their employees from January 2016. The generalization of group complementary health insurance to all employees will directly affect insurers, employers and employees, as well as individuals not directly concerned (students, retirees, unemployed and civil servants). In this paper, we present the issues raised by this regulation, the expected consequences and the current debate around this reform. In particular, we argue that this reform may have adverse effects on equity of access to complementary health insurance in France, since the risk structure of the market for individual health insurance will change, potentially increasing inequalities between wage-earners and others. Moreover, tax exemptions given to group contracts are problematic because public funds used to support these contracts can be higher at individual level for high-salary individuals than those allocated to improve access for the poorest. In response to the criticism and with the aim of ensuring equity in the system, the government decided to reconsider some of the fiscal advantages given to group contracts, to enhance programs and aids dedicated to the poorest and to redefine an overall context of incentives. Copyright © 2015. Published by Elsevier Ireland Ltd.
Formula-Based Public School Funding System in Victoria: An Empirical Analysis of Equity
ERIC Educational Resources Information Center
Bandaranayake, Bandara
2013-01-01
This article explores the formula-based school funding system in the state of Victoria, Australia, where state funds are directly allocated to schools based on a range of equity measures. The impact of Victoria' funding system for education in terms of alleviating inequality and disadvantage is contentious, to say the least. It is difficult to…
Equity, empowerment and different ways of knowing
NASA Astrophysics Data System (ADS)
Boaler, Jo
1997-11-01
This paper considers the experiences of two sets of students who attended schools that taught mathematics in completely different ways. One of the schools used a traditional, textbook approach, and the other used an open, project-based approach. The latter approach produced equity between girls and boys whereas the textbook approach prompted many of the girls to under achieve. This paper will consider the experiences of girls and boys who followed the project-based approach, reflect upon the sources of equity within this approach and relate the differences between the two approaches to Gilligan's notions of "separate" and "connected" knowing.
Squitieri, Lee; Chung, Kevin C
2017-07-01
In 2017, the Centers for Medicare and Medicaid Services began requiring all eligible providers to participate in the Quality Payment Program or face financial reimbursement penalty. The Quality Payment Program outlines two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. For the first performance period beginning in January of 2017, the Centers for Medicare and Medicaid Services estimates that approximately 83 to 90 percent of eligible providers will not qualify for participation in an Advanced Alternative Payment Model and therefore must participate in the Merit-Based Incentive Payment System program. The Merit-Based Incentive Payment System path replaces existing quality-reporting programs and adds several new measures to evaluate providers using four categories of data: (1) quality, (2) cost/resource use, (3) improvement activities, and (4) advancing care information. These categories will be combined to calculate a weighted composite score for each provider or provider group. Composite Merit-Based Incentive Payment System scores based on 2017 performance data will be used to adjust reimbursed payment in 2019. In this article, the authors provide relevant background for understanding value-based provider performance measurement. The authors also discuss Merit-Based Incentive Payment System reporting requirements and scoring methodology to provide plastic surgeons with the necessary information to critically evaluate their own practice capabilities in the context of current performance metrics under the Quality Payment Program.
An equity dashboard to monitor vaccination coverage.
Arsenault, Catherine; Harper, Sam; Nandi, Arijit; Rodríguez, José M Mendoza; Hansen, Peter M; Johri, Mira
2017-02-01
Equity monitoring is a priority for Gavi, the Vaccine Alliance, and for those implementing The 2030 agenda for sustainable development . For its new phase of operations, Gavi reassessed its approach to monitoring equity in vaccination coverage. To help inform this effort, we made a systematic analysis of inequalities in vaccination coverage across 45 Gavi-supported countries and compared results from different measurement approaches. Based on our findings, we formulated recommendations for Gavi's equity monitoring approach. The approach involved defining the vulnerable populations, choosing appropriate measures to quantify inequalities, and defining equity benchmarks that reflect the ambitions of the sustainable development agenda. In this article, we explain the rationale for the recommendations and for the development of an improved equity monitoring tool. Gavi's previous approach to measuring equity was the difference in vaccination coverage between a country's richest and poorest wealth quintiles. In addition to the wealth index, we recommend monitoring other dimensions of vulnerability (maternal education, place of residence, child sex and the multidimensional poverty index). For dimensions with multiple subgroups, measures of inequality that consider information on all subgroups should be used. We also recommend that both absolute and relative measures of inequality be tracked over time. Finally, we propose that equity benchmarks target complete elimination of inequalities. To facilitate equity monitoring, we recommend the use of a data display tool - the equity dashboard - to support decision-making in the sustainable development period. We highlight its key advantages using data from Côte d'Ivoire and Haiti.
An equity dashboard to monitor vaccination coverage
Harper, Sam; Nandi, Arijit; Rodríguez, José M Mendoza; Hansen, Peter M; Johri, Mira
2017-01-01
Abstract Equity monitoring is a priority for Gavi, the Vaccine Alliance, and for those implementing The 2030 agenda for sustainable development. For its new phase of operations, Gavi reassessed its approach to monitoring equity in vaccination coverage. To help inform this effort, we made a systematic analysis of inequalities in vaccination coverage across 45 Gavi-supported countries and compared results from different measurement approaches. Based on our findings, we formulated recommendations for Gavi’s equity monitoring approach. The approach involved defining the vulnerable populations, choosing appropriate measures to quantify inequalities, and defining equity benchmarks that reflect the ambitions of the sustainable development agenda. In this article, we explain the rationale for the recommendations and for the development of an improved equity monitoring tool. Gavi’s previous approach to measuring equity was the difference in vaccination coverage between a country’s richest and poorest wealth quintiles. In addition to the wealth index, we recommend monitoring other dimensions of vulnerability (maternal education, place of residence, child sex and the multidimensional poverty index). For dimensions with multiple subgroups, measures of inequality that consider information on all subgroups should be used. We also recommend that both absolute and relative measures of inequality be tracked over time. Finally, we propose that equity benchmarks target complete elimination of inequalities. To facilitate equity monitoring, we recommend the use of a data display tool – the equity dashboard – to support decision-making in the sustainable development period. We highlight its key advantages using data from Côte d’Ivoire and Haiti. PMID:28250513
On Supplementing “Foot in the Door” Incentives for eHealth Program Engagement
2014-01-01
Financial health incentives, such as paying people to lose weight, are being widely implemented by Western nations and large corporations. A growing number of studies have tested the impact of incentives on health behaviors, though few have evaluated the approach on a population-scale. In this issue of the Journal of Medical Internet Research, Liu et al add to the evidence-base by examining whether a single incentive can motivate enrollment and engagement in a preventive eHealth program in a sample of 142,726 Canadian adults. While the incentives increased enrollment significantly (by a factor of about 28), a very high level of program attrition was noted (90%). The “foot in the door” incentive technique employed was insufficient; enrollees received incentives for signing-up for, but not for engaging with, the eHealth program. To supplement this technique and drive sustained behavior change, several theoretically- and empirically-based strategies are proposed. Specifically, incentives indexed to behavioral achievements over time are highlighted as one approach to boost engagement in this population in the future. PMID:25092221
An equity tool for health impact assessments: Reflections from Mongolia
DOE Office of Scientific and Technical Information (OSTI.GOV)
Snyder, Jeremy, E-mail: jeremycsnyder@sfu.ca; Wagler, Meghan, E-mail: meghanwagler@gmail.com; Lkhagvasuren, Oyun, E-mail: l_oyun2002@yahoo.com
2012-04-15
A health impact assessment (HIA) is a tool for assessing the potential effects of a project or policy on a population's health. In this paper, we discuss a tool for successfully integrating equity concerns into HIAs. This discussion is the product of collaboration by Mongolian and Canadian experts, and it incorporates comments and suggestions of participants of a workshop on equity focused HIAs that took place in Mongolia in October, 2010. Our motivation for discussing this tool is based on the observation that existing HIAs tend either to fail to define equity or use problematic accounts of this concept. Inmore » this paper we give an overview of socio-demographic and health indicators in Mongolia and briefly discuss its mining industry. We then review three accounts of equity and argue for the importance of developing a consensus understanding of this concept when integrating considerations of equity into an HIA. Finally, we present findings from the workshop in Mongolia and outline a tool, derived from lessons from this workshop, for critically considering and integrating the concept of equity into an HIA.« less
NASA Astrophysics Data System (ADS)
Raza, Syed Ali; Zaighum, Isma; Shah, Nida
2018-02-01
This paper examines the relationship between economic policy uncertainty and equity premium in G7 countries over a period of the monthly data from January 1989 to December 2015 using a novel technique namely QQ regression proposed by Sim and Zhou (2015). Based on QQ approach, we estimate how the quantiles of the economic policy uncertainty affect the quantiles of the equity premium. Thus, it provides a comprehensive insight into the overall dependence structure between the equity premium and economic policy uncertainty as compared to traditional techniques like OLS or quantile regression. Overall, our empirical evidence suggests the existence of a negative association between equity premium and EPU predominately in all G7 countries, especially in the extreme low and extreme high tails. However, differences exist among countries and across different quantiles of EPU and the equity premium within each country. The existence of this heterogeneity among countries is due to the differences in terms of dependency on economic policy, other stock markets, and the linkages with other country's equity market.
Addressing equity in interventions to reduce air pollution in urban areas: a systematic review.
Benmarhnia, Tarik; Rey, Lynda; Cartier, Yuri; Clary, Christelle M; Deguen, Séverine; Brousselle, Astrid
2014-12-01
We did a systematic review to assess quantitative studies investigating the association between interventions aiming to reduce air pollution, health benefits and equity effects. Three databases were searched for studies investigating the association between evaluated interventions aiming to reduce air pollution and heath-related benefits. We designed a two-stage selection process to judge how equity was assessed and we systematically determined if there was a heterogeneous effect of the intervention between subgroups or subareas. Of 145 identified articles, 54 were reviewed in-depth with eight satisfying the inclusion criteria. This systematic review showed that interventions aiming to reduce air pollution in urban areas have a positive impact on air quality and on mortality rates, but the documented effect on equity is less straightforward. Integration of equity in evidence-based public health is a great challenge nowadays. In this review we draw attention to the importance of considering equity in air pollution interventions. We also propose further methodological and theoretical challenges when assessing equity in interventions to reduce air pollution and we present opportunities to develop this research area.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Dean, J.; Smith-Dreier, C.; Mekonnen, G.
2011-09-01
This case study covers the process of successfully integrating photovoltaic (PV) systems into a low-income housing development in northeast Denver, Colorado, focusing specifically on a new financing model and job training. The Northeast Denver Housing Center (NDHC), working in cooperation with Del Norte Neighborhood Development Corporation, Groundwork Denver, and the National Renewable Energy Laboratory (NREL), was able to finance the PV system installations by blending private equity funding with utility rebates, federal tax credits, and public sector funding. A grant provided by the Governor's Energy Office allowed for the creation of the new financing model. In addition, the program incorporatedmore » an innovative low-income job training program and an energy conservation incentive program.« less
Advancing Health Equity Through Student Empowerment and Professional Success: A Statewide Approach.
Noone, Joanne; Wros, Peggy; Cortez, David; Najjar, Rana; Magdaleno, Leela
2016-06-01
A lack of diversity in the nursing workforce nationally has been identified by Oregon state leaders as a factor contributing to health inequity. The goal of Advancing Health Equity Through Student Empowerment and Professional Success (HealthE STEPS) is to graduate nursing students from disadvantaged backgrounds to improve health equity within their communities. A comprehensive plan of evidence-based strategies was developed based on social determinants of health and addresses academic socialization, learning support, financial resources, networking, curriculum development, and campus culture. Ninety undergraduate nursing students participated in the program during a 2-year period. Retention of participants was 97% with graduation rates of 94%. First-time licensure pass rates were 82% and 96% of participating graduates employed in a medically underserved community. This comprehensive innovative program of evidence-based strategies addresses health equity by developing a diverse nursing workforce to practice in medically underserved communities. [J Nurs Educ. 2016;55(6):316-322.]. Copyright 2016, SLACK Incorporated.
ERIC Educational Resources Information Center
Slater, Jonathan S.; Parks, Michael J.; Malone, Michael E.; Henly, George A.; Nelson, Christina L.
2017-01-01
Financial incentives are being used increasingly to encourage a wide array of health behaviors because of their well-established efficacy. However, little is known about how to translate incentive-based strategies to public health practice geared toward improving population-level health, and a dearth of research exists on how individuals respond…
A framework linking community empowerment and health equity: it is a matter of CHOICE.
Rifkin, Susan B
2003-09-01
This paper presents a framework to explore the relationship between health equity and community empowerment. It traces the progression of the concept of participation to the present term of empowerment and the links among empowerment, equity, and health outcomes. It argues that the relationship can best be described by using the acronym CHOICE (Capacity-building, Human rights, Organizational sustainability, Institutional accountability, Contribution, and Enabling environment). Based on the concept of development as freedom put forward by Nobel Laureate Amartya Sen, the paper describes how each factor illustrates the relationship between equity and empowerment in positive health outcomes, giving appropriate examples. In conclusion, it is suggested that these factors might form the basis of a tool to assess the relationship between equity and empowerment and its impact on health outcomes.
Pinheiro, Marcelo Cardoso; Westphal, Márcia Faria; Akerman, Marco
2005-01-01
Based on a literature review and taking into account a concept of equity and its application to the field of public health, this article discusses the meaning ascribed to the term "equity" and its variations in the reports by the 9th, 10th, and 11th National Health Conferences in Brazil. Qualitative methods and content analysis were used to evaluate the approach to equity in two products the Conferences intended to formulate: analysis and presentation of the country's health profile and guidelines for public health policies. Little progress in understanding the issue of equity in health was observed; the predominant discourse was vague or excessively broad. The proposals were generic and nonspecific, failing to define the target problems and social groups.
Tax-Based Educational Equity: A New Approach to School Finance Reform.
ERIC Educational Resources Information Center
Cooper, Bruce S.; And Others
A new argument is made for school finance equalization, based not on "equal protection" or "equal educational opportunity," but on constitutional requirements for tax equity in New Hampshire. Since inequalities in school finance are a taxation problem, they call for tax reform. The analyses rest on four points: (1) that…
The Equity Consequences of School-Based Management
ERIC Educational Resources Information Center
Nir, Adam E.; Miran, Meir
2006-01-01
Purpose: The purpose of this paper is to examine the extent to which the introduction of school-based management (SBM) affects schools' incomes and educational equity? Design/methodology/approach: An analysis of financial reports coming from 31 SBM schools during a period of four sequential years reveals that the overall inequity among schools has…
Funding Education: Developing a Method of Allocation for Improvement
ERIC Educational Resources Information Center
BenDavid-Hadar, Iris
2018-01-01
Purpose: Resource allocation is a key policy instrument that affects the educational achievement distribution (EAD). The literature on methods of allocation is focused mainly on equity issues. The purpose of this paper is to develop a composite funding formula, which adds to the equity-based element (i.e. a needs-based element compensating for…
Evaluating an Adaptive Equity-Oriented Pedagogy: A Study of Its Impacts in Higher Education
ERIC Educational Resources Information Center
Phuong, Andrew Estrada; Nguyen, Judy; Marie, Dena
2017-01-01
This study examines whether and how an adaptive equity-oriented pedagogy can address diverse college students' needs and preferred modes of learning. Using a mixed-methods approach, we evaluated this pedagogical intervention that synthesizes democratic, assessment-driven, strengths-based, multimodal, and game-based instructional strategies. This…
Cross-Cultural Trust Networks and Advancing Education Equity in Place-Based Partnerships
ERIC Educational Resources Information Center
Banks, Amber Joy
2017-01-01
Research suggests that trust can be a foundational element for the success and sustainability of multi-organizational partnerships focused on advancing education equity in a particular neighborhood or region. As these place-based strategies gain popularity in the U.S., collaborators are increasingly required to navigate relationships where racial…
NASA Astrophysics Data System (ADS)
Yin, Honglian; Sun, Aihua; Liu, Quanru; Chen, Zhiyi
2018-03-01
It is the key of motivating sub-contractors working hard and mutual cooperation, ensuring implementation overall goal of the project that to design rational incentive mechanism for general contractor. Based on the principal-agency theory, the subcontractor efforts is divided into two parts, one for individual efforts, another helping other subcontractors, team Cooperation incentive models of multiple subcontractors are set up, incentive schemes and intensities are also given. The results show that the general contractor may provide individual and team motivation incentives when subcontractors working independently, not affecting each other in time and space; otherwise, the general contractor may only provide individual incentive to entice teams collaboration between subcontractors and helping each other. The conclusions can provide a reference for the subcontract design of general and sub-contractor dynamic alliances.
Baqui, Abdullah H; Rosecrans, Amanda M; Williams, Emma K; Agrawal, Praween K; Ahmed, Saifuddin; Darmstadt, Gary L; Kumar, Vishwajeet; Kiran, Usha; Panwar, Dharmendra; Ahuja, Ramesh C; Srivastava, Vinod K; Black, Robert E; Santosham, Mathuram
2008-07-01
Socio-economic disparities in health have been well documented around the world. This study examines whether NGO facilitation of the government's community-based health programme improved the equity of maternal and newborn health in rural Uttar Pradesh, India. A quasi-experimental study design included one intervention district and one comparison district of rural Uttar Pradesh. A household survey conducted between January and June 2003 established baseline rates of programme coverage, maternal and newborn care practices, and health care utilization during 2001-02. An endline household survey was conducted after 30 months of programme implementation between January and March 2006 to measure the same indicators during 2004-05. The changes in the indicators from baseline to endline in the intervention and comparison districts were calculated by socio-economic quintiles, and concentration indices were constructed to measure the equity of programme indicators. The equity of programme coverage and antenatal and newborn care practices improved from baseline to endline in the intervention district while showing little change in the comparison district. Equity in health care utilization for mothers and newborns also showed some improvements in the intervention district, but notable socio-economic differentials remained, with the poor demonstrating less ability to access health services. NGO facilitation of government programmes is a feasible strategy to improve equity of maternal and neonatal health programmes. Improvements in equity were most pronounced for household practices, and inequities were still apparent in health care utilization. Furthermore, overall programme coverage remained low, limiting the ability to address equity. Programmes need to identify and address barriers to universal coverage and care utilization, particularly in the poorest segments of the population.
Brand equity and willingness to pay for condoms in Zimbabwe.
Evans, W Douglas; Taruberekera, Noah; Longfield, Kim; Snider, Jeremy
2011-10-26
Zimbabwe suffers from one of the greatest burdens of HIV/AIDS in the world that has been compounded by social and economic instability in the past decade. However, from 2001 to 2009 HIV prevalence among 15-49 year olds declined from 26% to approximately 14%. Behavior change and condom use may in part explain this decline.PSI-Zimbabwe socially markets the Protector Plus (P+) branded line of condoms. When Zimbabwe converted to a dollar-based economy in 2009, the price of condoms was greatly increased and new marketing efforts were undertaken. This paper evaluates the role of condom marketing, a multi-dimensional scale of brand peceptions (brand equity), and price in condom use behavior. We randomly sampled sexually active men age 15-49 from 3 groups - current P+ users, former users, and free condom users. We compared their brand equity and willingness to pay based on survey results. We estimated multivariable logistic regression models to compare the 3 groups. We found that the brand equity scale was positive correlated with willingness to pay and with condom use. Former users also indicated a high willingness to pay for condoms. We found differences in brand equity between the 3 groups, with current P+ users having the highest P+ brand equity. As observed in previous studies, higher brand equity was associated with more of the targeted health behavior, in this case and more consistent condom use. Zimbabwe men have highly positive brand perceptions of P+. There is an opportunity to grow the total condom market in Zimbabwe by increasing brand equity across user groups. Some former users may resume using condoms through more effective marketing. Some free users may be willing to pay for condoms. Achieving these objectives will expand the total condom market and reduce HIV risk behaviors.
NASA Astrophysics Data System (ADS)
Kumar, R.; Barani, G.; Jagadeesan, S.
2012-10-01
This article reviews the various approaches to defining and Measuring Brand Equity. CRM strategy (Customer Relationship Management) is a business philosophy, stemming from relationship marketing that joins strategy and technology, with the aim of creating value for both customers and the company. In this paper we justify the interest of establishing a formal system to measure CRM performance. It analyses the diverse views regarding the set of attributes relevant for measurement of Brand equity. Existing measures of brand equity have been classified into three categories for the discussion in the paper. One set of measures are those focusing on outcome of Brand Equity at the product market level, the second category is that of measures related to customer mindset while the third set is based on measurement of financial parameters. The paper presents a comprehensive review of the work done by various researchers over the last few decades. It analyses the merits and limitations of the different types of measures. Based on the observations made by experts in related literature the authors suggest the scope for further research in the discipline.
Continuing nursing education policy in China and its impact on health equity.
Xiao, Lily Dongxia
2010-09-01
The aim of this study was to evaluate the mandatory continuing nursing education (MCNE) policy in China and to examine whether or not the policy addresses health equity. MCNE was instituted in 1996 in China to support healthcare reform was to include producing greater equity in health-care. However, the literature increasingly reports inequity in participation in MCNE, which is likely to have had a detrimental effect on the pre-existing discrepancies of education in the nursing workforce, and thereby failing to really address health equity. Despite a growing appeal for change, there is lack of critical reflection on the issues of MCNE policy. Critical ethnography underpinned by Habermas' Communicative Action Theory and Giddens' Structuration Theory were used to guide this study. Findings are presented in four themes: (i) inaccessibility of learning programs for nurses; (ii) undervaluation of workplace-based learning; (iii) inequality of the allocation of resources; and (iv) demands for additional support in MCNE from non-tertiary hospitals. The findings strongly suggest the need for an MCNE policy review based on rational consensus with stakeholders while reflecting the principles of health equity.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bird, L.; Reger, A.; Heeter, J.
Based on lessons from recent program experience, this report explores best practices for designing and implementing incentives for small and mid-sized residential and commercial distributed solar energy projects. The findings of this paper are relevant to both new incentive programs as well as those undergoing modifications. The report covers factors to consider in setting and modifying incentive levels over time, differentiating incentives to encourage various market segments, administrative issues such as providing equitable access to incentives and customer protection. It also explores how incentive programs can be designed to respond to changing market conditions while attempting to provide a longer-termmore » and stable environment for the solar industry. The findings are based on interviews with program administrators, regulators, and industry representatives as well as data from numerous incentive programs nationally, particularly the largest and longest-running programs. These best practices consider the perspectives of various stakeholders and the broad objectives of reducing solar costs, encouraging long-term market viability, minimizing ratepayer costs, and protecting consumers.« less
Zhao, Jianshi; Cai, Ximing; Wang, Zhongjing
2013-07-15
Water allocation can be undertaken through administered systems (AS), market-based systems (MS), or a combination of the two. The debate on the performance of the two systems has lasted for decades but still calls for attention in both research and practice. This paper compares water users' behavior under AS and MS through a consistent agent-based modeling framework for water allocation analysis that incorporates variables particular to both MS (e.g., water trade and trading prices) and AS (water use violations and penalties/subsidies). Analogous to the economic theory of water markets under MS, the theory of rational violation justifies the exchange of entitled water under AS through the use of cross-subsidies. Under water stress conditions, a unique water allocation equilibrium can be achieved by following a simple bargaining rule that does not depend upon initial market prices under MS, or initial economic incentives under AS. The modeling analysis shows that the behavior of water users (agents) depends on transaction, or administrative, costs, as well as their autonomy. Reducing transaction costs under MS or administrative costs under AS will mitigate the effect that equity constraints (originating with primary water allocation) have on the system's total net economic benefits. Moreover, hydrologic uncertainty is shown to increase market prices under MS and penalties/subsidies under AS and, in most cases, also increases transaction, or administrative, costs. Copyright © 2013 Elsevier Ltd. All rights reserved.
CEO performance appraisal: review and recommendations.
Newman, J F; Tyler, L; Dunbar, D M
2001-01-01
CEO performance appraisal (PA) is very valuable to an organization, but the chances of obtaining a PA of high quality decrease as executive responsibility increases. The realities of CEO PA are that it: (1) is inevitable; (2) is creative and complex; (3) involves politics; and (4) has a significant effect on the organization and the executive. PA is conducted for legal and social requirements, to enhance communication, to provide opportunities for improvement, and to relate performance to compensation. This article discusses several problems with chief executive officer (CEO) PA and the contemporary approaches that seek to improve it. Three fundamental areas for evaluation are identified: (1) organizational success; (2) areawide health status; and (3) professional role fulfillment. These provide an outline for successful healthcare PA. In addition to a discussion of the strategic considerations behind a successful CEO PA system, several recommendations are offered for the implementation of the annual evaluation process. The final goal of CEO PA is to link its results to CEO incentive compensation. It is strongly recommended that some portion of the CEO's salary directly hinge on his performance in two critical areas: organizational effectiveness and community health status.
Krishnan, Suneeta; Gambhir, Shalini; Luecke, Ellen; Jagannathan, Latha
2016-10-01
We describe the evaluation of a participatory, garment factory-based intervention to promote gender equity. The intervention comprised four campaigns focused on gender and violence against women, alcoholism, sexual and reproductive health, and HIV/AIDS, which were implemented using information displays (standees and posters) and interactive methods (street play, one-to-one interactions, experience-sharing, and health camps). Each campaign lasted six days and the entire intervention was implemented over 10 months. We evaluated the intervention using a quasi-experimental design in which one factory served as the intervention site and a second as a delayed control. Two mobile-phone-based cross-sectional surveys were conducted at baseline and 12 months with separate systematic random samples of employees from each site. Data on socio-demographic characteristics and knowledge and attitudes related to gender equity, intimate partner violence (IPV) and alcohol use were assessed, and differences in these variables associated with the intervention were examined using difference-in-difference estimation. Analyses of data from 835 respondents revealed substantial, statistically significant improvements in attitudes related to gender equity, unacceptability of IPV, and awareness of IPV and alcohol-related support services. In conclusion, our study offers compelling evidence on the effectiveness of workplace-based interventions in advancing gender equity.
Gajic, Aleksandra; Cameron, David; Hurley, Jeremiah
2012-12-01
We present the results of a randomized experiment to test the effectiveness and cost-effectiveness of response incentives for a stated-preference survey of a general community population. The survey was administered using a mixed-mode approach, in which community members were invited to participate using a traditional mailed letter using contact information for a representative sample of the community; but individuals completed the survey via the web, which exploited the advantages of electronic capture. Individuals were randomized to four incentive groups: (a) no incentive, (b) prepaid cash incentive ($2), (c) a low lottery (10 prizes of $25) and (d) a high lottery (2 prizes of $250). Letters of invitation were mailed to 3,000 individuals. In total, 405 individuals (14.4%) contacted the website and 277 (9.8%) provided complete responses. The prepaid cash incentive generated the highest contact and response rates (23.3 and 17.3%, respectively), and no incentive generated the lowest (9.1 and 5.7%, respectively). The high lottery, however, was the most cost-effective incentive for obtaining completed surveys: compared with no incentive, the incremental cost-effectiveness ratio (ICER) per completed survey for high lottery was $13.89; for prepaid cash, the ICER was $18.29. This finding suggests that the preferred response incentive for community-based, stated-preference surveys is a lottery with a small number of large prizes.
Building a regional health equity movement: the grantmaking model of a local health department.
Baril, Nashira; Patterson, Meghan; Boen, Courtney; Gowler, Rebekah; Norman, Nancy
2011-01-01
The Boston Public Health Commission's Center for Health Equity and Social Justice provides grant funding, training, and technical assistance to 15 organizations and coalitions across New England to develop, implement, and evaluate community-based policy and systems change strategies that address social determinants of health and reduce racial and ethnic health inequities. This article describes Boston Public Health Commission's health equity framework, theory of change regarding the elimination of racial and ethnic health inequities, and current grantmaking model. To conclude, the authors evaluate the grant model and offer lessons learned from providing multiyear regional grants to promote health equity.
[Public control and equity of access to hospitals under non-State public administration].
Carneiro Junior, Nivaldo; Elias, Paulo Eduardo
2006-10-01
To analyze social health organizations in the light of public control and the guarantee of equity of access to health services. Utilizing the case study technique, two social health organizations in the metropolitan region of São Paulo were selected. The analytical categories were equity of access and public control, and these were based on interviews with key informants and technical-administrative reports. It was observed that the overall funding and administrative control of the social health organizations are functions of the state administrator. The presence of a local administrator is important for ensuring equity of access. Public control is expressed through supervisory actions, by means of accounting and financial procedures. Equity of access and public control are not taken into consideration in the administration of these organizations. The central question lies in the capacity of the public authorities to have a presence in implementing this model at the local level, thereby ensuring equity of access and taking public control into consideration.
Equitable science education in urban middle schools: Do reform efforts make a difference?
NASA Astrophysics Data System (ADS)
Hewson, Peter W.; Butler Kahle, Jane; Scantlebury, Kathryn; Davies, Darleen
2001-12-01
A central commitment of current reforms in science education is that all students, regardless of culture, gender, race, and/ or socioeconomic status, are capable of understanding and doing science. The study Bridging the Gap: Equity in Systemic Reform assessed equity in systemic reform using a nested research design that drew on both qualitative and quantitative methodologies. As part of the study, case studies were conducted in two urban middle schools in large Ohio cities. The purpose of the case studies was to identify factors affecting equity in urban science education reform. Data were analyzed using Kahle's (1998) equity metric. That model allowed us to assess progress toward equity using a range of research-based indicators grouped into three categories critical for equitable education: access to, retention in, and achievement in quality science education. In addition, a fourth category was defined for systemic indicators of equity. Analyses indicated that the culture and climate of the case study schools differentially affected their progress toward equitable reform in science education.
Promoting Health Equity And Eliminating Disparities Through Performance Measurement And Payment.
Anderson, Andrew C; O'Rourke, Erin; Chin, Marshall H; Ponce, Ninez A; Bernheim, Susannah M; Burstin, Helen
2018-03-01
Current approaches to health care quality have failed to reduce health care disparities. Despite dramatic increases in the use of quality measurement and associated payment policies, there has been no notable implementation of measurement strategies to reduce health disparities. The National Quality Forum developed a road map to demonstrate how measurement and associated policies can contribute to eliminating disparities and promote health equity. Specifically, the road map presents a four-part strategy whose components are identifying and prioritizing areas to reduce health disparities, implementing evidence-based interventions to reduce disparities, investing in the development and use of health equity performance measures, and incentivizing the reduction of health disparities and achievement of health equity. To demonstrate how the road map can be applied, we present an example of how measurement and value-based payment can be used to reduce racial disparities in hypertension among African Americans.
Pricing of premiums for equity-linked life insurance based on joint mortality models
NASA Astrophysics Data System (ADS)
Riaman; Parmikanti, K.; Irianingsih, I.; Supian, S.
2018-03-01
Life insurance equity - linked is a financial product that not only offers protection, but also investment. The calculation of equity-linked life insurance premiums generally uses mortality tables. Because of advances in medical technology and reduced birth rates, it appears that the use of mortality tables is less relevant in the calculation of premiums. To overcome this problem, we use a combination mortality model which in this study is determined based on Indonesian Mortality table 2011 to determine the chances of death and survival. In this research, we use the Combined Mortality Model of the Weibull, Inverse-Weibull, and Gompertz Mortality Model. After determining the Combined Mortality Model, simulators calculate the value of the claim to be given and the premium price numerically. By calculating equity-linked life insurance premiums well, it is expected that no party will be disadvantaged due to the inaccuracy of the calculation result
NASA Astrophysics Data System (ADS)
Spiteri, Arian; Nepalz, Sanjay K.
2006-01-01
Biodiversity conservation in developing countries has been a challenge because of the combination of rising human populations, rapid technological advances, severe social hardships, and extreme poverty. To address the social, economic, and ecological limitations of people-free parks and reserves, incentives have been incorporated into conservation programs in the hopes of making conservation meaningful to local people. However, such incentive-based programs have been implemented with little consideration for their ability to fulfill promises of greater protection of biodiversity. Evaluations of incentive-based conservation programs indicate that the approach continually falls short of the rhetoric. This article provides an overview of the problems associated with incentive-based conservation approaches in developing countries. It argues that existing incentive-based programs (IBPs) have yet to realize that benefits vary greatly at different “community” scales and that a holistic conceptualization of a community is essential to incorporate the complexities of a heterogeneous community when designing and implementing the IBPs. The spatial complexities involved in correctly identifying the beneficiaries in a community and the short-term focus of IBPs are two major challenges for sustaining conservation efforts. The article suggests improvements in three key areas: accurate identification of “target” beneficiaries, greater inclusion of marginal communities, and efforts to enhance community aptitudes.
LeBlanc, Kimberly H; Maidment, Nigel T; Ostlund, Sean B
2013-01-01
There is growing evidence that mere exposure to drugs can induce long-term alterations in the neural systems that mediate reward processing, motivation, and behavioral control, potentially causing the pathological pursuit of drugs that characterizes the addicted state. The incentive sensitization theory proposes that drug exposure potentiates the influence of reward-paired cues on behavior. It has also been suggested that drug exposure biases action selection towards the automatic execution of habits and away from more deliberate goal-directed control. The current study investigated whether rats given repeated exposure to peripherally administered cocaine would show alterations in incentive motivation (assayed using the Pavlovian-to-instrumental transfer (PIT) paradigm) or habit formation (assayed using sensitivity to reward devaluation). After instrumental and Pavlovian training for food pellet rewards, rats were given 6 daily injections of cocaine (15 mg/kg, IP) or saline, followed by a 10-d period of rest. Consistent with the incentive sensitization theory, cocaine-treated rats showed stronger cue-evoked lever pressing than saline-treated rats during the PIT test. The same rats were then trained on a new instrumental action with a new food pellet reward before undergoing a reward devaluation testing. Although saline-treated rats exhibited sensitivity to reward devaluation, indicative of goal-directed performance, cocaine-treated rats were insensitive to this treatment, suggesting a reliance on habitual processes. These findings, when taken together, indicate that repeated exposure to cocaine can cause broad alterations in behavioral control, spanning both motivational and action selection processes, and could therefore help explain aberrations of decision-making that underlie drug addiction.
LeBlanc, Kimberly H.; Maidment, Nigel T.; Ostlund, Sean B.
2013-01-01
There is growing evidence that mere exposure to drugs can induce long-term alterations in the neural systems that mediate reward processing, motivation, and behavioral control, potentially causing the pathological pursuit of drugs that characterizes the addicted state. The incentive sensitization theory proposes that drug exposure potentiates the influence of reward-paired cues on behavior. It has also been suggested that drug exposure biases action selection towards the automatic execution of habits and away from more deliberate goal-directed control. The current study investigated whether rats given repeated exposure to peripherally administered cocaine would show alterations in incentive motivation (assayed using the Pavlovian-to-instrumental transfer (PIT) paradigm) or habit formation (assayed using sensitivity to reward devaluation). After instrumental and Pavlovian training for food pellet rewards, rats were given 6 daily injections of cocaine (15 mg/kg, IP) or saline, followed by a 10-d period of rest. Consistent with the incentive sensitization theory, cocaine-treated rats showed stronger cue-evoked lever pressing than saline-treated rats during the PIT test. The same rats were then trained on a new instrumental action with a new food pellet reward before undergoing a reward devaluation testing. Although saline-treated rats exhibited sensitivity to reward devaluation, indicative of goal-directed performance, cocaine-treated rats were insensitive to this treatment, suggesting a reliance on habitual processes. These findings, when taken together, indicate that repeated exposure to cocaine can cause broad alterations in behavioral control, spanning both motivational and action selection processes, and could therefore help explain aberrations of decision-making that underlie drug addiction. PMID:23646106
ERIC Educational Resources Information Center
Green, Terrance L.
2017-01-01
Purpose: To equitably transform urban schools of color and the neighborhoods where they are nested requires approaches that promote community equity and foster solidarity among a range of stakeholders. However, most school-community approaches solely focus on improving school-based outcomes and leave educational leaders with little guidance for…
Pay Equity Activity in the Public Sector: 1979-1989. Full Report.
ERIC Educational Resources Information Center
National Committee on Pay Equity, Washington, DC.
Pay equity, sometimes referred to as comparable worth, is a remedy for wage discrimination based on race or sex. It's basic premise is that pay should be based on job-related factors such as skill, effort, responsibility and working conditions, not on a worker's gender or race. Studies have consistently demonstrated that jobs predominantly held by…
Yé, Maurice; Diboulo, Eric; Kagoné, Moubassira; Sié, Ali; Sauerborn, Rainer; Loukanova, Svetla
2016-01-01
One promising way to improve the motivation of healthcare providers and the quality of healthcare services is performance-based incentives (PBIs) also referred as performance-based financing. Our study aims to explore healthcare providers' preferences for an incentive scheme based on local resources, which aimed at improving the quality of maternal and child health care in the Nouna Health District. A qualitative and quantitative survey was carried out in 2010 involving 94 healthcare providers within 34 health facilities. In addition, in-depth interviews involving a total of 33 key informants were conducted at health facility levels. Overall, 85% of health workers were in favour of an incentive scheme based on the health district's own financial resources (95% CI: [71.91; 88.08]). Most health workers (95 and 96%) expressed a preference for financial incentives (95% CI: [66.64; 85.36]) and team-based incentives (95% CI: [67.78; 86.22]), respectively. The suggested performance indicators were those linked to antenatal care services, prevention of mother-to-child human immunodeficiency virus transmission, neonatal care, and immunization. The early involvement of health workers and other stakeholders in designing an incentive scheme proved to be valuable. It ensured their effective participation in the process and overall acceptance of the scheme at the end. This study is an important contribution towards the designing of effective PBI schemes.
Yé, Maurice; Diboulo, Eric; Kagoné, Moubassira; Sié, Ali; Sauerborn, Rainer; Loukanova, Svetla
2016-01-01
Background One promising way to improve the motivation of healthcare providers and the quality of healthcare services is performance-based incentives (PBIs) also referred as performance-based financing. Our study aims to explore healthcare providers’ preferences for an incentive scheme based on local resources, which aimed at improving the quality of maternal and child health care in the Nouna Health District. Design A qualitative and quantitative survey was carried out in 2010 involving 94 healthcare providers within 34 health facilities. In addition, in-depth interviews involving a total of 33 key informants were conducted at health facility levels. Results Overall, 85% of health workers were in favour of an incentive scheme based on the health district's own financial resources (95% CI: [71.91; 88.08]). Most health workers (95 and 96%) expressed a preference for financial incentives (95% CI: [66.64; 85.36]) and team-based incentives (95% CI: [67.78; 86.22]), respectively. The suggested performance indicators were those linked to antenatal care services, prevention of mother-to-child human immunodeficiency virus transmission, neonatal care, and immunization. Conclusions The early involvement of health workers and other stakeholders in designing an incentive scheme proved to be valuable. It ensured their effective participation in the process and overall acceptance of the scheme at the end. This study is an important contribution towards the designing of effective PBI schemes. PMID:26739784
NASA Astrophysics Data System (ADS)
Meyer, Patrick E.
Numerous analyses exist which examine the energy, environmental, and economic tradeoffs between conventional gasoline vehicles and hydrogen fuel cell vehicles powered by hydrogen produced from a variety of sources. These analyses are commonly referred to as "E3" analyses because of their inclusion of Energy, Environmental, and Economic indicators. Recent research as sought a means to incorporate social Equity into E3 analyses, thus producing an "E4" analysis. However, E4 analyses in the realm of energy policy are uncommon, and in the realm of alternative transportation fuels, E4 analyses are extremely rare. This dissertation discusses the creation of a novel E4 simulation tool usable to weigh energy, environmental, economic, and equity trade-offs between conventional gasoline vehicles and alternative fuel vehicles, with specific application to hydrogen fuel cell vehicles. The model, dubbed the F uel Life-cycle Analysis of Solar Hydrogen -- Energy, Environment, Economic & Equity model, or FLASH-E4, is a total fuel-cycle model that combines energy, environmental, and economic analysis methodologies with the addition of an equity analysis component. The model is capable of providing results regarding total fuel-cycle energy consumption, emissions production, energy and environmental cost, and level of social equity within a population in which low-income drivers use CGV technology and high-income drivers use a number of advanced hydrogen FCV technologies. Using theories of equity and social indicators conceptually embodied in the Lorenz Curve and Gini Index, the equity of the distribution of societal energy and environmental costs are measured for a population in which some drivers use CGVs and other drivers use FCVs. It is found, based on baseline input data representative of the United States (US), that the distribution of energy and environmental costs in a population in which some drivers use CGVs and other drivers use natural gas-based hydrogen FCVs can be moderately inequitable. However, the distribution of energy and environmental costs in a population in which some drivers use CGVs and other drivers use solar-electrolysis-based FCVs can be extremely inequitable. Further, it is found that the method of production and delivery of hydrogen (i.e. centralized production or refueling station-based production) can have an impact on the equity of energy and environmental costs. The implications of these results are interesting, in that wealthy people purchase FCVs that have high upfront costs and very low societal energy and environmental costs. Simultaneously, however, low-income people purchase CGVs that have low upfront costs and very high societal energy and environmental costs. In this situation, due to the high-polluting nature of CGV technology in relation to FCV technology, CGV drivers account for more than their equitable share of energy and environmental costs. Scenarios are conducted which explore modifications of assumptions, such as the price of oil, price of natural gas, cost to offset emissions, consumer purchase price of FCVs, and the level of taxation on the cost streams. Among other findings, it is found that altering the purchase price of an FCV has the greatest impact on social equity whereas altering the cost to offset fuel-cycle emissions has the least impact, indicating that policy mechanisms aimed at incentivizing FCVs may have a more positive impact on social equity than policies aimed at mitigating emissions. Based on the results of the scenario analysis, policy recommendations are formulated which seek to maximize social equity in populations in which not all drivers use the same vehicular technology. The policies, if implemented as a single portfolio, would assist a systematic deviation away from the fossil fuel energy economy while ensuring that social equity is preserved to the greatest degree possible. (Abstract shortened by UMI.)
Harburger, Deborah S; Stephan, Sharon H; Kaye, Sarah
2013-10-01
The purpose of this paper was to examine the State of Maryland as a case study of sustained change efforts in the service delivery system for children with significant behavioral health needs and their families. A punctuated equilibrium paradigm is introduced to describe Maryland's behavioral health system transformation over the course of three decades. The context and specific strategies that characterized Maryland's execution of its recent Mental Health Transformation State Incentive Grant are highlighted. There is a discussion of one of the pinnacle achievements of Maryland's transformation efforts, the recent statewide establishment of care management entities for children with behavioral health challenges, and its implications for behavioral health in the context of health care reform changes. This case study illustrates how a state can systematically and incrementally develop systems of care for children and families that are values-based, sustainable, and flexible.
Age-based hiring discrimination as a function of equity norms and self-perceived objectivity.
Lindner, Nicole M; Graser, Alexander; Nosek, Brian A
2014-01-01
Participants completed a questionnaire priming them to perceive themselves as either objective or biased, either before or after evaluating a young or old job applicant for a position linked to youthful stereotypes. Participants agreed that they were objective and tended to disagree that they were biased. Extending past research, both the objective and bias priming conditions led to an increase in age discrimination compared to the control condition. We also investigated whether equity norms reduced age discrimination, by manipulating the presence or absence of an equity statement reminding decision-makers of the legal prohibitions against discrimination "on the basis of age, disability, national or ethnic origin, race, religion, or sex." The presence of equity norms increased enthusiasm for both young and old applicants when participants were not already primed to think of themselves as objective, but did not reduce age-based hiring discrimination. Equity norms had no effect when individuals thought of themselves as objective - they preferred the younger more than the older job applicant. However, the presence of equity norms did affect individuals' perceptions of which factors were important to their hiring decisions, increasing the perceived importance of applicants' expertise and decreasing the perceived importance of the applicants' age. The results suggest that interventions that rely exclusively on decision-makers' intentions to behave equitably may be ineffective.
The Effect of Pharmacy Benefit Design on Patient-Physician Communication About Costs
Shrank, William H; Fox, Sarah A; Kirk, Adele; Ettner, Susan L; Cantrell, Clairessa H; Glassman, Peter; Asch, Steven M
2006-01-01
BACKGROUND Incentive-based formularies have been widely instituted to control the rising costs of prescription drugs. To work properly, such formularies depend on patients to be aware of financial incentives and communicate their cost preferences with prescribing physicians. The impact of financial incentives on patient awareness of and communication about those costs is unknown. OBJECTIVE To evaluate the relationship between enrollment in incentive-based pharmacy benefit plans and awareness of out-of-pocket costs and rates of communication about out-of-pocket costs. DESIGN A matched telephone survey of patients and their primary care physicians. SETTING Los Angeles County. PARTICIPANTS One thousand nine hundred and seventeen patients aged 53 to 82 (73% response rate). MEASUREMENTS Patient-reported pharmacy benefit design, knowledge of out-of-pocket costs, and discussion of out-of-pocket costs with physicians. RESULTS Sixty-two percent of patients who had prescription drug coverage and were aware of their pharmacy benefit design reported being enrolled in incentive-based plans. The majority of these (54%) were “never” or only “sometimes” aware of their out-of-pocket cost requirements at the time of the physician visit. After controlling for numerous physician and patient level variables, we found that patients enrolled in pharmacy benefit designs requiring no copayments were more likely to report they “never” discuss out-of-pocket costs with physicians compared with patients enrolled in incentive-based pharmacy benefit designs (81% vs 67%, P =.001) and patients with no prescription druginsurance (57%, P <.001). CONCLUSIONS Incentive-based pharmacy benefit plans and lack of insurance are associated with increased rates of discussions about out-of-pocket costs. Nonetheless, most incentive-based enrollees are unaware of out-of-pocket costswhen prescriptions are written and never discuss out-of-pocket costs with their physicians, likely mitigating the effectiveness of financial incentives to guide decision making. Considering that out-of-pocket costs are associated with adherence to medical therapy, interventions to improve patient access to out-of-pocket cost information and the frequency of patient-physician discussions about costs are needed. PMID:16686808
Mannion, Russell; Goddard, Maria; Kuhn, Michael; Bate, Angela
2005-01-01
This article examines the incentive effects of delegating operational and financial decision making from central government to local healthcare providers. It addresses the economic consequences of a contemporary policy initiative in the English National Health Service (NHS)-earned autonomy. This policy entails awarding operational autonomy to 'front-line' organisations that are assessed to be meeting national performance targets. In doing so, it introduces new types of incentives into the healthcare system, changes the nature of established agency relationships and represents a novel approach to performance management. Theoretical elements of a principal-agent model are used to examine the impact of decentralization in the context of the results of an empirical study that elicited the perceptions of senior hospital managers regarding the incentive effects of earned autonomy. A multi-method approach was adopted. In order to capture the breadth of policy impact, we conducted a national postal questionnaire survey of all Chief Executives in acute-care hospital Trusts in England (n = 173). To provide added depth and richness to our understanding of the impact and incentive effects of earned autonomy at an organisational level, we interviewed senior managers in a purposeful sample of eight acute-care hospital Trusts. This theoretical framework and our empirical work suggest that some aspects of the earned autonomy as currently implemented in the NHS serve to weaken the potential incentive effect of decentralization. In particular, the nature of the freedoms is such that many senior managers do not view autonomy as a particularly valuable prize. This suggests that incentives associated with the policy will be insufficiently powerful to motivate providers to deliver better performance. We also found that principal commitment may be a problem in the NHS. Some hospital managers reported that they already enjoyed a large degree of autonomy, regardless of their current performance ratings. We also found evidence that the objectives of providers may differ from those of both the central government and local purchasers. There is, therefore, a risk that granting greater autonomy will allow providers to pursue their own objectives which, whilst not self-serving, may still jeopardize the achievement of strategic goals. It is apparent that the design and implementation features of decentralizing policies such as earned autonomy require careful attention if an optimal balance is to be struck between central oversight and local autonomy in the delivery of healthcare.
Individual- versus group-based financial incentives for weight loss: a randomized, controlled trial.
Kullgren, Jeffrey T; Troxel, Andrea B; Loewenstein, George; Asch, David A; Norton, Laurie A; Wesby, Lisa; Tao, Yuanyuan; Zhu, Jingsan; Volpp, Kevin G
2013-04-02
Data on the effectiveness of employer-sponsored financial incentives for employee weight loss are limited. To test the effectiveness of 2 financial incentive designs for promoting weight loss among obese employees. Randomized, controlled trial. (ClinicalTrials.gov: NCT01208350) Children's Hospital of Philadelphia. 105 employees with a body mass index between 30 and 40 kg/m2. 24 weeks of monthly weigh-ins (control group; n = 35); individual incentive, designed as $100 per person per month for meeting or exceeding weight-loss goals (n = 35); and group incentive, designed as $500 per month split among participants within groups of 5 who met or exceeded weight-loss goals (n = 35). Weight loss after 24 weeks (primary outcome) and 36 weeks and changes in behavioral mediators of weight loss (secondary outcomes). Group-incentive participants lost more weight than control participants (mean between-group difference, 4.4 kg [95% CI, 2.0 to 6.7 kg]; P < 0.001) and individual-incentive participants (mean between-group difference, 3.2 kg [CI, 0.9 to 5.5 kg]; P = 0.008). Twelve weeks after incentives ended and after adjustment for 3-group comparisons, group-incentive participants maintained greater weight loss than control group participants (mean between-group difference, 2.9 kg [CI, 0.5 to 5.3 kg]; P = 0.016) but not greater than individual-incentive participants (mean between-group difference, 2.7 kg [CI, 0.4 to 5.0 kg]; P = 0.024). Single employer and short follow-up. A group-based financial incentive was more effective than an individual incentive and monthly weigh-ins at promoting weight loss among obese employees at 24 weeks. National Institute on Aging.
Hillier-Brown, Frances; Bambra, Clare; Thomson, Katie; Balaj, Mirza; Walton, Nick; Todd, Adam
2017-08-30
Community pharmacies have great potential to deliver services aimed at promoting health and preventing disease, and are embedded within communities. In the light of a rapid increase in community pharmacy-delivered public health services and an accompanying increase in the evidence base, this systematic review of reviews will synthesise systematic reviews of public health community pharmacy interventions and assess their effects on public health and health inequalities. Systematic review methodology will be used to identify all systematic reviews that describe the health and health equity effects of community pharmacy public health interventions. Twenty databases will be searched using a pre-determined search strategy to evaluate community pharmacy-delivered public health interventions. Findings from the included reviews will be pooled, and a narrative synthesis executed to identify overarching patterns and results. Findings will support future decision-making around how community pharmacy public health services can be used alongside other strategies to promote health, prevent disease and reduce health inequalities. PROSPERO registration number: CRD42017056264 .
Executive nurse career progression: skills, wisdom and realities.
Ehrat, K S
2001-01-01
There are seven absolutes in an otherwise evolving health care industry. First, despite the amassed property, plant, and equipment, the industry is dominated by, and grounded in, human capital and functions on the basis of intellectual capital. Second, owing to its specialized nature, collaboration among disciplines and supports is required to achieve desired outcomes. Third, technologic, pharmacological, and biogenetic advancements continue to change the face of health care delivery, significantly contribute to escalating costs. The fourth absolute--misaligned economic incentives among the providers and payers--breeds competition and conflict. Fifth, economics in general, and reimbursement specifically, is the industry driver. In times of economic scarcity, competition for resources intensifies. A sixth absolute entails the increasing knowledge of health consumers and their access to heath information. Finally, there is a growing gap in ability to pay and wide variation in health care coverage. It is within this general context that executive nurse role advancement will be discussed.
Incentive-Based Primary Care: Cost and Utilization Analysis.
Hollander, Marcus J; Kadlec, Helena
2015-01-01
In its fee-for-service funding model for primary care, British Columbia, Canada, introduced incentive payments to general practitioners as pay for performance for providing enhanced, guidelines-based care to patients with chronic conditions. Evaluation of the program was conducted at the health care system level. To examine the impact of the incentive payments on annual health care costs and hospital utilization patterns in British Columbia. The study used Ministry of Health administrative data for Fiscal Year 2010-2011 for patients with diabetes, congestive heart failure, chronic obstructive pulmonary disease, and/or hypertension. In each disease group, cost and utilization were compared across patients who did, and did not, receive incentive-based care. Health care costs (eg, primary care, hospital) and utilization measures (eg, hospital days, readmissions). After controlling for patients' age, sex, service needs level, and continuity of care (defined as attachment to a general practice), the incentives reduced the net annual health care costs, in Canadian dollars, for patients with hypertension (by approximately Can$308 per patient), chronic obstructive pulmonary disease (by Can$496), and congestive heart failure (by Can$96), but not diabetes (incentives cost about Can$148 more per patient). The incentives were also associated with fewer hospital days, fewer admissions and readmissions, and shorter lengths of hospital stays for all 4 groups. Although the available literature on pay for performance shows mixed results, we showed that the funding model used in British Columbia using incentive payments for primary care might reduce health care costs and hospital utilization.
Zaidi, Shehla; Riaz, Atif; Rabbani, Fauziah; Azam, Syed Iqbal; Imran, Syeda Nida; Pradhan, Nouhseen Akber; Khan, Gul Nawaz
2015-11-25
The case of contracting out government health services to non-governmental organizations (NGOs) has been weak for maternal, newborn, and child health (MNCH) services, with documented gains being mainly in curative services. We present an in-depth assessment of the comparative advantages of contracting out on MNCH access, quality, and equity, using a case study from Pakistan. An end-line, cross-sectional assessment was conducted of government facilities contracted out to a large national NGO and government-managed centres serving as controls, in two remote rural districts of Pakistan. Contracting out was specific for augmenting MNCH services but without contractual performance incentives. A household survey, a health facility survey, and focus group discussions with client and spouses were used for assessment. Contracted out facilities had a significantly higher utilization as compared to control facilities for antenatal care, delivery, postnatal care, emergency obstetric care, and neonatal illness. Contracted facilities had comparatively better quality of MNCH services but not in all aspects. Better household practices were also seen in the district where contracting involved administrative control over outreach programs. Contracting was also faced with certain drawbacks. Facility utilization was inequitably higher amongst more educated and affluent clients. Contracted out catchments had higher out-of-pocket expenses on MNCH services, driven by steeper transport costs and user charges for additional diagnostics. Contracting out did not influence higher MNCH service coverage rates across the catchment. Physical distances, inadequate transport, and low demand for facility-based care in non-emergency settings were key client-reported barriers. Contracting out MNCH services at government health facilities can improve facility utilization and bring some improvement in quality of services. However, contracting out of health facilities is insufficient to increase service access across the catchment in remote rural contexts and requires accompanying measures for demand enhancement, transportation access, and targeting of the more disadvantaged clientele.
ERIC Educational Resources Information Center
Newman, Anne; Glass, Ronald David
2014-01-01
Criticisms of IRBs are proliferating. In response, we compare the ethical and epistemic standards of two closely related forms of inquiry, investigative journalism and equity-oriented collaborative community-based research (EOCCBR). We argue that a university affiliation justifies formal ethical review of research and suggest how institutionalized…
ERIC Educational Resources Information Center
Carlone, Heidi B.; Haun-Frank, Julie; Webb, Angela
2011-01-01
When evaluating equity, researchers often look at the "achievement gap." Privileging knowledge and skills as primary outcomes of science education misses other, more subtle, but critical, outcomes indexing inequitable science education. In this comparative ethnography, we examined what it meant to "be scientific" in two fourth-grade classes taught…
Putting equity center stage: challenging evidence-free reforms.
Whitehead, Margaret; Dahlgren, Göran; McIntyre, Di
2007-01-01
Do we have an "evidence-free zone" around the health sector reforms that have taken place over the past few decades? Certainly, many of the policy prescriptions have been based on ideology and assumptions about the likely impact of policies, rather than evidence-based. The provision of health care is increasingly treated as a commodity that can be subjected to the same prescription as other goods: privatization, competition, deregulation, decentralization. Evidence has slowly emerged over the 1990s and early 2000s on the adverse effects of these policy prescriptions on equity, particularly in low- and middle-income countries, but a shift in policy is barely perceptible. There is a need for a fresh approach that puts equity center stage. A gap that must be filled is on the "demand" or "need" side: in particular, the impact of policy changes on families and communities. This article is the first in a series of eight articles that present the findings of studies that attempt to fill this gap, helping to develop a more evidence-based approach to equity and health sector policy from the users'/potential patients' perspective.
Reducing the distance: equity issues in distance learning in public education
NASA Astrophysics Data System (ADS)
Campbell, Patricia B.; Storo, Jennifer
1996-12-01
Distance learning and educational equity both began with an emphasis on access, on providing underserved students with an increased access to education. Today definitions of equity have gone beyond simple access to include equal or equivalent treatment and outcomes while definitions of underserved students have expanded to include girls, children of color, children with limited English proficiency and children with disabilities. At the same time the definition of distance learning has expanded to include new technologies, new audiences and new roles. Based on these new definitions and roles, the article raises a number of equity challenges for distance learning educators centering around who is taught, what is taught and how the teaching is done. To answer these challenges, a series of recommendations are suggested that educators can implement to make distance learning a leader in increasing educational equity for all students. The time to act is now.
Predicting incentives to change among adolescents with substance abuse disorder.
Breda, Carolyn; Heflinger, Craig Anne
2004-05-01
While interest in understanding the incentives to change among individuals with substance abuse disorders is growing, little is known about incentives among adolescents with substance abuse disorders who are participating in formal services. The present research assesses the degree and nature of motivation and treatment readiness among adolescents admitted to substance abuse services, and whether such factors vary across significant subgroups of youth based on their social, legal, or clinical profiles. Data are based on interviews with 249 youth between 12 and 18 years of age who have been admitted to either inpatient, residential, or outpatient substance abuse treatment. Measures are adapted from an instrument developed to assess multiple domains of motivation to change (e.g., intrinsic and extrinsic motivation, treatment readiness). Results suggest that the incentive to change among adolescents with substance-abusing behavior is modest at best, regardless of dimension. Nonetheless, ethnicity, type of substance use, and psychopathology significantly predict incentives to change, though the predictors depend on which dimension is considered. The most robust predictor of incentives is the severity of negative consequences associated with youth's substance use--the greater the severity, the greater the incentives. Findings underscore the need to examine the utility and dimensionality of incentive for treatment planning, while at the same time, they identify factors that treatment planners can consider as they seek ways to enhance incentives and help adolescents with substance use disorders attain positive outcomes.
State Adoption of Incentives to Promote Evidence-Based Practices in Behavioral Health Systems.
Stewart, Rebecca E; Marcus, Steven C; Hadley, Trevor R; Hepburn, Brian M; Mandell, David S
2018-06-01
Despite the critical role behavioral health care payers can play in creating an incentive to use evidence-based practices (EBPs), little research has examined which incentives are used in public mental health systems, the largest providers of mental health care in the United States. The authors surveyed state mental health directors from 44 states about whether they used any of seven strategies to increase the use of EBPs. Participants also ranked attributes of each incentive on the basis of key characteristics of diffusion of innovation theory (perceived advantage, simplicity, compatibility, observability, and gradually implementable) and perceived effectiveness. Almost three-quarters of state directors endorsed using at least one financial incentive; most paid for training and technical assistance. Few used other incentives. Strategies perceived as simple and compatible were more readily adopted. Enhanced rates and paying for better outcomes were perceived as the most effective but were the least deployed, suggesting that simplicity and organizational compatibility may be the most decisive factors when choosing incentives. Payers are not using the incentives they perceive as most effective, and they are mostly using only one strategy for reasons of simplicity and compatibility. Future work should focus on barriers to measurement that likely hinder the adoption and implementation of paying for better outcomes and enhanced reimbursement rates, with the ultimate goal of measuring the effectiveness of incentives on EBP implementation efforts.
45 CFR 305.31 - Amount of incentive payment.
Code of Federal Regulations, 2010 CFR
2010-10-01
... PROGRAM PERFORMANCE MEASURES, STANDARDS, FINANCIAL INCENTIVES, AND PENALTIES § 305.31 Amount of incentive... establishment, support order, and current collections performance measures and 75 percent of the State's collections base for the fiscal year for the arrearage collections and cost-effectiveness performance measures...
48 CFR 3416.402-2 - Performance incentives.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Performance incentives. 3416.402-2 Section 3416.402-2 Federal Acquisition Regulations System DEPARTMENT OF EDUCATION...-2 Performance incentives. (b) Award-term contracting may be used for performance-based contracts or...
48 CFR 3416.402-2 - Performance incentives.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Performance incentives. 3416.402-2 Section 3416.402-2 Federal Acquisition Regulations System DEPARTMENT OF EDUCATION...-2 Performance incentives. (b) Award-term contracting may be used for performance-based contracts or...
48 CFR 3416.402-2 - Performance incentives.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 48 Federal Acquisition Regulations System 7 2011-10-01 2011-10-01 false Performance incentives. 3416.402-2 Section 3416.402-2 Federal Acquisition Regulations System DEPARTMENT OF EDUCATION...-2 Performance incentives. (b) Award-term contracting may be used for performance-based contracts or...
48 CFR 3416.402-2 - Performance incentives.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Performance incentives. 3416.402-2 Section 3416.402-2 Federal Acquisition Regulations System DEPARTMENT OF EDUCATION...-2 Performance incentives. (b) Award-term contracting may be used for performance-based contracts or...
Kelly Bricker; Stuart Cottrell; Peter Verhoven
1998-01-01
The purpose of this empirical study was to examine benefits sought from an incentive travel experience prior to departure and individuals' subsequent involvement in various activities during the experience. During September-November, 1996, a California-based adventure travel company organized two incentive travel experiences to Fiji and Kenya for radio stations in...
Morean, Meghan E.; Camenga, Deepa R.; Kong, Grace; Cavallo, Dana A.; Schepis, Ty S.
2014-01-01
Behavioral incentives have been used to encourage smoking cessation in older adolescents, but the acceptability of incentives to promote a smoke-free lifestyle in younger adolescents is unknown. To inform the development of novel, effective, school-based interventions for youth, we assessed middle school students' interest in participating in an incentive-based tobacco abstinence program. We surveyed 988 students (grades 6–8) attending three Connecticut middle schools to determine whether interest in program participation varied as a function of (1) intrapersonal factors (i.e., demographic characteristics (sex, age, race), smoking history, and trait impulsivity) and/or (2) aspects of program design (i.e., prize type, value, and reward frequency). Primary analyses were conducted using multiple regression. A majority of students (61.8%) reported interest in program participation. Interest did not vary by gender, smoking risk status, or offering cash prizes. However, younger students, non-Caucasian students, behaviorally impulsive students, and students with higher levels of self-regulation were more likely to report interest. Inexpensive awards (e.g., video games) offered monthly motivated program interest. In sum, middle school students reported high levels of interest in an incentive-based program to encourage a tobacco-free lifestyle. These formative data can inform the design of effective, incentive-based smoking cessation and prevention programs in middle schools. PMID:25147747
The Theory of Value-Based Payment Incentives and Their Application to Health Care.
Conrad, Douglas A
2015-12-01
To present the implications of agency theory in microeconomics, augmented by behavioral economics, for different methods of value-based payment in health care; and to derive a set of future research questions and policy recommendations based on that conceptual analysis. Original literature of agency theory, and secondarily behavioral economics, combined with applied research and empirical evidence on the application of those principles to value-based payment. Conceptual analysis and targeted review of theoretical research and empirical literature relevant to value-based payment in health care. Agency theory and secondarily behavioral economics have powerful implications for design of value-based payment in health care. To achieve improved value-better patient experience, clinical quality, health outcomes, and lower costs of care-high-powered incentives should directly target improved care processes, enhanced patient experience, and create achievable benchmarks for improved outcomes. Differing forms of value-based payment (e.g., shared savings and risk, reference pricing, capitation, and bundled payment), coupled with adjunct incentives for quality and efficiency, can be tailored to different market conditions and organizational settings. Payment contracts that are "incentive compatible"-which directly encourage better care and reduced cost, mitigate gaming, and selectively induce clinically efficient providers to participate-will focus differentially on evidence-based care processes, will right-size and structure incentives to avoid crowd-out of providers' intrinsic motivation, and will align patient incentives with value. Future research should address the details of putting these and related principles into practice; further, by deploying these insights in payment design, policy makers will improve health care value for patients and purchasers. © Health Research and Educational Trust.
Iyer, Smriti; Kapur, Avani; Mahbub, Rifaiyat; Mukherjee, Anit
2017-01-01
Summary Background There is limited empirical evidence about the efficacy of fiscal transfers for a specific purpose, including for health which represents an important source of funds for the delivery of public services especially in large populous countries such as India. Objective To examine two distinct methodologies for allocating specific‐purpose centre‐to‐state transfers, one using an input‐based formula focused on equity and the other using an outcome‐based formula focused on performance. Materials and Methods We examine the Twelfth Finance Commission (12FC)'s use of Equalization Grants for Health (EGH) as an input‐based formula and the Thirteenth Finance Commission (13FC)'s use of Incentive Grants for Health (IGH) as an outcome‐based formula. We simulate and replicate the allocation of these two transfer methodologies and examine the consequences of these fiscal transfer mechanisms. Results The EGH placed conditions for releasing funds, but states varied in their ability to meet those conditions, and hence their allocations varied, eg, Madhya Pradesh received 100% and Odisha 67% of its expected allocation. Due to the design of the IGH formula, IGH allocations were unequally distributed and highly concentrated in 4 states (Manipur, Sikkim, Tamil Nadu, Nagaland), which received over half the national IGH allocation. Discussion The EGH had limited impact in achieving equalization, whereas the IGH rewards were concentrated in states which were already doing better. Greater transparency and accountability of centre‐to‐state allocations and specifically their methodologies are needed to ensure that allocation objectives are aligned to performance. PMID:28857284
Fan, Victoria Y; Iyer, Smriti; Kapur, Avani; Mahbub, Rifaiyat; Mukherjee, Anit
2018-01-01
There is limited empirical evidence about the efficacy of fiscal transfers for a specific purpose, including for health which represents an important source of funds for the delivery of public services especially in large populous countries such as India. To examine two distinct methodologies for allocating specific-purpose centre-to-state transfers, one using an input-based formula focused on equity and the other using an outcome-based formula focused on performance. We examine the Twelfth Finance Commission (12FC)'s use of Equalization Grants for Health (EGH) as an input-based formula and the Thirteenth Finance Commission (13FC)'s use of Incentive Grants for Health (IGH) as an outcome-based formula. We simulate and replicate the allocation of these two transfer methodologies and examine the consequences of these fiscal transfer mechanisms. The EGH placed conditions for releasing funds, but states varied in their ability to meet those conditions, and hence their allocations varied, eg, Madhya Pradesh received 100% and Odisha 67% of its expected allocation. Due to the design of the IGH formula, IGH allocations were unequally distributed and highly concentrated in 4 states (Manipur, Sikkim, Tamil Nadu, Nagaland), which received over half the national IGH allocation. The EGH had limited impact in achieving equalization, whereas the IGH rewards were concentrated in states which were already doing better. Greater transparency and accountability of centre-to-state allocations and specifically their methodologies are needed to ensure that allocation objectives are aligned to performance. © 2017 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.
Lee, Wei-Chen; Veeranki, Sreenivas P.; Serag, Hani; Eschbach, Karl; Smith, Kenneth D.
2016-01-01
Well-designed electronic health records (EHRs) must integrate a variety of accurate information to support efforts to improve quality of care, particularly equity-in-care initiatives. This case study provides insight into the challenges those initiatives may face in collecting accurate race, ethnicity, and language (REAL) information in the EHR. We present the experience of an academic medical center strengthening its EHR for better collection of REAL data with funding from the EHR Incentive Programs for meaningful use of health information technology and the Texas Medicaid 1115 Waiver program. We also present a plan to address some of the challenges that arose during the course of the project. Our experience at an academic medical center can provide guidance about the likely challenges similar institutions may expect when they implement new initiatives to collect REAL data, particularly challenges regarding scope, personnel, and other resource needs. PMID:27843424
Economic Techniques of Occupational Health and Safety Management
NASA Astrophysics Data System (ADS)
Sidorov, Aleksandr I.; Beregovaya, Irina B.; Khanzhina, Olga A.
2016-10-01
The article deals with the issues on economic techniques of occupational health and safety management. Authors’ definition of safety management is given. It is represented as a task-oriented process to identify, establish and maintain such a state of work environment in which there are no possible effects of hazardous and harmful factors, or their influence does not go beyond certain limits. It was noted that management techniques that are the part of the control mechanism, are divided into administrative, organizational and administrative, social and psychological and economic. The economic management techniques are proposed to be classified depending on the management subject, management object, in relation to an enterprise environment, depending on a control action. Technoeconomic study, feasibility study, planning, financial incentives, preferential crediting of enterprises, pricing, profit sharing and equity, preferential tax treatment for enterprises, economic regulations and standards setting have been distinguished as economic techniques.
Brand equity and willingness to pay for condoms in zimbabwe
2011-01-01
Background Zimbabwe suffers from one of the greatest burdens of HIV/AIDS in the world that has been compounded by social and economic instability in the past decade. However, from 2001 to 2009 HIV prevalence among 15-49 year olds declined from 26% to approximately 14%. Behavior change and condom use may in part explain this decline. PSI-Zimbabwe socially markets the Protector Plus (P+) branded line of condoms. When Zimbabwe converted to a dollar-based economy in 2009, the price of condoms was greatly increased and new marketing efforts were undertaken. This paper evaluates the role of condom marketing, a multi-dimensional scale of brand peceptions (brand equity), and price in condom use behavior. Methods We randomly sampled sexually active men age 15-49 from 3 groups - current P+ users, former users, and free condom users. We compared their brand equity and willingness to pay based on survey results. We estimated multivariable logistic regression models to compare the 3 groups. Results We found that the brand equity scale was positive correlated with willingness to pay and with condom use. Former users also indicated a high willingness to pay for condoms. We found differences in brand equity between the 3 groups, with current P+ users having the highest P+ brand equity. As observed in previous studies, higher brand equity was associated with more of the targeted health behavior, in this case and more consistent condom use. Conclusions Zimbabwe men have highly positive brand perceptions of P+. There is an opportunity to grow the total condom market in Zimbabwe by increasing brand equity across user groups. Some former users may resume using condoms through more effective marketing. Some free users may be willing to pay for condoms. Achieving these objectives will expand the total condom market and reduce HIV risk behaviors. PMID:22029874
From denial to awareness: a conceptual model for obtaining equity in healthcare.
Höglund, Anna T; Carlsson, Marianne; Holmström, Inger K; Lännerström, Linda; Kaminsky, Elenor
2018-01-22
Although Swedish legislation prescribes equity in healthcare, studies have reported inequalities, both in face-to-face encounters and in telephone nursing. Research has suggested that telephone nursing has the capability to increase equity in healthcare, as it is open to all and not limited by long distances. However, this requires an increased awareness of equity in healthcare among telephone nurses. The aim of this study was to explore and describe perceptions of equity in healthcare among Swedish telephone nurses who had participated in an educational intervention on equity in health, including which of the power constructs gender, ethnicity and age they commented upon most frequently. Further, the aim was to develop a conceptual model for obtaining equity in healthcare, based on the results of the empirical investigation. A qualitative method was used. Free text comments from questionnaires filled out by 133 telephone nurses before and after an educational intervention on equity in health, as well as individual interviews with five participants, were analyzed qualitatively. The number of comments related to inequity based on gender, ethnicity or age in the free text comments was counted descriptively. Gender was the factor commented upon the least and ethnicity the most. Four concepts were found through the qualitative analysis: Denial, Defense, Openness, and Awareness. Some informants denied inequity in healthcare in general, and in telephone nursing in particular. Others acknowledged it, but argued that they had workplace routines that protected against it. There were also examples of an openness to the fact that inequity existed and a willingness to learn and prevent it, as well as an already high awareness of inequity in healthcare. A conceptual model was developed in which the four concepts were divided into two qualitatively different blocks, with Denial and Defense on one side of a continuum and Openness and Awareness on the other. In order to reach equity in healthcare, action is also needed, and that concept was therefore added to the model. The result can be used as a starting point when developing educational interventions for healthcare personnel.
How equity is addressed in clinical practice guidelines: a content analysis
Shi, Chunhu; Tian, Jinhui; Wang, Quan; Petkovic, Jennifer; Ren, Dan; Yang, Kehu; Yang, Yang
2014-01-01
Objectives Considering equity into guidelines presents methodological challenges. This study aims to qualitatively synthesise the methods for incorporating equity in clinical practice guidelines (CPGs). Setting Content analysis of methodological publications. Eligibility criteria for selecting studies Methodological publications were included if they provided checklists/frameworks on when, how and to what extent equity should be incorporated in CPGs. Data sources We electronically searched MEDLINE, retrieved references, and browsed guideline development organisation websites from inception to January 2013. After study selection by two authors, general characteristics and checklists items/framework components from included studies were extracted. Based on the questions or items from checklists/frameworks (unit of analysis), content analysis was conducted to identify themes and questions/items were grouped into these themes. Primary outcomes The primary outcomes were methodological themes and processes on how to address equity issues in guideline development. Results 8 studies with 10 publications were included from 3405 citations. In total, a list of 87 questions/items was generated from 17 checklists/frameworks. After content analysis, questions were grouped into eight themes (‘scoping questions’, ‘searching relevant evidence’, ‘appraising evidence and recommendations’, ‘formulating recommendations’, ‘monitoring implementation’, ‘providing a flow chart to include equity in CPGs’, and ‘others: reporting of guidelines and comments from stakeholders’ for CPG developers and ‘assessing the quality of CPGs’ for CPG users). Four included studies covered more than five of these themes. We also summarised the process of guideline development based on the themes mentioned above. Conclusions For disadvantaged population-specific CPGs, eight important methodological issues identified in this review should be considered when including equity in CPGs under the guidance of a scientific guideline development manual. PMID:25479795
Kim, Annice; Kamyab, Kian; Zhu, Jingsan; Volpp, Kevin
2011-01-01
Process evaluation of a worksite intervention in which employees were offered $750 to complete a cessation program and to quit smoking. Awareness and attitudes about financial incentives were assessed following a randomized controlled trial of 878 smokers at a US-based company. Cessation program attendance was higher in incentive group versus control (20.2% vs 7.1%, P < 0.01). Most quitters (69.8%) in the incentive group who were already motivated to quit and reported that they would have quit for less money, said incentives were "not at all" or only "somewhat" important. Most nonquitters in the incentive group reported that even $1500 would not have motivated them to quit. Financial incentives are ineffective at motivating some smokers to quit. Internal motivation and readiness to quit need to be sufficiently high for relatively modest incentives to be effective.
ERIC Educational Resources Information Center
Choi, Jeong Hoon; Meisenheimer, Jessica M.; McCart, Amy B.; Sailor, Wayne
2017-01-01
The present investigation examines the schoolwide applications model (SAM) as a potentially effective school reform model for increasing equity-based inclusive education practices while enhancing student reading and math achievement for all students. A 3-year quasi-experimental comparison group analysis using latent growth modeling (LGM) was used…
Effland, Kristin J; Hays, Karen
2018-06-01
Increasing the midwifery workforce requires that aspiring midwives complete education and training, but structural racism and microaggressions impact the lives of underrepresented midwifery students and apprentices, adding stressors and disparities to the usual demanding educational challenges. In order to be resilient, students rely on preceptors, faculty, administrators and institutions to promote equity. Equity-focused learning environments improve student experiences and success rates, and better prepare all students to provide culturally humble and sensitive care to diverse childbearing persons and other essential competencies outlined by the International Confederation of Midwives. The comprehensive web-based resource, www.equitymidwifery.org, is designed to support midwifery educators in promoting equity and social justice in midwifery education and training. The website highlights examples and provides tools including original webinar content and encourages visitors to attend virtual strategy and collaboration calls. It offers a model of continuous professional development that is easily accessible. Copyright © 2018 Elsevier Ltd. All rights reserved.
Effects of the above the influence brand on adolescent drug use prevention normative beliefs.
Evans, W Douglas; Holtz, Kristen; White, Tanya; Snider, Jeremy
2014-01-01
Health brands are based on the relations between individuals and health behaviors and lifestyles. Brands can be measured by the brand equity construct validated in previous studies. The National Youth Anti-Drug Media Campaign brands alternative, non-drug use behaviors as a behavior change strategy. This study goes beyond previous campaign evaluations, which did not include specific brand equity measurements. Using data from a nationally representative media tracking, this study examined the relation between antidrug campaign brand equity and adoption of targeted attitudes, beliefs, and behaviors. Data were gathered before the relaunch of the campaign, and follow-up data collected 3 months later. On the basis of factor analysis, the authors developed a higher order antidrug brand equity factor and regressed campaign outcomes on that factor in multivariable models. The authors observed significant effects of higher brand equity on higher levels of targeted antidrug attitudes and normative beliefs at follow-up. The authors also observed some counterintuitive relations (i.e., less positive attitudes at follow-up). They interpreted these results in light of the changing messages and campaign strategy. The authors conclude that antidrug brand equity is an important construct for understanding campaign effectiveness. The present campaign shows signs of changing targeted antidrug attitudes and beliefs among youth with brand equity.
NASA Astrophysics Data System (ADS)
Shahzad, Syed Jawad Hussain; Nor, Safwan Mohd; Mensi, Walid; Kumar, Ronald Ravinesh
2017-04-01
This study examines the power law properties of 11 US credit and stock markets at the industry level. We use multifractal detrended fluctuation analysis (MF-DFA) and multifractal detrended cross-correlation analysis (MF-DXA) to first investigate the relative efficiency of credit and stock markets and then evaluate the mutual interdependence between CDS-equity market pairs. The scaling exponents of the MF-DFA approach suggest that CDS markets are relatively more inefficient than their equity counterparts. However, Banks and Financial credit markets are relatively more efficient. Basic Materials (both CDS and equity indices) is the most inefficient sector of the US economy. The cross-correlation exponents obtained through MF-DXA also suggest that the relationship of the CDS and equity sectors within and across markets is multifractal for all pairs. Within the CDS market, Basic Materials is the most dependent sector, whereas equity market sectors can be divided into two distinct groups based on interdependence. The pair-wise dependence between Basic Materials sector CDSs and the equity index is also the highest. The degree of cross-correlation shows that the sectoral pairs of CDS and equity markets belong to a persistent cross-correlated series within selected time intervals.
Incentives for Organ Donation: Proposed Standards for an Internationally Acceptable System
2012-01-01
Incentives for organ donation, currently prohibited in most countries, may increase donation and save lives. Discussion of incentives has focused on two areas: (1) whether or not there are ethical principles that justify the current prohibition and (2) whether incentives would do more good than harm. We herein address the second concern and propose for discussion standards and guidelines for an acceptable system of incentives for donation. We believe that if systems based on these guidelines were developed, harms would be no greater than those to today’s conventional donors. Ultimately, until there are trials of incentives, the question of benefits and harms cannot be satisfactorily answered. PMID:22176925
42 CFR § 414.1460 - Monitoring and program integrity.
Code of Federal Regulations, 2010 CFR
2017-10-01
... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Merit-Based Incentive Payment System and Alternative Payment Model Incentive § 414.1460 Monitoring and program integrity. (a) Vetting eligible clinicians prior to payment of the APM Incentive Payment. Prior to...
48 CFR 2937.602 - Elements of performance-based contracting.
Code of Federal Regulations, 2010 CFR
2010-10-01
... objectively measurable incentives (e.g., Firm-Fixed-Price, Fixed-Price-Incentive-Fee, or Cost-Plus-Incentive-Fee) is appropriate. However, when contractor performance (e.g., cost control, schedule, or quality/technical) is best evaluated subjectively using qualitative measures, a Cost-Plus-Award-Fee contract may be...
Incentive-Based Primary Care: Cost and Utilization Analysis
Hollander, Marcus J; Kadlec, Helena
2015-01-01
Context: In its fee-for-service funding model for primary care, British Columbia, Canada, introduced incentive payments to general practitioners as pay for performance for providing enhanced, guidelines-based care to patients with chronic conditions. Evaluation of the program was conducted at the health care system level. Objective: To examine the impact of the incentive payments on annual health care costs and hospital utilization patterns in British Columbia. Design: The study used Ministry of Health administrative data for Fiscal Year 2010–2011 for patients with diabetes, congestive heart failure, chronic obstructive pulmonary disease, and/or hypertension. In each disease group, cost and utilization were compared across patients who did, and did not, receive incentive-based care. Main Outcome Measures: Health care costs (eg, primary care, hospital) and utilization measures (eg, hospital days, readmissions). Results: After controlling for patients’ age, sex, service needs level, and continuity of care (defined as attachment to a general practice), the incentives reduced the net annual health care costs, in Canadian dollars, for patients with hypertension (by approximately Can$308 per patient), chronic obstructive pulmonary disease (by Can$496), and congestive heart failure (by Can$96), but not diabetes (incentives cost about Can$148 more per patient). The incentives were also associated with fewer hospital days, fewer admissions and readmissions, and shorter lengths of hospital stays for all 4 groups. Conclusion: Although the available literature on pay for performance shows mixed results, we showed that the funding model used in British Columbia using incentive payments for primary care might reduce health care costs and hospital utilization. PMID:26263389
Jack, B. Kelsey; Kousky, Carolyn; Sims, Katharine R. E.
2008-01-01
Payments for ecosystem services (PES) policies compensate individuals or communities for undertaking actions that increase the provision of ecosystem services such as water purification, flood mitigation, or carbon sequestration. PES schemes rely on incentives to induce behavioral change and can thus be considered part of the broader class of incentive- or market-based mechanisms for environmental policy. By recognizing that PES programs are incentive-based, policymakers can draw on insights from the substantial body of accumulated knowledge about this class of instruments. In particular, this article offers a set of lessons about how the environmental, socioeconomic, political, and dynamic context of a PES policy is likely to interact with policy design to produce policy outcomes, including environmental effectiveness, cost-effectiveness, and poverty alleviation. PMID:18621696
Jack, B Kelsey; Kousky, Carolyn; Sims, Katharine R E
2008-07-15
Payments for ecosystem services (PES) policies compensate individuals or communities for undertaking actions that increase the provision of ecosystem services such as water purification, flood mitigation, or carbon sequestration. PES schemes rely on incentives to induce behavioral change and can thus be considered part of the broader class of incentive- or market-based mechanisms for environmental policy. By recognizing that PES programs are incentive-based, policymakers can draw on insights from the substantial body of accumulated knowledge about this class of instruments. In particular, this article offers a set of lessons about how the environmental, socioeconomic, political, and dynamic context of a PES policy is likely to interact with policy design to produce policy outcomes, including environmental effectiveness, cost-effectiveness, and poverty alleviation.
Lechner, William V; L Gunn, Rachel; Minto, Alexia; Philip, Noah S; Brown, Richard A; Uebelacker, Lisa A; Price, Lawrence H; Abrantes, Ana M
2018-06-07
Three key domains including negative emotionality, incentive salience, and executive function form the core functional elements of addictive behaviors. Variables related to these broader domains have been studied extensively in relation to one another; however, no studies to date, have examined models including variables from all three domains, in relation to nicotine dependence. Smokers (N = 117), 65.8% female, 78% white, mean age of 44.4 (SD = 10.8), enrolled in a smoking cessation program completed measures of negative affect (a component of negative emotionality), urge to smoke (incentive salience), and working memory (WM; a core executive function), during a baseline assessment period prior to initiating treatment. Negative affect was associated with greater urge to smoke, and this elevated urge to smoke was associated with higher levels of nicotine dependence. Further, a significant moderated mediation indicated that WM moderated the relationship between increased urge to smoke and nicotine dependence. For those with low to average WM, urge to smoke was significantly related to nicotine dependence; however, for those with higher WM (+1 SD), urge to smoke stemming from negative affect was not associated with nicotine dependence. To our knowledge, this is the first reported relationship between negative affect, urge to smoke, WM, and nicotine dependence. Although preliminary, results indicate that WM may moderate the relationship between urge to smoke associated with negative affect and nicotine dependence. Treatments targeting WM may be particularly useful for individuals with average to low WM who experience urge to smoke related to negative affect.
Human resource management in post-conflict health systems: review of research and knowledge gaps.
Roome, Edward; Raven, Joanna; Martineau, Tim
2014-01-01
In post-conflict settings, severe disruption to health systems invariably leaves populations at high risk of disease and in greater need of health provision than more stable resource-poor countries. The health workforce is often a direct victim of conflict. Effective human resource management (HRM) strategies and policies are critical to addressing the systemic effects of conflict on the health workforce such as flight of human capital, mismatches between skills and service needs, breakdown of pre-service training, and lack of human resource data. This paper reviews published literatures across three functional areas of HRM in post-conflict settings: workforce supply, workforce distribution, and workforce performance. We searched published literatures for articles published in English between 2003 and 2013. The search used context-specific keywords (e.g. post-conflict, reconstruction) in combination with topic-related keywords based on an analytical framework containing the three functional areas of HRM (supply, distribution, and performance) and several corresponding HRM topic areas under these. In addition, the framework includes a number of cross-cutting topics such as leadership and governance, finance, and gender. The literature is growing but still limited. Many publications have focused on health workforce supply issues, including pre-service education and training, pay, and recruitment. Less is known about workforce distribution, especially governance and administrative systems for deployment and incentive policies to redress geographical workforce imbalances. Apart from in-service training, workforce performance is particularly under-researched in the areas of performance-based incentives, management and supervision, work organisation and job design, and performance appraisal. Research is largely on HRM in the early post-conflict period and has relied on secondary data. More primary research is needed across the areas of workforce supply, workforce distribution, and workforce performance. However, this should apply a longer-term focus throughout the different post-conflict phases, while paying attention to key cross-cutting themes such as leadership and governance, gender equity, and task shifting. The research gaps identified should enable future studies to examine how HRM could be used to meet both short and long term objectives for rebuilding health workforces and thereby contribute to achieving more equitable and sustainable health systems outcomes after conflict.
Adolescent brain development in normality and psychopathology
LUCIANA, MONICA
2014-01-01
Since this journal’s inception, the field of adolescent brain development has flourished, as researchers have investigated the underpinnings of adolescent risk-taking behaviors. Explanations based on translational models initially attributed such behaviors to executive control deficiencies and poor frontal lobe function. This conclusion was bolstered by evidence that the prefrontal cortex and its interconnections are among the last brain regions to structurally and functionally mature. As substantial heterogeneity of prefrontal function was revealed, applications of neuroeconomic theory to adolescent development led to dual systems models of behavior. Current epidemiological trends, behavioral observations, and functional magnetic resonance imaging based brain activity patterns suggest a quadratic increase in limbically mediated incentive motivation from childhood to adolescence and a decline thereafter. This elevation occurs in the context of immature prefrontal function, so motivational strivings may be difficult to regulate. Theoretical models explain this patterning through brain-based accounts of subcortical–cortical integration, puberty-based models of adolescent sensation seeking, and neurochemical dynamics. Empirically sound tests of these mechanisms, as well as investigations of biology–context interactions, represent the field’s most challenging future goals, so that applications to psychopathology can be refined and so that developmental cascades that incorporate neurobiological variables can be modeled. PMID:24342843
Adolescent brain development in normality and psychopathology.
Luciana, Monica
2013-11-01
Since this journal's inception, the field of adolescent brain development has flourished, as researchers have investigated the underpinnings of adolescent risk-taking behaviors. Explanations based on translational models initially attributed such behaviors to executive control deficiencies and poor frontal lobe function. This conclusion was bolstered by evidence that the prefrontal cortex and its interconnections are among the last brain regions to structurally and functionally mature. As substantial heterogeneity of prefrontal function was revealed, applications of neuroeconomic theory to adolescent development led to dual systems models of behavior. Current epidemiological trends, behavioral observations, and functional magnetic resonance imaging based brain activity patterns suggest a quadratic increase in limbically mediated incentive motivation from childhood to adolescence and a decline thereafter. This elevation occurs in the context of immature prefrontal function, so motivational strivings may be difficult to regulate. Theoretical models explain this patterning through brain-based accounts of subcortical-cortical integration, puberty-based models of adolescent sensation seeking, and neurochemical dynamics. Empirically sound tests of these mechanisms, as well as investigations of biology-context interactions, represent the field's most challenging future goals, so that applications to psychopathology can be refined and so that developmental cascades that incorporate neurobiological variables can be modeled.
Incentives from Curriculum Tracking
ERIC Educational Resources Information Center
Koerselman, Kristian
2013-01-01
Curriculum tracking creates incentives in the years before its start, and we should therefore expect test scores to be higher during those years. I find robust evidence for incentive effects of tracking in the UK based on the UK comprehensive school reform. Results from the Swedish comprehensive school reform are inconclusive. Internationally, I…
42 CFR § 414.1455 - Limitation on review.
Code of Federal Regulations, 2010 CFR
2017-10-01
... (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Merit-Based Incentive Payment System and Alternative Payment Model Incentive § 414.1455 Limitation on review. There is... of the APM Incentive Payment under § 414.1450, including any estimation as part of such determination. ...
Deriving fair incentives for management of hardwood timber stands
David A. Gansner; W. Herrick Owen; David N. Larsen; David N. Larsen
1973-01-01
The authors present a practical method for deriving timber-management incentive payments and demonstrate its application in forest stands of upland hardwoods. The suggested incentive payment is based on the differences between discounted costs and returns of deliberate forest management and the "harvest and let grow" option.
Managing Salary Equity. AIR Forum 1981 Paper.
ERIC Educational Resources Information Center
Prather, James E.; Posey, Ellen I.
Technical considerations in the development of a salary equity model based upon regression analysis are reviewed, and a simplified salary prediction equation is examined. Application and communication of the results of the analysis within the existing operational context of a postsecondary institution are also addressed. The literature is…
A strategy to increase adoption of locally-produced, ceramic cookstoves in rural Kenyan households.
Silk, Benjamin J; Sadumah, Ibrahim; Patel, Minal K; Were, Vincent; Person, Bobbie; Harris, Julie; Otieno, Ronald; Nygren, Benjamin; Loo, Jennifer; Eleveld, Alie; Quick, Robert E; Cohen, Adam L
2012-05-16
Exposure to household air pollutants released during cooking has been linked to numerous adverse health outcomes among residents of rural areas in low-income countries. Improved cookstoves are one of few available interventions, but achieving equity in cookstove access has been challenging. Therefore, innovative approaches are needed. To evaluate a project designed to motivate adoption of locally-produced, ceramic cookstoves (upesi jiko) in an impoverished, rural African population, we assessed the perceived benefits of the cookstoves (in monetary and time-savings terms), the rate of cookstove adoption, and the equity of adoption. The project was conducted in 60 rural Kenyan villages in 2008 and 2009. Baseline (n = 1250) and follow-up (n = 293) surveys and a stove-tracking database were analyzed. At baseline, nearly all respondents used wood (95%) and firepits (99%) for cooking; 98% desired smoke reductions. Households with upesi jiko subsequently spent <100 Kenyan Shillings/week on firewood more often (40%) than households without upesi jiko (20%) (p = 0.0002). There were no significant differences in the presence of children <2 years of age in households using upesi jiko (48%) or three-stone stoves (49%) (p = 0.88); children 2-5 years of age were less common in households using upesi jiko versus three-stone stoves (46% and 69%, respectively) (p = 0.0001). Vendors installed 1,124 upesi jiko in 757 multi-family households in 18 months; 68% of these transactions involved incentives for vendors and purchasers. Relatively few (<10%) upesi jiko were installed in households of women in the youngest age quartile (<22 years) or among households in the poorest quintile. Our strategy of training of local vendors, appropriate incentives, and product integration effectively accelerated cookstove adoption into a large number of households. The strategy also created opportunities to reinforce health messages and promote cookstoves sales and installation. However, the project's overall success was diminished by inequitable and incomplete adoption by households with the lowest socioeconomic status and young children present. Additional evaluations of similar strategies will be needed to determine whether our strategy can be applied equitably elsewhere, and whether reductions in fuel use, household air pollution, and the incidence of respiratory diseases will follow adoption of improved cookstoves.
A strategy to increase adoption of locally-produced, ceramic cookstoves in rural Kenyan households
2012-01-01
Background Exposure to household air pollutants released during cooking has been linked to numerous adverse health outcomes among residents of rural areas in low-income countries. Improved cookstoves are one of few available interventions, but achieving equity in cookstove access has been challenging. Therefore, innovative approaches are needed. To evaluate a project designed to motivate adoption of locally-produced, ceramic cookstoves (upesi jiko) in an impoverished, rural African population, we assessed the perceived benefits of the cookstoves (in monetary and time-savings terms), the rate of cookstove adoption, and the equity of adoption. Methods The project was conducted in 60 rural Kenyan villages in 2008 and 2009. Baseline (n = 1250) and follow-up (n = 293) surveys and a stove-tracking database were analyzed. Results At baseline, nearly all respondents used wood (95%) and firepits (99%) for cooking; 98% desired smoke reductions. Households with upesi jiko subsequently spent <100 Kenyan Shillings/week on firewood more often (40%) than households without upesi jiko (20%) (p = 0.0002). There were no significant differences in the presence of children <2 years of age in households using upesi jiko (48%) or three-stone stoves (49%) (p = 0.88); children 2–5 years of age were less common in households using upesi jiko versus three-stone stoves (46% and 69%, respectively) (p = 0.0001). Vendors installed 1,124 upesi jiko in 757 multi-family households in 18 months; 68% of these transactions involved incentives for vendors and purchasers. Relatively few (<10%) upesi jiko were installed in households of women in the youngest age quartile (<22 years) or among households in the poorest quintile. Conclusions Our strategy of training of local vendors, appropriate incentives, and product integration effectively accelerated cookstove adoption into a large number of households. The strategy also created opportunities to reinforce health messages and promote cookstoves sales and installation. However, the project’s overall success was diminished by inequitable and incomplete adoption by households with the lowest socioeconomic status and young children present. Additional evaluations of similar strategies will be needed to determine whether our strategy can be applied equitably elsewhere, and whether reductions in fuel use, household air pollution, and the incidence of respiratory diseases will follow adoption of improved cookstoves. PMID:22591643
A top-down perspective on dopamine, motivation and memory.
Phillips, Anthony G; Vacca, Giada; Ahn, Soyon
2008-08-01
Dopamine (DA) activity, in the form of increased neural firing or enhanced release of transmitter from nerve terminals and varicosities, is linked to a number of important psychological processes including: movement; hedonic reactions to positive reward; provision of an error detection signal during the acquisition of new learning; response to novel stimuli; provision of reinforcement signals essential for acquisition of new action patterns; and incentive motivation. This review focuses primarily on our research linking dynamic changes in DA efflux on the timescale of minutes, with incentive motivation, as revealed by brain dialysis experiments in behaving animals. Recent experiments on sensory-specific satiety and successive positive and negative contrast are discussed along with the distinction between preparatory behaviors that precede contact with biologically significant stimuli and subsequent consummatory behaviors. The relationship between DA efflux in the medial prefrontal cortex (mPFC) and foraging for food based on working memory is also discussed in support of the conjecture that DA may serve as a link between motivation and memory functions. Evidence in support of 'top-down' regulation of dopaminergic activity in the mesocorticolimbic DA pathways is reviewed briefly to introduce a mechanism by which activation of ascending DA projections in this manner might optimize dopaminergic modulation of executive function within regions such as the mPFC. Collectively, these processes could ensure coordination between cognitive processes that assess current opportunities and the motivational systems that select and engage patterns of approach behavior that bring organisms into contact with the essentials for survival.
Butler, James; Fryer, Craig S; Ward, Earlise; Westaby, Katelyn; Adams, Alexandra; Esmond, Sarah L; Garza, Mary A; Hogle, Janice A; Scholl, Linda M; Quinn, Sandra C; Thomas, Stephen B; Sorkness, Christine A
2017-06-01
Efforts to address health disparities and achieve health equity are critically dependent on the development of a diverse research workforce. However, many researchers from underrepresented backgrounds face challenges in advancing their careers, securing independent funding, and finding the mentorship needed to expand their research. Faculty from the University of Maryland at College Park and the University of Wisconsin-Madison developed and evaluated an intensive week-long research and career-development institute-the Health Equity Leadership Institute (HELI)-with the goal of increasing the number of underrepresented scholars who can sustain their ongoing commitment to health equity research. In 2010-2016, HELI brought 145 diverse scholars (78% from an underrepresented background; 81% female) together to engage with each other and learn from supportive faculty. Overall, scholar feedback was highly positive on all survey items, with average agreement ratings of 4.45-4.84 based on a 5-point Likert scale. Eighty-five percent of scholars remain in academic positions. In the first three cohorts, 73% of HELI participants have been promoted and 23% have secured independent federal funding. HELI includes an evidence-based curriculum to develop a diverse workforce for health equity research. For those institutions interested in implementing such an institute to develop and support underrepresented early stage investigators, a resource toolbox is provided.
Introducing gender equity to adolescent school children: A mixed methods' study.
Syed, Saba
2017-01-01
Over the past decade, gender equality and women's empowerment have been explicitly recognized as key not only to the health of nations but also to social and economic development. The aim of the present study was to assess the effectiveness of a mixed methods' participatory group education approach to introduce gender equity to adolescent school children. It also assessed baseline and postintervention knowledge, attitudes, and practices regarding gender equity, sexual and reproductive health among adolescent students in government-aided schools, and finally, compare the pre- and post-intervention gender equitable (GE) attitudes among the study participants. A government-aided school was selected by nonprobalistic intentional sampling. On 5 predesignated days, willing students were included in the intervention which included a pretest, a group of educational-based participatory mixed methods' intervention followed by a posttest assessment. A total of 186 students participated in the study. Girls had better baseline GE scores as compared to boys and they also improvised more on the baseline scores following the intervention. The present mixed method approach to introduce gender equity to adolescent school children through a group education-based interventional approach proved to be effective in initiating dialog and sensitizing adolescents on gender equity and violence within a school setting.
Cost of capital to the hospital sector.
Sloan, F A; Valvona, J; Hassan, M; Morrisey, M A
1988-03-01
This paper provides estimates of the cost of equity and debt capital to for-profit and non-profit hospitals in the U.S. for the years 1972-83. The cost of equity is estimated using, alternatively, the Capital Asset Pricing Model and Arbitrage Pricing Theory. We find that the cost of equity capital, using either model, substantially exceeded anticipated inflation. The cost of debt capital was much lower. Accounting for the corporate tax shield on debt and capital paybacks by cost-based insurers lowered the net cost of capital to hospitals.
Paperless Transaction for Publication Incentive System
NASA Astrophysics Data System (ADS)
Ibrahim, Rosziati; Madon, Hamiza Diana; Nazri, Nurul Hashida Amira Mohd; Saarani, Norhafizah; Mustapha, Aida
2017-08-01
Within the Malaysian context, incentive system in scientific publishing rewards authors for publishing journal articles or conference papers that are indexed by Scopus. At Universiti Tun Hussein Onn Malaysia, the incentive system is going into its third year in operational. The main challenge lies in preparing the evidences as required by the application guideline. This paper presents an online module for publication incentive within the University Publication Information System (SMPU). The module was developed using the Scrum methodology based on the existing workflow of paper-based application. The module is hoped to increase the quality of the system deliverables of SMPU as well as having the ability to cope with change of university requirements in the future.
Critical considerations for the practical utility of health equity tools: a concept mapping study.
Pauly, Bernadette; Martin, Wanda; Perkin, Kathleen; van Roode, Thea; Kwan, Albert; Patterson, Tobie; Tong, Samantha; Prescott, Cheryl; Wallace, Bruce; Hancock, Trevor; MacDonald, Marjorie
2018-04-23
Promoting health equity within health systems is a priority and challenge worldwide. Health equity tools have been identified as one strategy for integrating health equity considerations into health systems. Although there has been a proliferation of health equity tools, there has been limited attention to evaluating these tools for their practicality and thus their likelihood for uptake. Within the context of a large program of research, the Equity Lens in Public Health (ELPH), we conducted a concept mapping study to identify key elements and themes related to public health leaders and practitioners' views about what makes a health equity tool practical and useful. Concept mapping is a participatory mixed-method approach to generating ideas and concepts to address a common concern. Participants brainstormed responses to the prompt "To be useful, a health equity tool should…" After participants sorted responses into groups based on similarity and rated them for importance and feasibility, the statements were analyzed using multidimensional scaling, then grouped using cluster analysis. Pattern matching graphs were constructed to illustrate the relationship between the importance and feasibility of statements, and go-zone maps were created to guide subsequent action. The process resulted in 67 unique statements that were grouped into six clusters: 1) Evaluation for Improvement; 2) User Friendliness; 3) Explicit Theoretical Background; 4) Templates and Tools 5) Equity Competencies; and 6) Nothing about Me without Me- Client Engaged. The result was a set of concepts and themes describing participants' views of the practicality and usefulness of health equity tools. These thematic clusters highlight the importance of user friendliness and having user guides, templates and resources to enhance use of equity tools. Furthermore, participants' indicated that practicality was not enough for a tool to be useful. In addition to practical characteristics of the tool, a useful tool is one that encourages and supports the development of practitioner competencies to engage in equity work including critical reflections on power and institutional culture as well as strategies for the involvement of community members impacted by health inequities in program planning and delivery. The results of this study will be used to inform the development of practical criteria to assess health equity tools for application in public health.
Private equity ownership and nursing home financial performance.
Pradhan, Rohit; Weech-Maldonado, Robert; Harman, Jeffrey S; Laberge, Alex; Hyer, Kathryn
2013-01-01
Private equity has acquired multiple large nursing home chains within the last few years; by 2009, it owned nearly 1,900 nursing homes. Private equity is said to improve the financial performance of acquired facilities. However, no study has yet examined the financial performance of private equity nursing homes, ergo this study. The primary purpose of this study is to understand the financial performance of private equity nursing homes and how it compares with other investor-owned facilities. It also seeks to understand the approach favored by private equity to improve financial performance-for instance, whether they prefer to cut costs or maximize revenues or follow a mixed approach. Secondary data from Medicare cost reports, the Online Survey, Certification and Reporting, Area Resource File, and Brown University's Long-term Care Focus data set are combined to construct a longitudinal data set for the study period 2000-2007. The final sample is 2,822 observations after eliminating all not-for-profit, independent, and hospital-based facilities. Dependent financial variables consist of operating revenues and costs, operating and total margins, payer mix (census Medicare, census Medicaid, census other), and acuity index. Independent variables primarily reflect private equity ownership. The study was analyzed using ordinary least squares, gamma distribution with log link, logit with binomial family link, and logistic regression. Private equity nursing homes have higher operating margin as well as total margin; they also report higher operating revenues and costs. No significant differences in payer mix are noted. Results suggest that private equity delivers superior financial performance compared with other investor-owned nursing homes. However, causes for concern remain particularly with the long-term financial sustainability of these facilities.
Development of industry-based strategies for motivating seat-belt usage
DOT National Transportation Integrated Search
1983-03-01
A variety of incentive-based programs to motivate safety belt use were tested during the 18-month grant period in order to define optimal incentive strategies for particular corporate settings. Initial programs provoked important research questions w...
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.
Diaz, Adrian; Merath, Katiuscha; Bagante, Fabio; Chen, Qinyu; Akgul, Ozgur; Beal, Eliza; Idrees, Jay; Olsen, Griffin; Gani, Faiz; Pawlik, Timothy M
2018-05-15
The Affordable Care Act established a Center for Medicare/Medicaid Services based 10% reimbursement bonus for general surgeons in Health Professional Shortage Areas. We sought to assess the impact of the Affordable Care Act Surgery Incentive Payment on surgical procedures performed in Health Professional Shortage Areas. Hospital utilization data from the California Office of Statewide Health Planning and Development between January 1, 2006, and December 31, 2015, were used to categorize hospitals according to Health Professional Shortage Area location. A difference-in-differences analysis measured the effect of the Surgery Incentive Payment on year-to-year differences for inpatient and outpatient surgical procedures by hospital type pre- (2006-2010) versus post- (2011-2015) Surgery Incentive Payment implementation. Among 409 unique hospitals that performed surgical procedures for at least 1 year of the study period, 2 performed surgery in a designated Health Professional Shortage Area. The two Health Professional Shortage Area -designated hospitals were located in a rural area, were non-teaching hospitals, and had 196 and 202 hospital beds, respectively. After the enactment of the Surgery Incentive Payment, while non- Health Professional Shortage Areas had only a modest relative decrease in total inpatient procedures (Pre-Surgery Incentive Payment: 4,666,938 versus Post-Surgery Incentive Payment: 4,451,612; Δ-4.6%), the proportional decrease in inpatient surgical procedures at Health Professional Shortage Area hospitals was more marked (Pre-Surgery Incentive Payment: 25,830 versus Post-Surgery Incentive Payment: 21,503; Δ-16.7%). In contrast, Health Professional Shortage Area hospitals proportionally had a greater increase in total outpatient procedures (Pre-Surgery Incentive Payment: 17,840 versus Post-Surgery Incentive Payment: 22,375: Δ+25.4%) versus non- Health Professional Shortage Area hospitals (Pre-Surgery Incentive Payment: 5,863,300 versus Post-Surgery Incentive Payment: 6,156,138; Δ+4.9%). Based on the difference-in-differences analysis, the increase in the trend of surgical procedures at Health Professional Shortage Area hospitals was much more notable after Surgery Incentive Payment implementation (Δ+75.2%). The Medicare Surgery Incentive Payment program was associated with an increase in the number of surgical procedures performed at Health Professional Shortage Area hospitals relative to non-Health Professional Shortage Area hospitals during the study period, reversing the trend from negative to positive. Copyright © 2018 Elsevier Inc. All rights reserved.
The Activation, Appropriation and Practices of Student-Equity Policy in Australian Higher Education
ERIC Educational Resources Information Center
Peacock, David; Sellar, Sam; Lingard, Bob
2014-01-01
Current national reforms in Australian higher education have prioritised efforts to reduce educational disadvantage within a vernacular expression of neoliberal education policy. Student-equity policy in universities is enmeshed in a set of competitive student recruitment relations. This raises practice-based tensions as universities strive to…
ERIC Educational Resources Information Center
Harper, Frances Kay
2017-01-01
This dissertation builds on and extends research on the relationship between equity-minded mathematics teaching, specifically teaching mathematics for social justice, complex instruction, and project-based learning, and students' learning and identity development. Although different in their structures and strategies, equity-minded mathematics…
Equity-Directed Instructional Practices: Beyond the Dominant Perspective
ERIC Educational Resources Information Center
Rubel, Laurie H.
2017-01-01
In this article, the author synthesizes four equity-directed instructional practices: standards-based mathematics instruction, complex instruction, culturally relevant pedagogy (CRP), and teaching mathematics for social justice (TMfSJ). The author organizes these practices according to the dominant and critical axes in Gutiérrez's (2007a) equity…
17 CFR 230.405 - Definitions of terms.
Code of Federal Regulations, 2013 CFR
2013-04-01
... purchased for the account of plan participants, at prices not in excess of current market prices at the time... specified in the plan and based upon average or current market prices at the time of purchase. Electronic... maintain a market for the registrant's securities. Equity security. The term equity security means any...
17 CFR 230.405 - Definitions of terms.
Code of Federal Regulations, 2012 CFR
2012-04-01
... purchased for the account of plan participants, at prices not in excess of current market prices at the time... specified in the plan and based upon average or current market prices at the time of purchase. Electronic... maintain a market for the registrant's securities. Equity security. The term equity security means any...
17 CFR 230.405 - Definitions of terms.
Code of Federal Regulations, 2014 CFR
2014-04-01
... purchased for the account of plan participants, at prices not in excess of current market prices at the time... specified in the plan and based upon average or current market prices at the time of purchase. Electronic... maintain a market for the registrant's securities. Equity security. The term equity security means any...
Bridging the Wage Gap: Pay Equity and Job Evaluations.
ERIC Educational Resources Information Center
Ferraro, Geraldine A.
1984-01-01
Discusses the growing gap between the wages of women and men and reviews arguments opposing pay equity. Cites occupational segregation and sex-based wage discrimination as causes for the wage gap, and considers some remedies that have proven to be effective: negotiation, collective bargaining, litigation, and job evaluation studies. (KH)
Equity Access Plans: A Regulatory and Educational State Response Model.
ERIC Educational Resources Information Center
DeLisle, James
1984-01-01
Introduces the basic notion of equity access plans as property-based solutions to the cash flow needs of elderly homeowners and then proposes a normative response model that states can adopt to help manage the risk exposures. The recommended model incorporates regulatory, information dissemination, and educational elements. (BH)
Assessing Equating Results on Different Equating Criteria
ERIC Educational Resources Information Center
Tong, Ye; Kolen, Michael
2005-01-01
The performance of three equating methods--the presmoothed equipercentile method, the item response theory (IRT) true score method, and the IRT observed score method--were examined based on three equating criteria: the same distributions property, the first-order equity property, and the second-order equity property. The magnitude of the…
School Integration Matters: Research-Based Strategies to Advance Equity
ERIC Educational Resources Information Center
Frankenberg, Erica, Ed.; Garces, Liliana M., Ed.; Hopkins, Megan, Ed.
2016-01-01
More than 60 years after the "Brown v. Board of Education" decision declared segregated schooling inherently unequal, this timely book sheds light on how and why U.S. schools are experiencing increasing segregation along racial, socioeconomic, and linguistic lines. It offers policy and programmatic alternatives for advancing equity and…
Personalisation and the Education Commodity: A Meta-Ethnographic Analysis
ERIC Educational Resources Information Center
Beach, Dennis
2017-01-01
This article is based on a meta-ethnography of research about schools, school experiences and learning following the recent (post-market) introduction of personalisation policies in Swedish schools. It pays particular attention to issues of equity. Tensions between personalisation, privatisation and equity are discussed and it is noted that…
Adult Instructors' Perceptions on ICT and Diffusion Practices: Implications for Equity of Access
ERIC Educational Resources Information Center
Salinas-Amescua, Bertha
2007-01-01
This study suggests equity of access goes beyond technological availability. Based on a larger exploratory study of the initial implementation stage of the Mexican government's community technology centers, CTCs ("plazas comunitarias"), adult education instructors' perceptions and diffusion practices are described as a mediating factor…
ERIC Educational Resources Information Center
DiMartino, Joseph; Miles, Sherri
2004-01-01
In this article, the authors discuss three reform strategies designed to produce educational equity. The first strategy, heterogeneous grouping, does away with the controversial practice of placing students in different tracks based on their ability, which can polarize the student population into pro- and anti-school camps, create a "caste system"…
Using financial incentives to improve value in orthopaedics.
Lansky, David; Nwachukwu, Benedict U; Bozic, Kevin J
2012-04-01
A variety of reforms to traditional approaches to provider payment and benefit design are being implemented in the United States. There is increasing interest in applying these financial incentives to orthopaedics, although it is unclear whether and to what extent they have been implemented and whether they increase quality or reduce costs. We reviewed and discussed physician- and patient-oriented financial incentives being implemented in orthopaedics, key challenges, and prerequisites to payment reform and value-driven payment policy in orthopaedics. We searched the MEDLINE database using as search terms various provider payment and consumer incentive models. We retrieved a total of 169 articles; none of these studies met the inclusion criteria. For incentive models known to the authors to be in use in orthopaedics but for which no peer-reviewed literature was found, we searched Google for further information. Provider financial incentives reviewed include payments for reporting, performance, and patient safety and episode payment. Patient incentives include tiered networks, value-based benefit design, reference pricing, and value-based purchasing. Reform of financial incentives for orthopaedic surgery is challenged by (1) lack of a payment/incentive model that has demonstrated reductions in cost trends and (2) the complex interrelation of current pay schemes in today's fragmented environment. Prerequisites to reform include (1) a reliable and complete data infrastructure; (2) new business structures to support cost sharing; and (3) a retooling of patient expectations. There is insufficient literature reporting the effects of various financial incentive models under implementation in orthopaedics to know whether they increase quality or reduce costs. National concerns about cost will continue to drive experimentation, and all anticipated innovations will require improved collaboration and data collection and reporting.
Williams, David M; Lee, Harold H; Connell, Lauren; Boyle, Holly; Emerson, Jessica; Strohacker, Kelley; Galárraga, Omar
2018-03-01
Regular physical activity (PA) enhances weight-loss and reduces risk of chronic disease. However, as few as 10% of U.S. adults engage in regular PA. Incentive programs to promote PA have shown some promise, but have typically used incentives that are too large to sustain over time and have not demonstrated habit formation or been tested in community settings. This report presents the rationale and design of a randomized pilot study testing the feasibility and preliminary efficacy of small monetary incentives for PA (n=25) versus charitable donations in the same amount (n=25) versus control (n=25) over 12months among 75 low-active but otherwise healthy adults at a local YMCA. Incentives are based on YMCA attendance, which is verified by electronic swipe card data and is the primary study outcome, with self-reported minutes/week of PA assessed as a secondary outcome. Incentives are intentionally small enough-$1/session, maximum of $5/week-such that they could be indefinitely sustained by community organizations, privately-owned health clubs, healthcare organizations, or employers (e.g., employer fitness facilities). Costs of the incentive program for the sponsoring organization may be partially offset by increases in membership resulting from the appeal of the program. Moreover, if efficacious, the charitable donation incentive program may have the added benefit of building social capital for the sponsoring organization and potentially serving as a tax write-off, thus further offsetting the cost of the incentives. Findings will also have implications for the use of financially sustainable community-based incentive programs for other health-related behaviors (e.g., weight loss, smoking). Copyright © 2018 Elsevier Inc. All rights reserved.
Perspectives on Performance-Based Incentive Plans.
ERIC Educational Resources Information Center
Duttweiler, Patricia Cloud; Ramos-Cancel, Maria L.
This document is a synthesis of the current literature on performance-based incentive systems for teachers and administrators. Section one provides an introduction to the reform movement and to performance-based pay initiatives; a definition of terms; a brief discussion of funding sources; a discussion of compensation strategies; a description of…
ERIC Educational Resources Information Center
Cooke, Valerie; Arling, Greg; Lewis, Teresa; Abrahamson, Kathleen A.; Mueller, Christine; Edstrom, Lisa
2010-01-01
Purpose: Minnesota's Nursing Facility Performance-Based Incentive Payment Program (PIPP) supports provider-initiated projects aimed at improving care quality and efficiency. PIPP moves beyond conventional pay for performance. It seeks to promote implementation of evidence-based practices, encourage innovation and risk taking, foster collaboration…
Randomized Trial of Four Financial-Incentive Programs for Smoking Cessation
Halpern, Scott D.; French, Benjamin; Small, Dylan S.; Saulsgiver, Kathryn; Harhay, Michael O.; Audrain-McGovern, Janet; Loewenstein, George; Brennan, Troyen A.; Asch, David A.; Volpp, Kevin G.
2015-01-01
BACKGROUND Financial incentives promote many health behaviors, but effective ways to deliver health incentives remain uncertain. METHODS We randomly assigned CVS Caremark employees and their relatives and friends to one of four incentive programs or to usual care for smoking cessation. Two of the incentive programs targeted individuals, and two targeted groups of six participants. One of the individual-oriented programs and one of the group-oriented programs entailed rewards of approximately $800 for smoking cessation; the others entailed refundable deposits of $150 plus $650 in reward payments for successful participants. Usual care included informational resources and free smoking-cessation aids. RESULTS Overall, 2538 participants were enrolled. Of those assigned to reward-based programs, 90.0% accepted the assignment, as compared with 13.7% of those assigned to deposit-based programs (P<0.001). In intention-to-treat analyses, rates of sustained abstinence from smoking through 6 months were higher with each of the four incentive programs (range, 9.4 to 16.0%) than with usual care (6.0%) (P<0.05 for all comparisons); the superiority of reward-based programs was sustained through 12 months. Group-oriented and individual-oriented programs were associated with similar 6-month abstinence rates (13.7% and 12.1%, respectively; P = 0.29). Reward-based programs were associated with higher abstinence rates than deposit-based programs (15.7% vs. 10.2%, P<0.001). However, in instrumental-variable analyses that accounted for differential acceptance, the rate of abstinence at 6 months was 13.2 percentage points (95% confidence interval, 3.1 to 22.8) higher in the deposit-based programs than in the reward-based programs among the estimated 13.7% of the participants who would accept participation in either type of program. CONCLUSIONS Reward-based programs were much more commonly accepted than deposit-based programs, leading to higher rates of sustained abstinence from smoking. Group-oriented incentive programs were no more effective than individual-oriented programs. (Funded by the National Institutes of Health and CVS Caremark; ClinicalTrials.gov number, NCT01526265.) PMID:25970009
The spatial equity principle in the administrative division of the Central European countries
Klapka, Pavel; Bačík, Vladimír; Klobučník, Michal
2017-01-01
The paper generally builds on the concept of justice in social science. It attempts to interpret this concept in a geographical and particularly in a spatial context. The paper uses the concept of accessibility to define the principle of spatial equity. The main objective of the paper is to propose an approach with which to assess the level of spatial equity in the administrative division of a territory. In order to fulfil this objective the paper theoretically discusses the concept of spatial equity and relates it to other relevant concepts, such as spatial efficiency. The paper proposes some measures of spatial equity and uses the territory of four Central European countries (Austria, the Czech Republic, Hungary, Slovakia) as example of the application of the proposed measures and the corroboration of the proposed approach. The analysis is based on the administrative division of four countries and is carried out at different hierarchical levels as defined by the Nomenclature of Units for Territorial Statistics (NUTS). PMID:29091953
Tidey, Jennifer W
2012-11-01
Serious mental illness (SMI) is associated with high rates of tobacco and other drug dependence, poor treatment compliance, obesity and low levels of physical activity, which have severe medical and psychosocial consequences. Interventions that effectively reduce these health risk behaviors among people with SMI are urgently needed. Published reports from studies evaluating incentive-based treatments for promoting tobacco and other drug abstinence, treatment attendance, medication use and increased physical activity are reviewed. Results of this review indicate the efficacy of incentive-based treatments for reducing tobacco and other drug use among people with SMI. Few studies have examined whether incentive-based treatments improve treatment attendance, medication use and physical activity levels in people with SMI; however, initial evidence is positive and indicates that further research in these areas is warranted. Given the medical and psychosocial costs of tobacco and other drug use, treatment non-compliance and physical inactivity, and the efficacy of incentive-based treatments for improving these behaviors, such interventions should be further developed and integrated into behavioral health treatment programs for people with SMI. Copyright © 2011 Elsevier Inc. All rights reserved.
Comparing Types of Financial Incentives to Promote Walking: An Experimental Test.
Burns, Rachel J; Rothman, Alexander J
2018-04-19
Offering people financial incentives to increase their physical activity is an increasingly prevalent intervention strategy. However, little is known about the relative effectiveness of different types of incentives. This study tested whether incentives based on specified reinforcement types and schedules differentially affected the likelihood of meeting a walking goal and explored if observed behavioural changes may have been attributable to the perceived value of the incentive. A 2 (reinforcement type: cash reward, deposit contract) × 2 (schedule: fixed, variable) between-subjects experiment with a hanging control condition was conducted over 8 weeks (n = 153). Although walking was greater in the incentive conditions relative to the control condition, walking did not differ across incentive conditions. Exploratory analyses indicated that the perceived value of the incentive was associated with the likelihood of meeting the walking goal, but was not affected by reinforcement type or schedule. The reinforcement type and schedule manipulations tested in this study did not differentially affect walking. Given that walking behaviour was associated with perceived value, designing incentive strategies that optimise the perceived value of the incentive may be a promising avenue for future research. © 2018 The International Association of Applied Psychology.
[The virtual library in equity, health, and human development].
Valdés, América
2002-01-01
This article attempts to describe the rationale that has led to the development of information sources dealing with equity, health, and human development in countries of Latin America and the Caribbean within the context of the Virtual Health Library (Biblioteca Virtual en Salud, BVS). Such information sources include the scientific literature, databases in printed and electronic format, institutional directories and lists of specialists, lists of events and courses, distance education programs, specialty journals and bulletins, as well as other means of disseminating health information. The pages that follow deal with the development of a Virtual Library in Equity, Health, and Human Development, an effort rooted in the conviction that decision-making and policy geared toward achieving greater equity in health must, of necessity, be based on coherent, well-organized, and readily accessible first-rate scientific information. Information is useless unless it is converted into knowledge that benefits society. The Virtual Library in Equity, Health, and Human Development is a coordinated effort to develop a decentralized regional network of scientific information sources, with strict quality control, from which public officials can draw data and practical examples that can help them set health and development policies geared toward achieving greater equity for all.
Farrell, Anne M.; Goh, Joshua O. S.; White, Brian J.
2018-01-01
Emotional and economic incentives often conflict in decision environments. To make economically desirable decisions then, deliberative neural processes must be engaged to regulate automatic emotional reactions. In this functional magnetic resonance imaging (fMRI) study, we evaluated how fixed wage (FW) incentives and performance-based (PB) financial incentives, in which pay is proportional to outcome, differentially regulate positive and negative emotional reactions to hypothetical colleagues that conflicted with the economics of available alternatives. Neural activity from FW to PB incentive contexts decreased for positive emotional stimuli but increased for negative stimuli in middle temporal, insula, and medial prefrontal regions. In addition, PB incentives further induced greater responses to negative than positive emotional decisions in the frontal and anterior cingulate regions involved in emotion regulation. Greater response to positive than negative emotional features in these regions also correlated with lower frequencies of economically desirable choices. Our findings suggest that whereas positive emotion regulation involves a reduction of responses in valence representation regions, negative emotion regulation additionally engages brain regions for deliberative processing and signaling of incongruous events. PMID:29487519
Farrell, Anne M; Goh, Joshua O S; White, Brian J
2018-01-01
Emotional and economic incentives often conflict in decision environments. To make economically desirable decisions then, deliberative neural processes must be engaged to regulate automatic emotional reactions. In this functional magnetic resonance imaging (fMRI) study, we evaluated how fixed wage (FW) incentives and performance-based (PB) financial incentives, in which pay is proportional to outcome, differentially regulate positive and negative emotional reactions to hypothetical colleagues that conflicted with the economics of available alternatives. Neural activity from FW to PB incentive contexts decreased for positive emotional stimuli but increased for negative stimuli in middle temporal, insula, and medial prefrontal regions. In addition, PB incentives further induced greater responses to negative than positive emotional decisions in the frontal and anterior cingulate regions involved in emotion regulation. Greater response to positive than negative emotional features in these regions also correlated with lower frequencies of economically desirable choices. Our findings suggest that whereas positive emotion regulation involves a reduction of responses in valence representation regions, negative emotion regulation additionally engages brain regions for deliberative processing and signaling of incongruous events.
Furtado, Karishma; Banks, Kira Hudson
2016-11-01
The Ferguson Commission was an independent body of 16 commissioners in operation from November 2014 to December 2015 and appointed by Missouri governor Jay Nixon to examine the root causes underlying the death of Michael Brown Jr. Its report, "Forward Through Ferguson: A Path Toward Racial Equity," raises many issues on racial equity that public health is well suited to address, such as trends in police use of force, the health implications of the school-based discipline gap, and the health benefits of a coordinated housing strategy. Public health can also learn from the principles the commission adopted, including being unflinching in the questions asked and conclusions drawn, applying a racial equity lens to public health work, and moving beyond programmatic solutions to policy solutions.