Sample records for shared savings program

  1. Incorporating shared savings programs into primary care: from theory to practice.

    PubMed

    Hayen, Arthur P; van den Berg, Michael J; Meijboom, Bert R; Struijs, Jeroen N; Westert, Gert P

    2015-12-30

    In several countries, health care policies gear toward strengthening the position of primary care physicians. Primary care physicians are increasingly expected to take accountability for overall spending and quality. Yet traditional models of paying physicians do not provide adequate incentives for taking on this new role. Under a so-called shared savings program physicians are instead incentivized to take accountability for spending and quality, as the program lets them share in cost savings when quality targets are met. We provide a structured approach to designing a shared savings program for primary care, and apply this approach to the design of a shared savings program for a Dutch chain of primary care providers, which is currently being piloted. Based on the literature, we defined five building blocks of shared savings models that encompass the definition of the scope of the program, the calculation of health care expenditures, the construction of a savings benchmark, the assessment of savings and the rules and conditions under which savings are shared. We apply insights from a variety of literatures to assess the relative merits of alternative design choices within these building blocks. The shared savings program uses an econometric model of provider expenditures as an input to calculating a casemix-corrected benchmark. The minimization of risk and uncertainty for both payer and provider is pertinent to the design of a shared savings program. In that respect, the primary care setting provides a number of unique opportunities for achieving cost and quality targets. Accountability can more readily be assumed due to the relatively long-lasting relationships between primary care physicians and patients. A stable population furthermore improves the confidence with which savings can be attributed to changes in population management. Challenges arise from the institutional context. The Dutch health care system has a fragmented structure and providers are typically small in size. Shared savings programs fit the concept of enhanced primary care. Incorporating a shared savings program into existing payment models could therefore contribute to the financial sustainability of this organizational form.

  2. Shared Savings Financing for College and University Energy Efficiency Investments.

    ERIC Educational Resources Information Center

    Business Officer, 1984

    1984-01-01

    Shared savings arrangements for campus energy efficient investments are discussed. Shared savings is a term for an agreement in which a private company offers to implement an energy efficiency program, including capital improvements, in exchange for a portion of the energy cost savings. Attention is directed to: types of shared savings…

  3. Creative Financing.

    ERIC Educational Resources Information Center

    Esteves, Richard M.

    1984-01-01

    This article analyzes cooperative programs that reduce the risks of financing energy conservation equipment. Savings guarantees, cash flow leasing, shared savings, and cooperative savings programs are described and sources of further information noted. (MJL)

  4. Minimum savings requirements in shared savings provider payment.

    PubMed

    Pope, Gregory C; Kautter, John

    2012-11-01

    Payer (insurer) sharing of savings is a way of motivating providers of medical services to reduce cost growth. A Medicare shared savings program is established for accountable care organizations in the 2010 Patient Protection and Affordable Care Act. However, savings created by providers cannot be distinguished from the normal (random) variation in medical claims costs, setting up a classic principal-agent problem. To lessen the likelihood of paying undeserved bonuses, payers may pay bonuses only if observed savings exceed minimum levels. We study the trade-off between two types of errors in setting minimum savings requirements: paying bonuses when providers do not create savings and not paying bonuses when providers create savings. Copyright © 2011 John Wiley & Sons, Ltd.

  5. Determinants of success in Shared Savings Programs: An analysis of ACO and market characteristics.

    PubMed

    Ouayogodé, Mariétou H; Colla, Carrie H; Lewis, Valerie A

    2017-03-01

    Medicare's Accountable Care Organization (ACO) programs introduced shared savings to traditional Medicare, which allow providers who reduce health care costs for their patients to retain a percentage of the savings they generate. To examine ACO and market factors associated with superior financial performance in Medicare ACO programs. We obtained financial performance data from the Centers for Medicare and Medicaid Services (CMS); we derived market-level characteristics from Medicare claims; and we collected ACO characteristics from the National Survey of ACOs for 215 ACOs. We examined the association between ACO financial performance and ACO provider composition, leadership structure, beneficiary characteristics, risk bearing experience, quality and process improvement capabilities, physician performance management, market competition, CMS-assigned financial benchmark, and ACO contract start date. We examined two outcomes from Medicare ACOs' first performance year: savings per Medicare beneficiary and earning shared savings payments (a dichotomous variable). When modeling the ACO ability to save and earn shared savings payments, we estimated positive regression coefficients for a greater proportion of primary care providers in the ACO, more practicing physicians on the governing board, physician leadership, active engagement in reducing hospital re-admissions, a greater proportion of disabled Medicare beneficiaries assigned to the ACO, financial incentives offered to physicians, a larger financial benchmark, and greater ACO market penetration. No characteristic of organizational structure was significantly associated with both outcomes of savings per beneficiary and likelihood of achieving shared savings. ACO prior experience with risk-bearing contracts was positively correlated with savings and significantly increased the likelihood of receiving shared savings payments. In the first year, performance is quite heterogeneous, yet organizational structure does not consistently predict performance. Organizations with large financial benchmarks at baseline have greater opportunities to achieve savings. Findings on prior risk bearing suggest that ACOs learn over time under risk-bearing contracts. Given the lack of predictive power for organizational characteristics, CMS should continue to encourage diversity in organizational structures for ACO participants, and provide alternative funding and risk bearing mechanisms to continue to allow a diverse group of organizations to participate. III. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Determinants of Success in Shared Savings Programs: An Analysis of ACO and Market Characteristics

    PubMed Central

    Colla, Carrie H.; Lewis, Valerie A.

    2016-01-01

    Background Medicare’s Accountable Care Organization (ACO) programs introduced shared savings to traditional Medicare, which allow providers who reduce health care costs for their patients to retain a percentage of the savings they generate. Objective To examine ACO and market factors associated with superior financial performance in Medicare ACO programs. Methods We obtained financial performance data from the Centers for Medicare and Medicaid Services (CMS); we derived market-level characteristics from Medicare claims; and we collected ACO characteristics from the National Survey of ACOs for 215 ACOs. We examined the association between ACO financial performance and ACO provider composition, leadership structure, beneficiary characteristics, risk bearing experience, quality and process improvement capabilities, physician performance management, market competition, CMS-assigned financial benchmark, and ACO contract start date. We examined two outcomes from Medicare ACOs’ first performance year: savings per Medicare beneficiary and earning shared savings payments (a dichotomous variable). Results When modeling the ACO ability to save and earn shared savings payments, we estimated positive regression coefficients for a greater proportion of primary care providers in the ACO, more practicing physicians on the governing board, physician leadership, active engagement in reducing hospital re-admissions, a greater proportion of disabled Medicare beneficiaries assigned to the ACO, financial incentives offered to physicians, a larger financial benchmark, and greater ACO market penetration. No characteristic of organizational structure was significantly associated with both outcomes of savings per beneficiary and likelihood of achieving shared savings. ACO prior experience with risk-bearing contracts was positively correlated with savings and significantly increased the likelihood of receiving shared savings payments. Conclusions In the first year performance is quite heterogeneous, yet organizational structure does not consistently predict performance. Organizations with large financial benchmarks at baseline have greater opportunities to achieve savings. Findings on prior risk bearing suggest that ACOs learn over time under risk-bearing contracts. Implications Given the lack of predictive power for organizational characteristics, CMS should continue to encourage diversity in organizational structures for ACO participants, and provide alternative funding and risk bearing mechanisms to continue to allow a diverse group of organizations to participate. Level of evidence III PMID:27687917

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

    PubMed

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

    2017-06-01

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

  8. 42 CFR 425.700 - General rules.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... privacy of individually identifiable health information and comply with the terms of the data use...) MEDICARE PROGRAM (CONTINUED) MEDICARE SHARED SAVINGS PROGRAM Data Sharing With ACOs § 425.700 General rules. (a) CMS shares aggregate reports with the ACO. (b) CMS shares beneficiary identifiable data with ACOs...

  9. Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2018; Medicare Shared Savings Program Requirements; and Medicare Diabetes Prevention Program. Final rule.

    PubMed

    2017-11-15

    This major final rule addresses changes to the Medicare physician fee schedule (PFS) and other Medicare Part B payment policies such as changes to the Medicare Shared Savings Program, to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. In addition, this final rule includes policies necessary to begin offering the expanded Medicare Diabetes Prevention Program model.

  10. 76 FR 67801 - Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-02

    ... Community Care Network NP Nurse Practitioner NPI National Provider Identifier NQF National Quality Forum OIG...: Accountable Care Organizations; Final Rule #0;#0;Federal Register / Vol. 76 , No. 212 / Wednesday, November 2... Savings Program: Accountable Care Organizations AGENCY: Centers for Medicare & Medicaid Services (CMS...

  11. Advanced Imaging Utilization and Cost Savings Among Medicare Shared Savings Program Accountable Care Organizations: An Initial Exploratory Analysis.

    PubMed

    Rosenkrantz, Andrew B; Duszak, Richard

    2018-03-01

    The purpose of this study was to explore associations between CT and MRI utilization and cost savings achieved by Medicare Shared Savings Program (MSSP)-participating accountable care organizations (ACOs). Summary data were obtained for all MSSP-participating ACOs (n = 214 in 2013; n = 333 in 2014). Multivariable regressions were performed to assess associations of CT and MRI utilization with ACOs' total savings and reaching minimum savings rates to share in Medicare savings. In 2014, 54.4% of ACOs achieved savings, meeting minimum rates to share in savings in 27.6%. Independent positive predictors of total savings included beneficiary risk scores (β = +20,265,720, P = .003) and MRI events (β = +19,964, P = .018) but not CT events (β = +2,084, P = .635). Independent positive predictors of meeting minimum savings rates included beneficiary risk scores (odds ratio = 2108, P = .001) and MRI events (odds ratio = 1.008, P = .002), but not CT events (odds ratio = 1.002, P = .289). Measures not independently associated with savings were total beneficiaries; beneficiaries' gender, age, race or ethnicity; and Medicare enrollment type (P > .05). For ACOs with 2013 and 2014 data, neither increases nor decreases in CT and MRI events between years were associated with 2014 total savings or meeting savings thresholds (P ≥ .466). Higher MRI utilization rates were independently associated with small but significant MSSP ACO savings. The value of MRI might relate to the favorable impact of appropriate advanced imaging utilization on downstream outcomes and other resource utilization. Because MSSP ACOs represent a highly select group of sophisticated organizations subject to rigorous quality and care coordination standards, further research will be necessary to determine if these associations are generalizable to other health care settings. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  12. 76 FR 19655 - Medicare Program; Waiver Designs in Connection With the Medicare Shared Savings Program and the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-07

    ... Savings Program and the Innovation Center AGENCY: Centers for Medicare & Medicaid Services (CMS) and...) of the Social Security Act (of the Act), as added by the Affordable Care Act (ACA) authorizes the... payment and service delivery models by the Center for Medicare and Medicaid Innovation. This notice with...

  13. System design of the Pioneer Venus spacecraft. Volume 12: International cooperation

    NASA Technical Reports Server (NTRS)

    Kelly, R. S.

    1973-01-01

    A spectrum of plans has been prepared to illustrate the range of practical sharing possibilities available so as to assist Ames Research Center (ARC) and European Space Research Organization (ESRO) in selection of a program meeting mutual goals. Five plans are described showing increased participation by ESRO WITH ascending plan number. Each of these has sharing properties fulfilling particular requirements such as available ESRO budget level, extent of ESRO program responsibility, matching particular ESRO capability, and cost saving to ARC through sharing. All plans apply to orbiter sharing only. A sharing plan based on the model Plan 4 may offer the most attractive division of Pioneer Venus between ARC and ESRO. This plan allows ESRO to bear primary responsibility for the orbiter and to avoid an extensive financial burden. Savings to ARC are commensurate with ARC loss of program control. Duplication of effort is avoided by using orbiter subsystems that are common to the probe bus and orbiter.

  14. Statistical uncertainty in the Medicare shared savings program.

    PubMed

    DeLia, Derek; Hoover, Donald; Cantor, Joel C

    2012-01-01

    Analyze statistical risks facing CMS and Accountable Care Organizations (ACOs) under the Medicare Shared Savings Program (MSSP). We calculate the probability that shared savings formulas lead to inappropriate payment, payment denial, and/or financial penalties, assuming that ACOs generate real savings in Medicare spending ranging from 0-10%. We also calculate expected payments from CMS to ACOs under these scenarios. The probability of an incorrect outcome is heavily dependent on ACO enrollment size. For example, in the MSSP two-sided model, an ACO with 5,000 enrollees that keeps spending constant faces a 0.24 probability of being inappropriately rewarded for savings and a 0.26 probability of paying an undeserved penalty for increased spending. For an ACO with 50,000 enrollees, both of these probabilities of incorrect outcomes are equal to 0.02. The probability of inappropriate payment denial declines as real ACO savings increase. Still, for ACOs with 5,000 patients, the probability of denial is at least 0.15 even when true savings are 5-7%. Depending on ACO size and the real ACO savings rate, expected ACO payments vary from $115,000 to $35.3 million. Our analysis indicates there may be greater statistical uncertainty in the MSSP than previously recognized. CMS and ACOs will have to consider this uncertainty in their financial, administrative, and care management planning. We also suggest analytic strategies that can be used to refine ACO payment formulas in the longer term to ensure that the MSSP (and other ACO initiatives that will be influenced by it) work as efficiently as possible.

  15. Statistical Uncertainty in the Medicare Shared Savings Program

    PubMed Central

    DeLia, Derek; Hoover, Donald; Cantor, Joel C.

    2012-01-01

    Objective Analyze statistical risks facing CMS and Accountable Care Organizations (ACOs) under the Medicare Shared Savings Program (MSSP). Methods We calculate the probability that shared savings formulas lead to inappropriate payment, payment denial, and/or financial penalties, assuming that ACOs generate real savings in Medicare spending ranging from 0–10%. We also calculate expected payments from CMS to ACOs under these scenarios. Results The probability of an incorrect outcome is heavily dependent on ACO enrollment size. For example, in the MSSP two-sided model, an ACO with 5,000 enrollees that keeps spending constant faces a 0.24 probability of being inappropriately rewarded for savings and a 0.26 probability of paying an undeserved penalty for increased spending. For an ACO with 50,000 enrollees, both of these probabilities of incorrect outcomes are equal to 0.02. The probability of inappropriate payment denial declines as real ACO savings increase. Still, for ACOs with 5,000 patients, the probability of denial is at least 0.15 even when true savings are 5–7%. Depending on ACO size and the real ACO savings rate, expected ACO payments vary from $115,000 to $35.3 million. Discussion Our analysis indicates there may be greater statistical uncertainty in the MSSP than previously recognized. CMS and ACOs will have to consider this uncertainty in their financial, administrative, and care management planning. We also suggest analytic strategies that can be used to refine ACO payment formulas in the longer term to ensure that the MSSP (and other ACO initiatives that will be influenced by it) work as efficiently as possible. PMID:24800155

  16. Innovative Older-Worker Programs.

    ERIC Educational Resources Information Center

    Jessup, Denise; Greenberg, Barbara

    1989-01-01

    Describes program innovations to keep older workers employed: retraining, job sharing, flexible working hours, job redesign, and phased retirement. Addresses costs and savings, disincentives for workers and employers, and future trends. (SK)

  17. Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2017; Medicare Advantage Bid Pricing Data Release; Medicare Advantage and Part D Medical Loss Ratio Data Release; Medicare Advantage Provider Network Requirements; Expansion of Medicare Diabetes Prevention Program Model; Medicare Shared Savings Program Requirements. Final rule.

    PubMed

    2016-11-15

    This major final rule addresses changes to the physician fee schedule and other Medicare Part B payment policies, such as changes to the Value Modifier, to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. This final rule also includes changes related to the Medicare Shared Savings Program, requirements for Medicare Advantage Provider Networks, and provides for the release of certain pricing data from Medicare Advantage bids and of data from medical loss ratio reports submitted by Medicare health and drug plans. In addition, this final rule expands the Medicare Diabetes Prevention Program model.

  18. Savings sharing: rewarding staff for responsible decision-making.

    PubMed

    Jones, Debi

    2005-04-01

    Shortages of professional nurses create a "buyer's market" in which nurses accept temporary assignments for the highest rates and offer little additional time to the primary employer. Use of temporary personnel use salary dollars at an inordinate rate while offering little continuity or support for the organization's standards. Methods for placing decision-making in the hands of the nurses are needed along with a reward system for establishing a pattern of sound decision-making. The author describes a savings sharing program that is gaining credibility in one organization for addressing both objectives.

  19. Spurring enrollment in Medicare savings programs through a substitute for the asset test focused on investment income.

    PubMed

    Dorn, Stan; Shang, Baoping

    2012-02-01

    Fewer than one-third of eligible Medicare beneficiaries enroll in Medicare savings programs, which pay premiums and, in some cases, eliminate out-of-pocket cost sharing for poor and near-poor enrollees. Many beneficiaries don't participate in savings programs because they must complete a cumbersome application process, including a burdensome asset test. We demonstrate that a streamlined alternative to the asset test-allowing seniors to qualify for Medicare savings programs by providing evidence of limited assets or showing a lack of investment income-would permit 78 percent of currently eligible seniors to bypass the asset test entirely. This simplified approach would increase the number of beneficiaries who qualify for Medicare savings programs from the current 3.6 million seniors to 4.6 million. Such an alternative would keep benefits targeted to people with low assets, eliminate costly administrative expenses and obstacles to enrollment associated with the asset test, and avoid the much larger influx of seniors that would occur if the asset test were eliminated entirely.

  20. 76 FR 67991 - Medicare Program; Final Waivers in Connection With the Shared Savings Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-02

    ... governance, management, and leadership of the ACO, as well as program integrity, transparency, compliance... ACOs to promote accountability for individual Medicare beneficiaries and population health management...-kickback statute safe harbors include, among others, those for employment, personal services and management...

  1. Retiring Old Cars : Programs To Save Gasoline and Reduce Emissions

    DOT National Transportation Integrated Search

    1992-07-01

    Older vehicles produce a disproportionate share of total U.S. vehicle air emissions. Congress asked Office of Technology Assessment to examine the ability of vehicle scrappage programs to reduce gasoline use and emissions. This report presents the re...

  2. Faculty Housing Assistance: A Model for Success.

    ERIC Educational Resources Information Center

    Mertens, Cynthia A.; Beaudoin, Ralph H.

    1993-01-01

    Santa Clara University (California), located where housing costs are high, has developed a faculty housing assistance program to retain faculty. It consists of a shared appreciation mortgage loan, a low interest down payment loan program, and a rental stipend program to give tenure-track faculty an opportunity to save for home purchase. (MSE)

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

    PubMed

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

    2013-08-01

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

  4. Building regulatory and operational flexibility into accountable care organizations and 'shared savings'.

    PubMed

    Lieberman, Steven M; Bertko, John M

    2011-01-01

    The Affordable Care Act created accountable care organizations (ACOs), which will be a new part of Medicare as of January 2012, together with a "shared savings program" that will modify how these organizations will be paid to care for patients. Accountable care organizations have the potential to lower costs, improve the quality of care, facilitate delivery system reform, and promote innovation in health care. The federal government is set to create rules to regulate these organizations and has broad discretion to allow them to pursue a variety of approaches. Drawing on experience from some ACO pilot programs and the Medicare Part D prescription drug coverage program, we argue that regulations governing accountable care organizations should be flexible, encouraging of diversity and innovation and allowing for changes over time based on lessons learned. We recommend using regulations as a general framework, while relying on notices and other guidance below the regulatory level to spell out specific requirements.

  5. 42 CFR 425.204 - Content of the application.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Content of the application. 425.204 Section 425.204 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE SHARED SAVINGS PROGRAM Application Procedures and Participation Agreement § 425.204 Content of the...

  6. Medicaid Eligibility

    MedlinePlus

    ... recover for other Medicaid benefits, except for Medicare cost-sharing benefits paid on behalf of Medicare Savings Program beneficiaries. Third Party Liability: Third Party Liability (TPL) refers to third ... or all of the cost of medical services provided to a Medicaid beneficiary. ...

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

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

    Sonnenblick, R.; Eto, J.

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

  8. Domestic embedded reporter program: saving lives and securing tactical operations

    DTIC Science & Technology

    2017-03-01

    estimated to average 1 hour per response, including the time for reviewing instruction, searching existing data sources, gathering and maintaining the...13. ABSTRACT (maximum 200 words) Advances in technology have provided journalists the tools to obtain and share real- time information during domestic...terrorist and mass-shooting incidents. This real- time information-sharing compromises the safety of first responders, victims, and reporters. Real

  9. Dryden Flight Research Center Chemical Pharmacy Program

    NASA Technical Reports Server (NTRS)

    Davis, Bette

    1997-01-01

    The Dryden Flight Research Center (DFRC) Chemical Pharmacy "Crib" is a chemical sharing system which loans chemicals to users, rather than issuing them or having each individual organization or group purchasing the chemicals. This cooperative system of sharing chemicals eliminates multiple ownership of the same chemicals and also eliminates stockpiles. Chemical management duties are eliminated for each of the participating organizations. The chemical storage issues, hazards and responsibilities are eliminated. The system also ensures safe storage of chemicals and proper disposal practices. The purpose of this program is to reduce the total releases and transfers of toxic chemicals. The initial cost of the program to DFRC was $585,000. A savings of $69,000 per year has been estimated for the Center. This savings includes the reduced costs in purchasing, disposal and chemical inventory/storage responsibilities. DFRC has chemicals stored in 47 buildings and at 289 locations. When the program is fully implemented throughout the Center, there will be three chemical locations at this facility. The benefits of this program are the elimination of chemical management duties; elimination of the hazard associated with chemical storage; elimination of stockpiles; assurance of safe storage; assurance of proper disposal practices; assurance of a safer workplace; and more accurate emissions reports.

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

    PubMed Central

    Kibicho, Jennifer; Pinkerton, Steven D.

    2014-01-01

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

  11. 76 FR 19527 - Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-07

    ... one of the addresses provided below, no later than 5 p.m. on June 6, 2011. ADDRESSES: In commenting... comments by facsimile (FAX) transmission. You may submit comments in one of four ways (please choose only one of the ways listed): 1. Electronically. You may submit electronic comments on this regulation to...

  12. Boiler house modernization through shared savings program

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

    Breault, R.W.

    1995-12-31

    Throughout Poland as well as the rest of Eastern Europe, communities and industries rely on small heat only boilers to provide district and process heat. Together these two sectors produce about 85,000 MW from boilers in the 2 to 35 MW size range. The bulk of these units were installed prior to 1992 and must be completely overhauled to meet the emission regulations which will be coming into effect on January 1, 1998. Since the only practical fuel is coal in most cases, these boilers must be either retrofit with emission control technology or be replaced entirely. The question thatmore » arises is how to accomplish this given the current tight control of capital in Poland and other East European countries. A solution that we have for this problem is shared savings. These boilers are typically operating with a quiet low efficiency as compared to western standards and with excessive manual labor. Installing modernization equipment to improve the efficiency and to automate the process provides savings. ECOGY provides the funds for the modernization to improve the efficiency, add automation and install emission control equipment. The savings that are generated during the operation of the modernized boiler system are split between the client company and ECOGY for a number of years and then the system is turned over in entirety to the client. Depending on the operating capacity, the shared savings agreement will usually span 6 to 10 years.« less

  13. 48 CFR 48.104-3 - Sharing collateral savings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Sharing collateral savings. 48.104-3 Section 48.104-3 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT VALUE ENGINEERING Policies and Procedures 48.104-3 Sharing collateral savings. (a) The...

  14. 48 CFR 2448.104-3 - Sharing collateral savings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Sharing collateral savings. 2448.104-3 Section 2448.104-3 Federal Acquisition Regulations System DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT CONTRACT MANAGEMENT VALUE ENGINEERING 2448.104-3 Sharing collateral savings. (a) The authority of...

  15. 48 CFR 2448.104-3 - Sharing collateral savings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Sharing collateral savings. 2448.104-3 Section 2448.104-3 Federal Acquisition Regulations System DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT CONTRACT MANAGEMENT VALUE ENGINEERING 2448.104-3 Sharing collateral savings. (a) The authority of...

  16. Center for Building Science: Annual report, FY 1986

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

    Cairns, E.J.; Rosenfeld, A.H.

    1987-05-01

    The Center for Building Science consists of four programs in the Applied Science Division: energy analysis, buildings energy systems, windows and lighting, and indoor environment. It was established to provide an umbrella so that goups in different programs but with similar interests could combine to perform joint research, develop new research areas, share resources, and produce joint publications. As detailed below, potential savings for the U.S. society from energy efficient buildings are enormous. But these savings can only be realized through an expanding federal RandD program that develops expertise in this new area. The Center for Building Science develops efficientmore » new building componenets, computer models, data and information systems, and trains needed builidng scientists. 135 refs., 72 figs., 18 tabs.« less

  17. Gainsharing. DOD Efforts Highlight an Effective Tool for Enhancing Federal Productivity. Briefing Report to the Chairman, Subcommittee on Defense, Committee on Appropriations, House of Representatives.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC.

    Data were obtained from Department of Defense (DOD) officials and installations having experience with gainsharing programs. (Gainsharing programs measure gains in employee productivity and share the resulting savings between employees and the organization.) Analysis of private sector studies on gainsharing efforts identified three major trends in…

  18. 48 CFR 2448.104-3 - Sharing collateral savings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... DEVELOPMENT CONTRACT MANAGEMENT VALUE ENGINEERING 2448.104-3 Sharing collateral savings. (a) The authority of the HCA to determine that the cost of calculating and tracking collateral savings will exceed the...

  19. 48 CFR 2448.104-3 - Sharing collateral savings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... DEVELOPMENT CONTRACT MANAGEMENT VALUE ENGINEERING 2448.104-3 Sharing collateral savings. (a) The authority of the HCA to determine that the cost of calculating and tracking collateral savings will exceed the...

  20. 48 CFR 2448.104-3 - Sharing collateral savings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... DEVELOPMENT CONTRACT MANAGEMENT VALUE ENGINEERING 2448.104-3 Sharing collateral savings. (a) The authority of the HCA to determine that the cost of calculating and tracking collateral savings will exceed the...

  1. 31 CFR 321.0 - Purpose.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... UNITED STATES SAVINGS BONDS AND UNITED STATES SAVINGS NOTES (FREEDOM SHARES) General Information § 321.0... agents for the redemption of: (a) United States Savings Bonds of Series A, B, C, D, E, EE, and I, and United States Savings Notes (Freedom Shares), presented for cash payment; and (b) Eligible Series E and...

  2. Student Centered Financial Services: Innovations That Succeed

    ERIC Educational Resources Information Center

    Sinsabaugh, Nancy, Ed.

    2007-01-01

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

  3. Better Buildings Alliance 2013 Annual Report

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

    None

    2014-01-31

    We are pleased to share with you a copy of the 2013 Annual Report. Inside, you’ll find significant program accomplishments, profiles on highlighted members, and plans for 2014. With your contributions, support, and leadership over the past 12 months, the program has reached significant milestones, including: Growing membership to over 200 members, to represent over 10 billion square feet of U.S. commercial building space and one-seventh of the market; Increasing participation in the 15 Solutions Teams by 75%; Developing 3 new high-efficiency technology specifications that if widely implemented, could save more than $5 billion in energy costs per year; Launchingmore » the Advanced RTU Campaign and Wireless Meter Challenge, and surpassing 100 million sq. ft. in the Lighting Energy Efficiency in Parking (LEEP) Campaign; Welcoming partners in new sectors, including K-12 schools and local governments; The program is a critical element of the Better Buildings Initiative, driving 20% energy savings in the building sector by 2020 through innovation, new technologies, and profiling leadership. Thank you for your ongoing participation, we are looking forward to working with you in the new year on your energy saving targets and advancing technical and market practices that promote energy savings at your organization.« less

  4. 78 FR 21368 - Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... FEDERAL RESERVE SYSTEM Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company The notificants listed below have applied under the Change in Bank Control Act (12 U.S.C. 1817(j)) and the Board's Regulation LL (12 CFR part 238) to acquire shares of a savings and...

  5. 78 FR 62302 - Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-15

    ... FEDERAL RESERVE SYSTEM Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company The notificants listed below have applied under the Change in Bank Control Act (12 U.S.C. 1817(j)) and the Board's Regulation LL (12 CFR Part 238) to acquire shares of a savings and...

  6. 77 FR 26009 - Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-02

    ... FEDERAL RESERVE SYSTEM Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company The notificants listed below have applied under the Change in Bank Control Act (12 U.S.C. 1817(j)) and the Board's Regulation LL (12 CFR part 238) to acquire shares of a savings and...

  7. 76 FR 72922 - Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-28

    ... FEDERAL RESERVE SYSTEM Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company The notificants listed below have applied under the Change in Bank Control Act (12 U.S.C. 1817(j)) and the Board's Regulation LL (12 CFR part 238) to acquire shares of a savings and...

  8. 76 FR 61102 - Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ... FEDERAL RESERVE SYSTEM Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company The notificants listed below have applied under the Change in Bank Control Act (12 U.S.C. 1817(j)) and the Board's Regulation LL (12 CFR part 238) to acquire shares of a savings and...

  9. 77 FR 74191 - Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-13

    ... FEDERAL RESERVE SYSTEM Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company The notificants listed below have applied under the Change in Bank Control Act (12 U.S.C. 1817(j)) and the Board's Regulation LL (12 CFR Part 238) to acquire shares of a savings and...

  10. 78 FR 38715 - Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-27

    ... FEDERAL RESERVE SYSTEM Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company The notificants listed below have applied under the Change in Bank Control Act (12 U.S.C. 1817(j)) and the Board's Regulation LL (12 CFR part 238) to acquire shares of a savings and...

  11. 78 FR 63978 - Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-25

    ... FEDERAL RESERVE SYSTEM Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company The notificants listed below have applied under the Change in Bank Control Act (12 U.S.C. 1817(j)) and the Board's Regulation LL (12 CFR part 238) to acquire shares of a savings and...

  12. 76 FR 75882 - Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-05

    ... FEDERAL RESERVE SYSTEM Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company The notificants listed below have applied under the Change in Bank Control Act (12 U.S.C. 1817(j)) and the Board's Regulation LL (12 CFR Part 238) to acquire shares of a savings and...

  13. 77 FR 66616 - Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-06

    ... FEDERAL RESERVE SYSTEM Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company The notificants listed below have applied under the Change in Bank Control Act (12 U.S.C. 1817(j)) and the Board's Regulation LL (12 CFR Part 238) to acquire shares of a savings and...

  14. 78 FR 65312 - Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-31

    ... FEDERAL RESERVE SYSTEM Change in Bank Control Notices; Acquisitions of Shares of a Savings and Loan Holding Company The notificants listed below have applied under the Change in Bank Control Act (12 U.S.C. 1817(j)) and the Board's Regulation LL (12 CFR Part 238) to acquire shares of a savings and...

  15. Home-Based Primary Care: Beyond Extension of the Independence at Home Demonstration.

    PubMed

    Rotenberg, James; Kinosian, Bruce; Boling, Peter; Taler, George

    2018-04-01

    The Independence at Home (IAH) Demonstration Year 2 results confirmed that the first-year savings were 10 times as great as those of the pioneer accountable care organizations during their initial 2 years. We update projected savings from nationwide conversion of the IAH demonstration, incorporating Year 2 results and improving attribution of IAH-qualified (IAH-Q) Medicare beneficiaries to home-based primary care (HBPC) practices. Applying IAH qualifying criteria to beneficiaries in the Medicare 5% claims file, the effect of expanding HBPC to the 2.4 million IAH-Q beneficiaries is projected using various growth rates. Total 10-year system-wide savings (accounting for IAH implementation but before excluding shared savings) range from $2.6 billion to $27.8 billion, depending on how many beneficiaries receive HBPC on conversion to a Medicare benefit, mix of clinical practice success, and growth rate of IAH practices. Net projected savings to the Centers for Medicare and Medicaid Services (CMS) after routine billing for IAH services and distribution of shared savings ranges from $1.8 billion to $10.9 billion. If aligning IAH with other advanced alternative payment models achieved at least 35% penetration of the eligible population in 10 years, CMS savings would exceed savings with the current IAH design and HBPC growth rate. If the demonstration were simply extended 2 years with a beneficiary cap of 50,000 instead of 15,000 (as currently proposed), CMS would save an additional $46 million. The recent extension of IAH, a promising person-centered CMS program for managing medically complex and frail elderly adults, offers the chance to evaluate modifications to promote more rapid HBPC growth. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  16. 42 CFR 425.306 - Participation agreement and exclusivity of ACO participant TINs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... participant TINs. 425.306 Section 425.306 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... participant TINs. (a) For purposes of the Shared Savings Program, each ACO participant TIN is required to commit to a participation agreement with CMS. (b) Each ACO participant TIN upon which beneficiary...

  17. 42 CFR 425.306 - Participation agreement and exclusivity of ACO participant TINs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... participant TINs. 425.306 Section 425.306 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... participant TINs. (a) For purposes of the Shared Savings Program, each ACO participant TIN is required to commit to a participation agreement with CMS. (b) Each ACO participant TIN upon which beneficiary...

  18. 42 CFR 425.306 - Participation agreement and exclusivity of ACO participant TINs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... participant TINs. 425.306 Section 425.306 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... participant TINs. (a) For purposes of the Shared Savings Program, each ACO participant TIN is required to commit to a participation agreement with CMS. (b) Each ACO participant TIN upon which beneficiary...

  19. The High Cost of Saving Energy Dollars.

    ERIC Educational Resources Information Center

    Rose, Patricia

    1985-01-01

    In alternative financing a private company provides the capital and expertise for improving school energy efficiency. Savings are split between the school system and the company. Options for municipal leasing, cost sharing, and shared savings are explained along with financial, procedural, and legal considerations. (MLF)

  20. 48 CFR 48.104-2 - Sharing acquisition savings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... CONTRACT MANAGEMENT VALUE ENGINEERING Policies and Procedures 48.104-2 Sharing acquisition savings. (a... value engineering clause or alternate used, and the type of savings, as follows: Government/Contractor... percent for fixed-price contracts; or (2) 75 percent for cost-reimbursement contracts. Value engineering...

  1. Avoiding unintended incentives in ACO payment models.

    PubMed

    Douven, Rudy; McGuire, Thomas G; McWilliams, J Michael

    2015-01-01

    One goal of the Medicare Shared Savings Program for accountable care organizations (ACOs) is to reduce Medicare spending for ACOs' patients relative to the organizations' spending history. However, we found that current rules for setting ACO spending targets (or benchmarks) diminish ACOs' incentives to generate savings and may even encourage higher instead of lower Medicare spending. Spending in the three years before ACOs enter or renew a contract is weighted unequally in the benchmark calculation, with a high weight of 0.6 given to the year just before a new contract starts. Thus, ACOs have incentives to increase spending in that year to inflate their benchmark for future years and thereby make it easier to obtain shared savings from Medicare in the new contract period. We suggest strategies to improve incentives for ACOs, including changes to the weights used to determine benchmarks and new payment models that base an ACO's spending target not only on its own past performance but also on the performance of other ACOs or Medicare providers. Project HOPE—The People-to-People Health Foundation, Inc.

  2. Ericsson General Electric: The Evolution of Empowerment.

    ERIC Educational Resources Information Center

    Filipczak, Bob

    1993-01-01

    Winshare is a gain-sharing system created to save a company. The program is based on the assumption that line workers know best how to do and improve their jobs. Employees are encouraged to suggest how to improve processes, reduce waste, or make their jobs easier. Employee teams are given the power and budget to implement changes. (JOW)

  3. 76 FR 74067 - Medicare Program; Announcement of a New Application Deadline for the Advance Payment Model

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-30

    .... One potential mechanism for achieving this goal is for CMS to partner with groups of health care... will test whether and how pre-paying a portion of future shared savings could increase participation in... Accountable Care Organization (ACO) through which they work together to coordinate care for a specified group...

  4. A proposal for risk sharing in the development of a lunar oxygen plant

    NASA Technical Reports Server (NTRS)

    Duke, Michael B.; Treadwell, Mead

    1990-01-01

    The production of lunar oxygen for use in a NASA lunar outpost program could provide a profitable investment for nongovernment development, savings for government, and an initiation of a new resource of capital financing for space industrialization. A joint endeavor to share development risks between government and nongovernment investment is proposed, based on some early assessments of technical and financial feasibility for the project. Successful initial negotiations between government and nongovernment investors can establish the requirements for financing the project with private funds.

  5. Financial and quality impacts of the Medicare physician group practice demonstration.

    PubMed

    Pope, Gregory; Kautter, John; Leung, Musetta; Trisolini, Michael; Adamache, Walter; Smith, Kevin

    2014-01-01

    To examine the impact of the Medicare Physician Group Practice (PGP) demonstration on expenditure, utilization, and quality outcomes. Secondary data analysis of 2001-2010 Medicare claims for 1,776,387 person years assigned to the ten participating provider organizations and 1,579,080 person years in the corresponding local comparison groups. We used a pre-post comparison group observational design consisting of four pre-demonstration years (1/01-12/04) and five demonstration years (4/05-3/10). We employed a propensity-weighted difference-in-differences regression model to estimate demonstration effects, adjusting for demographics, health status, geographic area, and secular trends. The ten demonstration sites combined saved $171 (2.0%) per assigned beneficiary person year (p<0.001) during the five-year demonstration period. Medicare paid performance bonuses to the participating PGPs that averaged $102 per person year. The net savings to the Medicare program were $69 (0.8%) per person year. Demonstration savings were achieved primarily from the inpatient setting. The demonstration improved quality of care as measured by six of seven claims-based process quality indicators. The PGP demonstration, which used a payment model similar to the Medicare Accountable Care Organization (ACO) program, resulted in small reductions in Medicare expenditures and inpatient utilization, and improvements in process quality indicators. Judging from this demonstration experience, it is unlikely that Medicare ACOs will initially achieve large savings. Nevertheless, ACOs paid through shared savings may be an important first step toward greater efficiency and quality in the Medicare fee-for-service program.

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

    PubMed

    Lee, Jason S; Tollen, Laura

    2002-01-01

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

  7. The Future of Utility Customer-Funded Energy Efficiency Programs in the United States: Projected Spending and Savings to 2025

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

    Barbose, Galen; Goldman, Charles; Hoffman, Ian

    2012-09-11

    We develop projections of future spending on, and savings from, energy efficiency programs funded by electric and gas utility customers in the United States, under three scenarios through 2025. Our analysis, which updates a previous LBNL study, relies on detailed bottom-up modeling of current state energy efficiency policies, regulatory decisions, and demand-side management and utility resource plans. The three scenarios are intended to represent a range of potential outcomes under the current policy environment (i.e., without considering possible major new policy developments). By 2025, spending on electric and gas efficiency programs (excluding load management programs) is projected to double frommore » 2010 levels to $9.5 billion in the medium case, compared to $15.6 billion in the high case and $6.5 billion in the low case. Compliance with statewide legislative or regulatory savings or spending targets is the primary driver for the increase in electric program spending through 2025, though a significant share of the increase is also driven by utility DSM planning activity and integrated resource planning. Our analysis suggests that electric efficiency program spending may approach a more even geographic distribution over time in terms of absolute dollars spent, with the Northeastern and Western states declining from over 70% of total U.S. spending in 2010 to slightly more than 50% in 2025, with the South and Midwest splitting the remainder roughly evenly. Under our medium case scenario, annual incremental savings from customer-funded electric energy efficiency programs increase from 18.4 TWh in 2010 in the U.S. (which is about 0.5% of electric utility retail sales) to 28.8 TWh in 2025 (0.8% of retail sales). These savings would offset the majority of load growth in the Energy Information Administration’s most recent reference case forecast, given specific assumptions about the extent to which future energy efficiency program savings are captured in that forecast. However, the pathway that customer-funded efficiency programs ultimately take will depend on a series of key challenges and uncertainties associated both with the broader market and policy context and with the implementation and regulatory oversight of the energy efficiency programs themselves.« less

  8. Texture Rubbings

    ERIC Educational Resources Information Center

    Szekely, George

    2011-01-01

    As hands-on environmental observers, children use printing to save and share "treasures" they find. In this article, the author shares thoughts which are based on observing what children find valuable and worth saving, and the printmaking processes used to "lift" images from their finds.

  9. Performance Differences in Year 1 of Pioneer Accountable Care Organizations

    PubMed Central

    McWilliams, J. Michael; Chernew, Michael E.; Landon, Bruce E.; Schwartz, Aaron L.

    2015-01-01

    BACKGROUND In 2012, a total of 32 organizations entered the Pioneer accountable care organization (ACO) program, in which providers can share savings with Medicare if spending falls below a financial benchmark. Performance differences associated with characteristics of Pioneer ACOs have not been well described. METHODS In a difference-in-differences analysis of Medicare fee-for-service claims, we compared Medicare spending for beneficiaries attributed to Pioneer ACOs (ACO group) with other beneficiaries (control group) before (2009 through 2011) and after (2012) the start of Pioneer ACO contracts, with adjustment for geographic area and beneficiaries’ sociodemographic and clinical characteristics. We estimated differential changes in spending for several subgroups of ACOs: those with and those without clear financial integration between hospitals and physician groups, those with higher and those with lower baseline spending, and the 13 ACOs that withdrew from the Pioneer program after 2012 and the 19 that did not. RESULTS Adjusted Medicare spending and spending trends were similar in the ACO group and the control group during the precontract period. In 2012, the total adjusted per-beneficiary spending differentially changed in the ACO group as compared with the control group (−$29.2 per quarter, P = 0.007), consistent with a 1.2% savings. Savings were significantly greater for ACOs with baseline spending above the local average, as compared with those with baseline spending below the local average (P = 0.05 for interaction), and for those serving high-spending areas, as compared with those serving low-spending areas (P = 0.04). Savings were similar in ACOs with financial integration between hospitals and physician groups and those without, as well as in ACOs that withdrew from the program and those that did not. CONCLUSIONS Year 1 of the Pioneer ACO program was associated with modest reductions in Medicare spending. Savings were greater for ACOs with higher baseline spending than for those with lower baseline spending and were unrelated to withdrawal from the program. (Funded by the National Institute on Aging and others.) PMID:25875195

  10. The success story of Fatima Begum.

    PubMed

    1999-12-01

    This article tells the success story of Fatima Begum from Jhenaidaha, Bangladesh. Having learned of the Integrated Rural Women Development Program of the Bangladesh Rural Development Board, Fatima started a Mohila Samobaya Samity or Women's Cooperative Society on August 21, 1993, with a deposit of Tk. 15 as savings and Tk. 10 as share. In 1994 and 1997 she received loans which she used to purchase a cow, for small trade, and for starting a grocery shop. She had repaid all her loans and had increased her savings deposit to Tk. 1530 and share to Tk. 710. She also had purchased 5 decimals of land and constructed a small house. Meanwhile, Fatima had adopted family planning methods and had two children. Fatima is now the elected Director of Jhenaidaha Sadar Thana Cooperative Societies Federation. Her own society is considered an ideal organization under her leadership. Her society now has 28 members and the amount of thrift-deposit has become Tk. 25,590.

  11. New Hampshire Nurse Practitioners Take the Lead in Forming an Accountable Care Organization.

    PubMed

    Wright, Wendy L

    In 2012, New Hampshire nurse practitioners (NPs), along with Anthem Blue Cross/Blue Shield, formed the first Patient Centered Shared Savings Program in the nation, composed of patients managed by nurse practitioners employed within NP-owned and operated clinics. In this accountable care organization (ACO), NP-attributed patients were grouped into one risk pool. Data from the ACO and the NP risk pool, now in its third year, have produced compelling statistics. Nurse practitioners participating in this program have met or exceeded the minimum scores for 29 quality metrics along with a demonstrated cost-savings in the first 2 years of the program. Hospitalization rates for NP-managed patients are among the lowest in the state. Cost of care for NP-managed patients is $66.85 less per member per month than the participating physician-managed patients. Data from this ACO provide evidence that NPs provide cost-effective, quality health care and are integral to the formation and sustainability of any ACO.

  12. The New Jersey Medicaid ACO Demonstration Project: seeking opportunities for better care and lower costs among complex low-income patients.

    PubMed

    Cantor, Joel C; Chakravarty, Sujoy; Tong, Jian; Yedidia, Michael J; Lontok, Oliver; DeLia, Derek

    2014-12-01

    A small but growing number of states are turning to accountable care concepts to improve their Medicaid programs. In 2011 New Jersey enacted the Medicaid Accountable Care Organization (ACO) Demonstration Project to offer local provider coalitions the opportunity to share any savings they generate. Impetus came from initiatives in Camden that aim to reduce costs through improved care coordination among hospital high users and that have received considerable media attention and substantial federal and private grant support. Though broadly similar to Medicare and commercial ACOs, the New Jersey demonstration addresses the unique concerns faced by Medicaid populations. Using hospital all-payer billing data, we estimate savings from care improvement efforts among inpatient and emergency department high users in thirteen communities that are candidates for participation in the New Jersey demonstration. We also examine their characteristics to inform Medicaid accountable care strategies. We find substantial variation in the share of high-user hospital patients across the study communities and high rates of avoidable use and costs among these patients. The potential savings among Medicaid enrollees are considerable, particularly if Medicaid ACOs can develop ways to successfully address the high burden of chronic illness and behavioral health conditions prevalent in the prospective demonstration communities. Copyright © 2014 by Duke University Press.

  13. 12 CFR 575.11 - Operating restrictions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... stockholders other than its parent mutual holding company may repurchase any share of stock within one year of its date of issuance (which may include the time period the shares issued by the savings association were outstanding if the subsidiary holding company was formed after the initial issuance by the savings...

  14. Sharing simulation-based training courses between institutions: opportunities and challenges.

    PubMed

    Laack, Torrey A; Lones, Ellen A; Schumacher, Donna R; Todd, Frances M; Cook, David A

    2017-01-01

    Sharing simulation-based training (SBT) courses between institutions could reduce time to develop new content but also presents challenges. We evaluate the process of sharing SBT courses across institutions in a mixed method study estimating the time required and identifying barriers and potential solutions. Two US academic medical institutions explored instructor experiences with the process of sharing four courses (two at each site) using personal interviews and a written survey and estimated the time needed to develop new content vs implement existing SBT courses. The project team spent approximately 618 h creating a collaboration infrastructure to support course sharing. Sharing two SBT courses was estimated to save 391 h compared with developing two new courses. In the qualitative analysis, participants noted the primary benefit of course sharing was time savings. Barriers included difficulty finding information and understanding overall course flow. Suggestions for improvement included establishing a standardized template, clearly identifying the target audience, providing a course overview, communicating with someone familiar with the original SBT course, employing an intuitive file-sharing platform, and considering local culture, context, and needs. Sharing SBT courses between institutions is feasible but not without challenges. An initial investment in a sharing infrastructure may facilitate downstream time savings compared with developing content de novo.

  15. Saving our shared birds: Partners in Flight tri-national vision for landbird conservation

    USGS Publications Warehouse

    Berlanga, Humberto; Kennedy, Judith A.; Rich, Terrell D.; Arizmendi, Maria del Coro; Beardmore, Carol J.; Blancher, Peter J.; Butcher, Gregory S.; Couturier, Andrew R.; Dayer, Ashley A.; Demarest, Dean W.; Easton, Wendy E.; Gustafson, Mary; Iñigo-Elias, Eduardo E.; Krebs, Elizabeth A.; Panjabi, Arvind O.; Rodriguez Contreras, Vicente; Rosenberg, Kenneth V.; Ruth, Janet M.; Santana Castellon, Eduardo; Vidal, Rosa Ma.; Will, Tom

    2010-01-01

    Landbirds are the most abundant and diverse group of birds in North America, with nearly 900 species distributed across every major terrestrial habitat. Birds are indicators of environmental health; their populations track changes in habitat, water, disease, and climate. They are providers of invaluable ecosystem services, such as pest control, seed dispersal, and pollination. As the focus of bird watching, they help generate billions of dollars for national economies. Yet, we are in danger of losing this spectacular and irreplaceable bird diversity: landbirds are experiencing significant declines, ominous threats, and shrinking habitats across a continent with growing human populations, increasing resource consumption, and changing climate. Saving Our Shared Birds presents for the first time a comprehensive conservation assessment of landbirds in Canada, Mexico, and the continental United States. This new tri-national vision encompasses the complete range of many migratory species and highlights the vital links among migrants and highly threatened resident species in Mexico. It points to a set of continent-scale actions necessary to maintain the landbird diversity and abundance that are our shared responsibility. This collaborative effort of Partners in Flight (PIF) is the next step in linking the countries of the Western Hemisphere to help species at risk and keep common birds common through voluntary partnerships—our mission since 1990. Saving Our Shared Birds builds upon PIF’s 2004 North American Landbird Conservation Plan, which presented science-based priorities for the conservation of 448 landbird species in Canada and the United States. Our three nations have expressed their commitment to cooperative conservation through numerous international treaties, agreements, and programs, including formation of the North American Bird Conservation Initiative (NABCI) a decade ago. The NABCI partnership recognizes that effective conservation requires a concerted effort within each country, as well as a tri-national strategy to address issues throughout the full life cycles of our birds. Today more than ever, it is urgent for the people of Canada, Mexico, and the United States to work together to keep common birds common, prevent extinction of our bird species at greatest risk, and ensure the diversity and abundance of birdlife across North America and throughout the hemisphere, far into the future. Saving Our Shared Birds shows the way forward.

  16. Alternative Fuels Data Center: Alternative Fuels Save Money in Indy

    Science.gov Websites

    Alternative Fuels Save Money in Indy to someone by E-mail Share Alternative Fuels Data Center : Alternative Fuels Save Money in Indy on Facebook Tweet about Alternative Fuels Data Center: Alternative Fuels Save Money in Indy on Twitter Bookmark Alternative Fuels Data Center: Alternative Fuels Save Money in

  17. Defense Health Care Reform: Additional Implementation Details Would Increase Transparency of DOD’s Plans and Enhance Accountability

    DTIC Science & Technology

    2013-11-01

    on timelines; and was not required to include information on shared services because the reporting time frame was not applicable. GAO also assessed...implementation costs and aggregated cost-savings estimates for the consolidation of four shared services . However, some key details of a sound business...case were missing, such as the basis for the savings. DOD’s business cases aggregated the separate business lines of its shared services , which

  18. Development of a Dynamic Time Sharing Scheduled Environment Final Report CRADA No. TC-824-94E

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

    Jette, M.; Caliga, D.

    Massively parallel computers, such as the Cray T3D, have historically supported resource sharing solely with space sharing. In that method, multiple problems are solved by executing them on distinct processors. This project developed a dynamic time- and space-sharing scheduler to achieve greater interactivity and throughput than could be achieved with space-sharing alone. CRI and LLNL worked together on the design, testing, and review aspects of this project. There were separate software deliverables. CFU implemented a general purpose scheduling system as per the design specifications. LLNL ported the local gang scheduler software to the LLNL Cray T3D. In this approach, processorsmore » are allocated simultaneously to aU components of a parallel program (in a “gang”). Program execution is preempted as needed to provide for interactivity. Programs are also reIocated to different processors as needed to efficiently pack the computer’s torus of processors. In phase one, CRI developed an interface specification after discussions with LLNL for systemlevel software supporting a time- and space-sharing environment on the LLNL T3D. The two parties also discussed interface specifications for external control tools (such as scheduling policy tools, system administration tools) and applications programs. CRI assumed responsibility for the writing and implementation of all the necessary system software in this phase. In phase two, CRI implemented job-rolling on the Cray T3D, a mechanism for preempting a program, saving its state to disk, and later restoring its state to memory for continued execution. LLNL ported its gang scheduler to the LLNL T3D utilizing the CRI interface implemented in phases one and two. During phase three, the functionality and effectiveness of the LLNL gang scheduler was assessed to provide input to CRI time- and space-sharing, efforts. CRI will utilize this information in the development of general schedulers suitable for other sites and future architectures.« less

  19. Final Technical Report: "Achieving Regional Energy Efficiency Potential in the Southeast”

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

    Mahoney, Mandy

    The overall objective of this award was to facilitate sharing of DOE resources and best practices as well as provide technical assistance to key stakeholders to support greater compliance with energy efficiency standards and increased energy savings. The outcomes of this award include greater awareness among key stakeholders on energy efficiency topics, increased deployment and utilization of DOE resources, and effective policies and programs to support energy efficiency in the Southeast.

  20. Tycho to Kepler: Four Centuries and More of Astronomy and the Media

    NASA Astrophysics Data System (ADS)

    Maran, Stephen P.

    2012-01-01

    From Tycho Brahe's printing press in 1584 to the Kepler Mission corn maze of September 2011, astronomers have indulged in a wide range of sometimes-novel methods to get the news out. The results have often edified (or irritated) colleagues and excited and occasionally, educated the public. The objectives have been to claim credit, show progress to funding entities, save endangered programs, and share the excitement of astronomical discovery.

  1. Tycho to Kepler: Four Centuries and More of Astronomy and the Media

    NASA Astrophysics Data System (ADS)

    Maran, Stephen P.

    2012-05-01

    From Tycho Brahe’s printing press in 1584 to the Kepler Mission corn maze of September 2011, astronomers have indulged in a wide range of sometimes-novel methods to get the news out. The results have often edified (or irritated) colleagues and excited and occasionally, educated the public. The objectives have been to claim credit, show progress to funding entities, save endangered programs, and share the excitement of astronomical discovery.

  2. Optimal savings and health spending over the life cycle.

    PubMed

    Fioroni, Tamara

    2010-08-01

    This paper investigates the relationship between saving and health spending in a two-period overlapping generations economy. Individuals work in the first period of life and live in retirement in old age. Health spending is an activity that increases quality of life and longevity. Empirical evidence shows that both health spending and saving behave as luxury goods but their behaviour differs markedly according to the level of per capita GDP. The share of saving on GDP has a concave shape with respect to per capita GDP, whereas the share of health spending on GDP increases more than proportionally with respect to per capita GDP. The ratio of saving to spending is nonlinear with respect to income, i.e. first increasing and then decreasing. This ratio, in the proposed model, is equal to the ratio between the elasticity of the utility function with respect to saving and the elasticity of the utility function with respect to health.

  3. Potential Savings in Rural Public School Non-Instructional Costs through Shared Services Arrangements: A Regional Study.

    ERIC Educational Resources Information Center

    ECM, Inc., Williamsville, NY.

    A study was undertaken in 16 rural New York school districts to determine the feasibility of sharing noninstructional services as an avenue to achieving cost savings and enhanced services. The districts involved were within the Delaware/Chenango/Madison/Otsego BOCES (Board of Cooperative Educational Services) in a rural mountainous region of…

  4. 26 CFR 1.594-1 - Mutual savings banks conducting life insurance business.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 7 2010-04-01 2010-04-01 true Mutual savings banks conducting life insurance... savings banks conducting life insurance business. (a) Scope of application. Section 594 applies to the case of a mutual savings bank not having capital stock represented by shares which conducts a life...

  5. Alternative Fuels Data Center: Propane Buses Save Money for Virginia

    Science.gov Websites

    Schools Propane Buses Save Money for Virginia Schools to someone by E-mail Share Alternative Fuels Data Center: Propane Buses Save Money for Virginia Schools on Facebook Tweet about Alternative Fuels Data Center: Propane Buses Save Money for Virginia Schools on Twitter Bookmark Alternative Fuels

  6. Alternative Fuels Data Center: Renzenberger Inc Saves Money With Propane

    Science.gov Websites

    Vans Renzenberger Inc Saves Money With Propane Vans to someone by E-mail Share Alternative Fuels Data Center: Renzenberger Inc Saves Money With Propane Vans on Facebook Tweet about Alternative Fuels Data Center: Renzenberger Inc Saves Money With Propane Vans on Twitter Bookmark Alternative Fuels

  7. 26 CFR 1.594-1 - Mutual savings banks conducting life insurance business.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 7 2013-04-01 2013-04-01 false Mutual savings banks conducting life insurance... savings banks conducting life insurance business. (a) Scope of application. Section 594 applies to the case of a mutual savings bank not having capital stock represented by shares which conducts a life...

  8. ImageJ: Image processing and analysis in Java

    NASA Astrophysics Data System (ADS)

    Rasband, W. S.

    2012-06-01

    ImageJ is a public domain Java image processing program inspired by NIH Image. It can display, edit, analyze, process, save and print 8-bit, 16-bit and 32-bit images. It can read many image formats including TIFF, GIF, JPEG, BMP, DICOM, FITS and "raw". It supports "stacks", a series of images that share a single window. It is multithreaded, so time-consuming operations such as image file reading can be performed in parallel with other operations.

  9. The impact of managed care in dentistry.

    PubMed

    Clouse, H R

    1999-01-01

    Managed care plans attempt to control health care expenditures aggressively. These plans directly influence access to medical care and the type, level, and frequency of care rendered. As a result, hospital stays are reduced, focus shifts from inpatient to outpatient care, and patients are responsible for a larger share of health care costs. Dentistry is not immune from the impact of managed care. The attractiveness of the dental market has drawn many managed care organizations, insurers, and entrepreneurs to encourage dentists to participate in a wide variety of managed care programs. However, the delivery of dental care differs markedly in many respects from that of medical care. Therefore, many of the cost saving aspects of managed care that have been so successful in medicine may not result in similar cost savings in dentistry.

  10. Alternative Fuels Data Center: Natural Gas School Buses Help Kansas City

    Science.gov Websites

    Save Money Natural Gas School Buses Help Kansas City Save Money to someone by E-mail Share Alternative Fuels Data Center: Natural Gas School Buses Help Kansas City Save Money on Facebook Tweet about Alternative Fuels Data Center: Natural Gas School Buses Help Kansas City Save Money on Twitter Bookmark

  11. The Complete Guide to Job Sharing.

    ERIC Educational Resources Information Center

    Hohn, Marcia D.

    This booklet provides information on job sharing that resulted from the research and experience of the Merrimack Valley Job Sharing Project. An overview of the topic considers the need for job sharing, employer benefits, types of jobs shared, job division, benefits, employer costs and savings, financial considerations for job sharers, perspectives…

  12. Mobil`s Energy Management Program

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

    Schoeneborn, F.C.

    1997-06-01

    Mobil`s Facilities Management Network sponsored a cross-divisional team to reduce energy costs. This team developed an Energy Management Plan to reduce energy costs by $25 million annually throughout all Mobil divisions over the next five years (total of $125 million committed savings). The core of this plan is the belief that energy costs are controllable and should be managed with the expertise that Mobil manages other parts of the business. Areas of focus are economic procurement, efficient consumption, and expertise sharing.

  13. The Economics of Provider Payment Reform: Are Accountable Care Organizations the Answer?

    PubMed

    Feldman, Roger

    2015-08-01

    A remarkable consensus has developed that the fee-for-service (FFS) approach for paying medical providers must be replaced. This payment approach is said to increase the volume of services without improving care coordination. In response to these calls, Medicare and private payers are experimenting with payment systems that combine the basic element of FFS - a fee for each service - with arrangements that allow providers to share the savings if they hold total spending per patient below a targeted amount. Medicare's accountable care organizations (ACOs) embody the shared savings approach to payment reform. Private payers have introduced total cost of care contracting (TCOC) in several locations. This article questions the consensus that FFS must go. If the fees are too high, then someone needs to "bite the bullet" and reduce fees in key areas. Hoping to control overspending by investment in ACOs is wishful thinking. I describe the theory and practice of shared savings payment systems and summarize recent TCOC contracting initiatives in the private sector. Medicare's shared savings approach is likely to be less effective than private contracts. Cutting providers' fees would be more efficient. Finally, the new payment models in the Affordable Care Act will not ease the problem of high prices for private payers. Copyright © 2015 by Duke University Press.

  14. Eliciting probabilistic expectations: Collaborations between psychologists and economists

    PubMed Central

    Bruine de Bruin, Wändi

    2017-01-01

    We describe two collaborations in which psychologists and economists provided essential support on foundational projects in major research programs. One project involved eliciting adolescents’ expectations regarding significant future life events affecting their psychological and economic development. The second project involved eliciting consumers’ expectations regarding inflation, a potentially vital input to their investment, saving, and purchasing decisions. In each project, we sought questions with the precision needed for economic modeling and the simplicity needed for lay respondents. We identify four conditions that, we believe, promoted our ability to sustain these transdisciplinary collaborations and coproduce the research: (i) having a shared research goal, which neither discipline could achieve on its own; (ii) finding common ground in shared methodology, which met each discipline’s essential evidentiary conditions, but without insisting on its culturally acquired tastes; (iii) sharing the effort throughout, with common language and sense of ownership; and (iv) gaining mutual benefit from both the research process and its products. PMID:28270610

  15. Eliciting probabilistic expectations: Collaborations between psychologists and economists.

    PubMed

    Bruine de Bruin, Wändi; Fischhoff, Baruch

    2017-03-28

    We describe two collaborations in which psychologists and economists provided essential support on foundational projects in major research programs. One project involved eliciting adolescents' expectations regarding significant future life events affecting their psychological and economic development. The second project involved eliciting consumers' expectations regarding inflation, a potentially vital input to their investment, saving, and purchasing decisions. In each project, we sought questions with the precision needed for economic modeling and the simplicity needed for lay respondents. We identify four conditions that, we believe, promoted our ability to sustain these transdisciplinary collaborations and coproduce the research: ( i ) having a shared research goal, which neither discipline could achieve on its own; ( ii ) finding common ground in shared methodology, which met each discipline's essential evidentiary conditions, but without insisting on its culturally acquired tastes; ( iii ) sharing the effort throughout, with common language and sense of ownership; and ( iv ) gaining mutual benefit from both the research process and its products.

  16. Federal workers' compensation programs: Department of Defense and Veterans Health Administration experiences.

    PubMed

    Mallon, Timothy M; Grizzell, Tifani L; Hodgson, Michael J

    2015-03-01

    The objective of this article is to introduce the reader to this special supplement to the Journal of Occupational and Environmental Medicine regarding Federal Workers' Compensation Programs. The short history of both the VHA and DoD Federal Workers' Compensation Programs are provided and a short synopsis of each author's article is provided. The lessons learned from the articles in the supplement are summarized in this article and 6 key findings are highlighted. Cooperation between human resources workers' compensation personnel, safety and occupational health personnel is a must for successful management of the WC program. Information and data sharing are critical for root cause and injury prevention, case management, and cost containment efforts. Enhancing efforts in these areas will save an estimated $100 million through cost avoidance efforts.

  17. Qualified Tuition Savings Programs: The Impact on Household Saving.

    ERIC Educational Resources Information Center

    Coronado, Julia Lynn; McIntosh, Susan Hume

    This study analyzed the impact tuition savings plans are likely to have on household savings. State-sponsored college savings programs rely mainly on tax incentives to motivate parents to save for their children's education in earmarked accounts. The first such programs were prepaid tuition plans, and other types of qualified tuition savings…

  18. Federal incentives for industrial modernization: Historical review and future opportunities

    NASA Technical Reports Server (NTRS)

    Coleman, Sandra C.; Batson, Robert G.

    1987-01-01

    Concerns over the aging of the U.S. aerospace industrial base led DOD to introduce first its Technology Modernization (Tech Mod) Program, and more recently the Industrial Modernization Incentive Program (IMIP). These incentives include productivity shared savings rewards, contractor investment protection to allow for amortization of plant and equipment, and subcontractor/vendor participation. The purpose here is to review DOD IMIP and to evaluate whether a similar program is feasible for NASA and other non-DOD agencies. The IMIP methodology is of interest to industrial engineers because it provides a structured, disciplined approach to identifying productivity improvement opportunities and documenting their expected benefit. However, it is shown that more research on predicting and validating cost avoidance is needed.

  19. 78 FR 68445 - Formations of, Acquisitions by, and Mergers of Bank Holding Companies

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-14

    ... bank holding company by acquiring 100 percent of the voting shares Share Plus Bank, both of Plano, Texas, (the resulting institution from the conversion of Share Plus Federal Bank, a federal savings...

  20. Assessment of China's Energy-Saving and Emission-Reduction Accomplishments and Opportunities During the 11th Five Year Plan

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

    Levine, Mark D.; Price, Lynn; Zhou, Nan

    2010-04-28

    During the period 1980 to 2002, China experienced a 5% average annual reduction in energy consumption per unit of gross domestic product (GDP). The period 2002-2005 saw a dramatic reversal of the historic relationship between energy use and GDP growth: energy use per unit of GDP increased an average of 3.8% per year during this period (NBS, various years). China's 11th Five Year Plan (FYP), which covers the period 2006-2010, required all government divisions at different levels to reduce energy intensity by 20% in five years in order to regain the relationship between energy and GDP growth experienced during themore » 1980s and 1990s. This report provides an assessment of selected policies and programs that China has instituted in its quest to fulfill the national goal of a 20% reduction in energy intensity by 2010. The report finds that China has made substantial progress toward its goal of achieving 20% energy intensity reduction from 2006 to 2010 and that many of the energy-efficiency programs implemented during the 11th FYP in support of China's 20% energy/GDP reduction goal appear to be on track to meet - or in some cases even exceed - their energy-saving targets. It appears that most of the Ten Key Projects, the Top-1000 Program, and the Small Plant Closure Program are on track to meet or surpass the 11th FYP savings goals. China's appliance standards and labeling program, which was established prior to the 11th FYP, has become very robust during the 11th FYP period. China has greatly enhanced its enforcement of new building energy standards but energy-efficiency programs for buildings retrofits, as well as the goal of adjusting China's economic structure to reduce the share of energy consumed by industry, do not appear to be on track to meet the stated goals. With the implementation of the 11th FYP now bearing fruit, it is important to maintain and strengthen the existing energy-saving policies and programs that are successful while revising programs or adding new policy mechanisms to improve the programs that are not on track to achieve the stated goals.« less

  1. Early Impact Of CareFirst's Patient-Centered Medical Home With Strong Financial Incentives.

    PubMed

    Afendulis, Christopher C; Hatfield, Laura A; Landon, Bruce E; Gruber, Jonathan; Landrum, Mary Beth; Mechanic, Robert E; Zinner, Darren E; Chernew, Michael E

    2017-03-01

    In 2011 CareFirst BlueCross BlueShield, a large mid-Atlantic health insurance plan, implemented a payment and delivery system reform program. The model, called the Total Care and Cost Improvement Program, includes enhanced payments for primary care, significant financial incentives for primary care physicians to control spending, and care coordination tools to support progress toward the goal of higher-quality and lower-cost patient care. We conducted a mixed-methods evaluation of the initiative's first three years. Our quantitative analyses used spending and utilization data for 2010-13 to compare enrollees who received care from participating physician groups to similar enrollees cared for by nonparticipating groups. Savings were small and fully shared with providers, which suggests no significant effect on total spending (including bonuses). Our qualitative analysis suggested that early in the program, many physicians were not fully engaged with the initiative and did not make full use of its tools. These findings imply that this and similar payment reforms may require greater time to realize significant savings than many stakeholders had expected. Patience may be necessary if payer-led reform is going to lead to system transformation. Project HOPE—The People-to-People Health Foundation, Inc.

  2. Financial Performance of Rural Medicare ACOs.

    PubMed

    Nattinger, Matthew C; Mueller, Keith; Ullrich, Fred; Zhu, Xi

    2018-12-01

    The Centers for Medicare & Medicaid Services (CMS) has facilitated the development of Medicare accountable care organizations (ACOs), mostly through the Medicare Shared Savings Program (MSSP). To inform the operation of the Center for Medicare & Medicaid Innovation's (CMMI) ACO programs, we assess the financial performance of rural ACOs based on different levels of rural presence. We used the 2014 performance data for Medicare ACOs to examine the financial performance of rural ACOs with different levels of rural presence: exclusively rural, mostly rural, and mixed rural/metropolitan. Of the ACOs reporting performance data, we identified 97 ACOs with a measurable rural presence. We found that successful rural ACO financial performance is associated with the ACO's organizational type (eg, physician-based) and that 8 of the 11 rural ACOs participating in the Advanced Payment Program (APP) garnered savings for Medicare. Unlike previous work, we did not find an association between ACO size or experience and rural ACO financial performance. Our findings suggest that rural ACO financial success is likely associated with factors unique to rural environments. Given the emphasis CMS has placed on rural ACO development, further research to identify these factors is warranted. © 2016 National Rural Health Association.

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

    PubMed

    Linehan, Kathryn

    2012-02-24

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

  4. 31 CFR 321.9 - Specific limitations on payment authority.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... FINANCIAL INSTITUTIONS OF UNITED STATES SAVINGS BONDS AND UNITED STATES SAVINGS NOTES (FREEDOM SHARES) Scope..., incomplete or unauthorized inscription, issue date, or issuing agent's validating data, or if any essential...

  5. 12 CFR 262.3 - Applications.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... merge or consolidate with any other bank holding company, (D) To become a savings and loan holding company (except as provided in § 238.14 of this chapter), and (E) By a savings and loan holding company to acquire ownership or control of shares or assets of a savings association, or to merge or consolidate with...

  6. 12 CFR 262.3 - Applications.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... merge or consolidate with any other bank holding company, (D) To become a savings and loan holding company (except as provided in § 238.14 of this chapter), and (E) By a savings and loan holding company to acquire ownership or control of shares or assets of a savings association, or to merge or consolidate with...

  7. 12 CFR 262.3 - Applications.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... merge or consolidate with any other bank holding company, (D) To become a savings and loan holding company (except as provided in § 238.14 of this chapter), and (E) By a savings and loan holding company to acquire ownership or control of shares or assets of a savings association, or to merge or consolidate with...

  8. 31 CFR 321.27 - Supplements, amendments, or revisions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... FINANCIAL INSTITUTIONS OF UNITED STATES SAVINGS BONDS AND UNITED STATES SAVINGS NOTES (FREEDOM SHARES... any time or from time to time, revise, supplement, amend or withdraw, in whole or in part, the...

  9. How to save money on medicines

    MedlinePlus

    ... patientinstructions/000863.htm How to save money on medicines To use the sharing features on this page, ... can help you pay for your medicines. Use Medicines Wisely Take all of your medicines as directed ...

  10. A Direct Experience in a New Accountable Care Organization: Results, Challenges, and the Role of the Neurosurgeon.

    PubMed

    Kim, Dong H; Lloyd, Christopher; Fernandez, Douglas K; Spielman, Amanda; Bradshaw, David

    2017-04-01

    The passage of the Affordable Care Act saw the creation of Accountable Care Organizations (ACOs), a new approach to healthcare delivery moving from fee-for-service toward population health. This paper presents a case study of the Memorial Hermann ACO (MHACO), launched in response to the Medicare Shared Savings Program, with goals to align physician and hospital incentives, practice evidence-based medicine, develop care coordination, and increase efficiency. Building blocks included an affiliated primary care network, a clinical integration program (involving shared electronic medical record platforms and quality data reporting), and significant investments in information technology. Presented is the approach taken to form MHACO; the management structure, technology developed, and a 2-year experience. Incorporated in July 2012, the MHACO involved 22 000 Medicare patients. In 2015, Centers for Medicare and Medicaid Services released data showing a composite quality score between 80 and 85 (from a maximum 100) and nearly $53 million in total savings (or 11% of expected expenditure), making MHACO one of the most successful nationally.1 In fewer than 5 years, almost 500 ACOs have developed, and by some estimates, a quarter of Medicare patients are currently enrolled in an ACO. Although ACOs to date have focused on primary care, the future will increasingly involve specialists. At Memorial Hermann, neurosurgeons took an early role in forming collaborative partnerships with the hospital, and started programs that served as precursors to the ACO model. This paper ends with an overview of ACO development, likely changes going forward, and a discussion of the role of specialists in general, and of neurosurgeons in particular. Copyright © 2016 by the Congress of Neurological Surgeons.

  11. Checkpointing Shared Memory Programs at the Application-level

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

    Bronevetsky, G; Schulz, M; Szwed, P

    2004-09-08

    Trends in high-performance computing are making it necessary for long-running applications to tolerate hardware faults. The most commonly used approach is checkpoint and restart(CPR)-the state of the computation is saved periodically on disk, and when a failure occurs, the computation is restarted from the last saved state. At present, it is the responsibility of the programmer to instrument applications for CPR. Our group is investigating the use of compiler technology to instrument codes to make them self-checkpointing and self-restarting, thereby providing an automatic solution to the problem of making long-running scientific applications resilient to hardware faults. Our previous work focusedmore » on message-passing programs. In this paper, we describe such a system for shared-memory programs running on symmetric multiprocessors. The system has two components: (i)a pre-compiler for source-to-source modification of applications, and (ii) a runtime system that implements a protocol for coordinating CPR among the threads of the parallel application. For the sake of concreteness, we focus on a non-trivial subset of OpenMP that includes barriers and locks. One of the advantages of this approach is that the ability to tolerate faults becomes embedded within the application itself, so applications become self-checkpointing and self-restarting on any platform. We demonstrate this by showing that our transformed benchmarks can checkpoint and restart on three different platforms (Windows/x86, Linux/x86, and Tru64/Alpha). Our experiments show that the overhead introduced by this approach is usually quite small; they also suggest ways in which the current implementation can be tuned to reduced overheads further.« less

  12. FAST User Guide

    NASA Technical Reports Server (NTRS)

    Walatka, Pamela P.; Clucas, Jean; McCabe, R. Kevin; Plessel, Todd; Potter, R.; Cooper, D. M. (Technical Monitor)

    1994-01-01

    The Flow Analysis Software Toolkit, FAST, is a software environment for visualizing data. FAST is a collection of separate programs (modules) that run simultaneously and allow the user to examine the results of numerical and experimental simulations. The user can load data files, perform calculations on the data, visualize the results of these calculations, construct scenes of 3D graphical objects, and plot, animate and record the scenes. Computational Fluid Dynamics (CFD) visualization is the primary intended use of FAST, but FAST can also assist in the analysis of other types of data. FAST combines the capabilities of such programs as PLOT3D, RIP, SURF, and GAS into one environment with modules that share data. Sharing data between modules eliminates the drudgery of transferring data between programs. All the modules in the FAST environment have a consistent, highly interactive graphical user interface. Most commands are entered by pointing and'clicking. The modular construction of FAST makes it flexible and extensible. The environment can be custom configured and new modules can be developed and added as needed. The following modules have been developed for FAST: VIEWER, FILE IO, CALCULATOR, SURFER, TOPOLOGY, PLOTTER, TITLER, TRACER, ARCGRAPH, GQ, SURFERU, SHOTET, and ISOLEVU. A utility is also included to make the inclusion of user defined modules in the FAST environment easy. The VIEWER module is the central control for the FAST environment. From VIEWER, the user can-change object attributes, interactively position objects in three-dimensional space, define and save scenes, create animations, spawn new FAST modules, add additional view windows, and save and execute command scripts. The FAST User Guide uses text and FAST MAPS (graphical representations of the entire user interface) to guide the user through the use of FAST. Chapters include: Maps, Overview, Tips, Getting Started Tutorial, a separate chapter for each module, file formats, and system administration.

  13. Everyone wins - a program to upgrade energy efficiency in manufactured housing

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

    Lee, A.D.; Onisko, S.A.; Sandahl, L.J.

    1994-03-01

    Other regions might well benefit from this case history, illustrating how a region marshalled its resources to bring manufactured housing--a significant share of its new residential sector--into the modern era of energy efficiency. Everyone was a winner. In the Pacific Northwest, as in many parts of the country, a significant proportion of new homes are HUD-code manufactured, or so-called mobile, homes. About 25% of new single-family houses in the Pacific Northwest are manufactured homes. They represent an even larger share - nearly 40% - of new electrically heated housing in the region, and this share has been growing. When Congressmore » enacted the Pacific Northwest Power Planning Act of 1980, it also permitted the four Northwest states to establish an interstate compact body - the Northwest Power Planning Council - and required the Council to produce an integrated resource plan for the region served by the Bonneville Power Administration, the federal power marketing and transmission agency that operates the region's major transmission grid and sells most of its bulk power. Both the law and the plan charge Bonneville with developing cost-effective programs to save electricity in all end-use sectors through improved energy efficiency.« less

  14. Energy Savings Lifetimes and Persistence

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

    Hoffman, Ian M.; Schiller, Steven R.; Todd, Annika

    2016-02-01

    This technical brief explains the concepts of energy savings lifetimes and savings persistence and discusses how program administrators use these factors to calculate savings for efficiency measures, programs and portfolios. Savings lifetime is the length of time that one or more energy efficiency measures or activities save energy, and savings persistence is the change in savings throughout the functional life of a given efficiency measure or activity. Savings lifetimes are essential for assessing the lifecycle benefits and cost effectiveness of efficiency activities and for forecasting loads in resource planning. The brief also provides estimates of savings lifetimes derived from amore » national collection of costs and savings for electric efficiency programs and portfolios.« less

  15. 12 CFR 584.4 - Certain acquisitions by savings and loan holding companies.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) Held by any insurance companies as defined in section 2(a)(17) of the Investment Company Act of 1940: Provided, That all shares held by all insurance company affiliates of such savings association or savings... of any company that is not a subsidiary that is engaged in any business activity other than those...

  16. 12 CFR 584.4 - Certain acquisitions by savings and loan holding companies.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) Held by any insurance companies as defined in section 2(a)(17) of the Investment Company Act of 1940: Provided, That all shares held by all insurance company affiliates of such savings association or savings... of any company that is not a subsidiary that is engaged in any business activity other than those...

  17. 31 CFR 321.8 - Redemption-exchange of Series E and EE savings bonds and savings notes.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Redemption-exchange of Series E and... STATES SAVINGS NOTES (FREEDOM SHARES) Scope of Authority § 321.8 Redemption-exchange of Series E and EE... payment of eligible securities presented for redemption in exchange for Series HH bonds. Securities...

  18. U.S. pharmacy policy: a public health perspective on safety and cost.

    PubMed

    Rosenau, Pauline Vaillancourt; Lal, Lincy S; Glasser, Jay H

    2009-01-01

    A public health perspective based on social justice and a population health point of view emphasizes pharmacy policy innovations regarding safety and costs. Such policies that effectively reduce costs include controlling profits, establishing profit targets, extending prescription providers, revising prescription classification schemes, emphasizing generic medications, and establishing formularies. Public education and universal programs may reduce costs, but co-pays and "cost-sharing" do not. Switching medications to over-the-counter (OTC) status, pill splitting, and importing medication from abroad are poor substitutes for authentic public health pharmacy policy. Where policy changes yield savings, public health insists that these savings should be used to increase access and improve population health. In the future, pharmacy policies may emphasize public health accountability more than individual liberty because of potential cost savings to society. Fear of litigation, as an informal mechanism of focusing manufacturer's attention on safety, is inefficient; public health pharmacy policy regarding safety looks toward a more active regulatory role on the part of government. A case study of direct-to-consumer advertising illustrates the complexity of public health pharmacy policy.

  19. Shifting physician prescribing to a preferred histamine-2-receptor antagonist. Effects of a multifactorial intervention in a mixed-model health maintenance organization.

    PubMed

    Brufsky, J W; Ross-Degnan, D; Calabrese, D; Gao, X; Soumerai, S B

    1998-03-01

    This study was undertaken to determine whether a program of education, therapeutic reevaluation of eligible patients, and performance feedback could shift prescribing to cimetidine from other histamine-2 receptor antagonists, which commonly are used in the management of ulcers and reflux, and reduce costs without increasing rates of ulcer-related hospital admissions. This study used an interrupted monthly time series with comparison series in a large mixed-model health maintenance organization. Physicians employed in health centers (staff model) and physicians in independent medical groups contracting to provide health maintenance organization services (group model) participated. The comparative percentage prescribed of specific histamine-2 receptor antagonists (market share), total histamine-2 receptor antagonist prescribing, cost per histamine-2 receptor antagonist prescription, and the rate of hospitalization for gastrointestinal illness were assessed. In the staff model, therapeutic reevaluation resulted in a sudden increase in market share of the preferred histamine-2 receptor antagonist cimetidine (+53.8%) and a sudden decrease in ranitidine (-44.7%) and famotidine (-4.8%); subsequently, cimetidine market share grew by 1.1% per month. In the group model, therapeutic reevaluation resulted in increased cimetidine market share (+9.7%) and decreased prescribing of other histamine-2 receptor antagonists (ranitidine -11.6%; famotidine -1.2%). Performance feedback did not result in further changes in prescribing in either setting. Use of omeprazole, an expensive alternative, essentially was unchanged by the interventions, as were overall histamine-2 receptor antagonist prescribing and hospital admissions for gastrointestinal illnesses. This intervention, which cost approximately $60,000 to implement, resulted in estimated annual savings in histamine-2 receptor antagonist expenditures of $1.06 million. Annual savings in histamine-2 receptor antagonist expenditures after this multifaceted intervention were more than implementation costs, with no discernible effects on numbers of hospitalizations. The magnitude of effect and cost savings were much greater in the staff model; organizational factors and economic incentives may have contributed to these differences. More research is needed to determine the generalizability of this approach to other technologies and managed care settings.

  20. Barriers to and facilitators of implementing shared decision making and decision support in a paediatric hospital: A descriptive study.

    PubMed

    Boland, Laura; McIsaac, Daniel I; Lawson, Margaret L

    2016-04-01

    To explore multiple stakeholders' perceived barriers to and facilitators of implementing shared decision making and decision support in a tertiary paediatric hospital. An interpretive descriptive qualitative study was conducted using focus groups and interviews to examine senior hospital administrators', clinicians', parents' and youths' perceived barriers to and facilitators of shared decision making and decision support implementation. Data were analyzed using inductive thematic analysis. Fifty-seven stakeholders participated. Six barrier and facilitator themes emerged. The main barrier was gaps in stakeholders' knowledge of shared decision making and decision support. Facilitators included compatibility between shared decision making and the hospital's culture and ideal practices, perceptions of positive patient and family outcomes associated with shared decision making, and positive attitudes regarding shared decision making and decision support. However, youth attitudes regarding the necessity and usefulness of a decision support program were a barrier. Two themes were both a barrier and a facilitator. First, stakeholder groups were uncertain which clinical situations are suitable for shared decision making (eg, new diagnoses, chronic illnesses, complex decisions or urgent decisions). Second, the clinical process may be hindered if shared decision making and decision support decrease efficiency and workflow; however, shared decision making may reduce repeat visits and save time over the long term. Specific knowledge translation strategies that improve shared decision making knowledge and match specific barriers identified by each stakeholder group may be required to promote successful shared decision making and decision support implementation in the authors' paediatric hospital.

  1. Identifying new technologies that save energy and reduce costs to the Federal sector: The New Technology Program

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

    Hunt, W.D.M.; Conover, D.R.; Stockmeyer, M.K.

    1995-11-01

    In 1990 the New Technology Demonstration Program (formerly the Test Bed Demonstration Program) was initiated by the US Department of Energy`s Office (DOE`s) of Federal Energy Management Programs with the purpose of accelerating the introduction of new technologies into the Federal sector. The program has since expanded into a multi-laboratory collaborative effort that evaluates new technologies and shares the results with the Federal design and procurement communities. These evaluations are performed on a collaborative basis which typically includes technology manufacturers, Federal facilities, utilities, trade associations, research institutes, and other in partnership with DOE. The end result is a range ofmore » effective technology transfer tools that provide operations and performance data on new technologies to Federal designers, building managers, and procurement officials. These tools assist in accelerating a technology`s Federal application and realizing reductions in energy consumption and costs.« less

  2. Strategies for Energy Efficient Resource Management of Hybrid Programming Models

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

    Li, Dong; Supinski, Bronis de; Schulz, Martin

    2013-01-01

    Many scientific applications are programmed using hybrid programming models that use both message-passing and shared-memory, due to the increasing prevalence of large-scale systems with multicore, multisocket nodes. Previous work has shown that energy efficiency can be improved using software-controlled execution schemes that consider both the programming model and the power-aware execution capabilities of the system. However, such approaches have focused on identifying optimal resource utilization for one programming model, either shared-memory or message-passing, in isolation. The potential solution space, thus the challenge, increases substantially when optimizing hybrid models since the possible resource configurations increase exponentially. Nonetheless, with the accelerating adoptionmore » of hybrid programming models, we increasingly need improved energy efficiency in hybrid parallel applications on large-scale systems. In this work, we present new software-controlled execution schemes that consider the effects of dynamic concurrency throttling (DCT) and dynamic voltage and frequency scaling (DVFS) in the context of hybrid programming models. Specifically, we present predictive models and novel algorithms based on statistical analysis that anticipate application power and time requirements under different concurrency and frequency configurations. We apply our models and methods to the NPB MZ benchmarks and selected applications from the ASC Sequoia codes. Overall, we achieve substantial energy savings (8.74% on average and up to 13.8%) with some performance gain (up to 7.5%) or negligible performance loss.« less

  3. Caring and professional practice settings: the impact of technology, change, and efficiency.

    PubMed

    Crow, G

    2001-01-01

    Technology, change, efficiency, and caring are not necessarily concepts that are used in the same sentence when describing motivational and professional practice settings. Caring within health care organizations can take many forms. One of the most significant and meaningful forms is through building networks for shared decision making and shared accountability. While caring can save the life of a patient and convey trust and commitment to patients, families, and staff, it can also save the life of your organization.

  4. 25 CFR 1000.400 - Can a Tribe/Consortium retain savings from programs?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 2 2013-04-01 2013-04-01 false Can a Tribe/Consortium retain savings from programs? 1000...-DETERMINATION AND EDUCATION ACT Miscellaneous Provisions § 1000.400 Can a Tribe/Consortium retain savings from programs? Yes, for BIA programs, the Tribe/Consortium may retain savings for each fiscal year during which...

  5. QoS support for end users of I/O-intensive applications using shared storage systems

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

    Davis, Marion Kei; Zhang, Xuechen; Jiang, Song

    2011-01-19

    I/O-intensive applications are becoming increasingly common on today's high-performance computing systems. While performance of compute-bound applications can be effectively guaranteed with techniques such as space sharing or QoS-aware process scheduling, it remains a challenge to meet QoS requirements for end users of I/O-intensive applications using shared storage systems because it is difficult to differentiate I/O services for different applications with individual quality requirements. Furthermore, it is difficult for end users to accurately specify performance goals to the storage system using I/O-related metrics such as request latency or throughput. As access patterns, request rates, and the system workload change in time,more » a fixed I/O performance goal, such as bounds on throughput or latency, can be expensive to achieve and may not lead to a meaningful performance guarantees such as bounded program execution time. We propose a scheme supporting end-users QoS goals, specified in terms of program execution time, in shared storage environments. We automatically translate the users performance goals into instantaneous I/O throughput bounds using a machine learning technique, and use dynamically determined service time windows to efficiently meet the throughput bounds. We have implemented this scheme in the PVFS2 parallel file system and have conducted an extensive evaluation. Our results show that this scheme can satisfy realistic end-user QoS requirements by making highly efficient use of the I/O resources. The scheme seeks to balance programs attainment of QoS requirements, and saves as much of the remaining I/O capacity as possible for best-effort programs.« less

  6. 31 CFR 359.66 - Is the Education Savings Bonds Program available for Series I savings bonds?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Is the Education Savings Bonds... Education Savings Bonds Program available for Series I savings bonds? You may be able to exclude from income... bonds during the year. To qualify for the program, you or the co-owner (in the case of definitive...

  7. On Why It Is Impossible to Prove that the BDX90 Dispatcher Implements a Time-sharing System

    NASA Technical Reports Server (NTRS)

    Boyer, R. S.; Moore, J. S.

    1983-01-01

    The Software Implemented Fault Tolerance SIFT system, is written in PASCAL except for about a page of machine code. The SIFT system implements a small time sharing system in which PASCAL programs for separate application tasks are executed according to a schedule with real time constraints. The PASCAL language has no provision for handling the notion of an interrupt such as the B930 clock interrupt. The PASCAL language also lacks the notion of running a PASCAL subroutine for a given amount of time, suspending it, saving away the suspension, and later activating the suspension. Machine code was used to overcome these inadequacies of PASCAL. Code which handles clock interrupts and suspends processes is called a dispatcher. The time sharing/virtual machine idea is completely destroyed by the reconfiguration task. After termination of the reconfiguration task, the tasks run by the dispatcher have no relation to those run before reconfiguration. It is impossible to view the dispatcher as a time-sharing system implementing virtual BDX930s running concurrently when one process can wipe out the others.

  8. Reference Pricing, Consumer Cost-Sharing, and Insurer Spending for Advanced Imaging Tests.

    PubMed

    Robinson, James C; Whaley, Christopher; Brown, Timothy T

    2016-12-01

    Fees charged for similar imaging tests often vary dramatically within the same market, leading to wide variation in insurer spending and consumer cost-sharing. Reference pricing is an insurance design that offers good coverage to patients up to a defined contribution limit but requires the patients who select high-priced facilities to pay the remainder out of pocket. To measure the association between implementation of reference pricing and patient choice of facility, test prices, out-of-pocket spending, and insurer spending for advanced imaging (CT and MRI) procedures. Difference-in-differences multivariable analysis of insurance claims data. Study included 4751 employees of a national grocery chain (treatment group) and 23,428 enrollees in the nation's largest private insurance plan (comparison group) that used CT or MRI tests between 2010 and 2013. Patient choice of facility, price paid per test, patient out-of-pocket cost-sharing, and employer spending. Compared with trends in prices paid by insurance enrollees not subject to reference pricing, and after adjusting for characteristics of tests and patients, implementation of reference pricing was associated with a 12.5% (95% CI, -25.0%, 2.1%) reduction in average price paid per test by the end of the second full year of the program for CT scans and a 10.5% (95% CI, -16.9%, 3.6%) for MRIs. Out-of-pocket cost-sharing by patients declined by $71,508 (13.8%). The savings accruing to employees amounted to 45.5% of total savings from reference pricing, with the remainder accruing to the employer. Implementation of reference pricing led to reductions in payments by both employer and employees.

  9. 31 CFR 321.8 - Redemption-exchange of Series E and EE savings bonds and savings notes.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Redemption-exchange of Series E and EE... NOTES (FREEDOM SHARES) Scope of Authority § 321.8 Redemption-exchange of Series E and EE savings bonds... eligible securities presented for redemption in exchange for Series HH bonds. Securities eligible for...

  10. 31 CFR 321.8 - Redemption-exchange of Series E and EE savings bonds and savings notes.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 2 2013-07-01 2013-07-01 false Redemption-exchange of Series E and EE... STATES SAVINGS NOTES (FREEDOM SHARES) Scope of Authority § 321.8 Redemption-exchange of Series E and EE... payment of eligible securities presented for redemption in exchange for Series HH bonds. Securities...

  11. 31 CFR 321.8 - Redemption-exchange of Series E and EE savings bonds and savings notes.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 2 2014-07-01 2014-07-01 false Redemption-exchange of Series E and... UNITED STATES SAVINGS NOTES (FREEDOM SHARES) Scope of Authority § 321.8 Redemption-exchange of Series E... agent may make payment of eligible securities presented for redemption in exchange for Series HH bonds...

  12. Canada Education Savings Program: Annual Statistical Review 2012

    ERIC Educational Resources Information Center

    Human Resources and Skills Development Canada, 2012

    2012-01-01

    The Canada Education Savings Program (CESP) has been an initiative of the Government of Canada since 1998. As part of the Department of Human Resources and Skills Development Canada, the program administers the Canada Education Savings Grant (CESG) and the Canada Learning Bond (CLB). These two initiatives help Canadian families save for a child's…

  13. Canada Education Savings Program: Annual Statistical Review--2009

    ERIC Educational Resources Information Center

    Human Resources and Skills Development Canada, 2009

    2009-01-01

    The Canada Education Savings Program is an initiative of the Government of Canada. As part of the Department of Human Resources and Skills Development, the program administers the Canada Education Savings Grant and the Canada Learning Bond. These two initiatives help Canadian families save for a child's post-secondary education in Registered…

  14. Canada Education Savings Program: Annual Statistical Review 2011

    ERIC Educational Resources Information Center

    Human Resources and Skills Development Canada, 2011

    2011-01-01

    The Canada Education Savings Program has been an initiative of the Government of Canada since 1998. As part of the Department of Human Resources and Skills Development, the program administers the Canada Education Savings Grant and the Canada Learning Bond. These two initiatives help Canadian families save for a child's post-secondary education in…

  15. BioBlocks: Programming Protocols in Biology Made Easier.

    PubMed

    Gupta, Vishal; Irimia, Jesús; Pau, Iván; Rodríguez-Patón, Alfonso

    2017-07-21

    The methods to execute biological experiments are evolving. Affordable fluid handling robots and on-demand biology enterprises are making automating entire experiments a reality. Automation offers the benefit of high-throughput experimentation, rapid prototyping, and improved reproducibility of results. However, learning to automate and codify experiments is a difficult task as it requires programming expertise. Here, we present a web-based visual development environment called BioBlocks for describing experimental protocols in biology. It is based on Google's Blockly and Scratch, and requires little or no experience in computer programming to automate the execution of experiments. The experiments can be specified, saved, modified, and shared between multiple users in an easy manner. BioBlocks is open-source and can be customized to execute protocols on local robotic platforms or remotely, that is, in the cloud. It aims to serve as a de facto open standard for programming protocols in Biology.

  16. Barriers to and facilitators of implementing shared decision making and decision support in a paediatric hospital: A descriptive study

    PubMed Central

    Boland, Laura; McIsaac, Daniel I; Lawson, Margaret L

    2016-01-01

    OBJECTIVE: To explore multiple stakeholders’ perceived barriers to and facilitators of implementing shared decision making and decision support in a tertiary paediatric hospital. METHODS: An interpretive descriptive qualitative study was conducted using focus groups and interviews to examine senior hospital administrators’, clinicians’, parents’ and youths’ perceived barriers to and facilitators of shared decision making and decision support implementation. Data were analyzed using inductive thematic analysis. RESULTS: Fifty-seven stakeholders participated. Six barrier and facilitator themes emerged. The main barrier was gaps in stakeholders’ knowledge of shared decision making and decision support. Facilitators included compatibility between shared decision making and the hospital’s culture and ideal practices, perceptions of positive patient and family outcomes associated with shared decision making, and positive attitudes regarding shared decision making and decision support. However, youth attitudes regarding the necessity and usefulness of a decision support program were a barrier. Two themes were both a barrier and a facilitator. First, stakeholder groups were uncertain which clinical situations are suitable for shared decision making (eg, new diagnoses, chronic illnesses, complex decisions or urgent decisions). Second, the clinical process may be hindered if shared decision making and decision support decrease efficiency and workflow; however, shared decision making may reduce repeat visits and save time over the long term. CONCLUSIONS: Specific knowledge translation strategies that improve shared decision making knowledge and match specific barriers identified by each stakeholder group may be required to promote successful shared decision making and decision support implementation in the authors’ paediatric hospital. PMID:27398058

  17. Advertising energy saving programs: The potential environmental cost of emphasizing monetary savings.

    PubMed

    Schwartz, Daniel; Bruine de Bruin, Wändi; Fischhoff, Baruch; Lave, Lester

    2015-06-01

    Many consumers have monetary or environmental motivations for saving energy. Indeed, saving energy produces both monetary benefits, by reducing energy bills, and environmental benefits, by reducing carbon footprints. We examined how consumers' willingness and reasons to enroll in energy-savings programs are affected by whether advertisements emphasize monetary benefits, environmental benefits, or both. From a normative perspective, having 2 noteworthy kinds of benefit should not decrease a program's attractiveness. In contrast, psychological research suggests that adding external incentives to an intrinsically motivating task may backfire. To date, however, it remains unclear whether this is the case when both extrinsic and intrinsic motivations are inherent to the task, as with energy savings, and whether removing explicit mention of extrinsic motivation will reduce its importance. We found that emphasizing a program's monetary benefits reduced participants' willingness to enroll. In addition, participants' explanations about enrollment revealed less attention to environmental concerns when programs emphasized monetary savings, even when environmental savings were also emphasized. We found equal attention to monetary motivations in all conditions, revealing an asymmetric attention to monetary and environmental motives. These results also provide practical guidance regarding the positioning of energy-saving programs: emphasize intrinsic benefits; the extrinsic ones may speak for themselves. (c) 2015 APA, all rights reserved).

  18. ONU Power Saving Scheme for EPON System

    NASA Astrophysics Data System (ADS)

    Mukai, Hiroaki; Tano, Fumihiko; Tanaka, Masaki; Kozaki, Seiji; Yamanaka, Hideaki

    PON (Passive Optical Network) achieves FTTH (Fiber To The Home) economically, by sharing an optical fiber among plural subscribers. Recently, global climate change has been recognized as a serious near term problem. Power saving techniques for electronic devices are important. In PON system, the ONU (Optical Network Unit) power saving scheme has been studied and defined in XG-PON. In this paper, we propose an ONU power saving scheme for EPON. Then, we present an analysis of the power reduction effect and the data transmission delay caused by the ONU power saving scheme. According to the analysis, we propose an efficient provisioning method for the ONU power saving scheme which is applicable to both of XG-PON and EPON.

  19. Military Health System: Sustained Senior Leadership Needed to Fully Develop Plans for Achieving Cost Savings

    DTIC Science & Technology

    2014-02-26

    left its existing structure in place, approving instead a shared - services directorate to consolidate common MHS functions (e.g., shared information...has seven main goals: (1) consolidate functions ( shared services ) common to DoD, (2) deliver more-integrated health care in areas with more than one

  20. Task Group on a Culture of Savings: Implementing Behavior Change in DoD

    DTIC Science & Technology

    2011-01-01

    Robert Hale Task Group Chairman – Navy Future Personnel and Pay Solution (FPPS) - Business Case November 30, 2009 – Case for Shared Services in the...Public Sector - Accenture Shared Services in Government - AT Kearney – 2009 Global Shared Services Survey Results - Deloitte – Shared Services - a...Benchmark Study - The Johnson Group – Economics of Business Process Outsourcing - Technology Association of Georgia – State of Shared Services and Business

  1. Report To The Secretary Of Defense-Task Group On A Culture Of Savings: Implementing Behavior Change In DoD

    DTIC Science & Technology

    2011-01-01

    Shared Services in the Public Sector - Accenture Shared Services in Government - AT Kearney – 2009 Global Shared Services Survey Results - Deloitte... Shared Services - a Benchmark Study - The Johnson Group – Economics of Business Process Outsourcing - Technology Association of Georgia – State of... Shared Services and Business Process Outsourcing - Accenture – Public Sector Outsourcing Surge in 2010 - National Outsourcing Association – Naval

  2. Practical use of a word processor in a histopathology laboratory.

    PubMed Central

    Briggs, J C; Ibrahim, N B; Mackintosh, I; Norris, D

    1982-01-01

    Some of the facilities available with a commercially purchased word processing program, linked to a DEC PDP 11/23 computer are described, together with an account of the practical histopathological use. The system is based on a share of the computer with a Clinical Chemistry Department. Development was time-consuming and required the constant availability of the Department of Physics. However, once working, considerable saving in secretarial time has resulted and a number of projects have been started which would not have been contemplated without the use of the word processor and its linked computer. Images PMID:7068906

  3. Exploring efficacy of residential energy efficiency programs in Florida

    NASA Astrophysics Data System (ADS)

    Taylor, Nicholas Wade

    Electric utilities, government agencies, and private interests in the U.S. have committed and continue to invest substantial resources in the pursuit of energy efficiency and conservation through demand-side management (DSM) programs. Program investments, and the demand for impact evaluations that accompany them, are projected to grow in coming years due to increased pressure from state-level energy regulation, costs and challenges of building additional production capacity, fuel costs and potential carbon or renewable energy regulation. This dissertation provides detailed analyses of ex-post energy savings from energy efficiency programs in three key sectors of residential buildings: new, single-family, detached homes; retrofits to existing single-family, detached homes; and retrofits to existing multifamily housing units. Each of the energy efficiency programs analyzed resulted in statistically significant energy savings at the full program group level, yet savings for individual participants and participant subgroups were highly variable. Even though savings estimates were statistically greater than zero, those energy savings did not always meet expectations. Results also show that high variability in energy savings among participant groups or subgroups can negatively impact overall program performance and can undermine marketing efforts for future participation. Design, implementation, and continued support of conservation programs based solely on deemed or projected savings is inherently counter to the pursuit of meaningful energy conservation and reductions in greenhouse gas emissions. To fully understand and optimize program impacts, consistent and robust measurement and verification protocols must be instituted in the design phase and maintained over time. Furthermore, marketing for program participation must target those who have the greatest opportunity for savings. In most utility territories it is not possible to gain access to the type of large scale datasets that would facilitate robust program analysis. Along with measuring and optimizing energy conservation programs, utilities should provide public access to historical consumption data. Open access to data, program optimization, consistent measurement and verification and transparency in reported savings are essential to reducing energy use and its associated environmental impacts.

  4. Evaluation Of A Residential Retrofit Program In Omaha Nebraska: A Comparison Of Actual Energy Savings With Audit Predictions Using Quantitative Analysis

    NASA Astrophysics Data System (ADS)

    Cory, Bradley S.

    The reEnergize Program conducted 957 energy upgrades in Omaha Nebraska from July 2010 to September 30th 2013, through a government grant within the Better Buildings Neighborhood Program. Projected program savings were provided upon program completion but it was unknown how effective the program was at actually reducing energy consumption in the homes that were upgraded. The following research report uses a PRISM analysis to remove the effect of weather and compare the actual pre and post utility usage rates to determine the actual effectiveness of the program. The housing characteristics, and individual energy upgrades were analyzed to see if any patterns or trends could be identified between consumption savings and housing type and specific upgrade measure. The results of the study showed that the program did induce savings but by much less than the engineering estimates predicted. It is likely that housing characteristics and upgrade measures play a role in inducing consumption savings but homeowner behavior is a stronger factor that influences savings.

  5. Modeling an enhanced ridesharing system with meet points and time windows

    PubMed Central

    Li, Xin; Hu, Sangen; Deng, Kai

    2018-01-01

    With the rising of e-hailing services in urban areas, ride sharing is becoming a common mode of transportation. This paper presents a mathematical model to design an enhanced ridesharing system with meet points and users’ preferable time windows. The introduction of meet points allows ridesharing operators to trade off the benefits of saving en-route delays and the cost of additional walking for some passengers to be collectively picked up or dropped off. This extension to the traditional door-to-door ridesharing problem brings more operation flexibility in urban areas (where potential requests may be densely distributed in neighborhood), and thus could achieve better system performance in terms of reducing the total travel time and increasing the served passengers. We design and implement a Tabu-based meta-heuristic algorithm to solve the proposed mixed integer linear program (MILP). To evaluate the validation and effectiveness of the proposed model and solution algorithm, several scenarios are designed and also resolved to optimality by CPLEX. Results demonstrate that (i) detailed route plan associated with passenger assignment to meet points can be obtained with en-route delay savings; (ii) as compared to CPLEX, the meta-heuristic algorithm bears the advantage of higher computation efficiency and produces good quality solutions with 8%~15% difference from the global optima; and (iii) introducing meet points to ridesharing system saves the total travel time by 2.7%-3.8% for small-scale ridesharing systems. More benefits are expected for ridesharing systems with large size of fleet. This study provides a new tool to efficiently operate the ridesharing system, particularly when the ride sharing vehicles are in short supply during peak hours. Traffic congestion mitigation will also be expected. PMID:29715302

  6. Spinoff 2013

    NASA Technical Reports Server (NTRS)

    2014-01-01

    Topics covered include: Innovative Software Tools Measure Behavioral Alertness; Miniaturized, Portable Sensors Monitor Metabolic Health; Patient Simulators Train Emergency Caregivers; Solar Refrigerators Store Life-Saving Vaccines; Monitors Enable Medication Management in Patients' Homes; Handheld Diagnostic Device Delivers Quick Medical Readings; Experiments Result in Safer, Spin-Resistant Aircraft; Interfaces Visualize Data for Airline Safety, Efficiency; Data Mining Tools Make Flights Safer, More Efficient; NASA Standards Inform Comfortable Car Seats; Heat Shield Paves the Way for Commercial Space; Air Systems Provide Life Support to Miners; Coatings Preserve Metal, Stone, Tile, and Concrete; Robots Spur Software That Lends a Hand; Cloud-Based Data Sharing Connects Emergency Managers; Catalytic Converters Maintain Air Quality in Mines; NASA-Enhanced Water Bottles Filter Water on the Go; Brainwave Monitoring Software Improves Distracted Minds; Thermal Materials Protect Priceless, Personal Keepsakes; Home Air Purifiers Eradicate Harmful Pathogens; Thermal Materials Drive Professional Apparel Line; Radiant Barriers Save Energy in Buildings; Open Source Initiative Powers Real-Time Data Streams; Shuttle Engine Designs Revolutionize Solar Power; Procedure-Authoring Tool Improves Safety on Oil Rigs; Satellite Data Aid Monitoring of Nation's Forests; Mars Technologies Spawn Durable Wind Turbines; Programs Visualize Earth and Space for Interactive Education; Processor Units Reduce Satellite Construction Costs; Software Accelerates Computing Time for Complex Math; Simulation Tools Prevent Signal Interference on Spacecraft; Software Simplifies the Sharing of Numerical Models; Virtual Machine Language Controls Remote Devices; Micro-Accelerometers Monitor Equipment Health; Reactors Save Energy, Costs for Hydrogen Production; Cameras Monitor Spacecraft Integrity to Prevent Failures; Testing Devices Garner Data on Insulation Performance; Smart Sensors Gather Information for Machine Diagnostics; Oxygen Sensors Monitor Bioreactors and Ensure Health and Safety; Vision Algorithms Catch Defects in Screen Displays; and Deformable Mirrors Capture Exoplanet Data, Reflect Lasers.

  7. 31 CFR 321.15 - Liability for losses.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Liability for losses. 321.15 Section... INSTITUTIONS OF UNITED STATES SAVINGS BONDS AND UNITED STATES SAVINGS NOTES (FREEDOM SHARES) Losses Resulting From Erroneous Payments § 321.15 Liability for losses. Under the governing statute, as amended (31 U.S...

  8. Matched Child Savings Accounts in Low-Resource Communities: Who Saves?

    PubMed Central

    Karimli, Leyla; Ssewamala, Fred M.; Neilands, Torsten B.; McKay, Mary McKernan

    2015-01-01

    This study examines variations in saving behavior among poor families enrolled in a Child Savings Account program for orphaned and vulnerable school-going children in Uganda. We employ multilevel analyses using longitudinal data from a cluster-randomized experimental design. Our analyses reveal the following significant results: (1) given the average number of months during which the account was open (18 months), families saved on average, USD 54.72, which, after being matched by the program (2:1 match rate) comes to USD 164.16—enough to cover approximately five academic terms of post-primary education; (2) children's saving behavior was not associated with quality of family relations; it was, however, significantly associated with family financial socialization; (3) family demographics were significantly associated with children's saving behavior in the matched Child Savings Account program; and (4) children enrolled in some schools saved better compared to children enrolled in other schools within the same treatment group. PMID:26636025

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

    PubMed

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

    2018-04-01

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

  10. Impact of low cost refurbishable and standard spacecraft upon future NASA space programs. Payload effects follow-on study

    NASA Technical Reports Server (NTRS)

    1972-01-01

    The study has concluded that there are very large space program cost savings to be obtained by use of low cost, refurbishable, and standard spacecraft in conjunction with the shuttle transportation system. The range of space program cost savings for three different groups of programs are shown in quantitative terms. The total savings for the 91 programs will range from $13.4 billion to $18.0 billion depending on the degree of hardware standardization. These savings, principally resulting from payload cost reductions, tangibly support the development costs of the shuttle system.

  11. Shared medical appointments save money for capitated groups.

    PubMed

    2003-02-01

    Shared medical appointments aren't money-makers for Palo Alto Medical Foundation, but they do cut expenses, improve patient healing and free up physician schedules. The group nature of the encounters also encourages patients to follow medical orders. Find out more.

  12. Saving for Success: Financial Education and Savings Goal Achievement in Individual Development Accounts

    ERIC Educational Resources Information Center

    Grinstead, Mary L.; Mauldin, Teresa; Sabia, Joseph J.; Koonce, Joan; Palmer, Lance

    2011-01-01

    Using microdata from the American Dream Demonstration, the current study examines factors associated with savings and savings goal achievement (indicated by a matched withdrawal) among participants of individual development account (IDA) programs. Multinomial logit results show that hours of participation in financial education programs, higher…

  13. Solving Disparities Through Payment And Delivery System Reform: A Program To Achieve Health Equity.

    PubMed

    DeMeester, Rachel H; Xu, Lucy J; Nocon, Robert S; Cook, Scott C; Ducas, Andrea M; Chin, Marshall H

    2017-06-01

    Payment systems generally do not directly encourage or support the reduction of health disparities. In 2013 the Finding Answers: Solving Disparities through Payment and Delivery System Reform program of the Robert Wood Johnson Foundation sought to understand how alternative payment models might intentionally incorporate a disparities-reduction component to promote health equity. A qualitative analysis of forty proposals to the program revealed that applicants generally did not link payment reform tightly to disparities reduction. Most proposed general pay-for-performance, global payment, or shared savings plans, combined with multicomponent system interventions. None of the applicants proposed making any financial payments contingent on having successfully reduced disparities. Most applicants did not address how they would optimize providers' intrinsic and extrinsic motivation to reduce disparities. A better understanding of how payment and care delivery models might be designed and implemented to reduce health disparities is essential. Project HOPE—The People-to-People Health Foundation, Inc.

  14. EPA ENERGY STAR: Tackling Growth in Home Electronics and Small Appliances

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

    Sanchez, Marla Christine; Brown, Richard; Homan, Gregory

    2008-11-17

    Over a decade ago, the electricity consumption associated with home electronics and other small appliances emerged onto the global energy policy landscape as one of the fastest growing residential end uses with the opportunity to deliver significant energy savings. As our knowledge of this end use matures, it is essential to step back and evaluate the degree to which energy efficiency programs have successfully realized energy savings and where savings opportunities have been missed.For the past fifteen years, we have quantified energy, utility bill, and carbon savings for US EPA?s ENERGY STAR voluntary product labeling program. In this paper, wemore » present a unique look into the US residential program savings claimed to date for EPA?s ENERGY STAR office equipment, consumer electronics, and other small household appliances as well as EPA?s projected program savings over the next five years. We present a top-level discussion identifying program areas where EPA?s ENERGY STAR efforts have succeeded and program areas where ENERGY STAR efforts did not successfully address underlying market factors, technology issues and/or consumer behavior. We end by presenting the magnitude of ?overlooked? savings.« less

  15. The Impact of Social and Financial Education on Savings Attitudes and Behavior Among Primary School Children in Uganda.

    PubMed

    Supanantaroek, Suthinee; Lensink, Robert; Hansen, Nina

    2016-09-07

    Saving plays a crucial role in the process of economic growth. However, one main reason why poor people often do not save is that they lack financial knowledge. Improving the savings culture of children through financial education is a promising way to develop savings attitudes and behavior early in life. This study is one of the first that examines the effects of social and financial education training and a children's club developed by Aflatoun on savings attitudes and behavior among primary school children in Uganda, besides Berry, Karlan, and Pradhan. A randomized phase in approach was used by randomizing the order in which schools implemented the program (school-level randomization). The treatment group consisted of students in schools where the program was implemented, while in the control group the program was not yet implemented. The program lasted 3 months including 16 hours. We compared posttreatment variables for the treatment and control group. Study participants included 1,746 students, of which 936 students were from 22 schools that were randomly assigned to receive the program between May and July 2011; the remaining 810 students attended 22 schools that did not implement the program during the study period. Indicators for children's savings attitudes and behavior were key outcomes. The intervention increased awareness of money, money recording, and savings attitudes. It also provides some evidence-although less robust-that the intervention increased actual savings. A short financial literacy and social training can improve savings attitudes and behavior of children considerably. © The Author(s) 2016.

  16. Value drivers: an approach for estimating health and disease management program savings.

    PubMed

    Phillips, V L; Becker, Edmund R; Howard, David H

    2013-12-01

    Health and disease management (HDM) programs have faced challenges in documenting savings related to their implementation. The objective of this eliminate study was to describe OptumHealth's (Optum) methods for estimating anticipated savings from HDM programs using Value Drivers. Optum's general methodology was reviewed, along with details of 5 high-use Value Drivers. The results showed that the Value Driver approach offers an innovative method for estimating savings associated with HDM programs. The authors demonstrated how real-time savings can be estimated for 5 Value Drivers commonly used in HDM programs: (1) use of beta-blockers in treatment of heart disease, (2) discharge planning for high-risk patients, (3) decision support related to chronic low back pain, (4) obesity management, and (5) securing transportation for primary care. The validity of savings estimates is dependent on the type of evidence used to gauge the intervention effect, generating changes in utilization and, ultimately, costs. The savings estimates derived from the Value Driver method are generally reasonable to conservative and provide a valuable framework for estimating financial impacts from evidence-based interventions.

  17. Delivery System Integration and Health Care Spending and Quality for Medicare Beneficiaries

    PubMed Central

    McWilliams, J. Michael; Chernew, Michael E.; Zaslavsky, Alan M.; Hamed, Pasha; Landon, Bruce E.

    2013-01-01

    Background The Medicare accountable care organization (ACO) programs rely on delivery system integration and provider risk sharing to lower spending while improving quality of care. Methods Using 2009 Medicare claims and linked American Medical Association Group Practice data, we assigned 4.29 million beneficiaries to provider groups based on primary care use. We categorized group size according to eligibility thresholds for the Shared Savings (≥5,000 assigned beneficiaries) and Pioneer (≥15,000) ACO programs and distinguished hospital-based from independent groups. We compared spending and quality of care between larger and smaller provider groups and examined how size-related differences varied by 2 factors considered central to ACO performance: group primary care orientation (measured by the primary care share of large groups’ specialty mix) and provider risk sharing (measured by county health maintenance organization penetration and its relationship to financial risk accepted by different group types for managed care patients). Spending and quality of care measures included total medical spending, spending by type of service, 5 process measures of quality, and 30-day readmissions, all adjusted for sociodemographic and clinical characteristics. Results Compared with smaller groups, larger hospital-based groups had higher total per-beneficiary spending in 2009 (mean difference: +$849), higher 30-day readmission rates (+1.3% percentage points), and similar performance on 4 of 5 process measures of quality. In contrast, larger independent physician groups performed better than smaller groups on all process measures and exhibited significantly lower per-beneficiary spending in counties where risk sharing by these groups was more common (−$426). Among all groups sufficiently large to participate in ACO programs, a strong primary care orientation was associated with lower spending, fewer readmissions, and better quality of diabetes care. Conclusions Spending was lower and quality of care better for Medicare beneficiaries served by larger independent physician groups with strong primary care orientations in environments where providers accepted greater risk. PMID:23780467

  18. Keys to the House: Unlocking Residential Savings With Program Models for Home Energy Upgrades

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

    Grevatt, Jim; Hoffman, Ian; Hoffmeyer, Dale

    After more than 40 years of effort, energy efficiency program administrators and associated contractors still find it challenging to penetrate the home retrofit market, especially at levels commensurate with state and federal goals for energy savings and emissions reductions. Residential retrofit programs further have not coalesced around a reliably successful model. They still vary in design, implementation and performance, and they remain among the more difficult and costly options for acquiring savings in the residential sector. If programs are to contribute fully to meeting resource and policy objectives, administrators need to understand what program elements are key to acquiring residentialmore » savings as cost effectively as possible. To that end, the U.S. Department of Energy (DOE) sponsored a comprehensive review and analysis of home energy upgrade programs with proven track records, focusing on those with robustly verified savings and constituting good examples for replication. The study team reviewed evaluations for the period 2010 to 2014 for 134 programs that are funded by customers of investor-owned utilities. All are programs that promote multi-measure retrofits or major system upgrades. We paid particular attention to useful design and implementation features, costs, and savings for nearly 30 programs with rigorous evaluations of performance. This meta-analysis describes program models and implementation strategies for (1) direct install retrofits; (2) heating, ventilating and air-conditioning (HVAC) replacement and early retirement; and (3) comprehensive, whole-home retrofits. We analyze costs and impacts of these program models, in terms of both energy savings and emissions avoided. These program models can be useful guides as states consider expanding their strategies for acquiring energy savings as a resource and for emissions reductions. We also discuss the challenges of using evaluations to create program models that can be confidently applied in multiple jurisdictions.« less

  19. Additional reductions in Medicare spending growth will likely require shifting costs to beneficiaries.

    PubMed

    Chernew, Michael E

    2013-05-01

    Policy makers have considerable interest in reducing Medicare spending growth. Clarity in the debate on reducing Medicare spending growth requires recognition of three important distinctions: the difference between public and total spending on health, the difference between the level of health spending and rate of health spending growth, and the difference between growth per beneficiary and growth in the number of beneficiaries in Medicare. The primary policy issue facing the US health care system is the rate of spending growth in public programs, and solving that problem will probably require reforms to the entire health care sector. The Affordable Care Act created a projected trajectory for Medicare spending per beneficiary that is lower than historical growth rates. Although opportunities for one-time savings exist, any long-term savings from Medicare, beyond those already forecast, will probably require a shift in spending from taxpayers to beneficiaries via higher beneficiary premium contributions (overall or via means testing), changes in eligibility, or greater cost sharing at the point of service.

  20. Experience with an integrated control and monitoring system at the El Segundo generating station

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

    Papilla, R.P.; McKinley, J.H.; Blanco, M.A.

    1992-01-01

    This paper describes the EPRI/Southern California Edison (SCE) El Segundo Integrated Control and Monitoring System (ICMS) project and relates key project experiences. The ICMS project is a cost-shared effort between EPRI and SCE designed to address the issues involved with integrating power plant diagnostic and condition monitoring with control. A digital distributed control system retrofit for SCE's El Segundo Units 3 and 4 provided the case study. although many utilities have retrofitted power plant units with distributed control systems (DCS's) and have applied diagnostics and monitoring programs to improve operations and performance, the approach taken in this project, that is,more » integrating the monitoring function with the control function, is profoundly new and unique. Over the life of the El Segundo ICMS, SCE expects to realize savings form life optimization, increased operating flexibility, improved heat rate, reduced NO{sub x} emissions, and lower maintenance costs. These savings are expected to be significant over the life of the system.« less

  1. PIVOT: platform for interactive analysis and visualization of transcriptomics data.

    PubMed

    Zhu, Qin; Fisher, Stephen A; Dueck, Hannah; Middleton, Sarah; Khaladkar, Mugdha; Kim, Junhyong

    2018-01-05

    Many R packages have been developed for transcriptome analysis but their use often requires familiarity with R and integrating results of different packages requires scripts to wrangle the datatypes. Furthermore, exploratory data analyses often generate multiple derived datasets such as data subsets or data transformations, which can be difficult to track. Here we present PIVOT, an R-based platform that wraps open source transcriptome analysis packages with a uniform user interface and graphical data management that allows non-programmers to interactively explore transcriptomics data. PIVOT supports more than 40 popular open source packages for transcriptome analysis and provides an extensive set of tools for statistical data manipulations. A graph-based visual interface is used to represent the links between derived datasets, allowing easy tracking of data versions. PIVOT further supports automatic report generation, publication-quality plots, and program/data state saving, such that all analysis can be saved, shared and reproduced. PIVOT will allow researchers with broad background to easily access sophisticated transcriptome analysis tools and interactively explore transcriptome datasets.

  2. Sino-US cooperation in water saving technologies: essential international problems

    USDA-ARS?s Scientific Manuscript database

    The United States and China share many agricultural problems, but one of great importance is the need to produce more crop yield in the face of water scarcity. Common recognition of this problem led to the development of a joint Sino-US Water Saving Technologies Flagship project within the larger US...

  3. 26 CFR 1.593-1 - Additions to reserve for bad debts.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... TAX (CONTINUED) INCOME TAXES (CONTINUED) Mutual Savings Banks, Etc. § 1.593-1 Additions to reserve for bad debts. (a) In general. A mutual savings bank not having capital stock represented by shares, a... for mutual purposes and without profit may, as an alternative to a deduction from gross income under...

  4. 26 CFR 1.593-1 - Additions to reserve for bad debts.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... TAX (CONTINUED) INCOME TAXES (CONTINUED) Mutual Savings Banks, Etc. § 1.593-1 Additions to reserve for bad debts. (a) In general. A mutual savings bank not having capital stock represented by shares, a... for mutual purposes and without profit may, as an alternative to a deduction from gross income under...

  5. Chapter 10: Peak Demand and Time-Differentiated Energy Savings Cross-Cutting Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

    Kurnik, Charles W; Stern, Frank; Spencer, Justin

    Savings from electric energy efficiency measures and programs are often expressed in terms of annual energy and presented as kilowatt-hours per year (kWh/year). However, for a full assessment of the value of these savings, it is usually necessary to consider the measure or program's impact on peak demand as well as time-differentiated energy savings. This cross-cutting protocol describes methods for estimating the peak demand and time-differentiated energy impacts of measures implemented through energy efficiency programs.

  6. Telephone-based disease management: why it does not save money.

    PubMed

    Motheral, Brenda R

    2011-01-01

    To understand why the current telephone-based model of disease management (DM) does not provide cost savings and how DM can be retooled based on the best available evidence to deliver better value. Literature review. The published peer-reviewed evaluations of DM and transitional care models from 1990 to 2010 were reviewed. Also examined was the cost-effectiveness literature on the treatment of chronic conditions that are commonly included in DM programs, including heart failure, diabetes mellitus, coronary artery disease, and asthma. First, transitional care models, which have historically been confused with commercial DM programs, can provide credible savings over a short period, rendering them low-hanging fruit for plan sponsors who desire real savings. Second, cost-effectiveness research has shown that the individual activities that constitute contemporary DM programs are not cost saving except for heart failure. Targeting of specific patients and activity combinations based on risk, actionability, treatment and program effectiveness, and costs will be necessary to deliver a cost-saving DM program, combined with an outreach model that brings vendors closer to the patient and physician. Barriers to this evidence-driven approach include resources required, marketability, and business model disruption. After a decade of market experimentation with limited success, new thinking is called for in the design of DM programs. A program design that is based on a cost-effectiveness approach, combined with greater program efficacy, will allow for the development of DM programs that are cost saving.

  7. Poor Families Striving to Save in Matched Children's Savings Accounts: Findings from a Randomized Experimental Design in Uganda.

    PubMed

    Karimli, Leyla; Ssewamala, Fred M; Neilands, Torsten B

    2014-12-01

    This study examines participants' savings in children's savings accounts (CSAs) set up for AIDS-orphaned children ages 10-15 in Uganda. Using a cluster randomized experimental design, we examine the extent to which families participating in a CSA program report more savings than their counterparts not participating in the program, explore the extent to which families who participate in the CSA program report using formal financial institutions compared with families who do not have a CSA, and consider whether families participating in the CSA program bring new money into the CSA or whether they reshuffle existing household assets. We find that participating in a CSA increased families' likelihood to report having saved money. However, our results show no intervention effect either on the amount of self-reported savings or on the likelihood of using formal financial institutions. Further research is needed to understand whether use of a CSA helps families generate new wealth.

  8. Poor Families Striving to Save in Matched Children’s Savings Accounts: Findings from a Randomized Experimental Design in Uganda

    PubMed Central

    Karimli, Leyla; Ssewamala, Fred M.; Neilands, Torsten B.

    2014-01-01

    This study examines participants’ savings in children’s savings accounts (CSAs) set up for AIDS-orphaned children ages 10–15 in Uganda. Using a cluster randomized experimental design, we examine the extent to which families participating in a CSA program report more savings than their counterparts not participating in the program, explore the extent to which families who participate in the CSA program report using formal financial institutions compared with families who do not have a CSA, and consider whether families participating in the CSA program bring new money into the CSA or whether they reshuffle existing household assets. We find that participating in a CSA increased families’ likelihood to report having saved money. However, our results show no intervention effect either on the amount of self-reported savings or on the likelihood of using formal financial institutions. Further research is needed to understand whether use of a CSA helps families generate new wealth. PMID:25525282

  9. Healthcare cost savings estimator tool for chronic disease self-management program: a new tool for program administrators and decision makers.

    PubMed

    Ahn, SangNam; Smith, Matthew Lee; Altpeter, Mary; Post, Lindsey; Ory, Marcia G

    2015-01-01

    Chronic disease self-management education (CDSME) programs have been delivered to more than 100,000 older Americans with chronic conditions. As one of the Stanford suite of evidence-based CDSME programs, the chronic disease self-management program (CDSMP) has been disseminated in diverse populations and settings. The objective of this paper is to introduce a practical, universally applicable tool to assist program administrators and decision makers plan implementation efforts and make the case for continued program delivery. This tool was developed utilizing data from a recent National Study of CDSMP to estimate national savings associated with program participation. Potential annual healthcare savings per CDSMP participant were calculated based on averted emergency room visits and hospitalizations. While national data can be utilized to estimate cost savings, the tool has built-in features allowing users to tailor calculations based on their site-specific data. Building upon the National Study of CDSMP's documented potential savings of $3.3 billion in healthcare costs by reaching 5% of adults with one or more chronic conditions, two heuristic case examples were also explored based on different population projections. The case examples show how a small county and large metropolitan city were not only able to estimate healthcare savings ($38,803 for the small county; $732,290 for the large metropolitan city) for their existing participant populations but also to project significant healthcare savings if they plan to reach higher proportions of middle-aged and older adults. Having a tool to demonstrate the monetary value of CDSMP can contribute to the ongoing dissemination and sustainability of such community-based interventions. Next steps will be creating a user-friendly, internet-based version of Healthcare Cost Savings Estimator Tool: CDSMP, followed by broadening the tool to consider cost savings for other evidence-based programs.

  10. STS 135 Landing

    NASA Image and Video Library

    2017-12-08

    Goddard's Ritsko Wins 2011 SAVE Award The winner of the 2011 SAVE Award is Matthew Ritsko, a Goddard financial manager. His tool lending library would track and enable sharing of expensive space-flight tools and hardware after projects no longer need them. This set of images represents the types of tools used at NASA. To read more go to: www.nasa.gov/topics/people/features/ritsko-save.html Exploration Systems Project Manager Mike Weiss speaks about a Hubble Servicing Mission hand tool, developed at Goddard. Credit: NASA/GSFC/Debbie McCallum

  11. Developing and integrating a practice model for health finance reform into wound healing programs: an examination of the triple aim approach.

    PubMed

    Flattau, Anna; Thompson, Maureen; Meara, Anne

    2013-10-01

    Throughout the United States, government and private payers are exploring new payment models such as accountable care organizations and shared savings agreements. These models are widely based on the construct of the Triple Aim, a set of three principles for health services reform: improving population-based outcomes, improving patient care experiences, and reducing costs through better delivery systems. Wound programs may adapt to the new health financing environment by incorporating initiatives known to promote the Triple Aim, such as diabetes amputation reduction and pressure ulcer prevention programs, and by rethinking how health services can best be delivered to meet these new criteria. The existing literature supports that programmatic approaches can improve care, quality, and cost, especially in the field of diabetic foot ulcers. Wound healing programs have opportunities to develop new business plan models that provide quality, cost-efficient care to their patient population and to be leaders in the development of new types of partnerships with payers and health delivery organizations.

  12. Planning and Implementing a Hospital Recycling Program at Naval Hospital, Camp Pendleton, California

    DTIC Science & Technology

    1992-08-01

    communities have refused to license incinerators, saying "not in my back yard!" Recycling is quick, it’s economical, it can save natural resources, and...total costs - total credits) 4. Net Savings <Costs>: Present disposal Net recycling Net savings costs program costs <costs> * Assign only a...RECYCLING PROGRAM COSTS $ 9,739 (total costs - total credits) 4. Net Savings <Costs>: $ 9.287 _ $ 9.739 - S > Present disposal Net recycling Net

  13. Chapter 17: Residential Behavior Evaluation Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

    Kurnik, Charles W.; Stewart, James; Todd, Annika

    Residential behavior-based (BB) programs use strategies grounded in the behavioral and social sciences to influence household energy use. These may include providing households with real-time or delayed feedback about their energy use; supplying energy efficiency education and tips; rewarding households for reducing their energy use; comparing households to their peers; and establishing games, tournaments, and competitions. BB programs often target multiple energy end uses and encourage energy savings, demand savings, or both. Savings from BB programs are usually a small percentage of energy use, typically less than 5 percent. Utilities will continue to implement residential BB programs as large-scale, randomizedmore » control trials (RCTs); however, some are now experimenting with alternative program designs that are smaller scale; involve new communication channels such as the web, social media, and text messaging; or that employ novel strategies for encouraging behavior change (for example, Facebook competitions). These programs will create new evaluation challenges and may require different evaluation methods than those currently employed to verify any savings they generate. Quasi-experimental methods, however, require stronger assumptions to yield valid savings estimates and may not measure savings with the same degree of validity and accuracy as randomized experiments.« less

  14. Understanding Effects of Flexible Spending Accounts on People with Disabilities: The Case of a Consumer-Directed Care Program.

    PubMed

    Lombe, Margaret; Inoue, Megumi; Mahoney, Kevin; Chu, Yoosun; Putnam, Michelle

    2016-01-01

    This study set out to explore the saving behavior, barriers, and facilitators along with effects of participating in a consumer-directed care program among people with disabilities in the state of West Virginia (N = 29). Results suggest that respondents were able to save money through the program to enable them to purchase goods and services they needed to enhance their welfare and quality of life. Generally, items saved for fell into 3 broad categories: household equipment, individual functioning, and home modification. Facilitators and barriers to saving were also indicated and so were the benefits of program participation. Program and policy implications are presented.

  15. Costs and savings associated with community water fluoridation programs in Colorado.

    PubMed

    O'Connell, Joan M; Brunson, Diane; Anselmo, Theresa; Sullivan, Patrick W

    2005-11-01

    Local, state, and national health policy makers require information on the economic burden of oral disease and the cost-effectiveness of oral health programs to set policies and allocate resources. In this study, we estimate the cost savings associated with community water fluoridation programs (CWFPs) in Colorado and potential cost savings if Colorado communities without fluoridation programs or naturally high fluoride levels were to implement CWFPs. We developed an economic model to compare the costs associated with CWFPs with treatment savings achieved through averted tooth decay. Treatment savings included those associated with direct medical costs and indirect nonmedical costs (i.e., patient time spent on dental visit). We estimated program costs and treatment savings for each water system in Colorado in 2003 dollars. We obtained parameter estimates from published studies, national surveys, and other sources. We calculated net costs for Colorado water systems with existing CWFPs and potential net costs for systems without CWFPs. The analysis includes data for 172 public water systems in Colorado that serve populations of 1000 individuals or more. We used second-order Monte Carlo simulations to evaluate the inherent uncertainty of the model assumptions on the results and report the 95% credible range from the simulation model. We estimated that Colorado CWFPs were associated with annual savings of 148.9 million dollars (credible range, 115.1 million dollars to 187.2 million dollars) in 2003, or an average of 60.78 dollars per person (credible range, 46.97 dollars dollars to 76.41 dollars). We estimated that Colorado would save an additional 46.6 million dollars (credible range, 36.0 dollars to 58.6 dollars million) annually if CWFPs were implemented in the 52 water systems without such programs and for which fluoridation is recommended. Colorado realizes significant annual savings from CWFPs; additional savings and reductions in morbidity could be achieved if fluoridation programs were implemented in other areas.

  16. Alternative Fuels Data Center: New Jersey Utility Saves With Alternative

    Science.gov Websites

    electric car. College Students Engineer Efficient Vehicles in EcoCAR 2 Competition Aug. 2, 2014 Photo of a FuelA> Jersey Utility Saves With Alternative Fuel to someone by E-mail Share Alternative Fuels . For information about this project, contact New Jersey Clean Cities Coalition. Download QuickTime

  17. Optimising boiler performance.

    PubMed

    Mayoh, Paul

    2009-01-01

    Soaring fuel costs continue to put the squeeze on already tight health service budgets. Yet it is estimated that combining established good practice with improved technologies could save between 10% and 30% of fuel costs for boilers. Paul Mayoh, UK technical manager at Spirax Sarco, examines some of the practical measures that healthcare organisations can take to gain their share of these potential savings.

  18. Insights from Smart Meters: Identifying Specific Actions, Behaviors, and Characteristics That Drive Savings in Behavior-Based Programs

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

    Todd, A.; Perry, M.; Smith, B.

    2014-12-01

    In this report, we use smart meter data to analyze specific actions, behaviors, and characteristics that drive energy savings in a BB program. Specifically, we examine a Home Energy Report (HER) program. These programs typically obtain 1% to 3% annual savings, and recent studies have shown hourly savings of between 0.5% and 3%.1 But what is driving these savings? What types of households tend to be “high-savers,” and what behaviors are they adopting? There are several possibilities: one-time behaviors (e.g., changing thermostat settings), reoccurring habitual behaviors (e.g., turning off lights), and equipment purchase behaviors (e.g., energy efficient appliances); these maymore » vary across households, regions, and over time.« less

  19. Insights from Smart Meters. Identifying Specific Actions, Behaviors and Characteristics that drive savings in Behavior-Based Programs

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

    Todd, Annika; Perry, Michael; Smith, Brian

    2014-12-01

    In this report, we use smart meter data to analyze specific actions, behaviors, and characteristics that drive energy savings in a behavior-based (BB) program. Specifically, we examine a Home Energy Report (HER) program. These programs typically obtain 1% to 3% annual savings, and recent studies have shown hourly savings of between 0.5% and 3%. But what is driving these savings? What types of households tend to be “high-savers”, and what behaviors are they adopting? There are several possibilities: one-time behaviors (e.g., changing thermostat settings); reoccurring habitual behaviors (e.g., turning off lights); and equipment purchase behaviors (e.g., energy efficient appliances), andmore » these may vary across households, regions, and over time.« less

  20. Accountable Care Organizations: roles and opportunities for hospitals.

    PubMed

    Schoenbaum, Stephen C

    2011-08-01

    Federal health reform has established Medicare Accountable Care Organizations (ACOs) as a new program, and some states and private payers have been independently developing ACO pilot projects. The objective is to hold provider groups accountable for the quality and cost of care to a population. The financial models for providers generally build off of shared savings between the payers and providers or some type of global payment that includes the possibility of partial or full capitation. For ACOs to achieve the same outcomes with lower costs or, better yet, improved outcomes with the same or lower costs, the delivery system will need to become more oriented toward primary care and care coordination than is currently the case. Providers of clinical services, in order to be more effective, efficient, and coordinated, will need to be supported by a variety of shared services, such as off-hours care, easy access to specialties, and information exchanges. These services can be organized by an ACO as a medical neighborhood or community. Hospitals, because they have a management structure, history of developing programs and services, and accessibility 24/7/365, are logical leaders of this enhancement of health care delivery for populations and other providers.

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

    Poore, WP

    The vision of the Distributed Energy Research Program (DER) program of the U.S. Department of Energy (DOE) is that the United States will have the cleanest and most efficient and reliable energy system in the world by maximizing the use of affordable distributed energy resources. Electricity consumers will be able to choose from a diverse number of efficient, cost-effective, and environmentally friendly distributed energy options and easily connect them into the nation's energy infrastructure while providing benefits to their owners and other stakeholders. The long-term goal of this vision is that DER will achieve a 20% share of new electricmore » capacity additions in the United States by 2010, thereby helping to make the nation's electric power generation and delivery system more efficient, reliable, secure, clean, economical, and diverse in terms of fuel use (oil, natural gas, solar, hydroelectric, etc.) and prime mover resource (solar, wind, gas turbines, etc.). Near- and mid-term goals are to develop new technologies for implementing and operating DER and address barriers associated with DER usage and then to reduce costs and emissions and improve the efficiency and reliability of DER. Numerous strategies for meeting these goals have been developed into a research, development, and demonstration (RD&D) program that supports generation and delivery systems architecture, including modeling and simulation tools. The benefits associated with DER installations are often significant and numerous. They almost always provide tangible economic benefits, such as energy savings or transmission and distribution upgrade deferrals, as well as intangible benefits, such as power quality improvements that lengthen maintenance or repair intervals for power equipment. Also, the benefits routinely are dispersed among end users, utilities, and the public. For instance, an end user may use the DER to reduce their peak demand and save money due to lower demand charges. Reduced end user peak demand, in turn, may lower a distribution system peak load such that upgrades are deferred or avoided. This could benefit other consumers by providing them with higher reliability and power quality as well as avoiding their cost share of a distribution system upgrade. In this example, the costs of the DER may be born by the end user, but that user reaps only a share of the benefits. This report, the first product of a study to quantify the value of DER, documents initial project efforts to develop an assessment methodology. The focus of currently available site-specific DER assessment techniques are typically limited to two parties, the owner/user and the local utility. Rarely are the impacts on other stakeholders, including interconnected distribution utilities, transmission system operators, generating system operators, other local utility customers, local and regional industry and business, various levels of government, and the environment considered. The goal of this assessment is to quantify benefits and cost savings that accrue broadly across a region, recognizing that DER installations may have local, regional, or national benefits.« less

  2. Vroom, Vroom

    ERIC Educational Resources Information Center

    Wasley, Paula

    2006-01-01

    The concept of car sharing is gaining ground on college campuses in the US, where parking and congestion are among the most problematic issues for administrators. There is a growing group of institutions that are turning to car-sharing companies like Zipcar and Flexcar in an effort to save money, free up parking spaces, and improve community…

  3. Energy Saving Melting and Revert Reduction Technology: Improved Die Casting Process to Preserve the Life of the Inserts

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

    David Schwam, PI; Xuejun Zhu, Sr. Research Associate

    2012-09-30

    The goal of this project was to study the combined effects of die design, proper internal cooling and efficient die lubricants on die life. The project targeted improvements in die casting insert life by: Optomized Die Design for Reduced Surface Temperature: The life of die casting dies is significantly shorter when the die is exposed to elevated temperature for significant periods of time. Any die operated under conditions leading to surface temperature in excess of 1050oF undergoes structural changes that reduce its strength. Optimized die design can improve die life significantly. This improvement can be accomplished by means of coolingmore » lines, baffles and bubblers in the die. A key objective of the project was to establish criteria for the minimal distance of the cooling lines from the surface. This effort was supported with alloys and machining by BohlerUddeholm, Dunn Steel, HH Stark and Rex Buckeye. In plant testing and evaluation was conducted as in-kind cost share at St. Clair Die Casting. The Uddeholm Dievar steel evaluated in this program showed superior resistance to thermal fatigue resistance. Based on the experimental evidence, cooling lines could be placed as close as 0.5" from the surface. Die Life Extension by Optimized Die Lubrication: The life of die casting dies is affected by additions made to its surface with the proper lubricants. These lubricants will protect the surface from the considerable temperature peaks that occur when the molten melt enters the die. Dies will reach a significantly higher temperature without this lubricant being applied. The amount and type of the lubricant are critical variables in the die casting process. However, these lubricants must not corrode the die surface. This effort was supported with alloys and machining by BohlerUddeholm, Dunn Steel, HH Stark and Rex Buckeye. In plant testing and evaluation was conducted as in-kind cost share at St. Clair Die Casting. Chem- Trend participated in the program with die lubricants and technical support. Experiments conducted with these lubricants demonstrated good protection of the substrate steel. Graphite and boron nitride used as benchmarks are capable of completely eliminating soldering and washout. However, because of cost and environmental considerations these materials are not widely used in industry. The best water-based die lubricants evaluated in this program were capable of providing similar protection from soldering and washout. In addition to improved part quality and higher production rates, improving die casting processes to preserve the life of the inserts will result in energy savings and a reduction in environmental wastes. Improving die life by means of optimized cooling line placement, baffles and bubblers in the die will allow for reduced die temperatures during processing, saving energy associated with production. The utilization of optimized die lubricants will also reduce heat requirements in addition to reducing waste associated with soldering and washout. This new technology was predicted to result in an average energy savings of 1.1 trillion BTU's/year over a 10 year period. Current (2012) annual energy saving estimates, based on commercial introduction in 2010, a market penetration of 70% by 2020 is 1.26 trillion BTU's/year. Along with these energy savings, reduction of scrap and improvement in casting yield will result in a reduction of the environmental emissions associated with the melting and pouring of the metal which will be saved as a result of this technology. The average annual estimate of CO2 reduction per year through 2020 is 0.025 Million Metric Tons of Carbon Equivalent (MM TCE).« less

  4. A generic model for evaluating payor net cost savings from a disease management program.

    PubMed

    McKay, Niccie L

    2006-01-01

    Private and public payors increasingly are turning to disease management programs as a means of improving the quality of care provided and controlling expenditures for individuals with specific medical conditions. This article presents a generic model that can be adapted to evaluate payor net cost savings from a variety of types of disease management programs, with net cost savings taking into account both changes in expenditures resulting from the program and the costs of setting up and operating the program. The model specifies the required data, describes the data collection process, and shows how to calculate the net cost savings in a spreadsheet format. An accompanying hypothetical example illustrates how to use the model.

  5. The Program Administrator Cost of Saved Energy for Utility Customer-Funded Energy Efficiency Programs

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

    Billingsley, Megan A.; Hoffman, Ian M.; Stuart, Elizabeth

    End-use energy efficiency is increasingly being relied upon as a resource for meeting electricity and natural gas utility system needs within the United States. There is a direct connection between the maturation of energy efficiency as a resource and the need for consistent, high-quality data and reporting of efficiency program costs and impacts. To support this effort, LBNL initiated the Cost of Saved Energy Project (CSE Project) and created a Demand-Side Management (DSM) Program Impacts Database to provide a resource for policy makers, regulators, and the efficiency industry as a whole. This study is the first technical report of themore » LBNL CSE Project and provides an overview of the project scope, approach, and initial findings, including: • Providing a proof of concept that the program-level cost and savings data can be collected, organized, and analyzed in a systematic fashion; • Presenting initial program, sector, and portfolio level results for the program administrator CSE for a recent time period (2009-2011); and • Encouraging state and regional entities to establish common reporting definitions and formats that would make the collection and comparison of CSE data more reliable. The LBNL DSM Program Impacts Database includes the program results reported to state regulators by more than 100 program administrators in 31 states, primarily for the years 2009–2011. In total, we have compiled cost and energy savings data on more than 1,700 programs over one or more program-years for a total of more than 4,000 program-years’ worth of data, providing a rich dataset for analyses. We use the information to report costs-per-unit of electricity and natural gas savings for utility customer-funded, end-use energy efficiency programs. The program administrator CSE values are presented at national, state, and regional levels by market sector (e.g., commercial, industrial, residential) and by program type (e.g., residential whole home programs, commercial new construction, commercial/industrial custom rebate programs). In this report, the focus is on gross energy savings and the costs borne by the program administrator—including administration, payments to implementation contractors, marketing, incentives to program participants (end users) and both midstream and upstream trade allies, and evaluation costs. We collected data on net savings and costs incurred by program participants. However, there were insufficient data on participant cost contributions, and uncertainty and variability in the ways in which net savings were reported and defined across states (and program administrators).« less

  6. ICU early physical rehabilitation programs: financial modeling of cost savings.

    PubMed

    Lord, Robert K; Mayhew, Christopher R; Korupolu, Radha; Mantheiy, Earl C; Friedman, Michael A; Palmer, Jeffrey B; Needham, Dale M

    2013-03-01

    To evaluate the potential annual net cost savings of implementing an ICU early rehabilitation program. Using data from existing publications and actual experience with an early rehabilitation program in the Johns Hopkins Hospital Medical ICU, we developed a model of net financial savings/costs and presented results for ICUs with 200, 600, 900, and 2,000 annual admissions, accounting for both conservative- and best-case scenarios. Our example scenario provided a projected financial analysis of the Johns Hopkins Medical ICU early rehabilitation program, with 900 admissions per year, using actual reductions in length of stay achieved by this program. U.S.-based adult ICUs. Financial modeling of the introduction of an ICU early rehabilitation program. Net cost savings generated in our example scenario, with 900 annual admissions and actual length of stay reductions of 22% and 19% for the ICU and floor, respectively, were $817,836. Sensitivity analyses, which used conservative- and best-case scenarios for length of stay reductions and varied the per-day ICU and floor costs, across ICUs with 200-2,000 annual admissions, yielded financial projections ranging from -$87,611 (net cost) to $3,763,149 (net savings). Of the 24 scenarios included in these sensitivity analyses, 20 (83%) demonstrated net savings, with a relatively small net cost occurring in the remaining four scenarios, mostly when simultaneously combining the most conservative assumptions. A financial model, based on actual experience and published data, projects that investment in an ICU early rehabilitation program can generate net financial savings for U.S. hospitals. Even under the most conservative assumptions, the projected net cost of implementing such a program is modest relative to the substantial improvements in patient outcomes demonstrated by ICU early rehabilitation programs.

  7. Financial Planning for Postsecondary Education in Canada: A Comparison of Savings and Savings Instruments Employed across Aspiration Groups

    ERIC Educational Resources Information Center

    Anisef, Paul; Sweet, Robert; Ng, Peggy

    2004-01-01

    Canadians have experienced a reduction in government funding toward postsecondary education over the past ten years, as well as a shift in student-support policies. Historically, paying the costs of postsecondary education in Canada has been a responsibility shared by the state, and students and parents. Changes in government policy have forced…

  8. Community Partnering as a Tool for Improving Live Release Rate in Animal Shelters in the United States

    PubMed Central

    Weiss, Emily; Patronek, Gary; Slater, Margaret; Garrison, Laurie; Medicus, Karen

    2013-01-01

    Collaboration among all shelters and nonhuman animal welfare groups within a community along with the transparent, shared reporting of uniform data have been promoted as effective ways to increase the number of animals' lives saved. This article summarizes the shelter intakes, outcomes, and live release rate (LRR) from 6 geographically diverse communities participating in the American Society for the Prevention of Cruelty to Animals Partnership program for 5 years (2007–2011). This program is both a grant program and a coaching program that works to focus the community partners on a data-driven goal using standardized definitions and metrics. There was improvement in LRR in all communities over time regardless of intake numbers, human population, or mix of dogs/puppies and cats/kittens entering shelters. Averaged across all communities over the 5-year period, there was an overall improvement in LRR of 62%. Within individual communities, the degree of improvement ranged from 18% to 96%. This improvement in LRR was accomplished through a wide variety of programs in each community based on resources and interests during the time period. PMID:23795686

  9. Maximizing Energy Savings Reliability in BC Hydro Industrial Demand-side Management Programs: An Assessment of Performance Incentive Models

    NASA Astrophysics Data System (ADS)

    Gosman, Nathaniel

    For energy utilities faced with expanded jurisdictional energy efficiency requirements and pursuing demand-side management (DSM) incentive programs in the large industrial sector, performance incentive programs can be an effective means to maximize the reliability of planned energy savings. Performance incentive programs balance the objectives of high participation rates with persistent energy savings by: (1) providing financial incentives and resources to minimize constraints to investment in energy efficiency, and (2) requiring that incentive payments be dependent on measured energy savings over time. As BC Hydro increases its DSM initiatives to meet the Clean Energy Act objective to reduce at least 66 per cent of new electricity demand with DSM by 2020, the utility is faced with a higher level of DSM risk, or uncertainties that impact the costeffective acquisition of planned energy savings. For industrial DSM incentive programs, DSM risk can be broken down into project development and project performance risks. Development risk represents the project ramp-up phase and is the risk that planned energy savings do not materialize due to low customer response to program incentives. Performance risk represents the operational phase and is the risk that planned energy savings do not persist over the effective measure life. DSM project development and performance risks are, in turn, a result of industrial economic, technological and organizational conditions, or DSM risk factors. In the BC large industrial sector, and characteristic of large industrial sectors in general, these DSM risk factors include: (1) capital constraints to investment in energy efficiency, (2) commodity price volatility, (3) limited internal staffing resources to deploy towards energy efficiency, (4) variable load, process-based energy saving potential, and (5) a lack of organizational awareness of an operation's energy efficiency over time (energy performance). This research assessed the capacity of alternative performance incentive program models to manage DSM risk in BC. Three performance incentive program models were assessed and compared to BC Hydro's current large industrial DSM incentive program, Power Smart Partners -- Transmission Project Incentives, itself a performance incentive-based program. Together, the selected program models represent a continuum of program design and implementation in terms of the schedule and level of incentives provided, the duration and rigour of measurement and verification (M&V), energy efficiency measures targeted and involvement of the private sector. A multi criteria assessment framework was developed to rank the capacity of each program model to manage BC large industrial DSM risk factors. DSM risk management rankings were then compared to program costeffectiveness, targeted energy savings potential in BC and survey results from BC industrial firms on the program models. The findings indicate that the reliability of DSM energy savings in the BC large industrial sector can be maximized through performance incentive program models that: (1) offer incentives jointly for capital and low-cost operations and maintenance (O&M) measures, (2) allow flexible lead times for project development, (3) utilize rigorous M&V methods capable of measuring variable load, process-based energy savings, (4) use moderate contract lengths that align with effective measure life, and (5) integrate energy management software tools capable of providing energy performance feedback to customers to maximize the persistence of energy savings. While this study focuses exclusively on the BC large industrial sector, the findings of this research have applicability to all energy utilities serving large, energy intensive industrial sectors.

  10. Return on Investment in Disease Management: A Review

    PubMed Central

    Goetzel, Ron Z.; Ozminkowski, Ronald J.; Villagra, Victor G.; Duffy, Jennifer

    2005-01-01

    The results of 44 studies investigating financial impact and return on investment (ROI) from disease management (DM) programs for asthma, congestive heart failure (CHF), diabetes, depression, and multiple illnesses were examined. A positive ROI was found for programs directed at CHF and multiple disease conditions. Some evidence suggests that diabetes programs may save more than they cost, but additional studies are needed. Results are mixed for asthma management programs. Depression management programs cost more than they save in medical expenses, but may save money when considering productivity outcomes. PMID:17288065

  11. Return on investment in disease management: a review.

    PubMed

    Goetzel, Ron Z; Ozminkowski, Ronald J; Villagra, Victor G; Duffy, Jennifer

    2005-01-01

    The results of 44 studies investigating financial impact and return on investment (ROI) from disease management (DM) programs for asthma, congestive heart failure (CHF), diabetes, depression, and multiple illnesses were examined. A positive ROI was found for programs directed at CHF and multiple disease conditions. Some evidence suggests that diabetes programs may save more than they cost, but additional studies are needed. Results are mixed for asthma management programs. Depression management programs cost more than they save in medical expenses, but may save money when considering productivity outcomes.

  12. Key Design Considerations When Calculating Cost Savings for Population Health Management Programs in an Observational Setting.

    PubMed

    Murphy, Shannon M E; Hough, Douglas E; Sylvia, Martha L; Dunbar, Linda J; Frick, Kevin D

    2018-02-08

    To illustrate the impact of key quasi-experimental design elements on cost savings measurement for population health management (PHM) programs. Population health management program records and Medicaid claims and enrollment data from December 2011 through March 2016. The study uses a difference-in-difference design to compare changes in cost and utilization outcomes between program participants and propensity score-matched nonparticipants. Comparisons of measured savings are made based on (1) stable versus dynamic population enrollment and (2) all eligible versus enrolled-only participant definitions. Options for the operationalization of time are also discussed. Individual-level Medicaid administrative and claims data and PHM program records are used to match study groups on baseline risk factors and assess changes in costs and utilization. Savings estimates are statistically similar but smaller in magnitude when eliminating variability based on duration of population enrollment and when evaluating program impact on the entire target population. Measurement in calendar time, when possible, simplifies interpretability. Program evaluation design elements, including population stability and participant definitions, can influence the estimated magnitude of program savings for the payer and should be considered carefully. Time specifications can also affect interpretability and usefulness. © Health Research and Educational Trust.

  13. Assessing the Potential of Social Networks as a Means for Information Diffusion the Weatherization Experiences (WE) Project.

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

    Rose, Erin M.; Hawkins, Beth A.

    In April 2009, U.S. Department of Energy (DOE) formally tasked Oak Ridge National Laboratory (ORNL) with conducting two impact and process evaluations of DOE’s Weatherization Assistance Program (WAP), known as the retrospective and American Recovery and Reinvestment Act of 2009 (ARRA) period evaluations, respectively. The former focused on WAP Program Year (PY) 2008, which covers the period from April 2008 to June 2009. The latter focused on PY 2010. This report presents in-depth analyses from ORNL’s social network study, the Weatherization Experiences (WE) Project, an exploratory study conducted as part of the ARRA period WAP evaluation. The WE Project exploredmore » the potential for WAP recipients and staff to influence energy savings beyond their homes and day jobs. Several studies conducted through ORNL’s evaluation of WAP found that the program has the ability to profoundly impact the lives of the people it serves (Tonn et al. 2014b). Recipients of WAP provided statements ranging from the newfound ability to pay utility bills and prescription medication to reduced emergency department visits for asthma and medical conditions associated with thermal stress. Through this exploratory research project, the stories of hundreds of weatherization recipients and providers were documented. The WE Project was designed to further investigate whether or not shared experiences with weatherization have the power to stimulate home energy saving action within an individual’s social network.« less

  14. Generic script share and the price of brand-name drugs: the role of consumer choice.

    PubMed

    Rizzo, John A; Zeckhauser, Richard

    2009-09-01

    Pharmaceutical expenditures have grown rapidly in recent decades, and now total nearly 10% of health care costs. Generic drug utilization has risen substantially alongside, from 19% of scripts in 1984 to 47% in 2001, thus tempering expenditure growth through significant direct dollar savings. However, generic drugs may lead to indirect savings as well if their use reduces the average price of those brand-name drugs that are still purchased. Prior work indicates that brand-name producers do not lower their prices in the face of generic competition, and our study confirms that finding. However, prior work is silent on how the mix of consumer choices between generic and brand-name drugs might affect the average price of those brand-name drugs that are purchased. We use a nationally representative panel of data on drug utilization and costs for the years 1996-2001 to examine how the share of an individual's prescriptions filled by generics (generic script share) affects his average out-of-pocket cost for brand-name drugs, and the net cost paid by the insurer. Our principal finding is that a higher generic script share lowers average brand-name prices to consumers, presumably because consumers are more likely to substitute generics when brand-name drugs would cost them more. This effect is substantial: a 10% increase in the consumer's generic script share is associated with a 15.6% decline in the average price paid for brand-name drugs by consumers. This implies that the potential cost savings to consumers from generic substitution are far greater than prior work suggests. In contrast, the percentage reduction in average brand costs to health plans is far smaller, and statistically insignificant.

  15. Lunar COTS: An Economical and Sustainable Approach to Reaching Mars

    NASA Technical Reports Server (NTRS)

    Zuniga, Allison F.; Rasky, Daniel; Pittman, Robert B.; Zapata, Edgar; Lepsch, Roger

    2015-01-01

    The NASA COTS (Commercial Orbital Transportation Services) Program was a very successful program that developed and demonstrated cost-effective development and acquisition of commercial cargo transportation services to the International Space Station (ISS). The COTS acquisition strategy utilized a newer model than normally accepted in traditional procurement practices. This new model used Space Act Agreements where NASA entered into partnerships with industry to jointly share cost, development and operational risks to demonstrate new capabilities for mutual benefit. This model proved to be very beneficial to both NASA and its industry partners as NASA saved significantly in development and operational costs while industry partners successfully expanded their market share of the global launch transportation business. The authors, who contributed to the development of the COTS model, would like to extend this model to a lunar commercial services program that will push development of technologies and capabilities that will serve a Mars architecture and lead to an economical and sustainable pathway to transporting humans to Mars. Over the past few decades, several architectures for the Moon and Mars have been proposed and studied but ultimately halted or not even started due to the projected costs significantly exceeding NASA's budgets. Therefore a new strategy is needed that will fit within NASA's projected budgets and takes advantage of the US commercial industry along with its creative and entrepreneurial attributes. The authors propose a new COTS-like program to enter into partnerships with industry to demonstrate cost-effective, cis-lunar commercial services, such as lunar transportation, lunar ISRU operations, and cis-lunar propellant depots that can enable an economical and sustainable Mars architecture. Similar to the original COTS program, the goals of the proposed program, being notionally referred to as Lunar Commercial Orbital Transfer Services (LCOTS) program will be to: 1) reduce development and operational costs by sharing costs with industry; 2) create new markets in cis-lunar space to further reduce operational costs; and 3) enable NASA to develop an affordable and economical exploration Mars architecture. The paper will describe a plan for a proposed LCOTS program, its potential impact to an eventual Mars architecture and its many benefits to NASA, commercial space industry and the US economy.

  16. 42 CFR 420.410 - Establishment of a program to collect suggestions for improving Medicare program efficiency and...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... for improving Medicare program efficiency and to reward suggesters for monetary savings. 420.410... Program Efficiency and to Reward Suggesters for Monetary Savings § 420.410 Establishment of a program to collect suggestions for improving Medicare program efficiency and to reward suggesters for monetary...

  17. 42 CFR 420.410 - Establishment of a program to collect suggestions for improving Medicare program efficiency and...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... for improving Medicare program efficiency and to reward suggesters for monetary savings. 420.410... Program Efficiency and to Reward Suggesters for Monetary Savings § 420.410 Establishment of a program to collect suggestions for improving Medicare program efficiency and to reward suggesters for monetary...

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

    PubMed

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

    2013-07-01

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

  19. Providing More Home-Delivered Meals Is One Way To Keep Older Adults With Low Care Needs Out Of Nursing Homes

    PubMed Central

    Thomas, Kali S.; Mor, Vincent

    2014-01-01

    Programs that help older adults live independently in the community can also deliver net savings to states on the costs of long-term supports and services. We estimate that if all states had increased by 1 percent the number of adults age sixty-five or older who received home-delivered meals in 2009 under Title III of the Older Americans Act, total annual savings to states’ Medicaid programs could have exceeded $109 million. The projected savings primarily reflect decreased Medicaid spending for an estimated 1,722 older adults with low-care needs who would no longer require nursing home care— instead, they could remain at home, sustained by home-delivered meals. Twenty-six states could have realized net savings in 2009 from the expansion of their home-delivered meals programs, while twenty-two states would have incurred net costs. Programs such as home-delivered meals have the potential to provide substantial savings to some states’ Medicaid programs. PMID:24101071

  20. Improving employee productivity through improved health.

    PubMed

    Mitchell, Rebecca J; Ozminkowski, Ronald J; Serxner, Seth

    2013-10-01

    The objective of this study was to estimate productivity-related savings associated with employee participation in health promotion programs. Propensity score weighting and multiple regression techniques were used to estimate savings. These techniques were adjusted for demographic and health status differences between participants who engaged in one or more telephonic health management programs and nonparticipants who were eligible for but did not engage in these programs. Employees who participated in a program and successfully improved their health care or lifestyle showed significant improvements in lost work time. These employees saved an average of $353 per person per year. This reflects about 10.3 hours in additional productive time annually, compared with similar, but nonparticipating employees. Participating in health promotion programs can help improve productivity levels among employees and save money for their employers.

  1. Fuel savings potential of the NASA Advanced Turboprop Program

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

    Whitlow, J.B. Jr.; Sievers, G.K.

    1984-01-01

    The NASA Advanced Turboprop (ATP) Program is directed at developing new technology for highly loaded, multibladed propellers for use at Mach 0.65 to 0.85 and at altitudes compatible with the air transport system requirements. Advanced turboprop engines offer the potential of 15 to 30 percent savings in aircraft block fuel relative to advanced turbofan engines (50 to 60 percent savings over today's turbofan fleet). The concept, propulsive efficiency gains, block fuel savings and other benefits, and the program objectives through a systems approach are described. Current program status and major accomplishments in both single rotation and counter rotation propeller technologymore » are addressed. The overall program from scale model wind tunnel tests to large scale flight tests on testbed aircraft is discussed.« less

  2. FLASTAR: Florida Alliance for Saving Taxes and Energy Resources. Final Report.

    ERIC Educational Resources Information Center

    Sherwin, John R.; Parker, Danny S.

    A study of the Florida Public Building Loan Concept pilot program determined its effectiveness in helping to upgrade building energy systems. The pilot program, termed FLASTAR (Florida Alliance for Saving Taxes and Resources), involved the comprehensive metering of an elementary school to demonstrate energy savings potential after retrofitting…

  3. Early Performance of Accountable Care Organizations in Medicare

    PubMed Central

    McWilliams, J. Michael; Hatfield, Laura A.; Chernew, Michael E.; Landon, Bruce E.; Schwartz, Aaron L.

    2016-01-01

    BACKGROUND In the Medicare Shared Savings Program (MSSP), accountable care organizations (ACOs) have financial incentives to lower spending and improve quality. We used quasi-experimental methods to assess the early performance of MSSP ACOs. METHODS Using Medicare claims from 2009 through 2013 and a difference-in-differences design, we compared changes in spending and in performance on quality measures from before the start of ACO contracts to after the start of the contracts between beneficiaries served by the 220 ACOs entering the MSSP in mid-2012 (2012 ACO cohort) or January 2013 (2013 ACO cohort) and those served by non-ACO providers (control group), with adjustment for geographic area and beneficiary characteristics. We analyzed the 2012 and 2013 ACO cohorts separately because entry time could reflect the capacity of an ACO to achieve savings. We compared ACO savings according to organizational structure, baseline spending, and concurrent ACO contracting with commercial insurers. RESULTS Adjusted Medicare spending and spending trends were similar in the ACO cohorts and the control group during the precontract period. In 2013, the differential change (i.e., the between-group difference in the change from the precontract period) in total adjusted annual spending was −$144 per beneficiary in the 2012 ACO cohort as compared with the control group (P = 0.02), consistent with a 1.4% savings, but only −$3 per beneficiary in the 2013 ACO cohort as compared with the control group (P = 0.96). Estimated savings were consistently greater in independent primary care groups than in hospital-integrated groups among 2012 and 2013 MSSP entrants (P = 0.005 for interaction). MSSP contracts were associated with improved performance on some quality measures and unchanged performance on others. CONCLUSIONS The first full year of MSSP contracts was associated with early reductions in Medicare spending among 2012 entrants but not among 2013 entrants. Savings were greater in independent primary care groups than in hospital-integrated groups. PMID:27075832

  4. Quality of Care Improves for Patients with Diabetes in Medicare Shared Savings Accountable Care Organizations: Organizational Characteristics Associated with Performance.

    PubMed

    Fraze, Taressa K; Lewis, Valerie A; Tierney, Emily; Colla, Carrie H

    2017-12-06

    Accountable care organizations (ACOs), a primary care-centric delivery and payment model, aim to promote integrated population health, which may improve care for those with chronic conditions such as diabetes. Research has shown that, overall, the ACO model is effective at reducing costs, but there is substantial variation in how effective different types of ACOs are at impacting costs and improving care delivery. This study examines how ACO organizational characteristics - such as composition, staffing, care management, and experiences with health reform - were associated with quality of care delivered to patients with diabetes. Secondary data were analyzed retrospectively to examine Medicare Shared Savings Program (MSSP) ACOs' performance on diabetes metrics in the first 2 years of ACO contracts. Ordinary least squares was used to analyze 162 MSSP ACOs with publicly available performance data and the National Survey of ACOs. ACOs improved performance significantly for patients with diabetes between contract years 1 and 2. In year 1, also having a private payer contract and an increased number of services within the ACO were positively associated with performance, while having a community health center or a hospital were negatively associated with performance. Better performance in year 1 was negatively associated with improved performance in year 2. This study found that ACOs substantively improved diabetes management within initial contract years. ACOs may need different types of support throughout their contracts to ensure continued improvements in performance.

  5. Defense Health Care Reform: Actions Needed to Help Realize Potential Cost Savings from Medical Education and Training

    DTIC Science & Technology

    2014-07-01

    services in carrying out their medical missions, manage the military s health plan, oversee the medical operations within and provide 10 shared services , including...oversight of medical education and training. According to DOD, a shared services concept is a combination of common services performed across

  6. Potential savings from an evidence-based consumer-oriented public education campaign on prescription drugs.

    PubMed

    Donohue, Julie M; Fischer, Michael A; Huskamp, Haiden A; Weissman, Joel S

    2008-10-01

    To estimate potential savings associated with the Consumer Reports Best Buy Drugs program, a national educational program that provides consumers with price and effectiveness information on prescription drugs. National data on 2006 prescription sales and retail prices paid for angiotensin-converting enzyme inhibitors (ACEIs), β-blockers, calcium channel blockers, and 3-hydroxy-3-methylglutaryl coenzyme A (HMG-coA) reductase inhibitors (statins). We converted national data on aggregate unit sales of drugs in the four classes to defined daily doses (DDD) and estimated a range of potential savings from generic and therapeutic substitution. We estimated that $2.76 billion, or 7.83 percent of sales, could be saved if use of the drugs recommended by the educational program was increased. The recommended drugs' prices were 15-65 percent lower per DDD than their therapeutic alternatives. The majority (57.4 percent) of potential savings would be achieved through therapeutic substitution. Substantial savings can be achieved through greater use of comparatively effective and lower cost drugs recommended by a national consumer education program. However, barriers to dissemination of consumer-oriented drug information must be addressed before savings can be realized. © Health Research and Educational Trust.

  7. Potential Savings from an Evidence-Based Consumer-Oriented Public Education Campaign on Prescription Drugs

    PubMed Central

    Donohue, Julie M; Fischer, Michael A; Huskamp, Haiden A; Weissman, Joel S

    2008-01-01

    Objective To estimate potential savings associated with the Consumer Reports Best Buy Drugs program, a national educational program that provides consumers with price and effectiveness information on prescription drugs. Data Sources National data on 2006 prescription sales and retail prices paid for angiotensin-converting enzyme inhibitors (ACEIs), β-blockers, calcium channel blockers, and 3-hydroxy-3-methylglutaryl coenzyme A (HMG-coA) reductase inhibitors (statins). Study Design We converted national data on aggregate unit sales of drugs in the four classes to defined daily doses (DDD) and estimated a range of potential savings from generic and therapeutic substitution. Principal Findings We estimated that $2.76 billion, or 7.83 percent of sales, could be saved if use of the drugs recommended by the educational program was increased. The recommended drugs’ prices were 15–65 percent lower per DDD than their therapeutic alternatives. The majority (57.4 percent) of potential savings would be achieved through therapeutic substitution. Conclusions Substantial savings can be achieved through greater use of comparatively effective and lower cost drugs recommended by a national consumer education program. However, barriers to dissemination of consumer-oriented drug information must be addressed before savings can be realized. PMID:18479406

  8. Costs And Savings Associated With Community Water Fluoridation In The United States.

    PubMed

    O'Connell, Joan; Rockell, Jennifer; Ouellet, Judith; Tomar, Scott L; Maas, William

    2016-12-01

    The most comprehensive study of US community water fluoridation program benefits and costs was published in 2001. This study provides updated estimates using an economic model that includes recent data on program costs, dental caries increments, and dental treatments. In 2013 more than 211 million people had access to fluoridated water through community water systems serving 1,000 or more people. Savings associated with dental caries averted in 2013 as a result of fluoridation were estimated to be $32.19 per capita for this population. Based on 2013 estimated costs ($324 million), net savings (savings minus costs) from fluoridation systems were estimated to be $6,469 million and the estimated return on investment, 20.0. While communities should assess their specific costs for continuing or implementing a fluoridation program, these updated findings indicate that program savings are likely to exceed costs. Project HOPE—The People-to-People Health Foundation, Inc.

  9. Gender training: creating change.

    PubMed

    Craun-selka, P

    1997-01-01

    Over the last 20 years, the Centre for Development and Population Activities (CEDPA) has developed a training program concerning gender policies and practices; it includes a curriculum, "Gender and Development," and a handbook, "Gender Equity: Concepts and Tools for Development." Gender training focuses on increasing individual awareness of gender issues and incorporating gender practices in programs. CEDPA has expanded its programs to include projects promoting increased decision-making power for women regarding their own lives. Family planning and reproductive health projects now include programs designed to increase "women's literacy, credit and income-generation opportunities, and participation in civil society and the political process." Projects address reproductive and human rights, land distribution, economic expansion, credit and savings, and violence against women. Youth programs focus on the changing nature of gender roles, the equal rights of women and girls, and the shared responsibility and mutual respect of the sexes. In the Better Life Options projects, youth of both sexes attend family life and sex education programs. The curriculum "Choose a Future" provides life skills training for young women; a version for young men will be provided in the future. Including men (community health workers and supervisors, educators, trainers, leaders, fathers, and husbands) in the CEDPA programs is essential for the empowerment of women.

  10. Cost savings threshold analysis of a capacity-building program for HIV prevention organizations.

    PubMed

    Dauner, Kim Nichols; Oglesby, Willie H; Richter, Donna L; LaRose, Christopher M; Holtgrave, David R

    2008-06-01

    Although the incidence of HIV each year remains steady, prevention funding is increasingly competitive. Programs need to justify costs in terms of evaluation outcomes, including economic ones. Threshold analyses set performance standards to determine program effectiveness relative to that threshold. This method was used to evaluate the potential cost savings of a national capacity-building program for HIV prevention organizations. Program costs were compared with the lifetime treatment costs of HIV, yielding an estimate of the HIV infections that would have to be prevented for the program to be cost saving. The 136 persons who completed the capacity-building program between 2000 and 2003 would have to avert 41 cases of HIV for the program to be considered cost saving. These figures represent less than one tenth of 1% of the 40,000 new HIV infections that occur in the United States annually and suggest a reasonable performance standard. These data underscore the resources needed to prevent HIV.

  11. Application of automated measurement and verification to utility energy efficiency program data

    DOE PAGES

    Granderson, Jessica; Touzani, Samir; Fernandes, Samuel; ...

    2017-02-17

    Trustworthy savings calculations are critical to convincing regulators of both the cost-effectiveness of energy efficiency program investments and their ability to defer supply-side capital investments. Today’s methods for measurement and verification (M&V) of energy savings constitute a significant portion of the total costs of energy efficiency programs. They also require time-consuming data acquisition. A spectrum of savings calculation approaches is used, with some relying more heavily on measured data and others relying more heavily on estimated, modeled, or stipulated data. The increasing availability of “smart” meters and devices that report near-real time data, combined with new analytical approaches to quantifymore » savings, offers the potential to conduct M&V more quickly and at lower cost, with comparable or improved accuracy. Commercial energy management and information systems (EMIS) technologies are beginning to offer these ‘M&V 2.0’ capabilities, and program administrators want to understand how they might assist programs in quickly and accurately measuring energy savings. This paper presents the results of recent testing of the ability to use automation to streamline the M&V process. In this paper, we apply an automated whole-building M&V tool to historic data sets from energy efficiency programs to begin to explore the accuracy, cost, and time trade-offs between more traditional M&V, and these emerging streamlined methods that use high-resolution energy data and automated computational intelligence. For the data sets studied we evaluate the fraction of buildings that are well suited to automated baseline characterization, the uncertainty in gross savings that is due to M&V 2.0 tools’ model error, and indications of labor time savings, and how the automated savings results compare to prior, traditionally determined savings results. The results show that 70% of the buildings were well suited to the automated approach. In a majority of the cases (80%) savings and uncertainties for each individual building were quantified to levels above the criteria in ASHRAE Guideline 14. In addition the findings suggest that M&V 2.0 methods may also offer time-savings relative to traditional approaches. Lastly, we discuss the implications of these findings relative to the potential evolution of M&V, and pilots currently being launched to test how M&V automation can be integrated into ratepayer-funded programs and professional implementation and evaluation practice.« less

  12. Application of automated measurement and verification to utility energy efficiency program data

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

    Granderson, Jessica; Touzani, Samir; Fernandes, Samuel

    Trustworthy savings calculations are critical to convincing regulators of both the cost-effectiveness of energy efficiency program investments and their ability to defer supply-side capital investments. Today’s methods for measurement and verification (M&V) of energy savings constitute a significant portion of the total costs of energy efficiency programs. They also require time-consuming data acquisition. A spectrum of savings calculation approaches is used, with some relying more heavily on measured data and others relying more heavily on estimated, modeled, or stipulated data. The increasing availability of “smart” meters and devices that report near-real time data, combined with new analytical approaches to quantifymore » savings, offers the potential to conduct M&V more quickly and at lower cost, with comparable or improved accuracy. Commercial energy management and information systems (EMIS) technologies are beginning to offer these ‘M&V 2.0’ capabilities, and program administrators want to understand how they might assist programs in quickly and accurately measuring energy savings. This paper presents the results of recent testing of the ability to use automation to streamline the M&V process. In this paper, we apply an automated whole-building M&V tool to historic data sets from energy efficiency programs to begin to explore the accuracy, cost, and time trade-offs between more traditional M&V, and these emerging streamlined methods that use high-resolution energy data and automated computational intelligence. For the data sets studied we evaluate the fraction of buildings that are well suited to automated baseline characterization, the uncertainty in gross savings that is due to M&V 2.0 tools’ model error, and indications of labor time savings, and how the automated savings results compare to prior, traditionally determined savings results. The results show that 70% of the buildings were well suited to the automated approach. In a majority of the cases (80%) savings and uncertainties for each individual building were quantified to levels above the criteria in ASHRAE Guideline 14. In addition the findings suggest that M&V 2.0 methods may also offer time-savings relative to traditional approaches. Lastly, we discuss the implications of these findings relative to the potential evolution of M&V, and pilots currently being launched to test how M&V automation can be integrated into ratepayer-funded programs and professional implementation and evaluation practice.« less

  13. National Weatherization Assistance Program Impact Evaluation: Energy Impacts for Large Multifamily Buildings

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

    Blasnik, Michael; Dalhoff, Greg; Carroll, David

    This report estimates energy savings, energy cost savings, and cost effectiveness attributable to weatherizing large multifamily buildings under the auspices of the Department of Energy's Weatherization Assistance Program during Program Year 2008.

  14. National Weatherization Assistance Program Impact Evaluation: Energy Impacts for Small Multifamily Buildings

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

    Blasnik, Michael; Dalhoff, Greg; Carroll, David

    2014-09-01

    This report estimates energy savings, energy cost savings, and cost effectiveness attributable to weatherizing small multifamily buildings under the auspices of the Department of Energy's Weatherization Assistance Program during Program Year 2008.

  15. Physician Payment Methods and the Patient-Centered Medical Home: Comment on "A Troubled Asset Relief Program for the Patient-Centered Medical Home".

    PubMed

    Quinn, Kevin

    This commentary analyzes the patient-centered medical home (PCMH) model within a framework of the 8 basic payment methods in health care. PCMHs are firmly within the fee-for-service tradition. Changes to the process and structure of the Resource Based Relative Value Scale, which underlies almost all physician fee schedules, could make PCMHs more financially viable. Of the alternative payment methods being considered, shared savings models are unlikely to transform medical practice whereas capitation models place unrealistic expectations on providers to accept epidemiological risk. Episode payment may strike a feasible balance for PCMHs, with newly available episode definitions presenting opportunities not previously available.

  16. Straddling care and education: Developing interprofessional collaboration through a hotspotting service learning project.

    PubMed

    Jones, Anne C; Li, Trudy; Zomorodi, Meg; Broadhurst, Rob; Weil, Amy B

    2018-06-01

    Interprofessional (IP) team work has been shown to decrease burnout and improve care and decrease costs. However, institutional barriers have challenged adoption in practice and education. Faculty and students are turning to IP service-learning projects to help students gain experience and provide needed services. This paper highlights a "hotspotting" program where students from different health professions work collaboratively to improve high utilizing patients' health. Benefits, challenges and preliminary results including cost savings and student efficacy are shared. Institutions should surmount barriers that make hotspotting service-learning challenging as IP team-based experiences prepare students for the workplace and can help mitigate burnout. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Fly on the Wall

    NASA Technical Reports Server (NTRS)

    Mulenburg, Gerald

    2003-01-01

    The email was addressed not only to me, but also to all the Project Knowledge Sharing Community at Ames Research Center. We were invited to sit in on a major project review as a new experiment in knowledge sharing. This first-of-its-kind opportunity had been conceived by Claire Smith, who leads the knowledge sharing program, as well as heading up the Center's Project Leadership Development Program and serving as coordinator of the APPL-West program at Ames. The objective was to offer Ames project practitioners the opportunity to observe project-review processes as they happen. Not that I haven't participated in my share of project reviews, but this seemed like a great way for me to get up-to-date about a new project, the Kepler mission, and to experience a review from a new perspective. Typically, when you're being reviewed, it's difficult to see what's happening objectively-the same way it is on a project. Presenters are always thinking, 'Okay, what's on my slides? How much time do I have left? What are they going to ask me?' So when Claire's email pinged on my computer, I quickly responded by asking her to save a place for me. It was to be an informational review about progress on the project: what the team had done, where they were going, and what they needed to do to get there. There were people on the project team from all over the United States, and it was the first time for them to get together from all aspects of the project. For our part, as observers, we were asked to abide by a couple of rules: Don't ask any questions. and don't talk about the specifics of what we saw or heard. The idea was that we weren't supposed to be noticed. We weren't to buzz around and bother people. Hence the name for this experinient: Fly on the Wall.

  18. International Review of Standards and Labeling Programs for Distribution Transformers

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

    Letschert, Virginie; Scholand, Michael; Carreño, Ana María

    Transmission and distribution (T&D) losses in electricity networks represent 8.5% of final energy consumption in the world. In Latin America, T&D losses range between 6% and 20% of final energy consumption, and represent 7% in Chile. Because approximately one-third of T&D losses take place in distribution transformers alone, there is significant potential to save energy and reduce costs and carbon emissions through policy intervention to increase distribution transformer efficiency. A large number of economies around the world have recognized the significant impact of addressing distribution losses and have implemented policies to support market transformation towards more efficient distribution transformers. Asmore » a result, there is considerable international experience to be shared and leveraged to inform countries interested in reducing distribution losses through policy intervention. The report builds upon past international studies of standards and labeling (S&L) programs for distribution transformers to present the current energy efficiency programs for distribution transformers around the world.« less

  19. Systems engineering and integration: Advanced avionics laboratories

    NASA Technical Reports Server (NTRS)

    1990-01-01

    In order to develop the new generation of avionics which will be necessary for upcoming programs such as the Lunar/Mars Initiative, Advanced Launch System, and the National Aerospace Plane, new Advanced Avionics Laboratories are required. To minimize costs and maximize benefits, these laboratories should be capable of supporting multiple avionics development efforts at a single location, and should be of a common design to support and encourage data sharing. Recent technological advances provide the capability of letting the designer or analyst perform simulations and testing in an environment similar to his engineering environment and these features should be incorporated into the new laboratories. Existing and emerging hardware and software standards must be incorporated wherever possible to provide additional cost savings and compatibility. Special care must be taken to design the laboratories such that real-time hardware-in-the-loop performance is not sacrificed in the pursuit of these goals. A special program-independent funding source should be identified for the development of Advanced Avionics Laboratories as resources supporting a wide range of upcoming NASA programs.

  20. 77 FR 42489 - Notice of Submission for OMB Review; Office of Postsecondary Education; Application for Gaining...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-19

    ... with the collection results from a program change to run this one-time college savings account...; Application for Gaining Early Awareness and Readiness for Undergraduate Programs (GEAR UP) College Savings... pairing federally supported college savings accounts with GEAR UP activities as part of an overall college...

  1. The hospital as business. How saving money can help save lives.

    PubMed

    Colonna, J; Garvin, M

    1997-11-01

    As hospitals and clinics merge into integrated delivery networks dependent for patients on health maintenance organizations, it is sometimes hard to remember who's on first. Instead of doctors, nurses, patients and hospitals, the world of health care now contains an alphabet soup of IDNs, HMOs, providers, consumers and payers. The changes extend deeply into the materials management department, where simply bargaining for the best price has been complicated by standardization, capitation, and a host of expense management strategies. Perhaps as a result of this ever-changing identity, most hospitals have yet to fully adopt the style and culture of the businesses they really are. Even purchasing managers, who are closer to the business end of the operation, are caught up in the traditional image. In the following comments, two experts in materials management explore the impact that this ambivalence has on a hospital's relationship with the outside world--including suppliers. Joseph Colonna is corporate vice president of the purchasing program at Shared Services Healthcare, Atlanta. Michael Garvin is an adjunct professor at the University of Iowa, and a researcher in medical supply purchasing practices.

  2. Assessing administrative costs of mental health and substance abuse services.

    PubMed

    Broyles, Robert W; Narine, Lutchmie; Robertson, Madeline J

    2004-05-01

    Increasing competition in the market for mental health and substance abuse MHSA services and the potential to realize significant administrative savings have created an imperative to monitor, evaluate, and control spending on administrative functions. This paper develops a generic model that evaluates spending on administrative personnel by a group of providers. The precision of the model is demonstrated by examining a set of data assembled from five MHSA service providers. The model examines a differential cost construction derived from inter-facility comparisons of administrative expenses. After controlling for the scale of operations, the results enable MHSA programs to control the efficiency of administrative personnel and related rates of compensation. The results indicate that the efficiency of using the administrative complement and the scale of operations represent the lion's share of the total differential cost. The analysis also indicates that a modest improvement in the use of administrative personnel results in substantial cost savings, an increase in the net cash flow derived from operations, an improvement in the fiscal performance of the provider, and a decline in opportunity costs that assume the form of foregone direct patient care.

  3. Ways to Save Your Money. The CIRcular: Consumer Information Report 2.

    ERIC Educational Resources Information Center

    Bank of America NT & SA, San Francisco, CA.

    This report explains savings accounts and low-deposit investments in order to help consumers determine which accounts are right for them. It is divided into the following four sections (topics covered are listed in parentheses): (1) the savings program (setting savings goals, saving regularly, choosing a savings account, interest, the savings…

  4. Integrated Payment and Delivery Models Offer Opportunities and Challenges for Residential Care Facilities

    PubMed Central

    Grabowski, David C.; Caudry, Daryl J.; Dean, Katie M.; Stevenson, David G.

    2016-01-01

    Under health care reform, a series of new financing and delivery models are being piloted to integrate health and long-term care services for older adults. To date, these programs have not encompassed residential care facilities, with most programs focusing on long-term care recipients in the community or the nursing home. Our analyses indicate that individuals living in residential care facilities have similarly high rates of chronic illness and Medicare utilization when compared with similar populations in the community and nursing home. These results suggest the residential care facility population could benefit greatly from models that coordinate health and long-term care. However, few providers have invested in integrated delivery models. Several challenges exist toward greater integration including the private payment of residential care facility services and the fact that residential care facilities do not share in any Medicare savings due to improved coordination of care. PMID:26438740

  5. A gradient of childhood self-control predicts health, wealth, and public safety

    PubMed Central

    Moffitt, Terrie E.; Arseneault, Louise; Belsky, Daniel; Dickson, Nigel; Hancox, Robert J.; Harrington, HonaLee; Houts, Renate; Poulton, Richie; Roberts, Brent W.; Ross, Stephen; Sears, Malcolm R.; Thomson, W. Murray; Caspi, Avshalom

    2011-01-01

    Policy-makers are considering large-scale programs aimed at self-control to improve citizens’ health and wealth and reduce crime. Experimental and economic studies suggest such programs could reap benefits. Yet, is self-control important for the health, wealth, and public safety of the population? Following a cohort of 1,000 children from birth to the age of 32 y, we show that childhood self-control predicts physical health, substance dependence, personal finances, and criminal offending outcomes, following a gradient of self-control. Effects of children's self-control could be disentangled from their intelligence and social class as well as from mistakes they made as adolescents. In another cohort of 500 sibling-pairs, the sibling with lower self-control had poorer outcomes, despite shared family background. Interventions addressing self-control might reduce a panoply of societal costs, save taxpayers money, and promote prosperity. PMID:21262822

  6. Delivery system integration and health care spending and quality for Medicare beneficiaries.

    PubMed

    McWilliams, J Michael; Chernew, Michael E; Zaslavsky, Alan M; Hamed, Pasha; Landon, Bruce E

    2013-08-12

    The Medicare accountable care organization (ACO) programs rely on delivery system integration and health care provider risk sharing to lower spending while improving quality of care. To compare spending and quality between larger and smaller provider groups and examine how size-related differences vary by 2 factors considered central to ACO performance: group primary care orientation and financial risk sharing by health care providers. Using 2009 Medicare claims and linked American Medical Association Group Practice data, we assigned 4.29 million beneficiaries to health care provider groups based on primary care use. We categorized group size according to eligibility thresholds for the Shared Savings (≥5000 assigned beneficiaries) and Pioneer (≥15,000) ACO programs and distinguished hospital-based from independent groups. We assessed the primary care orientation of larger groups' specialty mix and used health maintenance organization market penetration and data from the Community Tracking Study to measure the extent of financial risk accepted by different types of provider groups in different areas for managed care patients. We estimated linear regression models comparing spending and quality between larger and smaller health care provider groups, allowing size-related differences to vary by measures of group primary care orientation and risk sharing. Spending and quality measures included total medical spending, spending by type of service, 5 process measures of quality, and 30-day readmissions, all adjusted for sociodemographic and clinical characteristics. Compared with smaller groups, larger hospital-based groups had higher total per-beneficiary spending in 2009 (mean difference, +$849), higher 30-day readmission rates (+1.3 percentage points), and similar performance on 4 of 5 process measures of quality. In contrast, larger independent physician groups performed better than smaller groups on all process measures and exhibited significantly lower per-beneficiary spending in counties where risk sharing by these groups was more common (-$426). Among all groups sufficiently large to participate in ACO programs, a strong primary care orientation was associated with lower spending, fewer readmissions, and better quality of diabetes care. Spending was lower and quality of care better for Medicare beneficiaries served by larger independent physician groups with strong primary care orientations in environments where health care providers accepted greater risk.

  7. Reported Energy and Cost Savings from the DOE ESPC Program: FY 2015

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

    Slattery, Bob S.

    2017-01-01

    The objective of this work was to determine the realization rate of energy and cost savings from the Department of Energy’s Energy Savings Performance Contract (ESPC) program based on information reported by the energy services companies (ESCOs) that are carrying out ESPC projects at federal sites. Information was extracted from 151 Measurement and Verification (M&V) reports to determine reported, estimated, and guaranteed cost savings and reported and estimated energy savings for the previous contract year. Because the quality of the reports varied, it was not possible to determine all of these parameters for each project.

  8. A cost-benefit analysis of a deposit-refund program for beverage containers in Israel.

    PubMed

    Lavee, Doron

    2010-02-01

    The paper presents a full cost-benefit analysis of a deposit-refund program for beverage containers in Israel. We examine all cost elements of the program--storage, collection, and treatment costs of empty containers, and all potential benefits--savings in alternative treatment costs (waste collection and landfill disposal), cleaner public spaces, reduction of landfill volumes, energy-savings externalities associated with use of recycled materials, and creation of new workplaces. A wide variety of data resources is employed, and some of the critical issues are examined via several approaches. The main finding of the paper is that the deposit-refund program is clearly economically worthwhile. The paper contributes to the growing body of literature on deposit-refund programs by its complete and detailed analysis of all relevant factors of such a program, and also specifically in its analysis of the savings in alternative waste management costs. This analysis reveals greater savings than are usually assumed, and thus shows the deposit-refund program to be highly efficient.

  9. Transforming healthcare delivery: Why and how accountable care organizations must evolve.

    PubMed

    Chen, Christopher T; Ackerly, D Clay; Gottlieb, Gary

    2016-09-01

    Accountable care organizations (ACOs) have shown promise in reducing healthcare spending growth, but have proven to be financially unsustainable for many healthcare organizations. Even ACOs with shared savings have experienced overall losses because the shared savings bonuses have not covered the costs of delivering population health. As physicians and former ACO leaders, we believe in the concept of accountable care, but ACOs need to evolve if they are to have a viable future. We propose the novel possibility of allowing ACOs to bill fee-for-service for their population health interventions, a concept we call population health billing. Journal of Hospital Medicine 2016;11:658-661. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  10. Measuring the wealth of nations.

    PubMed

    Hamilton, Kirk; Dixon, John A

    2003-01-01

    The sustainability of development is closely linked to changes in total per capita wealth. This paper presents estimates of the wealth of nations for nearly 100 countries, broken down into produced assets, natural resources and human resources. While the latter is the dominant form of wealth in virtually all countries, in low income natural resource exporters the share of natural resources in total wealth is equal to the share of produced assets. For low income countries in general, cropland forms the vast majority of natural wealth. The analysis suggests the process of development can be viewed as one of portfolio management: sustainable development entails saving the rents from exhaustible resources, managing renewable resources sustainably, and investing savings in both produced assets and human resources.

  11. Chapter 21: Estimating Net Savings - Common Practices. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

    Kurnik, Charles W; Violette, Daniel M.; Rathbun, Pamela

    This chapter focuses on the methods used to estimate net energy savings in evaluation, measurement, and verification (EM and V) studies for energy efficiency (EE) programs. The chapter provides a definition of net savings, which remains an unsettled topic both within the EE evaluation community and across the broader public policy evaluation community, particularly in the context of attribution of savings to a program. The chapter differs from the measure-specific Uniform Methods Project (UMP) chapters in both its approach and work product. Unlike other UMP resources that provide recommended protocols for determining gross energy savings, this chapter describes and comparesmore » the current industry practices for determining net energy savings but does not prescribe methods.« less

  12. Formative Value of an Active Learning Strategy: Technology Based Think-Pair-Share in an EFL Writing Classroom

    ERIC Educational Resources Information Center

    Demirci, Cavide; Düzenli, Halil

    2017-01-01

    Think-Pair-Share (TPS) activities in classrooms provide an opportunity for students to revise, practice and reproduce previously learned knowledge. Teachers also benefit from this active learning strategy by exploiting new learning materials, saving time by minimizing presentations and using it as a formative assessment tool. This article explores…

  13. Comparing the Medicaid Retrospective Drug Utilization Review Program Cost-Savings Methods Used by State Agencies.

    PubMed

    Prada, Sergio I

    2017-12-01

    The Medicaid Drug Utilization Review (DUR) program is a 2-phase process conducted by Medicaid state agencies. The first phase is a prospective DUR and involves electronically monitoring prescription drug claims to identify prescription-related problems, such as therapeutic duplication, contraindications, incorrect dosage, or duration of treatment. The second phase is a retrospective DUR and involves ongoing and periodic examinations of claims data to identify patterns of fraud, abuse, underutilization, drug-drug interaction, or medically unnecessary care, implementing corrective actions when needed. The Centers for Medicare & Medicaid Services requires each state to measure prescription drug cost-savings generated from its DUR programs on an annual basis, but it provides no guidance or unified methodology for doing so. To describe and synthesize the methodologies used by states to measure cost-savings using their Medicaid retrospective DUR program in federal fiscal years 2014 and 2015. For each state, the cost-savings methodologies included in the Medicaid DUR 2014 and 2015 reports were downloaded from Medicaid's website. The reports were then reviewed and synthesized. Methods described by the states were classified according to research designs often described in evaluation textbooks. In 2014, the most often used prescription drugs cost-savings estimation methodology for the Medicaid retrospective DUR program was a simple pre-post intervention method, without a comparison group (ie, 12 states). In 2015, the most common methodology used was a pre-post intervention method, with a comparison group (ie, 14 states). Comparisons of savings attributed to the program among states are still unreliable, because of a lack of a common methodology available for measuring cost-savings. There is great variation among states in the methods used to measure prescription drug utilization cost-savings. This analysis suggests that there is still room for improvement in terms of methodology transparency, which is important, because lack of transparency hinders states from learning from each other. Ultimately, the federal government needs to evaluate and improve its DUR program.

  14. Codes Don't Always Get Enforced, But Contracts Do: Changing the Procurement Paradigm to Drive Building Energy Performance

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

    Torcellini, Paul A; Scheib, Jennifer G; Pless, Shanti

    New construction could account for more than 25% of the U.S. energy consumption by 2030. Millions of square feet are built every year that will not perform as expected - despite advancing codes, rating systems, super-efficient technologies, and advanced utility programs. With retrofits of these under-performers decades away, savings potential will be lost for years to come. Only the building owner is in the driver's seat to demand - and verify - higher-performing buildings. Yet our current policy and market interventions really target the design team, not the owner. Accelerate Performance, a U.S. Department of Energy funded initiative, is changingmore » the building procurement approach to drive deeper, verified savings in three pilot states: Illinois, Minnesota, and Connecticut. Performance-based procurement ties energy performance to design and contractor team compensation while freeing them to meet energy targets with strategies most familiar to them. The process teases out the creativity of the design and contracting teams to deliver energy performance - without driving up the construction cost. The paper will share early results and lessons learned from new procurement and contract approaches in government, public, and private sector building projects. The paper provides practical guidance for building owners, facilities managers, design, and contractor teams who wish to incorporate effective performance-based procurement for deeper energy savings in their buildings.« less

  15. Medicare Accountable Care Organizations of Diverse Structures Achieve Comparable Quality and Cost Performance.

    PubMed

    Comfort, Leeann N; Shortell, Stephen M; Rodriguez, Hector P; Colla, Carrie H

    2018-01-31

    To examine whether an empirically derived taxonomy of Accountable Care Organizations (ACOs) is associated with quality and spending performance among patients of ACOs in the Medicare Shared Savings Program (MSSP). Three waves of the National Survey of ACOs and corresponding publicly available Centers for Medicare & Medicaid Services performance data for NSACO respondents participating in the MSSP (N = 204); SK&A Office Based Physicians Database from QuintilesIMS. We compare the performance of three ACO types (physician-led, integrated, and hybrid) for three domains: quality, spending, and likelihood of achieving savings. Sources of performance variation within and between ACO types are compared for each performance measure. There is greater heterogeneity within ACO types than between ACO types. There were no consistent differences in quality by ACO type, nor were there differences in likelihood of achieving savings or overall spending per-person-year. There was evidence for higher spending on physician services for physician-led ACOs. ACOs of diverse structures perform comparably on core MSSP quality and spending measures. CMS should maintain its flexibility and continue to support participation of diverse ACOs. Future research to identify modifiable organizational factors that account for performance variation within ACO types may provide insight as to how best to improve ACO performance based on organizational structure and ownership. © Health Research and Educational Trust.

  16. How to Cut Costs by Saving School Bus Fuel.

    ERIC Educational Resources Information Center

    Seiff, Hank

    A program started in Washington County, Maryland in 1980 has been successful in saving school bus fuel and bringing down transportation costs incurred by its fleet of 200 buses. Driver training and motivation, as well as a partial transfer to diesel buses, are at the heart of the program. The drivers are taught five fuel saving techniques: cut…

  17. Evaluating the Effects of Child Savings Accounts Program Participation on Parental Well-Being

    ERIC Educational Resources Information Center

    Okech, David

    2012-01-01

    Objectives: Using baseline and second wave data, the study evaluated the impact of child savings accounts participation on parenting stress, personal mastery, and economic strain with N = 381 lower income parents who decided to join and those who did not join in a child development savings account program. Methods: Structural equation modeling for…

  18. Status and Opportunities for Improving the Consistency of Technical Reference Manuals

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

    Jayaweera, Tina; Velonis, Aquila; Haeri, Hossein

    Across the United States, energy-efficiency program administrators rely on Technical Reference Manuals (TRMs) as sources for calculations and deemed savings values for specific, well-defined efficiency measures. TRMs play an important part in energy efficiency program planning by providing a common and consistent source for calculation of ex ante and often ex post savings. They thus help reduce energy-efficiency resource acquisition costs by obviating the need for extensive measurement and verification and lower performance risk for program administrators and implementation contractors. This paper considers the benefits of establishing region-wide or national TRMs and considers the challenges of such undertaking due tomore » the difficulties in comparing energy savings across jurisdictions. We argue that greater consistency across TRMs in the approaches used to determine deemed savings values, with more transparency about assumptions, would allow better comparisons in savings estimates across jurisdictions as well as improve confidence in reported efficiency measure savings. To support this thesis, we review approaches for the calculation of savings for select measures in TRMs currently in use in 17 jurisdictions. The review reveals differences in the saving methodologies, technical assumptions, and input variables used for estimating deemed savings values. These differences are described and their implications are summarized, using four, common energy-efficiency measures as examples. Recommendations are then offered for establishing a uniform approach for determining deemed savings values.« less

  19. Mental health and retirement savings: Confounding issues with compounding interest.

    PubMed

    Bogan, Vicki L; Fertig, Angela R

    2018-02-01

    The questionable ability of the U.S. pension system to provide for the growing elderly population combined with the rising number of people affected by depression and other mental health issues magnifies the need to understand how these household characteristics affect retirement. Mental health problems have a large and significant negative effect on retirement savings. Specifically, psychological distress is associated with decreasing the probability of holding retirement accounts by as much as 24 percentage points and decreasing retirement savings as a share of financial assets by as much as 67 percentage points. The magnitude of these effects underscores the importance of employer management policy and government regulation of these accounts to help ensure households have adequate retirement savings. Copyright © 2017 John Wiley & Sons, Ltd.

  20. TV Energy Consumption Trends and Energy-Efficiency Improvement Options

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

    Park, Won Young; Phadke, Amol; Shah, Nihar

    2011-07-01

    The SEAD initiative aims to transform the global market by increasing the penetration of highly efficient equipment and appliances. SEAD is a government initiative whose activities and projects engage the private sector to realize the large global energy savings potential from improved appliance and equipment efficiency. SEAD seeks to enable high-level global action by informing the Clean Energy Ministerial dialogue as one of the initiatives in the Global Energy Efficiency Challenge. In keeping with its goal of achieving global energy savings through efficiency, SEAD was approved as a task within the International Partnership for Energy Efficiency Cooperation (IPEEC) in Januarymore » 2010. SEAD partners work together in voluntary activities to: (1) ?raise the efficiency ceiling? by pulling super-efficient appliances and equipment into the market through cooperation on measures like incentives, procurement, awards, and research and development (R&D) investments; (2) ?raise the efficiency floor? by working together to bolster national or regional policies like minimum efficiency standards; and (3) ?strengthen the efficiency foundations? of programs by coordinating technical work to support these activities. Although not all SEAD partners may decide to participate in every SEAD activity, SEAD partners have agreed to engage actively in their particular areas of interest through commitment of financing, staff, consultant experts, and other resources. In addition, all SEAD partners are committed to share information, e.g., on implementation schedules for and the technical detail of minimum efficiency standards and other efficiency programs. Information collected and created through SEAD activities will be shared among all SEAD partners and, to the extent appropriate, with the global public.As of April 2011, the governments participating in SEAD are: Australia, Brazil, Canada, the European Commission, France, Germany, India, Japan, Korea, Mexico, Russia, South Africa, Sweden, the United Arab Emirates, the United Kingdom, and the United States. More information on SEAD is available from its website at http://www.superefficient.org/.« less

  1. Integrated care experiences and outcomes in Germany, the Netherlands, and England.

    PubMed

    Busse, Reinhard; Stahl, Juliane

    2014-09-01

    Care for people with chronic conditions is an issue of increasing importance in industrialized countries. This article examines three recent efforts at care coordination that have been evaluated but not yet included in systematic reviews. The first is Germany's Gesundes Kinzigtal, a population-based approach that organizes care across all health service sectors and indications in a targeted region. The second is a program in the Netherlands that bundles payments for patients with certain chronic conditions. The third is England's integrated care pilots, which take a variety of approaches to care integration for a range of target populations. Results have been mixed. Some intermediate clinical outcomes, process indicators, and indicators of provider satisfaction improved; patient experience improved in some cases and was unchanged or worse in others. Across the English pilots, emergency hospital admissions increased compared to controls in a difference-in-difference analysis, but planned admissions declined. Using the same methods to study all three programs, we observed savings in Germany and England. However, the disease-oriented Dutch approach resulted in significantly increased costs. The Kinzigtal model, including its shared-savings incentive, may well deserve more attention both in Europe and in the United States because it combines addressing a large population and different conditions with clear but simple financial incentives for providers, the management company, and the insurer. Project HOPE—The People-to-People Health Foundation, Inc.

  2. Potential cost savings for Medi-Cal, AFDC, food stamps, and WIC programs associated with increasing breast-feeding among low-income Hmong women in California.

    PubMed

    Tuttle, C R; Dewey, K G

    1996-09-01

    To determine the potential cost savings for four social service programs if breast-feeding rates increased among Hmong women in California. Cost-savings analysis. Hmong women in California. In this population, breast-feeding is currently uncommon, and use of contraceptives is minimal. Savings were based on estimates of the resulting decrease in infant morbidity, maternal fertility, and formula purchases (Special Supplemental Nutrition Program for Women, Infants, and Children) if women breast-fed each child for at least 6 months. Costs were projected over a 7.5-year period and future values were discounted with annual interest rates of 2% or 4%. Substantial savings estimates were associated with breast-feeding for all four programs. The total projected savings over the 7.5-year period ranges from $3,442 to $4,944 (4% discount) to $4,475 to $6,0960 (0% discount) per family enrolled in all four programs. This translates into an estimated yearly savings of between $459 and $659 (4% discount) and $597 and $808 (0% discount) per family. Although health care providers generally accept that breast-feeding is the preferred method for feeding infants, many still view the choice as a neutral one; that is, they consider low breast-feeding rates in the United States a cultural choice with no cost to society. This analysis provides evidence that breast-feeding is economically advantageous for individuals and society.

  3. Implementation Costs of an Enhanced Recovery After Surgery Program in the United States: A Financial Model and Sensitivity Analysis Based on Experiences at a Quaternary Academic Medical Center.

    PubMed

    Stone, Alexander B; Grant, Michael C; Pio Roda, Claro; Hobson, Deborah; Pawlik, Timothy; Wu, Christopher L; Wick, Elizabeth C

    2016-03-01

    Despite positive results from several international Enhanced Recovery After Surgery (ERAS) protocols, the United States has been slow to adopt ERAS protocols, in part due to concern regarding the expenses of such a program. We sought to evaluate the potential annual net cost savings of implementing a US-based ERAS program. Using data from existing publications and experience with an ERAS program, a model of net financial costs was developed for surgical groups of escalating numbers of annual cases. Our example scenario provided a financial analysis of the implementation of an ERAS program at a United States academic institution based on data from the ERAS Program for Colorectal Surgery at The Johns Hopkins Hospital. Based on available data from the United States, ERAS programs lead to reductions in lengths of hospital stay that range from 0.7 to 2.7 days and substantial direct cost savings. Using example data from a quaternary hospital, the considerable cost of $552,783 associated with implementation of an ERAS program was offset by even greater savings in the first year of nearly $948,500, yielding a net savings of $395,717. Sensitivity analysis across several caseload and direct cost scenarios yielded similar savings in 20 of the 27 projections. Enhanced Recovery After Surgery protocols have repeatedly led to reduction in length of hospital stay and improved surgical outcomes. A financial model, based on published data and experience, projects that investment in an ERAS program can also lead to net financial savings for US hospitals. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Calendar Year 2007 Program Benefits for U.S. EPA Energy Star Labeled Products: Expanded Methodology

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

    Sanchez, Marla; Homan, Gregory; Lai, Judy

    2009-09-24

    This report provides a top-level summary of national savings achieved by the Energy Star voluntary product labeling program. To best quantify and analyze savings for all products, we developed a bottom-up product-based model. Each Energy Star product type is characterized by product-specific inputs that result in a product savings estimate. Our results show that through 2007, U.S. EPA Energy Star labeled products saved 5.5 Quads of primary energy and avoided 100 MtC of emissions. Although Energy Star-labeled products encompass over forty product types, only five of those product types accounted for 65percent of all Energy Star carbon reductions achieved tomore » date, including (listed in order of savings magnitude)monitors, printers, residential light fixtures, televisions, and furnaces. The forecast shows that U.S. EPA?s program is expected to save 12.2 Quads of primary energy and avoid 215 MtC of emissions over the period of 2008?2015.« less

  5. An overview on integrated data system for archiving and sharing marine geology and geophysical data in Korea Institute of Ocean Science & Technology (KIOST)

    NASA Astrophysics Data System (ADS)

    Choi, Sang-Hwa; Kim, Sung Dae; Park, Hyuk Min; Lee, SeungHa

    2016-04-01

    We established and have operated an integrated data system for managing, archiving and sharing marine geology and geophysical data around Korea produced from various research projects and programs in Korea Institute of Ocean Science & Technology (KIOST). First of all, to keep the consistency of data system with continuous data updates, we set up standard operating procedures (SOPs) for data archiving, data processing and converting, data quality controls, and data uploading, DB maintenance, etc. Database of this system comprises two databases, ARCHIVE DB and GIS DB for the purpose of this data system. ARCHIVE DB stores archived data as an original forms and formats from data providers for data archive and GIS DB manages all other compilation, processed and reproduction data and information for data services and GIS application services. Relational data management system, Oracle 11g, adopted for DBMS and open source GIS techniques applied for GIS services such as OpenLayers for user interface, GeoServer for application server, PostGIS and PostgreSQL for GIS database. For the sake of convenient use of geophysical data in a SEG Y format, a viewer program was developed and embedded in this system. Users can search data through GIS user interface and save the results as a report.

  6. Cost-Benefit Analysis of a Support Program for Nursing Staff.

    PubMed

    Moran, Dane; Wu, Albert W; Connors, Cheryl; Chappidi, Meera R; Sreedhara, Sushama K; Selter, Jessica H; Padula, William V

    2017-04-27

    A peer-support program called Resilience In Stressful Events (RISE) was designed to help hospital staff cope with stressful patient-related events. The aim of this study was to evaluate the impact of the RISE program by conducting an economic evaluation of its cost benefit. A Markov model with a 1-year time horizon was developed to compare the cost benefit with and without the RISE program from a provider (hospital) perspective. Nursing staff who used the RISE program between 2015 and 2016 at a 1000-bed, private hospital in the United States were included in the analysis. The cost of running the RISE program, nurse turnover, and nurse time off were modeled. Data on costs were obtained from literature review and hospital data. Probabilities of quitting or taking time off with or without the RISE program were estimated using survey data. Net monetary benefit (NMB) and budget impact of having the RISE program were computed to determine cost benefit to the hospital. Expected model results of the RISE program found a net monetary benefit savings of US $22,576.05 per nurse who initiated a RISE call. These savings were determined to be 99.9% consistent on the basis of a probabilistic sensitivity analysis. The budget impact analysis revealed that a hospital could save US $1.81 million each year because of the RISE program. The RISE program resulted in substantial cost savings to the hospital. Hospitals should be encouraged by these findings to implement institution-wide support programs for medical staff, based on a high demand for this type of service and the potential for cost savings.

  7. A method for estimating maternal and newborn lives saved from health-related investments funded by the UK government Department for International Development using the Lives Saved Tool.

    PubMed

    Friberg, Ingrid K; Baschieri, Angela; Abbotts, Jo

    2017-11-07

    In 2010, the UK Government Department for International Development (DFID) committed through its 'Framework for results for reproductive, maternal and newborn health (RMNH)' to save 50,000 maternal lives and 250,000 newborn lives by 2015. They also committed to monitoring the performance of this portfolio of investments to demonstrate transparency and accountability. Methods currently available to directly measure lives saved are cost-, time-, and labour-intensive. The gold standard for calculating the total number of lives saved would require measuring mortality with large scale population based surveys or annual vital events surveillance. Neither is currently available in all low- and middle-income countries. Estimating the independent effect of DFID support relative to all other effects on health would also be challenging. The Lives Saved Tool (LiST) is an evidence based software for modelling the effect of changes in health intervention coverage on reproductive, maternal, newborn and child mortality. A multi-country LiST-based analysis protocol was developed to retrospectively assess the total annual number of maternal and newborn lives saved from DFID aid programming in low- and middle-income countries. Annual LiST analyses using the latest program data from DFID country offices were conducted between 2013 and 2016, estimating the annual number of maternal and neonatal lives saved across 2010-2015. For each country, independent project results were aggregated into health intervention coverage estimates, with and in the absence of DFID funding. More than 80% of reported projects were suitable for inclusion in the analysis, with 151 projects analysed in the 2016 analysis. Between 2010 and 2014, it is estimated that DFID contributed to saving the lives of 15,000 women in pregnancy and childbirth with health programming and 88,000 with family planning programming. It is estimated that DFID health programming contributed to saving 187,000 newborn lives. It is feasible to estimate the overall contribution and impact of DFID's investment in RMNH from currently available information on interventions and coverage from individual country offices. This utilization of LiST, with estimated population coverage based on DFID program inputs, can be applied to similar types of datasets to quantify programme impact. The global data were used to estimate DFID's progress against the Framework for results targets to inform future programming. The identified limitations can also be considered to inform future monitoring and evaluation program design and implementation within DFID.

  8. Could a federal program to promote influenza vaccination among elders be cost-effective?

    PubMed

    Patel, Mitesh S; Davis, Matthew M

    2006-03-01

    Influenza-related mortality predominately and disproportionately impacts the elderly. Rates of annual influenza vaccination among the elderly are approximately 65%, far below the Healthy People 2010 target of 90%. We estimated the cost-effectiveness of a 10-year federal program to promote influenza vaccine, intended to increase vaccination rates among persons > or = 65 years old. Published estimates regarding influenza-associated mortality rates and vaccine efficacy among the US elderly were used to calculate the number needed to vaccinate (NNV) to prevent one all-cause death due to influenza, as well as the mortality reduction expected from increased vaccination rates. The costs per life-year saved were estimated for a hypothetical federal promotional campaign, patterned after a direct-to-consumer (DTC) advertising program (2006-2015). The base case scenario presumed a 25-percentage-point increase in vaccination rates to 90%; in sensitivity analyses, we examined programs that increased rates by 10-20 points. The base case NNV was 1116 (95% CI: 993-1348). Over the 10-year DTC-style influenza vaccine promotion program, 6516 (5576-7435) elderly lives would be saved. The incremental cost-effectiveness (C/E) of the program was dollar 16,300 (dollar 11,347-dollar 25,174) per life-year saved in 2006 and increased to dollar 199,906 (dollar 138,613-dollar 307,423) per life-year saved by 2015. Overall, the C/E for the 10-year program was dollar 37,621 (dollar 32,644-dollar 43,939) per life-year saved. Programs that yielded a 15-percentage-point increase or less in vaccination rates would have C/E values exceeding dollar 50,000 per life-year saved and save fewer than 4000 total lives. DTC-style promotional campaigns for influenza vaccine among elders may represent a cost-effective strategy for the federal government to pursue as a means of increasing elders' vaccination rates and reducing influenza-related mortality.

  9. 76 FR 73682 - Agency Information Collection Activities; Submission for OMB Review; Comment Request...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-29

    ... of a Bona Fide Profit-Sharing Plan or Trust ACTION: Notice. SUMMARY: The Department of Labor (DOL) is..., ``Requirements of a Bona Fide Thrift or Savings Plan and Requirements of a Bona Fide Profit-Sharing Plan or Trust... with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501 et seq.). DATES: Submit comments on or...

  10. Viewing the Impact of Shared Services through the Four Frames of Bolman and Deal

    ERIC Educational Resources Information Center

    Schumacher, Kyle A.

    2011-01-01

    On March 31, 2011, Governor Quinn of Illinois called for schools to consolidate in order to become more financially and administratively efficient. This call for massive school reform is not new. Although consolidation, or reducing the number of school districts to save administrative costs, seemed radical to some, the idea of sharing services to…

  11. 78 FR 64498 - Change in Bank Control Notices; Acquisitions of Shares of a Bank or Bank Holding Company

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-29

    ... Peoples Savings Bank, both in Indianola, Iowa. 2. David H. McKee, individually, and as special voting... FEDERAL RESERVE SYSTEM Change in Bank Control Notices; Acquisitions of Shares of a Bank or Bank Holding Company The notificants listed below have applied under the Change in Bank Control Act (12 U.S.C...

  12. A comparison of time-shared vs. batch development of space software

    NASA Technical Reports Server (NTRS)

    Forthofer, M.

    1977-01-01

    In connection with a study regarding the ground support software development for the Space Shuttle, an investigation was conducted concerning the most suitable software development techniques to be employed. A time-sharing 'trial period' was used to determine whether or not time-sharing would be a cost-effective software development technique for the Ground Based Shuttle system. It was found that time-sharing substantially improved job turnaround and programmer access to the computer for the representative group of ground support programmers. Moreover, this improvement resulted in an estimated saving of over fifty programmer days during the trial period.

  13. Economic Analysis of the Return-on-Investment of a Worksite Wellness Program for a Large Multistate Retail Grocery Organization.

    PubMed

    Light, Emily M W; Kline, Allison S; Drosky, Megan A; Chapman, Larry S

    2015-08-01

    The objective of this study is to measure the return on investment (ROI) of the Price Chopper/Golub Corporation employee population who participate in wellness programs available to them. Medical claims data, risk level, and presence of comorbidities such as diabetes and heart disease were compared in a matched retrospective cohort of participants and nonparticipants, with 2008, 2009, and 2010 serving as measurement years. Program costs and estimated savings were used to calculate an ROI of $4.33 for every dollar invested in wellness programs. Reductions in medical costs were observed at several risk and participation levels, with an average savings of $133 per participant and a 3-year savings estimate of $285,706. The positive ROI and savings estimate indicate that wellness interventions added economic value to Price Chopper/Golub Corporation.

  14. Value at Risk on Composite Price Share Index Stock Data

    NASA Astrophysics Data System (ADS)

    Oktaviarina, A.

    2018-01-01

    The financial servicest authority was declared Let’s Save Campaign on n commemoration of the World Savings Day that falls on this day, October 31, 2016. The activity was greeted enthusiastically by Indonesia Stock Exchange by taking out the slogan Let’s Save The Stocks. Stock is a form of investment that is expected to benefit in the future despite has risks. Value at Risk (VaR) is a method that can measure how much the risk of a financial investment. Composite Stock Price Indeks is the stock price index used by Indonesia Stock Exchange as stock volatility benchmarks in Indonesia. This study aimed to estimate Value at Risk (VaR) on closing price Composite Price Share Index Stock data on the period 20 September 2016 until 20 September 2017. Box-Pierce test results p value=0.9528 which is greater than a, that shows homoskedasticity. Value at Risk (VaR) with Variance Covariance Method is Rp.3.054.916,07 which means with 99% confindence interval someone who invests Rp.100.000.000,00 will get Rp.3.054.916,07 as a maximum loss.

  15. Tweeting and Treating: How Hospitals Use Twitter to Improve Care.

    PubMed

    Gomes, Christian; Coustasse, Alberto

    2015-01-01

    Hospitals that have adopted Twitter primarily use it to share organizational news, provide general health care information, advertise upcoming community events, and foster networking. The purpose of this study was to explore the benefits that Twitter utilization has had in improving quality of care, access to care, patient satisfaction, and community footprint while assessing the barriers to its implementation. The methodology used was a qualitative study with a semistructured interview combined with a literature review, which followed the basic principles of a systematic review. The utilization of Twitter by hospitals suggest that it leads to savings of resources, enhanced employee and patient communication, and expanded patient reach in the community. Savings opportunities are generated by preventing unnecessary office visits, producing billable patient encounters, and eliminating high recruiting costs. Communication is enhanced using Twitter by sharing organizational content, news, and health promotions and can be also a useful tool during crises. The utilization of Twitter in the hospital setting has been more beneficial than detrimental in its ability to generate opportunities for cost savings, recruiting, communication with employees and patients, and community reach.

  16. Autonomous taxis could greatly reduce greenhouse-gas emissions of US light-duty vehicles

    NASA Astrophysics Data System (ADS)

    Greenblatt, Jeffery B.; Saxena, Samveg

    2015-09-01

    Autonomous vehicles (AVs) are conveyances to move passengers or freight without human intervention. AVs are potentially disruptive both technologically and socially, with claimed benefits including increased safety, road utilization, driver productivity and energy savings. Here we estimate 2014 and 2030 greenhouse-gas (GHG) emissions and costs of autonomous taxis (ATs), a class of fully autonomous shared AVs likely to gain rapid early market share, through three synergistic effects: (1) future decreases in electricity GHG emissions intensity, (2) smaller vehicle sizes resulting from trip-specific AT deployment, and (3) higher annual vehicle-miles travelled (VMT), increasing high-efficiency (especially battery-electric) vehicle cost-effectiveness. Combined, these factors could result in decreased US per-mile GHG emissions in 2030 per AT deployed of 87-94% below current conventionally driven vehicles (CDVs), and 63-82% below projected 2030 hybrid vehicles, without including other energy-saving benefits of AVs. With these substantial GHG savings, ATs could enable GHG reductions even if total VMT, average speed and vehicle size increased substantially. Oil consumption would also be reduced by nearly 100%.

  17. A cost-benefit analysis of a deposit-refund program for beverage containers in Israel

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

    Lavee, Doron, E-mail: doron@pareto.co.i

    2010-02-15

    The paper presents a full cost-benefit analysis of a deposit-refund program for beverage containers in Israel. We examine all cost elements of the program - storage, collection, and treatment costs of empty containers, and all potential benefits - savings in alternative treatment costs (waste collection and landfill disposal), cleaner public spaces, reduction of landfill volumes, energy-savings externalities associated with use of recycled materials, and creation of new workplaces. A wide variety of data resources is employed, and some of the critical issues are examined via several approaches. The main finding of the paper is that the deposit-refund program is clearlymore » economically worthwhile. The paper contributes to the growing body of literature on deposit-refund programs by its complete and detailed analysis of all relevant factors of such a program, and also specifically in its analysis of the savings in alternative waste management costs. This analysis reveals greater savings than are usually assumed, and thus shows the deposit-refund program to be highly efficient.« less

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

    PubMed

    Chen, Stephanie C; Pearson, Steven D

    2016-08-01

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

  19. Sustainability in health care by allocating resources effectively (SHARE) 3: examining how resource allocation decisions are made, implemented and evaluated in a local healthcare setting.

    PubMed

    Harris, Claire; Allen, Kelly; Waller, Cara; Brooke, Vanessa

    2017-05-09

    This is the third in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. Leaders in a large Australian health service planned to establish an organisation-wide, systematic, integrated, evidence-based approach to disinvestment. In order to introduce new systems and processes for disinvestment into existing decision-making infrastructure, we aimed to understand where, how and by whom resource allocation decisions were made, implemented and evaluated. We also sought the knowledge and experience of staff regarding previous disinvestment activities. Structured interviews, workshops and document analysis were used to collect information from multiple sources in an environmental scan of decision-making systems and processes. Findings were synthesised using a theoretical framework. Sixty-eight respondents participated in interviews and workshops. Eight components in the process of resource allocation were identified: Governance, Administration, Stakeholder engagement, Resources, Decision-making, Implementation, Evaluation and, where appropriate, Reinvestment of savings. Elements of structure and practice for each component are described and a new framework was developed to capture the relationships between them. A range of decision-makers, decision-making settings, type and scope of decisions, criteria used, and strengths, weaknesses, barriers and enablers are outlined. The term 'disinvestment' was not used in health service decision-making. Previous projects that involved removal, reduction or restriction of current practices were driven by quality and safety issues, evidence-based practice or a need to find resource savings and not by initiatives where the primary aim was to disinvest. Measuring resource savings is difficult, in some situations impossible. Savings are often only theoretical as resources released may be utilised immediately by patients waiting for beds, clinic appointments or surgery. Decision-making systems and processes for resource allocation are more complex than assumed in previous studies. There is a wide range of decision-makers, settings, scope and type of decisions, and criteria used for allocating resources within a single institution. To our knowledge, this is the first paper to report this level of detail and to introduce eight components of the resource allocation process identified within a local health service.

  20. Methodology for National Water Savings Model and Spreadsheet Tool—Outdoor Water Use

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

    Williams, Alison, A; Chen, Yuting; Dunham, Camilla

    This report describes the method Lawrence Berkeley National Laboratory (LBNL) developed to estimate national impacts of the U.S. Environmental Protection Agency’s (EPA’s) WaterSense labeling program for weather-based irrigation controllers (WBIC). Estimated impacts include the national water savings attributable to the program and the net present value of the lifetime water savings for consumers of irrigation controllers.

  1. Saving Energy in Industrial Companies: Case Studies of Energy Efficiency Programs in Large U.S. Industrial Corporations and the Role of Ratepayer-Funded Support

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

    None, None

    This paper is designed for companies looking to cut costs through energy savings, ratepayer-funded program administrators interested in increasing large industrial company participation in energy efficiency program offerings, and state utility commissions.

  2. Activity and task of the saveMLAK and aid for library

    NASA Astrophysics Data System (ADS)

    Okamoto, Makoto

    We report the activities of saveMLAK, an organization dedicated to supporting museums, libraries, archives, and kominkans damaged by the Great East Japan Earthquake, focusing on the activities for libraries. saveMLAK provides a website using MediaWiki collaborative editing software for accumulating information regarding damage and support activities, offering information support, indirect support, and intermediary support. We also report the collaboration with Miyagi Prefectural Library based on the accumulated, shared information as an example of support for libraries in the disaster area. We describe the process of the activities of saveMLAK and problems emerging so far, and provide constructive criticism and proposals to other support activities for libraries. In conclusion, we suggest establishment of permanent organizations/functions to prepare for emergencies and to cope with disasters in the future.

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

    Schatz, Glenn

    Higher education uses less energy per square foot than most commercial building sectors. However, higher education campuses house energy-intensive laboratories and data centers that may spend more than this average; laboratories, in particular, are disproportionately represented in the higher education sector. The Commercial Building Partnership (CBP), a public/private, cost-shared program sponsored by the U.S. Department of Energy (DOE), paired selected commercial building owners and operators with representatives of DOE, its national laboratories, and private-sector technical experts. These teams explored energy-saving measures across building systems–including some considered too costly or technologically challenging–and used advanced energy modeling to achieve peak whole-building performance.more » Modeling results were then included in new construction or retrofit designs to achieve significant energy reductions.« less

  4. DOE saves time and money with ORAU's upfront characterization

    ScienceCinema

    Cange, Sue

    2018-02-06

    Acting DOE Assistant Manager for Environmental Management Sue Cange shares how ORAU provided valuable upfront characterization work that helped accelerate the cleanup efforts on the Oak Ridge Reservation.

  5. DOE saves time and money with ORAU's upfront characterization

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

    Cange, Sue

    2012-03-08

    Acting DOE Assistant Manager for Environmental Management Sue Cange shares how ORAU provided valuable upfront characterization work that helped accelerate the cleanup efforts on the Oak Ridge Reservation.

  6. Comparative costs of family planning services and hospital-based maternity care in Turkey.

    PubMed

    Cakir, H V; Fabricant, S J; Kircalioğlu, F N

    1996-01-01

    The costs of running a recently established family planning program in the Turkish social security system were measured and compared with the costs of providing the medical services and nonmedical benefits for pregnant women. The undiscounted cost savings from averting pregnancy were estimated to exceed the program's recurrent costs by 17.6 to 1. Cost savings represent only 1 percent of all of the system's medical expenditures, but the family planning program is in an early stage, and potential savings could influence management decisionmaking regarding investments in specialized maternity hospitals.

  7. Chapter 11: Sample Design Cross-Cutting Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

    Kurnik, Charles W; Khawaja, M. Sami; Rushton, Josh

    Evaluating an energy efficiency program requires assessing the total energy and demand saved through all of the energy efficiency measures provided by the program. For large programs, the direct assessment of savings for each participant would be cost-prohibitive. Even if a program is small enough that a full census could be managed, such an undertaking would almost always be an inefficient use of evaluation resources. The bulk of this chapter describes methods for minimizing and quantifying sampling error. Measurement error and regression error are discussed in various contexts in other chapters.

  8. Comparing the Medicaid Retrospective Drug Utilization Review Program Cost-Savings Methods Used by State Agencies

    PubMed Central

    Prada, Sergio I.

    2017-01-01

    Background The Medicaid Drug Utilization Review (DUR) program is a 2-phase process conducted by Medicaid state agencies. The first phase is a prospective DUR and involves electronically monitoring prescription drug claims to identify prescription-related problems, such as therapeutic duplication, contraindications, incorrect dosage, or duration of treatment. The second phase is a retrospective DUR and involves ongoing and periodic examinations of claims data to identify patterns of fraud, abuse, underutilization, drug–drug interaction, or medically unnecessary care, implementing corrective actions when needed. The Centers for Medicare & Medicaid Services requires each state to measure prescription drug cost-savings generated from its DUR programs on an annual basis, but it provides no guidance or unified methodology for doing so. Objectives To describe and synthesize the methodologies used by states to measure cost-savings using their Medicaid retrospective DUR program in federal fiscal years 2014 and 2015. Method For each state, the cost-savings methodologies included in the Medicaid DUR 2014 and 2015 reports were downloaded from Medicaid's website. The reports were then reviewed and synthesized. Methods described by the states were classified according to research designs often described in evaluation textbooks. Discussion In 2014, the most often used prescription drugs cost-savings estimation methodology for the Medicaid retrospective DUR program was a simple pre-post intervention method, without a comparison group (ie, 12 states). In 2015, the most common methodology used was a pre-post intervention method, with a comparison group (ie, 14 states). Comparisons of savings attributed to the program among states are still unreliable, because of a lack of a common methodology available for measuring cost-savings. Conclusion There is great variation among states in the methods used to measure prescription drug utilization cost-savings. This analysis suggests that there is still room for improvement in terms of methodology transparency, which is important, because lack of transparency hinders states from learning from each other. Ultimately, the federal government needs to evaluate and improve its DUR program. PMID:29403573

  9. Cost-savings for biosimilars in the United States: a theoretical framework and budget impact case study application using filgrastim.

    PubMed

    Grewal, Simrun; Ramsey, Scott; Balu, Sanjeev; Carlson, Josh J

    2018-05-18

    Biosimilars can directly reduce the cost of treating patients for whom a reference biologic is indicated by offering a highly similar, lower priced alternative. We examine factors related to biosimilar regulatory approval, uptake, pricing, and financing and the potential impact on drug expenditures in the U.S. We developed a framework to illustrate how key factors including regulatory policies, provider and patient perception, pricing, and payer policies impact biosimilar cost-savings. Further, we developed a budget impact cost model to estimate savings from filgrastim biosimilars under various scenarios. The model uses publicly available data on disease incidence, treatment patterns, market share, and drug prices to estimate the cost-savings over a 5-year time horizon. We estimate five-year cost savings of $256 million, of which 18% ($47 million) are from reduced patient out-of-pocket costs, 34% ($86 million) are savings to commercial payers, and 48% ($123 million) are savings for Medicare. Additional scenarios demonstrate the impact of uncertain factors, including price, uptake, and financing policies. A variety or interrelated factors influence the development, uptake, and cost-savings for Biosimilars use in the U.S. The filgrastim case is a useful example that illustrates these factors and the potential magnitude of costs savings.

  10. Residential Water Conservation in a Noncrisis Setting: Results of a New Jersey Experiment

    NASA Astrophysics Data System (ADS)

    Palmini, Dennis J.; Shelton, Theodore B.

    1982-08-01

    East Brunswick Township, New Jersey, conducted a water conservation program in 1980 by distributing to 564 households free packets of water-saving devices purchased with municipal funds. The program was not a response to a current water supply crisis, and appeals for cooperation were based on the private economic benefits of water conservation. Statistical procedures were developed to measure the proportions of households installing each of the devices distributed, water savings and program costs. Two-thirds of the households receiving the packets installed at least one device. Average annual water savings per home receiving a packet were estimated at 5010 gallons (18.96 kl). Amortized over ten years at a 10% discount rate, the program cost was approximately 35 cents per 1000 gallons of water saved (9.2 cents per kl). The East Brunswick results compare well to the results obtained from similar conservation programs in a pair of California communities during the 1976-1977 drought.

  11. Higher Education ERP: Lessons Learned.

    ERIC Educational Resources Information Center

    Swartz, Dave; Orgill, Ken

    2001-01-01

    Shares experiences and lessons learned by chief information officers of large universities about enterprise resource planning (ERP). Specifically, provides a framework for approaching an ERP that could save universities millions of dollars. (EV)

  12. Computer-Based Patient Records: Better Planning and Oversight by VA, DOD, and IHS Would Enhance Health Data Sharing

    DTIC Science & Technology

    2001-04-01

    IHS), could share information technology (IT) and patient medical information to provide greater continuity of care, accelerate VA eligibility... patient medical information to provide greater continuity of care, accelerate VA eligibility determinations, and save software development costs.1 In...system, which primarily includes information on patient hospital admission and discharge, patient medications , laboratory results, and radiology

  13. Diffusion Dynamics of Energy Saving Practices in Large Heterogeneous Online Networks

    PubMed Central

    Mohammadi, Neda; Wang, Qi; Taylor, John E.

    2016-01-01

    Online social networks are today’s fastest growing communications channel and a popular source of information for many, so understanding their contribution to building awareness and shaping public perceptions of climate change is of utmost importance. Today’s online social networks are composed of complex combinations of entities and communication channels and it is not clear which communicators are the most influential, what the patterns of communication flow are, or even whether the widely accepted two-step flow of communication model applies in this new arena. This study examines the diffusion of energy saving practices in a large online social network across organizations, opinion leaders, and the public by tracking 108,771 communications on energy saving practices among 1,084 communicators, then analyzing the flow of information and influence over a 28 day period. Our findings suggest that diffusion networks of messages advocating energy saving practices are predominantly led by the activities of dedicated organizations but their attempts do not result in substantial public awareness, as most of these communications are effectively trapped in organizational loops in which messages are simply shared between organizations. Despite their comparably significant influential values, opinion leaders played a weak role in diffusing energy saving practices to a wider audience. Thus, the two-step flow of communication model does not appear to describe the sharing of energy conservation practices in large online heterogeneous networks. These results shed new light on the underlying mechanisms driving the diffusion of important societal issues such as energy efficiency, particularly in the context of large online social media outlets. PMID:27736912

  14. Diffusion Dynamics of Energy Saving Practices in Large Heterogeneous Online Networks.

    PubMed

    Mohammadi, Neda; Wang, Qi; Taylor, John E

    2016-01-01

    Online social networks are today's fastest growing communications channel and a popular source of information for many, so understanding their contribution to building awareness and shaping public perceptions of climate change is of utmost importance. Today's online social networks are composed of complex combinations of entities and communication channels and it is not clear which communicators are the most influential, what the patterns of communication flow are, or even whether the widely accepted two-step flow of communication model applies in this new arena. This study examines the diffusion of energy saving practices in a large online social network across organizations, opinion leaders, and the public by tracking 108,771 communications on energy saving practices among 1,084 communicators, then analyzing the flow of information and influence over a 28 day period. Our findings suggest that diffusion networks of messages advocating energy saving practices are predominantly led by the activities of dedicated organizations but their attempts do not result in substantial public awareness, as most of these communications are effectively trapped in organizational loops in which messages are simply shared between organizations. Despite their comparably significant influential values, opinion leaders played a weak role in diffusing energy saving practices to a wider audience. Thus, the two-step flow of communication model does not appear to describe the sharing of energy conservation practices in large online heterogeneous networks. These results shed new light on the underlying mechanisms driving the diffusion of important societal issues such as energy efficiency, particularly in the context of large online social media outlets.

  15. When does mass screening for open neural tube defects in low-risk pregnancies result in cost savings?

    PubMed Central

    Tosi, L L; Detsky, A S; Roye, D P; Morden, M L

    1987-01-01

    Using a decision analysis model, we estimated the savings that might be derived from a mass prenatal screening program aimed at detecting open neural tube defects (NTDs) in low-risk pregnancies. Our baseline analysis showed that screening v. no screening could be expected to save approximately $8 per pregnancy given a cost of $7.50 for the maternal serum alpha-feto-protein (MSAFP) test and a cost of $42,507 for hospital and rehabilitation services for the first 10 years of life for a child with spina bifida. When a more liberal estimate of the costs of caring for such a child was used, the savings with the screening program were more substantial. We performed extensive sensitivity analyses, which showed that the savings were somewhat sensitive to the cost of the MSAFP test and highly sensitive to the specificity (but not the sensitivity) of the test. A screening program for NTDs in low-risk pregnancies may result in substantial savings in direct health care costs if the screening protocol is followed rigorously and efficiently. PMID:2433011

  16. Impact of a comprehensive population health management program on health care costs.

    PubMed

    Grossmeier, Jessica; Seaverson, Erin L D; Mangen, David J; Wright, Steven; Dalal, Karl; Phalen, Chris; Gold, Daniel B

    2013-06-01

    Assess the influence of participation in a population health management (PHM) program on health care costs. A quasi-experimental study relied on logistic and ordinary least squares regression models to compare the costs of program participants with those of nonparticipants, while controlling for differences in health care costs and utilization, demographics, and health status. Propensity score models were developed and analyses were weighted by inverse propensity scores to control for selection bias. Study models yielded an estimated savings of $60.65 per wellness participant per month and $214.66 per disease management participant per month. Program savings were combined to yield an integrated return-on-investment of $3 in savings for every dollar invested. A PHM program yielded a positive return on investment after 2 years of wellness program and 1 year of integrated disease management program launch.

  17. A Cost-Savings Analysis of a Statewide Parenting Education Program in Child Welfare

    ERIC Educational Resources Information Center

    Maher, Erin J.; Corwin, Tyler W.; Hodnett, Rhenda; Faulk, Karen

    2012-01-01

    Objectives: This article presents a cost-savings analysis of the statewide implementation of an evidence-informed parenting education program. Methods: Between the years 2005 and 2008, the state of Louisiana used the Nurturing Parenting Program (NPP) to impart parenting skills to child welfare-involved families. Following these families' outcomes…

  18. Wellness incentives in the workplace: cost savings through cost shifting to unhealthy workers.

    PubMed

    Horwitz, Jill R; Kelly, Brenna D; DiNardo, John E

    2013-03-01

    The Affordable Care Act encourages workplace wellness programs, chiefly by promoting programs that reward employees for changing health-related behavior or improving measurable health outcomes. Recognizing the risk that unhealthy employees might be punished rather than helped by such programs, the act also forbids health-based discrimination. We reviewed results of randomized controlled trials and identified challenges for workplace wellness programs to function as the act intends. For example, research results raise doubts that employees with health risk factors, such as obesity and tobacco use, spend more on medical care than others. Such groups may not be especially promising targets for financial incentives meant to save costs through health improvement. Although there may be other valid reasons, beyond lowering costs, to institute workplace wellness programs, we found little evidence that such programs can easily save costs through health improvement without being discriminatory. Our evidence suggests that savings to employers may come from cost shifting, with the most vulnerable employees--those from lower socioeconomic strata with the most health risks--probably bearing greater costs that in effect subsidize their healthier colleagues.

  19. U.S. utilities' experiences with the implementation of energy efficiency programs

    NASA Astrophysics Data System (ADS)

    Goss, Courtney

    In the U.S., many electric utility companies are offering demand-side management (DSM) programs to their customers as ways to save money and energy. However, it is challenging to compare these programs between utility companies throughout the U.S. because of the variability of state energy policies. For example, some states in the U.S. have deregulated electricity markets and others do not. In addition, utility companies within a state differ depending on ownership and size. This study examines 12 utilities' experiences with DSM programs and compares the programs' annual energy savings results that the selected utilities reported to the Energy Information Administration (EIA). The 2009 EIA data suggests that DSM program effectiveness is not significantly affected by electricity market deregulation or utility ownership. However, DSM programs seem to generally be more effective when administered by utilities located in states with energy savings requirements and DSM program mandates.

  20. Columbus Saves: Saving Money in Ohio

    ERIC Educational Resources Information Center

    Shockey, Susan

    2004-01-01

    The "Columbus Saves" educational program is a broad-based community coalition made up of more than 40 local organizations from the education, nonprofit, government, faith-based, and private sectors. Common goals of partners in reaching Columbus, Ohio's 1.5 million residents are to: (a) promote increased savings through education and…

  1. Welfare Recipiency and Savings Outcomes in Individual Development Accounts

    ERIC Educational Resources Information Center

    Zhan, Min; Sherraden, Michael; Schreiner, Mark

    2004-01-01

    The authors examined how welfare recipiency is associated with savings outcomes in individual development accounts (IDAs), a structured savings program for low-income people. They investigated whether welfare recipients can save if they are provided with incentives. Data for this study ore from the American Dream Demonstration (ADD), the first…

  2. 24 CFR 221.1 - Savings clause.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Savings clause. 221.1 Section 221.1... MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES LOW COST AND MODERATE INCOME MORTGAGE INSURANCE-SAVINGS CLAUSE Eligibility Requirements-Low Cost Homes-Savings Clause § 221.1...

  3. Reported Energy and Cost Savings from the DOE ESPC Program: FY 2014

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

    Slattery, Bob S.

    2015-03-01

    The objective of this work was to determine the realization rate of energy and cost savings from the Department of Energy’s Energy Savings Performance Contract (ESPC) program based on information reported by the energy services companies (ESCOs) that are carrying out ESPC projects at federal sites. Information was extracted from 156 Measurement and Verification (M&V) reports to determine reported, estimated, and guaranteed cost savings and reported and estimated energy savings for the previous contract year. Because the quality of the reports varied, it was not possible to determine all of these parameters for each project. For all 156 projects, theremore » was sufficient information to compare estimated, reported, and guaranteed cost savings. For this group, the total estimated cost savings for the reporting periods addressed were $210.6 million, total reported cost savings were $215.1 million, and total guaranteed cost savings were $204.5 million. This means that on average: ESPC contractors guaranteed 97% of the estimated cost savings; projects reported achieving 102% of the estimated cost savings; and projects reported achieving 105% of the guaranteed cost savings. For 155 of the projects examined, there was sufficient information to compare estimated and reported energy savings. On the basis of site energy, estimated savings for those projects for the previous year totaled 11.938 million MMBtu, and reported savings were 12.138 million MMBtu, 101.7% of the estimated energy savings. On the basis of source energy, total estimated energy savings for the 155 projects were 19.052 million MMBtu, and reported saving were 19.516 million MMBtu, 102.4% of the estimated energy savings.« less

  4. Building Energy Model Development for Retrofit Homes

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

    Chasar, David; McIlvaine, Janet; Blanchard, Jeremy

    2012-09-30

    Based on previous research conducted by Pacific Northwest National Laboratory and Florida Solar Energy Center providing technical assistance to implement 22 deep energy retrofits across the nation, 6 homes were selected in Florida and Texas for detailed post-retrofit energy modeling to assess realized energy savings (Chandra et al, 2012). However, assessing realized savings can be difficult for some homes where pre-retrofit occupancy and energy performance are unknown. Initially, savings had been estimated using a HERS Index comparison for these homes. However, this does not account for confounding factors such as occupancy and weather. This research addresses a method to moremore » reliably assess energy savings achieved in deep energy retrofits for which pre-retrofit utility bills or occupancy information in not available. A metered home, Riverdale, was selected as a test case for development of a modeling procedure to account occupancy and weather factors, potentially creating more accurate estimates of energy savings. This “true up” procedure was developed using Energy Gauge USA software and post-retrofit homeowner information and utility bills. The 12 step process adjusts the post-retrofit modeling results to correlate with post-retrofit utility bills and known occupancy information. The “trued” post retrofit model is then used to estimate pre-retrofit energy consumption by changing the building efficiency characteristics to reflect the pre-retrofit condition, but keeping all weather and occupancy-related factors the same. This creates a pre-retrofit model that is more comparable to the post-retrofit energy use profile and can improve energy savings estimates. For this test case, a home for which pre- and post- retrofit utility bills were available was selected for comparison and assessment of the accuracy of the “true up” procedure. Based on the current method, this procedure is quite time intensive. However, streamlined processing spreadsheets or incorporation into existing software tools would improve the efficiency of the process. Retrofit activity appears to be gaining market share, and this would be a potentially valuable capability with relevance to marketing, program management, and retrofit success metrics.« less

  5. A Cost Analysis of the Iowa Medicaid Primary Care Case Management Program

    PubMed Central

    Momany, Elizabeth T; Flach, Stephen D; Nelson, Forrest D; Damiano, Peter C

    2006-01-01

    Objective To determine the cost savings attributable to the implementation and expansion of a primary care case management (PCCM) program on Medicaid costs per member in Iowa from 1989 to 1997. Data Sources Medicaid administrative data from Iowa aggregated at the county level. Study Design Longitudinal analysis of costs per member per month, analyzed by category of medical expense using weighted least squares. We compared the actual costs with the expected costs (in the absence of the PCCM program) to estimate cost savings attributable to the PCCM program. Principal Findings We estimated that the PCCM program was associated with a savings of $66 million to the state of Iowa over the study period. Medicaid expenses were 3.8 percent less than what they would have been in the absence of the PCCM program. Effects of the PCCM program appeared to grow stronger over time. Use of the PCCM program was associated with increases in outpatient care and pharmaceutical expenses, but a decrease in hospital and physician expenses. Conclusions Use of a Medicaid PCCM program was associated with substantial aggregate cost savings over an 8-year period, and this effect became stronger over time. Cost reductions appear to have been mediated by substituting outpatient care for inpatient care. PMID:16899012

  6. ACE Inhibitor and ARB utilization and expenditures in the Medicaid fee-for-service program from 1991 to 2008.

    PubMed

    Bian, Boyang; Kelton, Christina M L; Guo, Jeff J; Wigle, Patricia R

    2010-01-01

    Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are widely prescribed for the treatment of hypertension and heart failure, as well as for kidney disease prevention in patients with diabetes mellitus and the management of patients after myocardial infarction. To (a) describe ACE inhibitor and ARB utilization and spending in the Medicaid fee-for-service program from 1991 through 2008, and (b) estimate the potential cost savings for the collective Medicaid programs from a higher ratio of generic ACE inhibitor utilization. A retrospective, descriptive analysis was performed using the National Summary Files from the Medicaid State Drug Utilization Data, which are composed of pharmacy claims that are subject to federally mandated rebates from pharmaceutical manufacturers. For the years 1991-2008, quarterly claim counts and expenditures were calculated by summing data for individual ACE inhibitors and ARBs. Quarterly per-claim expenditure as a proxy for drug price was computed for all brand and generic drugs. Market shares were calculated based on the number of pharmacy claims and Medicaid expenditures. In the Medicaid fee-for-service program, ACE inhibitors accounted for 100% of the claims in the combined market for ACE inhibitors and ARBs in 1991, 80.6% in 2000, and 64.7% in 2008. The Medicaid expenditure per ACE inhibitor claim dropped from $37.24 in 1991 to $24.03 in 2008 when generics accounted for 92.5% of ACE inhibitor claims; after adjusting for inflation for the period from 1991 to 2008, the real price drop was 59.2%. Brand ACE inhibitors accounted for only 7.5% of the claims in 2008 for all ACE inhibitors but 32.1% of spending; excluding the effects of manufacturer rebates, Medicaid spending would have been reduced by $28.7 million (9%) in 2008 if all ACE inhibitor claims were generic. The average price per ACE inhibitor claim in 2008 was $24.03 ($17.64 per generic claim vs. $103.45 per brand claim) versus $81.98 per ARB claim. If the ACE inhibitor ratio had been 75% in 2008 rather than 64.7%, the Medicaid program would have saved approximately 13% or about $41.8 million, again excluding the effects of manufacturer rebates. If the ACE inhibitor ratio had been 90% in 2008, the cost savings for the combined Medicaid fee-forservice programs would have been about 33% or about $102.3 million. The total cost savings opportunity with 100% generic ACE inhibitor utilization in 2008 and an ACE inhibitor ratio of 75% was $75.1 million (24%) or $142.3M (46%) with a 90% ACE inhibitor ratio. Factors that affect Medicaid spending by contributing to increased utilization of ACE inhibitors and ARBs, such as the rising prevalence of hypertension, heart disease, and diabetes, can be offset by reduction in the average price attained through a higher proportion of ACE inhibitors and a higher percentage of generic versus brand ACE inhibitors.

  7. WaterSense Program: Methodology for National Water Savings Analysis Model Indoor Residential Water Use

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

    Whitehead, Camilla Dunham; McNeil, Michael; Dunham_Whitehead, Camilla

    2008-02-28

    The U.S. Environmental Protection Agency (EPA) influences the market for plumbing fixtures and fittings by encouraging consumers to purchase products that carry the WaterSense label, which certifies those products as performing at low flow rates compared to unlabeled fixtures and fittings. As consumers decide to purchase water-efficient products, water consumption will decline nationwide. Decreased water consumption should prolong the operating life of water and wastewater treatment facilities.This report describes the method used to calculate national water savings attributable to EPA?s WaterSense program. A Microsoft Excel spreadsheet model, the National Water Savings (NWS) analysis model, accompanies this methodology report. Version 1.0more » of the NWS model evaluates indoor residential water consumption. Two additional documents, a Users? Guide to the spreadsheet model and an Impacts Report, accompany the NWS model and this methodology document. Altogether, these four documents represent Phase One of this project. The Users? Guide leads policy makers through the spreadsheet options available for projecting the water savings that result from various policy scenarios. The Impacts Report shows national water savings that will result from differing degrees of market saturation of high-efficiency water-using products.This detailed methodology report describes the NWS analysis model, which examines the effects of WaterSense by tracking the shipments of products that WaterSense has designated as water-efficient. The model estimates market penetration of products that carry the WaterSense label. Market penetration is calculated for both existing and new construction. The NWS model estimates savings based on an accounting analysis of water-using products and of building stock. Estimates of future national water savings will help policy makers further direct the focus of WaterSense and calculate stakeholder impacts from the program.Calculating the total gallons of water the WaterSense program saves nationwide involves integrating two components, or modules, of the NWS model. Module 1 calculates the baseline national water consumption of typical fixtures, fittings, and appliances prior to the program (as described in Section 2.0 of this report). Module 2 develops trends in efficiency for water-using products both in the business-as-usual case and as a result of the program (Section 3.0). The NWS model combines the two modules to calculate total gallons saved by the WaterSense program (Section 4.0). Figure 1 illustrates the modules and the process involved in modeling for the NWS model analysis.The output of the NWS model provides the base case for each end use, as well as a prediction of total residential indoor water consumption during the next two decades. Based on the calculations described in Section 4.0, we can project a timeline of water savings attributable to the WaterSense program. The savings increase each year as the program results in the installation of greater numbers of efficient products, which come to compose more and more of the product stock in households throughout the United States.« less

  8. OpenStudio: A Platform for Ex Ante Incentive Programs

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

    Roth, Amir; Brackney, Larry; Parker, Andrew

    Many utilities operate programs that provide ex ante (up front) incentives for building energy conservation measures (ECMs). A typical incentive program covers two kinds of ECMs. ECMs that deliver similar savings in different contexts are associated with pre-calculated 'deemed' savings values. ECMs that deliver different savings in different contexts are evaluated on a 'custom' per-project basis. Incentive programs often operate at less than peak efficiency because both deemed ECMs and custom projects have lengthy and effort-intensive review processes--deemed ECMs to gain confidence that they are sufficiently context insensitive, custom projects to ensure that savings are claimed appropriately. DOE's OpenStudio platformmore » can be used to automate ex ante processes and help utilities operate programs more efficiently, consistently, and transparently, resulting in greater project throughput and energy savings. A key concept of the platform is the OpenStudio Measure, a script that queries and transforms building energy models. Measures can be simple or surgical, e.g., applying different transformations based on space-type, orientation, etc. Measures represent ECMs explicitly and are easier to review than ECMs that are represented implicitly as the difference between a with-ECM and without-ECM models. Measures can be automatically applied to large numbers of prototype models--and instantiated from uncertainty distributions--facilitating the large scale analysis required to develop deemed savings values. For custom projects, Measures can also be used to calibrate existing building models, to automatically create code baseline models, and to perform quality assurance screening.« less

  9. Costs and savings associated with implementation of a police crisis intervention team.

    PubMed

    El-Mallakh, Peggy L; Kiran, Kranti; El-Mallakh, Rif S

    2014-06-01

    Police crisis intervention teams (CIT) have demonstrated their effectiveness in reducing injury to law enforcement personnel and citizens and the criminalization of mental illness; however, their financial effect has not been fully investigated. The objective of the study was to determine the total costs or total savings associated with implementing a CIT program in a medium-size city. The costs and savings associated with the implementation of a CIT program were analyzed in a medium-size city, Louisville, Kentucky, 9 years after the program's initiation. Costs associated with officer training, increased emergency psychiatry visits, and hospital admissions resulting from CIT activity were compared with the savings associated with diverted hospitalizations and reduced legal bookings. Based on an average of 2400 CIT calls annually, the overall costs associated with CIT per year were $2,430,128 ($146,079 for officer training, $1,768,536 for hospitalizations of patients brought in by CIT officers, $508,690 for emergency psychiatry evaluations, and $6823 for arrests). The annual savings of the CIT were $3,455,025 ($1,148,400 in deferred hospitalizations, $2,296,800 in reduced inpatient referrals from jail, and $9825 in avoided bookings and jail time). The balance is $1,024,897 in annual cost savings. The net financial effect of a CIT program is of modest benefit; however, much of this analysis was based on estimates and average length of stay. Furthermore, the costs and savings associated with officer or citizen injuries were not included because there was inadequate information about their prevalence and costs. Finally, this analysis does not take into account the nonmonetary gains of a CIT program.

  10. How a south Florida hospital targeted Hispanic consumers.

    PubMed

    Weinstein, A

    1988-02-01

    Last month's "Case in Point" presented AMI Parkway Regional Medical Center, a 412-bed acute care hospital in North Miami Beach, Fla. The hospital's administration has recognized the ethnic make-up of the South Florida market (white, black and Hispanic) and wants to increase its penetration into the large and potentially lucrative Latin market. The hospital is one of six in South Florida that are owned by American Medical International Inc., Los Angeles. Parkway recently completed a modernization and development program that resulted in an expanded emergency department, state-of-the-art critical care units, a cost-saving ambulatory unit and facilities for outpatient and community education programs. Positioned in a fiercely competitive market, Parkway has adopted an aggressive marketing posture. The marketing function has been elevated to one of six hospital divisions, sharing equal footing with finance, professional services, administrative services, nursing and human resources. Given the hospital's reputation for action and the previous success of programs based on market research, the assistant administrator for marketing and business development secured support for research on the Latin market.

  11. Coming Together To Cut Health Care Costs.

    ERIC Educational Resources Information Center

    Heron, W. David; Donatelli, Ben

    2003-01-01

    Describes how, through a shared plan, the Health Insurance Initiative of the Independent Colleges and Universities in Florida (ICUF) is saving participating institutions millions in costs associated with providing employee health care. (EV)

  12. QuakeSim Project Networking

    NASA Astrophysics Data System (ADS)

    Kong, D.; Donnellan, A.; Pierce, M. E.

    2012-12-01

    QuakeSim is an online computational framework focused on using remotely sensed geodetic imaging data to model and understand earthquakes. With the rise in online social networking over the last decade, many tools and concepts have been developed that are useful to research groups. In particular, QuakeSim is interested in the ability for researchers to post, share, and annotate files generated by modeling tools in order to facilitate collaboration. To accomplish this, features were added to the preexisting QuakeSim site that include single sign-on, automated saving of output from modeling tools, and a personal user space to manage sharing permissions on these saved files. These features implement OpenID and Lightweight Data Access Protocol (LDAP) technologies to manage files across several different servers, including a web server running Drupal and other servers hosting the computational tools themselves.

  13. World Wide Web Metaphors for Search Mission Data

    NASA Technical Reports Server (NTRS)

    Norris, Jeffrey S.; Wallick, Michael N.; Joswig, Joseph C.; Powell, Mark W.; Torres, Recaredo J.; Mittman, David S.; Abramyan, Lucy; Crockett, Thomas M.; Shams, Khawaja S.; Fox, Jason M.; hide

    2010-01-01

    A software program that searches and browses mission data emulates a Web browser, containing standard meta - phors for Web browsing. By taking advantage of back-end URLs, users may save and share search states. Also, since a Web interface is familiar to users, training time is reduced. Familiar back and forward buttons move through a local search history. A refresh/reload button regenerates a query, and loads in any new data. URLs can be constructed to save search results. Adding context to the current search is also handled through a familiar Web metaphor. The query is constructed by clicking on hyperlinks that represent new components to the search query. The selection of a link appears to the user as a page change; the choice of links changes to represent the updated search and the results are filtered by the new criteria. Selecting a navigation link changes the current query and also the URL that is associated with it. The back button can be used to return to the previous search state. This software is part of the MSLICE release, which was written in Java. It will run on any current Windows, Macintosh, or Linux system.

  14. Cost savings in a hospital clinical laboratory with a pay-for-performance incentive program for supervisors.

    PubMed

    Winkelman, J W; Aitken, J L; Wybenga, D R

    1991-01-01

    A pay-for-performance incentive program for clinical laboratory supervisors was developed and implemented at Brigham and Women's Hospital (Boston, Mass). It provides monetary rewards to personnel who directly produce cost savings in their area of responsibility. This reward system is new to the hospital laboratory but is commonly used in industry. Substantial true cost savings over and above previously established stringent budgets were achieved, 11% of which was returned to first-line supervisors in the form of a bonus. The program expanded the scope of professionalism for supervisors to include fiscal management.

  15. Delivering Savings with Open Architecture and Product Lines

    DTIC Science & Technology

    2011-04-30

    p.m. Chair: Christopher Deegan , Executive Director, Program Executive Office for Integrated Warfare Systems Delivering Savings with Open...Architectures Walt Scacchi and Thomas Alspaugh, Institute for Software Research Christopher Deegan —Executive Director, Program Executive Officer...Integrated Warfare Systems (PEO IWS). Mr. Deegan directs the development, acquisition, and fleet support of 150 combat weapon system programs managed by 350

  16. Australian surf life-saving and the "forgotten members".

    PubMed

    Jaggard, E

    1999-01-01

    The history and mythology of Australia's surf life-saving movement portray the surf life-saver as an inter and postwar national symbol, an image of manhood often regarded as the successor to that of the bushman and the digger. According to this viewpoint, women had no place on the beaches, being supportive fundraisers and social organisers. In fact, almost from surf life-saving's commencement in 1906, many women refused to be confined to these roles; they participated in their own competitions, were proficient in rescue techniques and were proud to belong to the movement, thus contradicting the widely shared belief that their active involvement began only in 1980 when they were granted full membership.

  17. Contributions of Qualitative Research to Understanding Savings for Children and Youth

    ERIC Educational Resources Information Center

    Sherraden, Margaret; Peters, Clark; Wagner, Kristen; Guo, Baorong; Clancy, Margaret

    2013-01-01

    This paper explores contributions of qualitative research to saving theory for children, youth, and parents in children's development account (CDAs) programs. It brings together findings from three studies: (1) elementary school age children saving for college, (2) youth transitioning from foster care saving for education and other purposes, and…

  18. "You Pay Your Share, We'll Pay Our Share": The College Cost Burden and the Role of Race, Income, and College Assets

    ERIC Educational Resources Information Center

    Elliott, William; Friedline, Terri

    2013-01-01

    Changes in financial aid policies raise questions about students being asked to pay too much for college and whether parents' college savings for their children helps reduce the burden on students to pay for college. Using trivariate probit analysis with predicted probabilities, in this exploratory study we find recent changes in the financial aid…

  19. Educational Approach to Seismic Risk Mitigation in Indian Himalayas -Hazard Map Making Workshops at High Schools-

    NASA Astrophysics Data System (ADS)

    Koketsu, K.; Oki, S.; Kimura, M.; Chadha, R. K.; Davuluri, S.

    2014-12-01

    How can we encourage people to take preventive measures against damage risks and empower them to take the right actions in emergencies to save their lives? The conventional approach taken by scientists had been disseminating intelligible information on up-to-date seismological knowledge. However, it has been proven that knowledge alone does not have enough impact to modify people's behaviors in emergencies (Oki and Nakayachi, 2012). On the other hand, the conventional approach taken by practitioners had been to conduct emergency drills at schools or workplaces. The loss of many lives from the 2011 Tohoku earthquake has proven that these emergency drills were not enough to save people's lives, unless they were empowered to assess the given situation on their own and react flexibly. Our challenge is to bridge the gap between knowledge and practice. With reference to best practices observed in Tohoku, such as The Miracles of Kamaishi, our endeavor is to design an effective Disaster Preparedness Education Program that is applicable to other disaster-prone regions in the world, even with different geological, socio-economical and cultural backgrounds. The key concepts for this new approach are 1) empowering individuals to take preventive actions to save their lives, 2) granting community-based understanding of disaster risks and 3) building a sense of reality and relevancy to disasters. With these in mind, we held workshops at some high schools in the Lesser Himalayan Region, combining lectures with an activity called "Hazard Map Making" where students proactively identify and assess the hazards around their living areas and learn practical strategies on how to manage risks. We observed the change of awareness of the students by conducting a preliminary questionnaire survey and interviews after each session. Results strongly implied that the significant change of students' attitudes towards disaster preparedness occurred not by the lectures of scientific knowledge, but after completing the whole program of activities. Students closed their presentation by spontaneously adding messages to others about importance of life and preparedness. In this presentation, we share good practices in terms of program design and facilitation that encouraged the transition of participants from a learner to an actor.

  20. Energy-Saving Opportunities for Manufacturing Enterprises (International English Fact Sheet)

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

    Not Available

    This fact sheet provides information about the Industrial Technologies Program Save Energy Now energy audit process, software tools, training, energy management standards, and energy efficient technologies to help U.S. companies identify energy cost savings.

  1. The Cost and Threshold Analysis of Retention in Care (RiC): A Multi-Site National HIV Care Program.

    PubMed

    Maulsby, Catherine; Jain, Kriti M; Weir, Brian W; Enobun, Blessing; Riordan, Maura; Charles, Vignetta E; Holtgrave, David R

    2017-03-01

    Persons diagnosed with HIV but not retained in HIV medical care accounted for the majority of HIV transmissions in 2009 in the United States (US). There is an urgent need to implement and disseminate HIV retention in care programs; however little is known about the costs associated with implementing retention in care programs. We assessed the costs and cost-saving thresholds for seven Retention in Care (RiC) programs implemented in the US using standard methods recommended by the US Panel on Cost-effectiveness in Health and Medicine. Data were gathered from accounting and program implementation records, entered into a standardized RiC economic analysis spreadsheet, and standardized to a 12 month time frame. Total program costs for from the societal perspective ranged from $47,919 to $423,913 per year or $146 to $2,752 per participant. Cost-saving thresholds ranged from 0.13 HIV transmissions averted to 1.18 HIV transmission averted per year. We estimated that these cost-saving thresholds could be achieved through 1 to 16 additional person-years of viral suppression. Across a range of program models, retention in care interventions had highly achievable cost-saving thresholds, suggesting that retention in care programs are a judicious use of resources.

  2. Field test of wavelength-saving quantum key distribution network.

    PubMed

    Wang, Shuang; Chen, Wei; Yin, Zhen-Qiang; Zhang, Yang; Zhang, Tao; Li, Hong-Wei; Xu, Fang-Xing; Zhou, Zheng; Yang, Yang; Huang, Da-Jun; Zhang, Li-Jun; Li, Fang-Yi; Liu, Dong; Wang, Yong-Gang; Guo, Guang-Can; Han, Zheng-Fu

    2010-07-15

    We propose a wavelength-saving topology of a quantum key distribution (QKD) network based on passive optical elements, and we report on the field test of this network on commercial telecom optical fiber at the frequency of 20 MHz. In this network, five nodes are supported with two wavelengths, and every two nodes can share secure keys directly at the same time. We also characterized the insertion loss and cross talk effects on the point-to-point QKD system after introducing this QKD network.

  3. Competition in the Acquisition of Replenishment Spare Parts.

    DTIC Science & Technology

    1983-09-01

    Brost for willingly sharing his knowledge, data, and time to help get this project off the ground. Mr. Bob Begley of AFLC, who, on the basis of a...lower than originally perceived and reported (5; 24:82). Brost found that there could just as likely be losses as savings from the use of competition in...to competitive savings (s3:54). Research Study 6 In a 1982 thesis at the Air Force Institute of Technology, Brost studied the effects of competition

  4. Report: EPA’s Voluntary WaterSense Program Demonstrated Success

    EPA Pesticide Factsheets

    Report #17-P-0352, August 1, 2017. The EPA estimated that consumers saved over 1.5 trillion gallons of water through use of WaterSense-labeled products. Consumers saved an estimated $1,100 for every federal dollar spent on the program.

  5. Approaches to pharmacy benefit management and the impact of consumer cost sharing.

    PubMed

    Olson, Bridget M

    2003-01-01

    Numerous mechanisms have been introduced to deliver prescription drug benefits while controlling pharmaceutical costs. An understanding of the most prominent mechanisms of benefit management is an important step in determining the most effective approach to take in future years. The aims of this review were to illustrate the mechanisms by which managed care has attempted to efficiently and equitably deliver pharmacy benefits and to discuss the impact of such programs, including consumer cost sharing. A review of the literature was conducted using the PreMedline and MEDLINE databases from the years 1966 to 2002, reference lists from relevant articles, and online sources, including news releases, conference materials, and pharmacy benefit management reports. Numerous pharmacy benefit management tools and their impact on utilization, expenditures, and health outcomes are reviewed, including disease state management; utilization management (ie, quantity limitations and prior authorization); drug utilization review; formulary management (ie, open and closed); delivery systems (ie, retail and mail order); and mechanisms for implementing consumer cost sharing (ie, generic incentives, multitiered copayments, and co-insurance). Although there is some evidence to suggest that certain benefit management tools have been successful in reducing health plan expenditures, a more thorough investigation of their potential unintended consequences is needed. Implementing adequate levels of consumer cost sharing is necessary if employers and health plans are to continue offering prescription drug benefits. It is important to remember, however, that quality health care cannot be forfeited for the sake of short-term cost savings.

  6. Cost effectiveness analysis of a smoke alarm giveaway program in Oklahoma City, Oklahoma.

    PubMed

    Haddix, A C; Mallonee, S; Waxweiler, R; Douglas, M R

    2001-12-01

    To estimate the cost effectiveness of the Lifesavers Residential Fire and Injury Prevention Program (LRFIPP), a smoke alarm giveaway program. In 1990, the LRFIPP distributed over 10,000 smoke alarms in an area of Oklahoma City at high risk for residential fire injuries. The program also included fire prevention education and battery replacement components. A cost effectiveness analysis was conducted from the societal and health care systems perspectives. The study compared program costs with the total costs of medical treatment and productivity losses averted over a five year period. Fatal and non-fatal residential fire related injuries prevented were estimated from surveillance data. Medical costs were obtained from chart reviews of patients with fire related injuries that occurred during the pre-intervention period. During the five years post-intervention, it is estimated that the LRFIPP prevented 20 fatal and 24 non-fatal injuries. From the societal perspective, the total discounted cost of the program was $531,000. Total discounted net savings exceeded $15 million. From the health care system perspective, the total discounted net savings were almost $1 million and would have a net saving even if program effectiveness was reduced by 64%. The program was effective in reducing fatal and non-fatal residential fire related injuries and was cost saving. Similar programs in other high risk areas would be good investments even if program effectiveness was lower than that achieved by the LRFIPP.

  7. Impact of a University-Based Outpatient Telemedicine Program on Time Savings, Travel Costs, and Environmental Pollutants.

    PubMed

    Dullet, Navjit W; Geraghty, Estella M; Kaufman, Taylor; Kissee, Jamie L; King, Jesse; Dharmar, Madan; Smith, Anthony C; Marcin, James P

    2017-04-01

    The objective of this study was to estimate travel-related and environmental savings resulting from the use of telemedicine for outpatient specialty consultations with a university telemedicine program. The study was designed to retrospectively analyze the telemedicine consultation database at the University of California Davis Health System (UCDHS) between July 1996 and December 2013. Travel distances and travel times were calculated between the patient home, the telemedicine clinic, and the UCDHS in-person clinic. Travel cost savings and environmental impact were calculated by determining differences in mileage reimbursement rate and emissions between those incurred in attending telemedicine appointments and those that would have been incurred if a visit to the hub site had been necessary. There were 19,246 consultations identified among 11,281 unique patients. Telemedicine visits resulted in a total travel distance savings of 5,345,602 miles, a total travel time savings of 4,708,891 minutes or 8.96 years, and a total direct travel cost savings of $2,882,056. The mean per-consultation round-trip distance savings were 278 miles, average travel time savings were 245 minutes, and average cost savings were $156. Telemedicine consultations resulted in a total emissions savings of 1969 metric tons of CO 2 , 50 metric tons of CO, 3.7 metric tons of NO x , and 5.5 metric tons of volatile organic compounds. This study demonstrates the positive impact of a health system's outpatient telemedicine program on patient travel time, patient travel costs, and environmental pollutants. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  8. The effects of hospice coverage on Medicare expenditures.

    PubMed Central

    Kidder, D

    1992-01-01

    This article reports on the findings of a study of the effects of the hospice program on Medicare Part A expenditures during the first three years of the program. The analysis compared treatment costs between hospice beneficiaries and nonbenefit patients with diagnosis of malignant cancer during their last seven months of life. It was estimated that during the first three years of the hospice program, Medicare saved $1.26 for every dollar spent on Part A expenditures. While the methodology included use of data from Medicare claims to adjust for confounding factors, including self-selection bias, our estimated savings might still have been overstated due to persistent selection effects. The extent of savings also varied according to the hospice's organization. Freestanding hospices, in contrast to those affiliated with either a hospital, nursing home, or home health agency, achieved the greatest savings by utilizing home care more extensively. However, we note that payment rates are increasing and the limits on the benefit period are being lifted, making it possible that the savings related to the hospice program found in this study will not continue. Of greater importance may be the long-term access and quality effects engendered by the benefit's preference for home care. PMID:1592605

  9. The effects of hospice coverage on Medicare expenditures.

    PubMed

    Kidder, D

    1992-06-01

    This article reports on the findings of a study of the effects of the hospice program on Medicare Part A expenditures during the first three years of the program. The analysis compared treatment costs between hospice beneficiaries and nonbenefit patients with diagnosis of malignant cancer during their last seven months of life. It was estimated that during the first three years of the hospice program, Medicare saved $1.26 for every dollar spent on Part A expenditures. While the methodology included use of data from Medicare claims to adjust for confounding factors, including self-selection bias, our estimated savings might still have been overstated due to persistent selection effects. The extent of savings also varied according to the hospice's organization. Freestanding hospices, in contrast to those affiliated with either a hospital, nursing home, or home health agency, achieved the greatest savings by utilizing home care more extensively. However, we note that payment rates are increasing and the limits on the benefit period are being lifted, making it possible that the savings related to the hospice program found in this study will not continue. Of greater importance may be the long-term access and quality effects engendered by the benefit's preference for home care.

  10. Return on Investment: A Fuller Assessment of the Benefits and Cost Savings of the US Publicly Funded Family Planning Program

    PubMed Central

    Frost, Jennifer J; Sonfield, Adam; Zolna, Mia R; Finer, Lawrence B

    2014-01-01

    Context Each year the United States’ publicly supported family planning program serves millions of low-income women. Although the health impact and public-sector savings associated with this program's services extend well beyond preventing unintended pregnancy, they never have been fully quantified. Methods Drawing on an array of survey data and published parameters, we estimated the direct national-level and state-level health benefits that accrued from providing contraceptives, tests for the human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs), Pap tests and tests for human papillomavirus (HPV), and HPV vaccinations at publicly supported family planning settings in 2010. We estimated the public cost savings attributable to these services and compared those with the cost of publicly funded family planning services in 2010 to find the net public-sector savings. We adjusted our estimates of the cost savings for unplanned births to exclude some mistimed births that would remain publicly funded if they had occurred later and to include the medical costs for births through age 5 of the child. Findings In 2010, care provided during publicly supported family planning visits averted an estimated 2.2 million unintended pregnancies, including 287,500 closely spaced and 164,190 preterm or low birth weight (LBW) births, 99,100 cases of chlamydia, 16,240 cases of gonorrhea, 410 cases of HIV, and 13,170 cases of pelvic inflammatory disease that would have led to 1,130 ectopic pregnancies and 2,210 cases of infertility. Pap and HPV tests and HPV vaccinations prevented an estimated 3,680 cases of cervical cancer and 2,110 cervical cancer deaths; HPV vaccination also prevented 9,000 cases of abnormal sequelae and precancerous lesions. Services provided at health centers supported by the Title X national family planning program accounted for more than half of these benefits. The gross public savings attributed to these services totaled approximately $15.8 billion—$15.7 billion from preventing unplanned births, $123 million from STI/HIV testing, and $23 million from Pap and HPV testing and vaccines. Subtracting $2.2 billion in program costs from gross savings resulted in net public-sector savings of $13.6 billion. Conclusions Public expenditures for the US family planning program not only prevented unintended pregnancies but also reduced the incidence and impact of preterm and LBW births, STIs, infertility, and cervical cancer. This investment saved the government billions of public dollars, equivalent to an estimated taxpayer savings of $7.09 for every public dollar spent. PMID:25314928

  11. Responding to a Suicide Emergency

    MedlinePlus

    ... Share this! Home » Health Tips Responding To A Suicide Emergency Suicide takes the lives of nearly 40,000 Americans ... year saving those who try to kill themselves. "Suicide can be prevented if people learn to recognize ...

  12. A Review of the American Recovery and Reinvestment Act Smart Grid Projects and Their Implications for China

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

    Liu, Xu; Marnay, Chris; Feng, Wei

    The Chinese government has paid growing attention to renewable energy development and has set ambitious goals for carbon dioxide (CO2) emissions reduction and energy savings. Smart grid (SG) technologies have been regarded as emerging ways to integrate renewable energy and to help achieve these climate and energy goals. This report first reviews completed SG demonstrations under the U.S. American Recovery and Reinvestment Act (ARRA); especially two key programs: the SG Investment Grant (SGIG) and the SG Demonstration Project (SGDP). Under the SGIG, the larger of the two programs, over $3.4 billion was used to help industry deploy existing advanced SGmore » technologies and tools to improve grid performance and reduce costs. Including industry investment, a total of $8 billion was spent on 99 cost-shared projects, which involved more than 200 participating electric utilities and other organizations. These projects aimed to modernize the electric grid, strengthen cyber security, improve interoperability, and collect comprehensive data on SG operations and benefits.« less

  13. Can disease management reduce health care costs by improving quality?

    PubMed

    Fireman, Bruce; Bartlett, Joan; Selby, Joe

    2004-01-01

    Disease management (DM) promises to achieve cost savings by improving the quality of care for chronic diseases. During the past decade the Permanente Medical Group in Northern California has implemented extensive DM programs. Examining quality indicators, utilization, and costs for 1996-2002 for adults with four conditions, we find evidence of substantial quality improvement but not cost savings. The causal pathway--from improved care to reduced morbidity to cost savings--has not produced sufficient savings to offset the rising costs of improved care. We conclude that the rationale for DM programs, like the rationale for any medical treatments, should rest on their effectiveness and value.

  14. NASA SAVE Award Winner

    NASA Image and Video Library

    2012-01-09

    NASA Goddard Space Flight Center Financial Manager and White House 2011 SAVE award winner Matthew Ritsko is seen during a television interview at NASA Headquarters shortly after meeting with President Obama at the White House on Monday, Jan. 9, 2011, in Washington. The Presidential Securing Americans' Value and Efficiency (SAVE) program gives front-line federal workers the chance to submit their ideas on how their agencies can save money and work more efficiently. Matthew's proposal calls for NASA to create a "lending library" where specialized space tools and hardware purchased by one NASA organization will be made available to other NASA programs and projects. Photo Credit: (NASA/Bill Ingalls)

  15. A method for estimating cost savings for population health management programs.

    PubMed

    Murphy, Shannon M E; McGready, John; Griswold, Michael E; Sylvia, Martha L

    2013-04-01

    To develop a quasi-experimental method for estimating Population Health Management (PHM) program savings that mitigates common sources of confounding, supports regular updates for continued program monitoring, and estimates model precision. Administrative, program, and claims records from January 2005 through June 2009. Data are aggregated by member and month. Study participants include chronically ill adult commercial health plan members. The intervention group consists of members currently enrolled in PHM, stratified by intensity level. Comparison groups include (1) members never enrolled, and (2) PHM participants not currently enrolled. Mixed model smoothing is employed to regress monthly medical costs on time (in months), a history of PHM enrollment, and monthly program enrollment by intensity level. Comparison group trends are used to estimate expected costs for intervention members. Savings are realized when PHM participants' costs are lower than expected. This method mitigates many of the limitations faced using traditional pre-post models for estimating PHM savings in an observational setting, supports replication for ongoing monitoring, and performs basic statistical inference. This method provides payers with a confident basis for making investment decisions. © Health Research and Educational Trust.

  16. Energy Efficient Engine Program: Technology Benefit/Cost Study, Volume II

    NASA Technical Reports Server (NTRS)

    Gray, D. E.; Gardner, W. B.

    1983-01-01

    The Benefit/Cost Study portion of the NASA-sponsored Energy Efficient Engine Component Development and Integration program was successful in achieving its objectives: identification of air transport propulsion system technology requirements for the years 2000 and 2010, and formulation of programs for developing these technologies. It is projected that the advanced technologies identified, when developed to a state of readiness, will provide future commercial and military turbofan engines with significant savings in fuel consumption and related operating costs. These benefits are significant and far from exhausted. The potential savings translate into billions of dollars in annual savings for the airlines. Analyses indicate that a significant portion of the overall savings is attributed to aerodynamic and structure advancements. Another important consideration in acquiring these benefits is developing a viable reference technology base that will permit engines to operate at substantially higher overall pressure ratios and bypass ratios. Results have pointed the direction for future research and a comprehensive program plan for achieving this was formulated. The next major step is initiating the program effort that will convert the advanced technologies into the expected benefits.

  17. An evaluation of the Well at Dell health management program: health risk change and financial return on investment.

    PubMed

    Musich, Shirley; McCalister, Tre'; Wang, Sara; Hawkins, Kevin

    2015-01-01

    To investigate the effectiveness of the Well at Dell comprehensive health management program in delivering health care and productivity cost savings relative to program investment (i.e., return on investment). A quasi-experimental design was used to quantify the financial impact of the program and nonexperimental pre-post design to evaluate change in health risks. Ongoing worksite health management program implemented across multiple U.S. locations. Subjects were 24,651 employees with continuous medical enrollment in 2010-2011 who were eligible for 2011 health management programming. Incentive-driven, outcomes-based multicomponent corporate health management program including health risk appraisal (HRA)/wellness, lifestyle management, and disease management coaching programs. Medical, pharmacy, and short-term disability pre/post expenditure trends adjusted for demographics, health status, and baseline costs. Self-reported health risks from repeat HRA completers. Analysis: Propensity score-weighted and multivariate regression-adjusted comparison of baseline to post trends in health care expenditures and productivity costs for program participants and nonparticipants (i.e., difference in difference) relative to programmatic investment. The Well at Dell program achieved an overall return on investment of 2.48 in 2011. Most of the savings were realized from the HRA/wellness component of the program. Cost savings were supported with high participation and significant health risk improvement. An incentive-driven, well-managed comprehensive corporate health management program can continue to achieve significant health improvement while promoting health care and productivity cost savings in an employee population.

  18. What can a pilot congestive heart failure disease management program tell us about likely return on investment?: A case study from a program offered to federal employees.

    PubMed

    vanVonno, Catherine J; Ozminkowski, Ronald J; Smith, Mark W; Thomas, Eileen G; Kelley, Doniece; Goetzel, Ron; Berg, Gregory D; Jain, Susheel K; Walker, David R

    2005-12-01

    In 1999, the Blue Cross and Blue Shield Federal Employee Program (FEP) implemented a pilot disease management program to manage congestive heart failure (CHF) among members. The purpose of this project was to estimate the financial return on investment in the pilot CHF program, prior to a full program rollout. A cohort of 457 participants from the state of Maryland was matched to a cohort of 803 nonparticipants from a neighboring state where the CHF program was not offered. Each cohort was followed for 12 months before the program began and 12 months afterward. The outcome measures of primary interest were the differences over time in medical care expenditures paid by FEP and by all payers. Independent variables included indicators of program participation, type of heart disease, comorbidity measures, and demographics. From the perspective of the funding organization (FEP), the estimated return on investment for the pilot CHF disease management program was a savings of $1.08 in medical expenditure for every dollar spent on the program. Adding savings to other payers as well, the return on investment was a savings of $1.15 in medical expenditures per dollar spent on the program. The amount of savings depended upon CHF risk levels. The value of a pilot initiative and evaluation is that lessons for larger-scale efforts can be learned prior to full-scale rollout.

  19. Saving Lives.

    ERIC Educational Resources Information Center

    Moon, Daniel

    2002-01-01

    Advises schools on how to establish an automated external defibrillator (AED) program. These laptop-size devices can save victims of sudden cardiac arrest by delivering an electrical shock to return the heartbeat to normal. Discusses establishing standards, developing a strategy, step-by-step advice towards establishing an AED program, and school…

  20. A taxonomy of hospitals participating in Medicare accountable care organizations.

    PubMed

    Bazzoli, Gloria J; Harless, David W; Chukmaitov, Askar S

    2017-03-03

    Medicare was an early innovator of accountable care organizations (ACOs), establishing the Medicare Shared Savings Program (MSSP) and Pioneer programs in 2012-2013. Existing research has documented that ACOs bring together an array of health providers with hospitals serving as important participants. Hospitals vary markedly in their service structure and organizational capabilities, and thus, one would expect hospital ACO participants to vary in these regards. Our research identifies hospital subgroups that share certain capabilities and competencies. Such research, in conjunction with existing ACO research, provides deeper understanding of the structure and operation of these organizations. Given that Medicare was an initiator of the ACO concept, our findings provide a baseline to track the evolution of ACO hospitals over time. Hierarchical clustering methods are used in separate analyses of MSSP and Pioneer ACO hospitals. Hospitals participating in ACOs with 2012-2013 start dates are identified through multiple sources. Study data come from the Centers for Medicare and Medicaid Services, American Hospital Association, and Health Information and Management Systems Society. Five-cluster solutions were developed separately for the MSSP and Pioneer hospital samples. Both the MSSP and Pioneer taxonomies had several clusters with high levels of health information technology capabilities. Also distinct clusters with strong physician linkages were present. We examined Pioneer ACO hospitals that subsequently left the program and found that they commonly had low levels of ambulatory care services or health information technology. Distinct subgroups of hospitals exist in both the MSSP and Pioneer programs, suggesting that individual hospitals serve different roles within an ACO. Health information technology and physician linkages appear to be particularly important features in ACO hospitals. ACOs need to consider not only geographic and service mix when selecting hospital participants but also their vertical integration features and management competencies.

  1. Save Energy Now (SEN) Assessment Helps Expand Energy Management Program at Shaw Industries: Flooring Company Saves $872,000 Annually by Improving Steam System Efficiency

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

    Not Available

    This case study describes how the Shaw Industries plant #20 in Dalton, Georgia, achieved annual savings of $872,000 and 93,000 MMBtu after receiving a DOE Save Energy Now energy assessment and implementing recommendations to improve the efficiency of its steam system.

  2. An Evaluation of the Kansas Child Support Savings Initiative

    ERIC Educational Resources Information Center

    Baird, Peter; Walter, Johanna; Landers, Patrick; Timm, Jonathan; Luczywek, Beata

    2017-01-01

    The state of Kansas created the Child Support Savings Initiative (CSSI) in 2013 to help parents who owe child support pay off debt that is owed to the state while also saving for their children's future higher education. The program aims to encourage parents to make qualifying deposits into tax-advantaged college savings plans--529…

  3. Pollution prevention as a market-enhancing strategy: a storehouse of economical and environmental opportunities.

    PubMed Central

    Hoffman, J S

    1992-01-01

    EPA's (Environmental Protection Agency) Green Lights Program for energy-efficient lighting illustrates the economic benefits and the market-transforming value of a pollution prevention philosophy. Using technologies available today, and assuming current prices, this program is expected to reduce air pollution 5%, while saving the nation's businesses up to 20 billion in electric bills every year. However, these pollution prevention and savings estimates may be low. As Green Lights transforms the market for lighting services by creating a higher demand for better technologies at lower costs, the program will likely achieve even larger pollution reductions and electricity savings. PMID:11607262

  4. Economic Evaluation of Community-Based HIV Prevention Programs in Ontario: Evidence of Effectiveness in Reducing HIV Infections and Health Care Costs.

    PubMed

    Choi, Stephanie K Y; Holtgrave, David R; Bacon, Jean; Kennedy, Rick; Lush, Joanne; McGee, Frank; Tomlinson, George A; Rourke, Sean B

    2016-06-01

    Investments in community-based HIV prevention programs in Ontario over the past two and a half decades are assumed to have had an impact on the HIV epidemic, but they have never been systematically evaluated. To help close this knowledge gap, we conducted a macro-level evaluation of investment in Ontario HIV prevention programs from the payer perspective. Our results showed that, from 1987 to 2011, province-wide community-based programs helped to avert a total of 16,672 HIV infections, saving Ontario's health care system approximately $6.5 billion Canadian dollars (range 4.8-7.5B). We also showed that these community-based HIV programs were cost-saving: from 2005 to 2011, every dollar invested in these programs saved about $5. This study is an important first step in understanding the impact of investing in community-based HIV prevention programs in Ontario and recognizing the impact that these programs have had in reducing HIV infections and health care costs.

  5. 77 FR 796 - Formations of, Acquisitions by, and Mergers of Bank Holding Companies

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-06

    ... fiduciary capacity, 9.75 percent of the outstanding voting shares of Mechanics Financial Corporation, and thereby retain Mechanics Savings Bank, both in Mansfield, Ohio. B. Federal Reserve Bank of Kansas City...

  6. Defense Health Care Reform: Actions Needed to Help Ensure Defense Health Agency Maintains Implementation Progress

    DTIC Science & Technology

    2015-09-01

    business case analyses, and performance measures for the DHA’s shared services. GAO compared this information with key management practices and DOD...headquarters personnel within the MHS in annual budget documents. • Approach to help achieve cost savings - The DHA has developed a business case...comprehensive business case analyses for 2 shared services— Public Health, and Medical Education and Training. Specifically, the DHA has proposed the

  7. So This is Knowledge Sharing

    NASA Technical Reports Server (NTRS)

    Motil, Susan

    2003-01-01

    People within large organizations have probably already dealt with problems similar to the problems that you face; you can save time and money by taking advantage of that experience and knowledge. Knowledge sharing by mentors can empower less experienced managers who would otherwise not challenge the status quo. Reviews should encourage joint problem solving rather than just reporting. To accomplish this, ensure that the review process is viewed as feedback from independent and supportive experts.

  8. COSMIC: Software catalog 1991 edition diskette format

    NASA Technical Reports Server (NTRS)

    1991-01-01

    The PC edition of the annual COSMIC Software contains descriptions of the over 1,200 computer programs available for use within the United States as of January 1, 1991. By using the PC version of the catalog, it is possible to conduct extensive searches of the software inventory for programs that meet specific criteria. Elements such as program keywords, hardware specifications, source code languages, and title acronyms can be used for the basis of such searches. After isolating those programs that might be of best interest to the user, it is then possible to either view at the monitor, or generate a hardcopy listing of all information on those packages. In addition to the program elements that the user can search on, information such as total program size, distribution media, and program price, as well as extensive abstracts on the program, are also available to the user at this time. Another useful feature of the catalog allows for the retention of programs that meet certain search criteria between individual sessions of using the catalog. This allows users to save the information on those programs that are of interest to them in different areas of application. They can then recall a specific collection of programs for information retrieval or further search reduction if desired. In addition, this version of the catalog is adaptable to a network/shared resource environment, allowing multiple users access to a single copy of the catalog database simultaneously.

  9. The costs of HIV antiretroviral therapy adherence programs and impact on health care utilization.

    PubMed

    Sansom, Stephanie L; Anthony, Monique N; Garland, Wendy H; Squires, Kathleen E; Witt, Mallory D; Kovacs Andrea, A; Larsen, Robert A; Valencia, Rosa; Pals, Sherri L; Hader, Shannon; Weidle, Paul J; Wohl, Amy R

    2008-02-01

    From a trial comparing interventions to improve adherence to antiretroviral therapy-directly administered antiretroviral therapy (DAART) or an intensive adherence case management (IACM)-to standard of care (SOC), for HIV-infected participants at public HIV clinics in Los Angeles County, California, we examined the cost of adherence programs and associated health care utilization. We assessed differences between DAART, IACM, and SOC in the rate of hospitalizations, hospital days, and outpatient and emergency department visits during an average of 1.7 years from study enrollment, beginning November 2001. We assigned costs to health care utilization and program delivery. We calculated incremental costs of DAART or IACM v SOC, and compared those costs with savings in health care utilization among participants in the adherence programs. IACM participants experienced fewer hospital days compared with SOC (2.3 versus 6.7 days/1000 person-days, incidence rate ratio [IRR]: 0.34, 97.5% confidence interval [CI]: 0.13-0.87). DAART participants had more outpatient visits than SOC (44.2 versus 31.5/1000 person-days, IRR: 1.4; 97.5% CI: 1.01-1.95). Average per-participant health care utilization costs were $13,127, $8,988, and $14,416 for DAART, IACM, and SOC, respectively. Incremental 6-month program costs were $2,120 and $1,653 for DAART and IACM participants, respectively. Subtracting savings in health care utilization from program costs resulted in an average net program cost of $831 per DAART participant; and savings of $3,775 per IACM participant. IACM was associated with a significant decrease in hospital days compared to SOC and was cost saving when program costs were compared to savings in health care utilization.

  10. Long-term impact of a chronic disease management program on hospital utilization and cost in an Australian population with heart disease or diabetes.

    PubMed

    Hamar, G Brent; Rula, Elizabeth Y; Coberley, Carter; Pope, James E; Larkin, Shaun

    2015-04-22

    To evaluate the longitudinal value of a chronic disease management program, My Health Guardian (MHG), in reducing hospital utilization and costs over 4 years. The MHG program provides individualized support via telephonic nurse outreach and online tools for self-management, behavior change and well-being. In follow up to an initial 18-month analysis of MHG, the current study evaluated program impact over 4 years. A matched-cohort analysis retrospectively compared MHG participants with heart disease or diabetes (treatment, N = 4,948) to non-participants (comparison, N = 28,520) on utilization rates (hospital admission, readmission, total bed days) and hospital claims cost savings. Outcomes were evaluated using regression analyses, controlling for remaining demographic, disease, and pre-program admissions or cost differences between the study groups. Over the 4 year period, program participation resulted in significant reductions in hospital admissions (-11.4%, P < 0.0001), readmissions (-36.7%, P < 0.0001), and bed days (-17.2%, P < 0.0001). The effect size increased over time for admissions and bed days. The relative odds of any admission and readmission over the 4 years were 27% and 45% lower, respectively, in the treatment group. Cumulative program savings from reduced hospital claims was $3,549 over 4-years; savings values for each program year were significant and increased with time (P = 0.003 to P < 0.0001). Savings calculations did not adjust for pooled costs (and savings) in Australia's risk equalization system for private insurers. Results confirm and extend prior program outcomes and support the longitudinal value of the MHG program in reducing hospital utilization and costs for individuals with heart disease or diabetes and demonstrate the increasing program effect with continued participation over time.

  11. Socioeconomic and Institutional Factors that Facilitate and Prevent Low-Income African American Parents' Involvement in a Children's Savings Program

    ERIC Educational Resources Information Center

    Johnson, Toni

    2011-01-01

    National and international reports have established the legitimate use of child savings accounts (CSAs) as asset-building vehicles for youths. However, many U.S. programs report difficulty in recruiting parents for CSA programs and note the failure of some parents to take full advantage of the financial match available when they do participate.…

  12. 48 CFR 23.205 - Energy-savings performance contracts.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Energy-savings performance... SOCIOECONOMIC PROGRAMS ENVIRONMENT, ENERGY AND WATER EFFICIENCY, RENEWABLE ENERGY TECHNOLOGIES, OCCUPATIONAL SAFETY, AND DRUG-FREE WORKPLACE Energy and Water Efficiency and Renewable Energy 23.205 Energy-savings...

  13. 48 CFR 23.205 - Energy-savings performance contracts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Energy-savings performance... SOCIOECONOMIC PROGRAMS ENVIRONMENT, ENERGY AND WATER EFFICIENCY, RENEWABLE ENERGY TECHNOLOGIES, OCCUPATIONAL SAFETY, AND DRUG-FREE WORKPLACE Energy and Water Efficiency and Renewable Energy 23.205 Energy-savings...

  14. 48 CFR 23.205 - Energy-savings performance contracts.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Energy-savings performance... SOCIOECONOMIC PROGRAMS ENVIRONMENT, ENERGY AND WATER EFFICIENCY, RENEWABLE ENERGY TECHNOLOGIES, OCCUPATIONAL SAFETY, AND DRUG-FREE WORKPLACE Energy and Water Efficiency and Renewable Energy 23.205 Energy-savings...

  15. 48 CFR 23.205 - Energy-savings performance contracts.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Energy-savings performance... SOCIOECONOMIC PROGRAMS ENVIRONMENT, ENERGY AND WATER EFFICIENCY, RENEWABLE ENERGY TECHNOLOGIES, OCCUPATIONAL SAFETY, AND DRUG-FREE WORKPLACE Energy and Water Efficiency and Renewable Energy 23.205 Energy-savings...

  16. 48 CFR 23.205 - Energy-savings performance contracts.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Energy-savings performance... SOCIOECONOMIC PROGRAMS ENVIRONMENT, ENERGY AND WATER EFFICIENCY, RENEWABLE ENERGY TECHNOLOGIES, OCCUPATIONAL SAFETY, AND DRUG-FREE WORKPLACE Energy and Water Efficiency and Renewable Energy 23.205 Energy-savings...

  17. Your Savings and Investment Dollar. [Revised.] Money Management.

    ERIC Educational Resources Information Center

    Baran, Nancy H., Ed.; Tarrant, Sharon M., Ed.

    This booklet on savings and investment, 1 in a series of 12, covers all the basic aspects of personal- and family-money management. Suitable for use by high school and college students as well as adults, this handbook shows how to develop a savings and investment program based on present and future needs and goals. Section 1 overviews savings and…

  18. Our School Wellness Program Cut Staff Absenteeism and Might Save Lives.

    ERIC Educational Resources Information Center

    Oxrieder, Ann

    1987-01-01

    Describes Bellevue (Washington) School District's employee wellness program's successful efforts to (1) save lives by promoting healthy lifestyles, (2) boost morale by taking health services to the workplace, (3) improve on-the-job performance by providing inexpensive, convenient opportunities for exercise and weight loss, and (4) reduce staff…

  19. Taxing Matters: College Aid, Tax Policy & Equal Opportunity.

    ERIC Educational Resources Information Center

    Education Resources Inst., Boston, MA.

    This report uses government data to review current, past, and proposed tax-based policies and programs to promote college affordability as well as need-based grant aid. Tax-incentive-based programs include savings bonds for education, employer-provided educational assistance, state college savings plans, deductibility of student loan interest,…

  20. Saving Schoolhouse Energy. Final Report.

    ERIC Educational Resources Information Center

    Rudy, John; And Others

    The objective of the Saving Schoolhouse Energy Program was to generate information that school administrators and federal energy/education decision makers could use to identify ways of implementing specific, economical remedies to reduce energy waste in schools. This program was designed to have five phases: (1) Conduct an energy audit of ten…

  1. Effect of a pharmacist-managed hypertension program on health system costs: an evaluation of the Study of Cardiovascular Risk Intervention by Pharmacists-Hypertension (SCRIP-HTN).

    PubMed

    Houle, Sherilyn K D; Chuck, Anderson W; McAlister, Finlay A; Tsuyuki, Ross T

    2012-06-01

    To quantify the potential cost savings of a community pharmacy-based hypertension management program based on the results of the Study of Cardiovascular Risk Intervention by Pharmacists-Hypertension (SCRIP-HTN) study in terms of avoided cardiovascular events-myocardial infarction, stroke, and heart failure hospitalization, and to compare these cost savings with the cost of the pharmacist intervention program. An economic model was developed to estimate the potential cost avoidance in direct health care resources from reduced cardiovascular events over a 1-year period. The SCRIP-HTN study found that patients with diabetes mellitus and hypertension who were receiving the pharmacist intervention had a greater mean reduction in systolic blood pressure of 5.6 mm Hg than patients receiving usual care. For our model, published meta-analysis data were used to compute cardiovascular event absolute risk reductions associated with a 5.6-mm Hg reduction in systolic blood pressure over 6 months. Costs/event were obtained from administrative data, and probabilistic sensitivity analyses were performed to assess the robustness of the results. Two program scenarios were evaluated-one with monthly follow-up for a total of 1 year with sustained blood pressure reduction, and the other in which pharmacist care ended after the 6-month program but the effects on systolic blood pressure diminished over time. The cost saving results from the economic model were then compared with the costs of the program. Annual estimated cost savings (in 2011 Canadian dollars) from avoided cardiovascular events were $265/patient (95% confidence interval [CI] $63-467) if the program lasted 1 year or $221/patient (95%CI $72-371) if pharmacist care ceased after 6 months with an assumed loss of effect afterward. Estimated pharmacist costs were $90/patient for 6 months or $150/patient for 1 year, suggesting that pharmacist-managed programs are cost saving, with the annual net total cost savings/patient estimated to be $131 for a program lasting 6 months or $115 for a program lasting 1 year. Our model found that community pharmacist interventions capable of reducing systolic blood pressure by 5.6 mm Hg within 6 months are cost saving and result in improved patient outcomes. Wider adoption of pharmacist-managed hypertension care for patients with diabetes and hypertension is encouraged. © 2012 Pharmacotherapy Publications, Inc.

  2. Cardiovascular Conditions of Childhood

    MedlinePlus

    ... Learn the symptoms, diagnosis and treatment for Kawasaki disease. Congenital Heart Defects If your child is born with ... and read personal stories of young stroke survivors. Congenital Heart Defects ... about children and heart disease. Login or Sign Up to save and share ...

  3. Commuter choice managers and parking managers coordination

    DOT National Transportation Integrated Search

    2002-11-01

    Shared use park and ride represents a unique approach for addressing parking problems, and can offer substantial savings in land and development costs. One of the fundamental factors that determines the success of this approach is the level of coordi...

  4. 78 FR 41929 - Formations of, Acquisitions by, and Mergers of Bank Holding Companies

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-12

    ... holding company by acquiring 100 percent of the voting shares of The Geo. D. Warthen Bank, both in... Bank, FSB, Pasadena, California, from a federal savings association to a national bank. Board of...

  5. 78 FR 65312 - Notice of Proposals To Engage in or To Acquire Companies Engaged in Permissible Nonbanking...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-31

    ... to be closely related to banking and permissible for bank holding companies. Unless otherwise noted... Services, Inc., Gratz, Pennsylvania, and thereby indirectly acquire voting shares of Liberty Savings Bank...

  6. 40 CFR 64.10 - Savings provisions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Savings provisions. 64.10 Section 64.10 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.10 Savings provisions. (a) Nothing in this part shall: (1) Excuse the...

  7. Creative Energy Management Can Save Money.

    ERIC Educational Resources Information Center

    Rose, Patricia

    1984-01-01

    Schools can launch energy conservation programs with simple money-saving measures like improving boiler maintenance, recalibrating utility meters, and obtaining preferred utility rates. Becoming more assertive in the marketplace and using "creative financing" when needed, they can then reinvest their savings in more extensive projects. (MCG)

  8. 40 CFR 64.10 - Savings provisions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Savings provisions. 64.10 Section 64.10 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.10 Savings provisions. (a) Nothing in this part shall: (1) Excuse the...

  9. Costs and benefits of bicycling investments in Portland, Oregon.

    PubMed

    Gotschi, Thomas

    2011-01-01

    Promoting bicycling has great potential to increase overall physical activity; however, significant uncertainty exists with regard to the amount and effectiveness of investment needed for infrastructure. The objective of this study is to assess how costs of Portland's past and planned investments in bicycling relate to health and other benefits. Costs of investment plans are compared with 2 types of monetized health benefits, health care cost savings and value of statistical life savings. Levels of bicycling are estimated using past trends, future mode share goals, and a traffic demand model. By 2040, investments in the range of $138 to $605 million will result in health care cost savings of $388 to $594 million, fuel savings of $143 to $218 million, and savings in value of statistical lives of $7 to $12 billion. The benefit-cost ratios for health care and fuel savings are between 3.8 and 1.2 to 1, and an order of magnitude larger when value of statistical lives is used. This first of its kind cost-benefit analysis of investments in bicycling in a US city shows that such efforts are cost-effective, even when only a limited selection of benefits is considered.

  10. The Impact of Rate Design and Net Metering on the Bill Savings from Distributed PV for Residential Customers in California

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

    Energy and Resources Group, University of California, Berkeley; Darghouth, Naim R.; Barbose, Galen

    2011-06-01

    Net metering has become a widespread mechanism in the U.S. for supporting customer adoption of distributed photovoltaics (PV), but has faced challenges as PV installations grow to a larger share of generation in a number of states. This paper examines the value of the bill savings that customers receive under net metering, and the associated role of retail rate design, based on a sample of approximately two hundred residential customers of California's two largest electric utilities. We find that the bill savings per kWh of PV electricity generated varies by more than a factor of four across the customers inmore » the sample, which is largely attributable to the inclining block structure of the utilities' residential retail rates. We also compare the bill savings under net metering to that received under three potential alternative compensation mechanisms, based on California's Market Price Referent (MPR). We find that net metering provides significantly greater bill savings than a full MPR-based feed-in tariff, but only modestly greater savings than alternative mechanisms under which hourly or monthly net excess generation is compensated at the MPR rate.« less

  11. 78 FR 5781 - Cost-Sharing Rates for Pharmacy Benefits Program of the TRICARE Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-28

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

  12. Investigating the Gap Between Estimated and Actual Energy Efficiency and Conservation Savings for Public Buildings Projects & Programs in United States

    NASA Astrophysics Data System (ADS)

    Qaddus, Muhammad Kamil

    The gap between estimated and actual savings in energy efficiency and conservation (EE&C) projects or programs forms the problem statement for the scope of public and government buildings. This gap has been analyzed first on impact and then on process-level. On the impact-level, the methodology leads to categorization of the gap as 'Realization Gap'. It then views the categorization of gap within the context of past and current narratives linked to realization gap. On process-level, the methodology leads to further analysis of realization gap on process evaluation basis. The process evaluation criterion, a product of this basis is then applied to two different programs (DESEU and NYC ACE) linked to the scope of this thesis. Utilizing the synergies of impact and process level analysis, it offers proposals on program development and its structure using our process evaluation criterion. Innovative financing and benefits distribution structure is thus developed and will remain part of the proposal. Restricted Stakeholder Crowd Financing and Risk-Free Incentivized return are the products of proposed financing and benefit distribution structure respectively. These products are then complimented by proposing an alternative approach in estimating EE&C savings. The approach advocates estimation based on range-allocation rather than currently utilized unique estimated savings approach. The Way Ahead section thus explores synergy between financial and engineering ranges of energy savings as a multi-discipline approach for future research. Moreover, it provides the proposed program structure with risk aversion and incentive allocation while dealing with uncertainty. This set of new approaches are believed to better fill the realization gap between estimated and actual energy efficiency savings.

  13. Return on investment: a fuller assessment of the benefits and cost savings of the US publicly funded family planning program.

    PubMed

    Frost, Jennifer J; Sonfield, Adam; Zolna, Mia R; Finer, Lawrence B

    2014-12-01

    Policy Points: The US publicly supported family planning effort serves millions of women and men each year, and this analysis provides new estimates of its positive impact on a wide range of health outcomes and its net savings to the government. The public investment in family planning programs and providers not only helps women and couples avoid unintended pregnancy and abortion, but also helps many thousands avoid cervical cancer, HIV and other sexually transmitted infections, infertility, and preterm and low birth weight births. This investment resulted in net government savings of $13.6 billion in 2010, or $7.09 for every public dollar spent. Each year the United States' publicly supported family planning program serves millions of low-income women. Although the health impact and public-sector savings associated with this program's services extend well beyond preventing unintended pregnancy, they never have been fully quantified. Drawing on an array of survey data and published parameters, we estimated the direct national-level and state-level health benefits that accrued from providing contraceptives, tests for the human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs), Pap tests and tests for human papillomavirus (HPV), and HPV vaccinations at publicly supported family planning settings in 2010. We estimated the public cost savings attributable to these services and compared those with the cost of publicly funded family planning services in 2010 to find the net public-sector savings. We adjusted our estimates of the cost savings for unplanned births to exclude some mistimed births that would remain publicly funded if they had occurred later and to include the medical costs for births through age 5 of the child. In 2010, care provided during publicly supported family planning visits averted an estimated 2.2 million unintended pregnancies, including 287,500 closely spaced and 164,190 preterm or low birth weight (LBW) births, 99,100 cases of chlamydia, 16,240 cases of gonorrhea, 410 cases of HIV, and 13,170 cases of pelvic inflammatory disease that would have led to 1,130 ectopic pregnancies and 2,210 cases of infertility. Pap and HPV tests and HPV vaccinations prevented an estimated 3,680 cases of cervical cancer and 2,110 cervical cancer deaths; HPV vaccination also prevented 9,000 cases of abnormal sequelae and precancerous lesions. Services provided at health centers supported by the Title X national family planning program accounted for more than half of these benefits. The gross public savings attributed to these services totaled approximately $15.8 billion-$15.7 billion from preventing unplanned births, $123 million from STI/HIV testing, and $23 million from Pap and HPV testing and vaccines. Subtracting $2.2 billion in program costs from gross savings resulted in net public-sector savings of $13.6 billion. Public expenditures for the US family planning program not only prevented unintended pregnancies but also reduced the incidence and impact of preterm and LBW births, STIs, infertility, and cervical cancer. This investment saved the government billions of public dollars, equivalent to an estimated taxpayer savings of $7.09 for every public dollar spent. © 2014 The Authors The Milbank Quarterly published by Wiley Periodicals, Inc. on behalf of The Milbank Memorial Fund.

  14. Thermal storage for industrial process and reject heat

    NASA Technical Reports Server (NTRS)

    Duscha, R. A.; Masica, W. J.

    1978-01-01

    Industrial production uses about 40 percent of the total energy consumed in the United States. The major share of this is derived from fossil fuel. Potential savings of scarce fuel is possible through the use of thermal energy storage (TES) of reject or process heat for subsequent use. Three especially significant industries where high temperature TES appears attractive - paper and pulp, iron and steel, and cement are discussed. Potential annual fuel savings, with large scale implementation of near-term TES systems for these three industries, is nearly 9,000,000 bbl of oil.

  15. Innovative Phase Change Approach for Significant Energy Savings

    DTIC Science & Technology

    2016-09-01

    September 2016 Innovative Phase Change Approach For Significant Energy Savings September 2016 8 After conducting a market survey...FINAL REPORT Innovative Phase Change Approach for Significant Energy Savings ESTCP Project EW-201138 SEPTEMBER 2016 Dr. Aly H Shaaban Applied...5a. CONTRACT NUMBER W912HQ-11-C-0011 Innovative Phase Change Approach for Significant Energy Savings 5b. GRANT NUMBER 5c. PROGRAM

  16. Water Conservation Checklist for the Home. Save Water, Save Energy, Save Money. Program Aid No. 1192.

    ERIC Educational Resources Information Center

    Pifer, Glenda; And Others

    Few people realize that the average person uses about 60 gallons of water each day. Water shortages are already occurring on a regional scale; someday they may become a national problem. Accordingly, this checklist is designed to help house and apartment dwellers determine how efficiently they use water and identify additional ways to save it.…

  17. 7 CFR 272.11 - Systematic Alien Verification for Entitlements (SAVE) Program.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 4 2013-01-01 2013-01-01 false Systematic Alien Verification for Entitlements (SAVE... FOR PARTICIPATING STATE AGENCIES § 272.11 Systematic Alien Verification for Entitlements (SAVE... and Naturalization Service (INS), in order to verify the validity of documents provided by aliens...

  18. 7 CFR 272.11 - Systematic Alien Verification for Entitlements (SAVE) Program.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 4 2012-01-01 2012-01-01 false Systematic Alien Verification for Entitlements (SAVE... FOR PARTICIPATING STATE AGENCIES § 272.11 Systematic Alien Verification for Entitlements (SAVE... and Naturalization Service (INS), in order to verify the validity of documents provided by aliens...

  19. 7 CFR 272.11 - Systematic Alien Verification for Entitlements (SAVE) Program.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Systematic Alien Verification for Entitlements (SAVE... FOR PARTICIPATING STATE AGENCIES § 272.11 Systematic Alien Verification for Entitlements (SAVE... and Naturalization Service (INS), in order to verify the validity of documents provided by aliens...

  20. 7 CFR 272.11 - Systematic Alien Verification for Entitlements (SAVE) Program.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 4 2011-01-01 2011-01-01 false Systematic Alien Verification for Entitlements (SAVE... FOR PARTICIPATING STATE AGENCIES § 272.11 Systematic Alien Verification for Entitlements (SAVE... and Naturalization Service (INS), in order to verify the validity of documents provided by aliens...

  1. 7 CFR 272.11 - Systematic Alien Verification for Entitlements (SAVE) Program.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 4 2014-01-01 2014-01-01 false Systematic Alien Verification for Entitlements (SAVE... FOR PARTICIPATING STATE AGENCIES § 272.11 Systematic Alien Verification for Entitlements (SAVE... and Naturalization Service (INS), in order to verify the validity of documents provided by aliens...

  2. Water resources transfers through Chinese interprovincial and foreign food trade

    PubMed Central

    Dalin, Carole; Hanasaki, Naota; Qiu, Huanguang; Mauzerall, Denise L.; Rodriguez-Iturbe, Ignacio

    2014-01-01

    China’s water resources are under increasing pressure from socioeconomic development, diet shifts, and climate change. Agriculture still concentrates most of the national water withdrawal. Moreover, a spatial mismatch in water and arable land availability—with abundant agricultural land and little water resources in the north—increases water scarcity and results in virtual water transfers from drier to wetter regions through agricultural trade. We use a general equilibrium welfare model and linear programming optimization to model interprovincial food trade in China. We combine these trade flows with province-level estimates of commodities’ virtual water content to build China’s domestic and foreign virtual water trade network. We observe large variations in agricultural water-use efficiency among provinces. In addition, some provinces particularly rely on irrigation vs. rainwater. We analyze the virtual water flow patterns and the corresponding water savings. We find that this interprovincial network is highly connected and the flow distribution is relatively homogeneous. A significant share of water flows is from international imports (20%), which are dominated by soy (93%). We find that China’s domestic food trade is efficient in terms of rainwater but inefficient regarding irrigation, meaning that dry, irrigation-intensive provinces tend to export to wetter, less irrigation-intensive ones. Importantly, when incorporating foreign imports, China’s soy trade switches from an inefficient system to a particularly efficient one for saving water resources (20 km3/y irrigation water savings, 41 km3/y total). Finally, we identify specific provinces (e.g., Inner Mongolia) and products (e.g., corn) that show high potential for irrigation productivity improvements. PMID:24958864

  3. Reducing calories and added sugars by improving children's beverage choices.

    PubMed

    Briefel, Ronette R; Wilson, Ander; Cabili, Charlotte; Hedley Dodd, Allison

    2013-02-01

    Because childhood obesity is such a threat to the physical, mental, and social health of youth, there is a great need to identify effective strategies to reduce its prevalence. The objective of this study was to estimate the mean calories from added sugars that are saved by switching sugar-sweetened beverages (including soda, fruit-flavored drinks, and sport drinks) and flavored milks consumed to unflavored low-fat milk (<1% fat) at meals and water between meals. Simulation analyses used 24-hour dietary recall data from the third School Nutrition Dietary Assessment Study (n=2,314), a 2005 national cross-sectional study of schools and students participating in the National School Lunch Program, to estimate changes in mean calories from added sugars both at and away from school. Overall, these changes translated to a mean of 205 calories or a 10% savings in energy intake across all students (8% among children in elementary school and 11% in middle and high schools). Eighty percent of the daily savings were attributed to beverages consumed away from school, with results consistent across school level, sex, race/ethnicity, and weight status. Children's consumption of sugar-sweetened beverages at home contributed the greatest share of empty calories from added sugars. Such findings indicate that parental education should focus on the importance of reducing or eliminating sugar-sweetened beverages served at home. This conclusion has implications for improving children's food and beverage environments for food and nutrition educators and practitioners, other health care professionals, policy makers, researchers, and parents. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  4. Water resources transfers through Chinese interprovincial and foreign food trade.

    PubMed

    Dalin, Carole; Hanasaki, Naota; Qiu, Huanguang; Mauzerall, Denise L; Rodriguez-Iturbe, Ignacio

    2014-07-08

    China's water resources are under increasing pressure from socioeconomic development, diet shifts, and climate change. Agriculture still concentrates most of the national water withdrawal. Moreover, a spatial mismatch in water and arable land availability--with abundant agricultural land and little water resources in the north--increases water scarcity and results in virtual water transfers from drier to wetter regions through agricultural trade. We use a general equilibrium welfare model and linear programming optimization to model interprovincial food trade in China. We combine these trade flows with province-level estimates of commodities' virtual water content to build China's domestic and foreign virtual water trade network. We observe large variations in agricultural water-use efficiency among provinces. In addition, some provinces particularly rely on irrigation vs. rainwater. We analyze the virtual water flow patterns and the corresponding water savings. We find that this interprovincial network is highly connected and the flow distribution is relatively homogeneous. A significant share of water flows is from international imports (20%), which are dominated by soy (93%). We find that China's domestic food trade is efficient in terms of rainwater but inefficient regarding irrigation, meaning that dry, irrigation-intensive provinces tend to export to wetter, less irrigation-intensive ones. Importantly, when incorporating foreign imports, China's soy trade switches from an inefficient system to a particularly efficient one for saving water resources (20 km(3)/y irrigation water savings, 41 km(3)/y total). Finally, we identify specific provinces (e.g., Inner Mongolia) and products (e.g., corn) that show high potential for irrigation productivity improvements.

  5. Benefits and Costs of Aggressive Energy Efficiency Programs and the Impacts of Alternative Sources of Funding: Case Study of Massachusetts

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

    Cappers, Peter; Satchwell, Andrew; Goldman, Charles

    2010-08-06

    Increased interest by state (and federal) policymakers and regulatory agencies in pursuing aggressive energy efficiency efforts could deliver significant utility bill savings for customers while having long-term implications for ratepayers (e.g. potential rate impacts). Equity and distributional concerns associated with the authorized recovery of energy efficiency program costs may necessitate the pursuit of alternative program funding approaches. In 2008, Massachusetts passed the Green Communities Act which directed its energy efficiency (EE) program administrators to obtain all cost-effective EE resources. This goal has translated into achieving annual electric energy savings equivalent to a 2.4% reduction in retail sales from energy efficiencymore » programs in 2012. Representatives of electricity consumer groups supported the new portfolio of EE programs (and the projected bill savings) but raised concerns about the potential rate impacts associated with achieving such aggressive EE goals, leading policymakers to seek out alternative funding sources which can potentially mitigate these effects. Utility administrators have also raised concerns about under-recovery of fixed costs when aggressive energy efficiency programs are pursued and have proposed ratemaking policies (e.g. decoupling) and business models that better align the utility's financial interests with the state's energy efficiency public policy goals. Quantifying these concerns and identifying ways they can be addressed are crucial steps in gaining the support of major stakeholder groups - lessons that can apply to other states looking to significantly increase savings targets that can be achieved from their own ratepayer-funded energy efficiency programs. We use a pro-forma utility financial model to quantify the bill and rate impacts on electricity customers when very aggressive annual energy efficiency savings goals ({approx}2.4%) are achieved over the long-term and also assess the impact of different cost recovery approaches that integrate alternative revenue sources. We also analyze alternative lost fixed cost recovery approaches to better understand how to mitigate the erosion of utility shareholder returns in states that have adopted (and achieved) very aggressive savings targets.« less

  6. Save Our Streams and Waterways.

    ERIC Educational Resources Information Center

    Indiana State Dept. of Education, Indianapolis. Center for School Improvement and Performance.

    Protection of existing water supplies is critical to ensuring good health for people and animals alike. This program is aligned with the Izaak Walton League of American's Save Our Streams program which is based on the concept that students can greatly improve the quality of a nearby stream, pond, or river by regular visits and monitoring. The…

  7. Didactic or Dialogical? The Shifting Nature of INGO Development Education Programming in England and Canada

    ERIC Educational Resources Information Center

    Weber, Nadya

    2017-01-01

    This paper looks at the changing nature of international development nongovernmental organizations' development education programming in England and Canada. A documentary analysis of the changes in Save the Children Canada and Save the Children UK's development education materials illuminates the shift in international development agencies'…

  8. Effect of a therapeutic maximum allowable cost (MAC) program on the cost and utilization of proton pump inhibitors in an employer-sponsored drug plan in Canada.

    PubMed

    Mabasa, Vincent H; Ma, Johnny

    2006-06-01

    Therapeutic maximum allowable cost (MAC) is a managed care intervention that uses reference pricing in a therapeutic class or category of drugs or an indication (e.g., heartburn). Therapeutic MAC has not been studied in Canada or the United States. The proton pump inhibitor (PPI) rabeprazole was used as the reference drug in this therapeutic MAC program based on prices for PPIs in the province of Ontario. No PPI is available over the counter in Canada. To evaluate the utilization and anticipated drug cost savings for PPIs in an employer-sponsored drug plan in Canada that implemented a therapeutic MAC program for PPIs. An employer group with an average of 6,300 covered members, which adopted the MAC program for PPIs in June 2003, was compared with a comparison group comprising the book of business throughout Canada (approximately 5 million lives) without a PPI MAC program (non-MAC group). Pharmacy claims for PPIs were identified using the first 6 characters of the generic product identifier (GPI 492700) for a 36-month period from June 1, 2002, through May 31, 2005. The primary comparison was the year prior to the intervention (from June 1, 2002, through May 31, 2003) and the first full year following the intervention (June 1, 2004, through May 31, 2005). Drug utilization was evaluated by comparing the market share of each of the PPIs for the 2 time periods and by the days of PPI therapy per patient per year (PPPY) and days of therapy per prescription (Rx). Drug cost was defined as the cost of the drug (ingredient cost), including allowable provincial pharmacy markup but excluding pharmacy dispense fee. Cost savings were calculated from the allowed drug cost per claim, allowed cost per day, and allowed cost PPPY. (All amounts are in Canadian dollars.) The MAC intervention group experienced an 11.7% reduction in the average cost per day of PPI drug therapy, from 2.14 US dollars in the preperiod to 1.89 US dollars in the postperiod, compared with a 3.7% reduction in the comparison group (2.16 US dollars vs. 2.08 US dollars). Utilization dropped by 11.9% in the intervention group, from 166.7 days of PPI drug therapy PPPY to 146.9 days PPPY, compared with an increase of 7.9% in the comparison group, from 136.1 days to 146.8 days PPPY. The combined effect of the decrease in drug cost per day and utilization was a 22.1% reduction in allowed drug cost PPPY in the intervention (MAC) group (from 357 US dollars to 278 US dollars PPPY) versus a 4.1% increase in the comparison group (from 293 US dollars to 305 US dollars PPPY). A MAC program for PPIs for one employer in Canada was associated with savings for the drug plan sponsor of approximately 8% in actual drug cost per day of therapy compared with the comparison group. Total savings after consideration of utilization was approximately 26% for the intervention group versus the comparison group.

  9. 76 FR 6653 - Public Housing Capital Fund Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-07

    ...; heating system replacements; wall insulation; site-based generation; advanced energy savings technologies...; wall insulation; site-based generation; advanced energy savings technologies, including renewable...

  10. New York State Educational Programs That Work. Sharing Successful Programs, 1990 Edition.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany.

    Sharing Successful Programs (SSP) is a national dissemination process for validating, sharing, and implementing successful educational programs. It offers effective strategies for educational improvement by sharing validated programs and provides a cost-effective way for school districts to duplicate validated programs in accordance with their…

  11. 32 CFR 50.3 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... private business or trade. Securities. Mutual funds, stocks, bonds, or any product registered with the... fund employees and special Government employees, of the Department of Defense. Financial services... banking (e.g., ATMs), in-store banking, checking, share and savings accounts, fund transfers, sale of...

  12. 32 CFR 50.3 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... private business or trade. Securities. Mutual funds, stocks, bonds, or any product registered with the... fund employees and special Government employees, of the Department of Defense. Financial services... banking (e.g., ATMs), in-store banking, checking, share and savings accounts, fund transfers, sale of...

  13. Medicare Part D: successes and continuing challenges. Impact of Medicare Part D on Massachusetts health programs and beneficiaries.

    PubMed

    Thomas, Cindy Parks; Sussman, Jeffrey

    2007-05-30

    On January 1, 2006, the Centers for Medicare and Medicaid Services (CMS) implemented the Medicare Drug Benefit, or "Medicare Part D." The program offers prescription drug coverage for the one million Medicare beneficiaries in Massachusetts. Part D affects Massachusetts state health programs and beneficiaries in a number of ways. The program: (1) provides prescription drug insurance, including catastrophic coverage, through a choice of private prescription drug plans (PDPs) or integrated Medicare Advantage (MA-PD) health plans; (2) shifts prescription drug coverage for dual-eligible Medicare / Medicaid beneficiaries from Medicaid to Medicare Part D drug plans; (3) requires a maintenance-of-effort, or "clawback" payments from states to CMS designed to capture a portion of states' Medicaid savings to help finance the benefit; (4) offers additional help for premiums and cost sharing to low income beneficiaries through the Low Income Subsidy (LIS); and (5) provides a subsidy to employer groups that maintain their own prescription drug coverage for retired beneficiaries. This paper summarizes the activities involved in implementing Medicare Part D, the impact it has had on Massachusetts health programs, and the experiences of beneficiaries and others conducting outreach and enrollment. The data are drawn from interviews with officials and documents provided by state health programs, CMS and the Social Security Administration, and representatives of provider and advocacy groups involved in the enrollment and ongoing support of Medicare beneficiaries.

  14. Prescription Program Provides Significant Savings

    ERIC Educational Resources Information Center

    Rowan, James M.

    2010-01-01

    Most school districts today are looking for ways to save money without decreasing services to its staff. Retired pharmacist Tim Sylvester, a lifelong resident of Alpena Public Schools in Alpena, Michigan, presented the district with a pharmaceuticals plan that would save the district money without raising employee co-pays for prescriptions. The…

  15. Incentives for Tuition Savings.

    ERIC Educational Resources Information Center

    Miller, Scott E.

    The role of the federal government in authorizing tuition savings plans and the relationship of these incentives to more traditional student aid programs are examined. Most of the recent proposals to provide incentives for families to save for their children's education would allow tax breaks. For example, the Reagan administration proposal would…

  16. Colorado's Alternative School Calendar Program.

    ERIC Educational Resources Information Center

    Stiverson, C. L.

    1982-01-01

    Colorado's 22 school districts on a four-day week schedule, as authorized by Colorado Senate Bill 78, show comparable student achievement levels as those on a five-day schedule; support from parents, teachers; and students; improved energy savings and/or time savings; and cost savings. Five other possible benefits are listed. (LC)

  17. Literature Searching Services--Choosing the Contract with the Best Discount Plan.

    ERIC Educational Resources Information Center

    Buckel, William L. (Bill)

    1982-01-01

    Focuses on the cost-saving technique--selecting the contract that offers the best discount--available when using the Lockheed DIALOG system. Examples of savings, password/contract options, and discount plans are given and a microcomputer program written in BASIC II to aid in calculating savings is described. (EJS)

  18. Insuring That Families Plan and Save for College.

    ERIC Educational Resources Information Center

    Belvin, James

    1995-01-01

    Because so many Americans can afford to save for children's college costs but do not, it is proposed that employers take a more active role in promoting college financial planning. Possible solutions include company-sponsored contributory accounts, educational savings plans; payroll deduction plans, educational annuity programs, subsidized or…

  19. A Save-Energy, Save-Money Program That Pays Off

    ERIC Educational Resources Information Center

    Embersits, John F.

    1976-01-01

    Suggested guidelines for energy saving on campus include a 3-phase plan: (1) Quick Fix--effective management of what you already have; (2) Refitting--modification of existing systems and installation of simple controls; (3) Systems Convert--installation of computerized controls, waste-heat recovery, solid-waste recovery utilization and other…

  20. An Orthopedic Performance Improvement Initiative at a Small Military Treatment Facility.

    PubMed

    McGee, John Christopher; Bise, Christopher G; Stevens, Joel M

    2017-03-01

    The scientific literature demonstrates a cost-benefit associated with early access to physical therapy. The purpose of this case study is to report the results of an orthopedic performance improvement initiative (OPII) at a small military treatment facility (approximately 4.5K active duty beneficiaries). The OPII was introduced to (1) limit variation by ensuring that all active duty orthopedic consults were audited ensuring proper timing of appropriate services and (2) establish contractual agreement for shared resources with the U.S. Naval Jacksonville Orthopedic Department. OPII was accomplished through consensus development and strong leadership support. All orthopedic referrals (n = 260) were audited for 6 months. Appropriate recommendations were provided to either continue with orthopedic care or to redirect to a physical therapy first approach. Orthopedic referrals decreased 27% with concomitant 32% increase in physical therapy referrals producing overall savings of $462K (33%). Meanwhile, surgical throughput improved 45%. Seventy percent of the savings were attributed to improved utilization translating to a relative value unit savings per beneficiary of $17.64 (23.7%). Our results support the value of a conservative physical therapy first approach for musculoskeletal conditions and shared mil-to-mil resourcing agreements. Success requires an iterative audit/feedback process balanced with stakeholder consensus. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  1. Application of XML in DICOM

    NASA Astrophysics Data System (ADS)

    You, Xiaozhen; Yao, Zhihong

    2005-04-01

    As a standard of communication and storage for medical digital images, DICOM has been playing a very important role in integration of hospital information. In DICOM, tags are expressed by numbers, and only standard data elements can be shared by looking up Data Dictionary while private tags can not. As such, a DICOM file's readability and extensibility is limited. In addition, reading DICOM files needs special software. In our research, we introduced XML into DICOM, defining an XML-based DICOM special transfer format, XML-DCM, a DICOM storage format, X-DCM, as well as developing a program package to realize format interchange among DICOM, XML-DCM, and X-DCM. XML-DCM is based on the DICOM structure while replacing numeric tags with accessible XML character string tags. The merits are as following: a) every character string tag of XML-DCM has explicit meaning, so users can understand standard data elements and those private data elements easily without looking up the Data Dictionary. In this way, the readability and data sharing of DICOM files are greatly improved; b) According to requirements, users can set new character string tags with explicit meaning to their own system to extend the capacity of data elements; c) User can read the medical image and associated information conveniently through IE, ultimately enlarging the scope of data sharing. The application of storage format X-DCM will reduce data redundancy and save storage memory. The result of practical application shows that XML-DCM does favor integration and share of medical image data among different systems or devices.

  2. Beyond Widgets -- Systems Incentive Programs for Utilities

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

    Regnier, Cindy; Mathew, Paul; Robinson, Alastair

    Utility incentive programs remain one of the most significant means of deploying commercialized, but underutilized building technologies to scale. However, these programs have been largely limited to component-based products (e.g., lamps, RTUs). While some utilities do provide ‘custom’ incentive programs with whole building and system level technical assistance, these programs require deeper levels of analysis, resulting in higher program costs. This results in custom programs being restricted to utilities with greater resources, and are typically applied mainly to large or energy-intensive facilities, leaving much of the market without cost effective access and incentives for these solutions. In addition, with increasinglymore » stringent energy codes, cost effective component-based solutions that achieve significant savings are dwindling. Building systems (e.g., integrated façade, HVAC and/or lighting solutions) can deliver higher savings that translate into large sector-wide savings if deployed at the scale of these programs. However, systems application poses a number of challenges – baseline energy use must be defined and measured; the metrics for energy and performance must be defined and tested against; in addition, system savings must be validated under well understood conditions. This paper presents a sample of findings of a project to develop validated utility incentive program packages for three specific integrated building systems, in collaboration with Xcel Energy (CO, MN), ComEd, and a consortium of California Public Owned Utilities (CA POUs) (Northern California Power Agency(NCPA) and the Southern California Public Power Authority(SCPPA)). Furthermore, these program packages consist of system specifications, system performance, M&V protocols, streamlined assessment methods, market assessment and implementation guidance.« less

  3. Energy-related emissions from telework.

    PubMed

    Kitou, Erasmia; Horvath, Arpad

    2003-08-15

    Telework is a growing phenomenon that is thought to save energy and air emissions. This paper applies a systems model to telework and nontelework scenarios in order to quantify greenhouse gas and other air emissions from transportation, heating, cooling, lighting, and electronic and electrical equipment use both at the company and the home office. Using United States data, a WWW-based, scalable decision-support tool was created to evaluate the environmental impacts of teleworkers. For a typical case reflecting United States teleworker patterns, the analysis found that telework has the potential to reduce air emissions. However, Monte Carlo simulation employed to perform a probabilistic analysis over a set of likely parameters has revealed that telework may not affect equally the emissions of all types of pollutants. It may decrease CO2, NOx, SO2, PM10, and CO but not N2O and CH4 emissions. Therefore, the scope and goal of telework programs must be defined early in the implementation process. Work-related transportation (commuting) impacts could be reduced as a result of telework; however, home-related impacts due to an employee spending additional time at home could potentially offset these reductions. Company office-related impacts may not be reduced unless the office space is shared with other employees during telework days or eliminated entirely. In states with high telework potential (California, Georgia, Illinois, New York, Texas), telework could save emissions, but it would depend on commuting and climatic patterns and the electricity mix. Environmentally beneficial telework programs are found to depend mainly on commuting patterns, induced energy usage, and characteristics of the office and home space and equipment use.

  4. Cost-benefit analysis of childhood asthma management through school-based clinic programs.

    PubMed

    Tai, Teresa; Bame, Sherry I

    2011-04-01

    Asthma is a leading chronic illness among American children. School-based health clinics (SBHCs) reduced expensive ER visits and hospitalizations through better healthcare access and monitoring in select case studies. The purpose of this study was to examine the cost-benefit of SBHC programs in managing childhood asthma nationwide for reduction in medical costs of ER, hospital and outpatient physician care and savings in opportunity social costs of lowing absenteeism and work loss and of future earnings due to premature deaths. Eight public data sources were used to compare costs of delivering primary and preventive care for childhood asthma in the US via SBHC programs, including direct medical and indirect opportunity costs for children and their parents. The costs of nurse staffing for a nationwide SBHC program were estimated at $4.55 billion compared to the estimated medical savings of $1.69 billion, including ER, hospital, and outpatient care. In contrast, estimated total savings for opportunity costs of work loss and premature death were $23.13 billion. Medical savings alone would not offset the expense of implementing a SBHC program for prevention and monitoring childhood asthma. However, even modest estimates of reducing opportunity costs of parents' work loss would be far greater than the expense of this program. Although SBHC programs would not be expected to affect the increasing prevalence of childhood asthma, these programs would be designed to reduce the severity of asthma condition with ongoing monitoring, disease prevention and patient compliance.

  5. Creating the Business Case for Achieving Health Equity.

    PubMed

    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.

  6. Cost Savings From the Provision of Specific Methods of Contraception in a Publicly Funded Program

    PubMed Central

    Rostovtseva, Daria P.; Brindis, Claire D.; Biggs, M. Antonia; Hulett, Denis; Darney, Philip D.

    2009-01-01

    Objectives. We examined the cost-effectiveness of contraceptive methods dispensed in 2003 to 955 000 women in Family PACT (Planning, Access, Care and Treatment), California's publicly funded family planning program. Methods. We estimated the number of pregnancies averted by each contraceptive method and compared the cost of providing each method with the savings from averted pregnancies. Results. More than half of the 178 000 averted pregnancies were attributable to oral contraceptives, one fifth to injectable methods, and one tenth each to the patch and barrier methods. The implant and intrauterine contraceptives were the most cost-effective, with cost savings of more than $7.00 for every $1.00 spent in services and supplies. Per $1.00 spent, injectable contraceptives yielded savings of $5.60; oral contraceptives, $4.07; the patch, $2.99; the vaginal ring, $2.55; barrier methods, $1.34; and emergency contraceptives, $1.43. Conclusions. All contraceptive methods were cost-effective—they saved more in public expenditures for unintended pregnancies than they cost to provide. Because no single method is clinically recommended to every woman, it is medically and fiscally advisable for public health programs to offer all contraceptive methods. PMID:18703437

  7. Savings opportunities through Medicaid disease management.

    PubMed

    Lewis, Alfred

    2004-01-01

    In their attempts to control spending in Medicaid, a few states have looked beyond the obvious reductions in reimbursement, tightened eligibility requirements, and institution of copays to disease management outsourcing. While the traditional panoply of cutbacks will save money the year they are instituted, they tend to have trade-offs. Reducing reimbursement, for example, may encourage providers to leave the program. As a result, several states are implementing outsourced medical management programs, which together at maturity will, as shown below, noticeably reduce Medicaid spending by improving the way health care is delivered. These purely voluntary, quality-enhancing outsourced medical management programs are also fully guaranteed by a wide variety of vendors to save money starting in the first year they are implemented.

  8. Intervention Packages to Reduce the Impact of HIV and HCV Infections Among People Who Inject Drugs in Eastern Europe and Central Asia: A Modeling and Cost-effectiveness Study.

    PubMed

    Mabileau, Guillaume; Scutelniciuc, Otilia; Tsereteli, Maia; Konorazov, Ivan; Yelizaryeva, Alla; Popovici, Svetlana; Saifuddin, Karimov; Losina, Elena; Manova, Manoela; Saldanha, Vinay; Malkin, Jean-Elie; Yazdanpanah, Yazdan

    2018-03-01

    We evaluated the effectiveness and cost-effectiveness of interventions targeting hepatitis C virus (HCV) and HIV infections among people who inject drugs (PWID) in Eastern Europe/Central Asia. We specifically considered the needle-syringe program (NSP), opioid substitution therapy (OST), HCV and HIV diagnosis, antiretroviral therapy (ART), and/or new HCV treatment (direct acting antiviral [DAA]) in Belarus, Georgia, Kazakhstan, Republic of Moldova, and Tajikistan. We developed a deterministic dynamic compartmental model and evaluated the number of infections averted, costs, and incremental cost-effectiveness ratios (ICERs) of interventions. OST decreased frequencies of injecting by 85% and NSP needle sharing rates by 57%; ART was introduced at CD4 <350 and DAA at fibrosis stage ≥F2 at a $2370 to $23 280 cost. Increasing NSP+OST had a high impact on transmissions (infections averted in PWID: 42% in Tajikistan to 55% in Republic of Moldova for HCV; 30% in Belarus to 61% in Kazakhstan for HIV over 20 years). Increasing NSP+OST+ART was very cost-effective in Georgia (ICER = $910/year of life saved [YLS]), and was cost-saving in Kazakhstan and Republic of Moldova. NSP+OST+ART and HIV diagnosis was very cost-effective in Tajikistan (ICER = $210/YLS). Increasing the coverage of all interventions was always the most effective strategy and was cost-effective in Belarus and Kazakhstan (ICER = $12 960 and $21 850/YLS); it became cost-effective/cost-saving in all countries when we decreased DAA costs. Increasing NSP+OST coverage, in addition to ART and HIV diagnosis, had a high impact on both epidemics and was very cost-effective and even cost-saving. When HCV diagnosis was improved, increased DAA averted a high number of new infections if associated with NSP+OST.

  9. 12 CFR 167.1 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... institution. The term domestic depository institution means a financial institution that engages in the... substitute. Direct credit substitutes include: (1) Financial standby letters of credit that support financial claims on a third party that exceed a savings association's pro rata share in the financial claim; (2...

  10. 12 CFR 167.1 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... institution. The term domestic depository institution means a financial institution that engages in the... substitute. Direct credit substitutes include: (1) Financial standby letters of credit that support financial claims on a third party that exceed a savings association's pro rata share in the financial claim; (2...

  11. 12 CFR 167.1 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... institution. The term domestic depository institution means a financial institution that engages in the... substitute. Direct credit substitutes include: (1) Financial standby letters of credit that support financial claims on a third party that exceed a savings association's pro rata share in the financial claim; (2...

  12. 77 FR 61607 - Change in Bank Control Notices; Acquisitions of Shares of a Bank or Bank Holding Company

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-10

    ... and Susan Job Hollingshead, all of Knoxville, Iowa; to acquire control of Duclarkee, Inc., and thereby indirectly acquire control of Iowa State Savings Bank, both in Knoxville, Iowa. 2. Richard P. DelMedico...

  13. 11 CFR 110.1 - Contributions by persons other than multicandidate political committees (2 U.S.C. 441a(a)(1)).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., including: currency; balances on deposit in banks, savings and loan institutions, and other depository... publicly-traded shares, shall be considered a corporation pursuant to 11 CFR Part 114. (4) A contribution...

  14. 78 FR 941 - Formations of, Acquisitions by, and Mergers of Bank Holding Companies

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-07

    ... ownership of, control of, or the power to vote shares of a bank or bank holding company and all of the banks... Bank, Jacksonville, Illinois to be treated as a savings association. Dated: Board of Governors of the...

  15. Measuring energy-saving retrofits: Experiences from the Texas LoanSTAR program

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

    Haberl, J.S.; Reddy, T.A.; Claridge, D.E.

    1996-02-01

    In 1988 the Governor`s Energy Management Center of Texas received approval from the US Department of Energy to establish a $98.6 million state-wide retrofit demonstration revolving loan program to fund energy-conserving retrofits in state, public school, and local government buildings. As part of this program, a first-of-its-kind, statewide Monitoring and Analysis Program (MAP) was established to verify energy and dollar savings of the retrofits, reduce energy costs by identifying operational and maintenance improvements, improve retrofit selection in future rounds of the LoanSTAR program, and initiate a data base of energy use in institutional and commercial buildings located in Texas. Thismore » report discusses the LoanSTAR MAP with an emphasis on the process of acquiring and analyzing data to measure savings from energy conservation retrofits when budgets are a constraint. This report includes a discussion of the program structure, basic measurement techniques, data archiving and handling, data reporting and analysis, and includes selected examples from LoanSTAR agencies. A summary of the program results for the first two years of monitoring is also included.« less

  16. Plan, Save, Succeed! Financial Literacy Poster/Teaching Guide. Expect the Unexpected with Math[R

    ERIC Educational Resources Information Center

    Actuarial Foundation, 2013

    2013-01-01

    "Plan, Save, Succeed!" is a new program aligned with Jumpstart Coalition National Standards in K-12 Personal Finance Education, National Council of Teachers of Mathematics (NCTM) Standards, and Common Core Standards for Mathematical Practice. "Plan, Save, Succeed!" is designed to help students understand key financial literacy topics including…

  17. "Save the Music?" Toward Culturally Relevant, Joyful, and Sustainable School Music

    ERIC Educational Resources Information Center

    Koza, Julia Eklund

    2006-01-01

    In recent years saving the music has become a favorite project of major corporations, especially as privatization of public schooling has gained momentum. Here, the author presents examples of these projects like the corporate-sponsored initiative "VH1 Save the Music" which claims helping flailing school music programs. Among other things, she…

  18. Will the Measurement Robots Take Our Jobs? An Update on the State of Automated M&V for Energy Efficiency Programs

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

    Granderson, Jessica; Touzani, Samir; Taylor, Cody

    Trustworthy savings calculations are critical to convincing regulators of both the cost-effectiveness of energy efficiency program investments and their ability to defer supply-side capital investments. Today’s methods for measurement and verification (M&V) of energy savings constitute a significant portion of the total costs of energy efficiency programs. They also require time-consuming data acquisition. A spectrum of savings calculation approaches is used, with some relying more heavily on measured data and others relying more heavily on estimated, modeled, or stipulated data. The rising availability of “smart” meters and devices that report near-real time data, combined with new analytical approaches to quantifyingmore » savings, offers potential to conduct M&V more quickly and at lower cost, with comparable or improved accuracy. Commercial energy management and information systems (EMIS) technologies are beginning to offer M&V capabilities, and program administrators want to understand how they might assist programs in quickly and accurately measuring energy savings. This paper presents the results of recent testing of the ability to use automation to streamline some parts of M&V. Here in this paper, we detail metrics to assess the performance of these new M&V approaches, and a framework to compute the metrics. We also discuss the accuracy, cost, and time trade-offs between more traditional M&V, and these emerging streamlined methods that use high-resolution energy data and automated computational intelligence. Finally we discuss the potential evolution of M&V and early results of pilots currently underway to incorporate M&V automation into ratepayer-funded programs and professional implementation and evaluation practice.« less

  19. Implementation of an optical diagnosis strategy saves costs and does not impair clinical outcomes of a fecal immunochemical test-based colorectal cancer screening program.

    PubMed

    Vleugels, Jasper L A; Greuter, Marjolein J E; Hazewinkel, Yark; Coupé, Veerle M H; Dekker, Evelien

    2017-12-01

     In an optical diagnosis strategy, diminutive polyps that are endoscopically characterized with high confidence are removed without histopathological analysis and distal hyperplastic polyps are left in situ. We evaluated the effectiveness and costs of optical diagnosis.  Using the Adenoma and Serrated pathway to Colorectal CAncer (ASCCA) model, we simulated biennial fecal immunochemical test (FIT) screening in individuals aged 55 - 75 years. In this program, we compared an optical diagnosis strategy with current histopathology assessment of all diminutive polyps. Base-case assumptions included 76 % high-confidence predictions and sensitivities of 88 %, 91 %, and 88 % for endoscopically characterizing adenomas, sessile serrated polyps, and hyperplastic polyps, respectively. Outcomes were colorectal cancer burden, number of colonoscopies, life-years, and costs.  Both the histopathology strategy and the optical diagnosis strategy resulted in 21 life-days gained per simulated individual compared with no screening. For optical diagnosis, €6 per individual was saved compared with the current histopathology strategy. These cost savings were related to a 31 % reduction in colonoscopies in which histopathology was needed for diminutive polyps. Projecting these results onto the Netherlands (17 million inhabitants), assuming a fully implemented FIT-based screening program, resulted in an annual undiscounted cost saving of € 1.7 - 2.2 million for optical diagnosis.  Implementation of optical diagnosis in a FIT-based screening program saves costs without decreasing program effectiveness when compared with current histopathology analysis of all diminutive polyps. Further work is required to evaluate how endoscopists participating in a screening program should be trained, audited, and monitored to achieve adequate competence in optical diagnosis.

  20. Pediatric Specialty Care Model for Management of Chronic Respiratory Failure: Cost and Savings Implications and Misalignment With Payment Models.

    PubMed

    Graham, Robert J; McManus, Michael L; Rodday, Angie Mae; Weidner, Ruth Ann; Parsons, Susan K

    2018-05-01

    To describe program design, costs, and savings implications of a critical care-based care coordination model for medically complex children with chronic respiratory failure. All program activities and resultant clinical outcomes were tracked over 4 years using an adapted version of the Care Coordination Measurement Tool. Patient characteristics, program activity, and acute care resource utilization were prospectively documented in the adapted version of the Care Coordination Measurement Tool and retrospectively cross-validated with hospital billing data. Impact on total costs of care was then estimated based on program outcomes and nationally representative administrative data. Tertiary children's hospital. Critical Care, Anesthesia, Perioperative Extension and Home Ventilation Program enrollees. None. The program provided care for 346 patients and families over the study period. Median age at enrollment was 6 years with more than half deriving secondary respiratory failure from a primary neuromuscular disease. There were 11,960 encounters over the study period, including 1,202 home visits, 673 clinic visits, and 4,970 telephone or telemedicine encounters. Half (n = 5,853) of all encounters involved a physician and 45% included at least one care coordination activity. Overall, we estimated that program interventions were responsible for averting 556 emergency department visits and 107 hospitalizations. Conservative monetization of these alone accounted for annual savings of $1.2-2 million or $407/pt/mo net of program costs. Innovative models, such as extension of critical care services, for high-risk, high-cost patients can result in immediate cost savings. Evaluation of financial implications of comprehensive care for high-risk patients is necessary to complement clinical and patient-centered outcomes for alternative care models. When year-to-year cost variability is high and cost persistence is low, these savings can be estimated from documentation within care coordination management tools. Means of financial sustainability, scalability, and equal access of such care models need to be established.

  1. Delays and Uncertain Energy Savings in Program to Promote State Energy Conservation. Report to the Congress by the Comptroller General of the United States.

    ERIC Educational Resources Information Center

    Comptroller General of the U.S., Washington, DC.

    Presented is a study and assessment of the United States Department of Energy State Energy Conservation Program (SECP). The goal of the SECP is to reduce energy consumption in each state by 5% by 1980. However, it is unlikely that this goal will be attained or that the savings reported for 1978 are a valid measure of the program's impact on energy…

  2. Automated procedures for sizing aerospace vehicle structures /SAVES/

    NASA Technical Reports Server (NTRS)

    Giles, G. L.; Blackburn, C. L.; Dixon, S. C.

    1972-01-01

    Results from a continuing effort to develop automated methods for structural design are described. A system of computer programs presently under development called SAVES is intended to automate the preliminary structural design of a complete aerospace vehicle. Each step in the automated design process of the SAVES system of programs is discussed, with emphasis placed on use of automated routines for generation of finite-element models. The versatility of these routines is demonstrated by structural models generated for a space shuttle orbiter, an advanced technology transport,n hydrogen fueled Mach 3 transport. Illustrative numerical results are presented for the Mach 3 transport wing.

  3. Age differences in IDA savings outcomes: findings from the American Dream Demonstration.

    PubMed

    Putnam, Michelle; Sherraden, Michael; Zhang, Lin; Morrow-Howell, Nancy

    2008-01-01

    This study aims to develop a greater understanding of age differences in savings outcomes within Individual Development Accounts (IDAs). Participant data from the American Dream Demonstration (ADD) are examined for age differences in accumulated net deposits, average monthly net deposits, and deposit frequency. ADDprogram data are examined for savings match rates, monthly savings targets, direct deposit, and hours of financial education offered. Results indicate that, on average, older IDA participants have better savings outcomes than younger participants. Findings from this study suggest that impoverished middleaged and older adults can save if provided an opportunity and incentives. However, success will depend on the characteristics of the programs.

  4. 16 CFR 310.2 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... partnership, corporation, or other business entity. (w) Preacquired account information means any information... General means the chief legal officer of a state. (c) Billing information means any data that enables any person to access a customer's or donor's account, such as a credit card, checking, savings, share or...

  5. Managing Credit Card Expenses: Nova Southeastern University Shares Cost-Saving Techniques.

    ERIC Educational Resources Information Center

    Peskin, Carol Ann

    1994-01-01

    Nova Southeastern University, Florida, has implemented a variety of techniques of cost containment for campus credit card transactions. These include restricted card acceptance parameters, careful merchant rate negotiation, increased automation of transaction processing, and sophisticated processing techniques. The university has demonstrated…

  6. 26 CFR 1.482-0 - Outline of regulations under section 482.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) Property or services. (4) Special circumstances. (i) Market share strategy. (ii) Different geographic markets. (A) In general. (B) Example. (C) Location savings. (D) Example. (iii) Transactions ordinarily not... of multiple year data. (C) Comparable effect over comparable period. (D) Applications of methods...

  7. Pervious concrete mix optimization for sustainable pavement solution

    NASA Astrophysics Data System (ADS)

    Barišić, Ivana; Galić, Mario; Netinger Grubeša, Ivanka

    2017-10-01

    In order to fulfill requirements of sustainable road construction, new materials for pavement construction are investigated with the main goal to preserve natural resources and achieve energy savings. One of such sustainable pavement material is pervious concrete as a new solution for low volume pavements. To accommodate required strength and porosity as the measure of appropriate drainage capability, four mixtures of pervious concrete are investigated and results of laboratory tests of compressive and flexural strength and porosity are presented. For defining the optimal pervious concrete mixture in a view of aggregate and financial savings, optimization model is utilized and optimal mixtures defined according to required strength and porosity characteristics. Results of laboratory research showed that comparing single-sized aggregate pervious concrete mixtures, coarse aggregate mixture result in increased porosity but reduced strengths. The optimal share of the coarse aggregate turn to be 40.21%, the share of fine aggregate is 49.79% for achieving required compressive strength of 25 MPa, flexural strength of 4.31 MPa and porosity of 21.66%.

  8. U.S. Department of Energy’s Industrial Technology Program and Its Impacts

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

    Weakley, Steven A.; Roop, Joseph M.

    The U.S. Department of Energy’s Industrial Technologies Program (ITP) has been working with industry since 1976 to encourage the development and adoption of new, energy-efficient technologies. ITP has helped industry not only use energy and materials more efficiently but also improve environ-mental performance, product quality, and productivity. To help ITP determine the impacts of its pro-grams, Pacific Northwest National Laboratory (PNNL) periodically reviews and analyzes ITP pro-gram benefits. PNNL contacts vendors and users of ITP-sponsored technologies that have been commer-cialized, estimates the number of units that have penetrated the market, conducts engineering analyses to estimate energy savings from the newmore » technolo¬gies, and estimates air pollution and carbon emission reductions. This paper discusses the results of PNNL’s most recent review (conducted in 2009). From 1976-2008, the commercialized technologies from ITP’s research and development programs and other activities have cumulatively saved 9.27 quadrillion Btu, with a net cost savings of $63.91 billion.« less

  9. U.S. Department of Energy’s Industrial Technologies Program and Its Impacts

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

    Weakley, Steven A.; Brown, Scott A.

    The U.S. Department of Energy’s Industrial Technologies Program (ITP) has been working with industry since 1976 to encourage the development and adoption of new, energy-efficient technologies. ITP has helped industry not only use energy and materials more efficiently but also improve environ-mental performance, product quality, and productivity. To help ITP determine the impacts of its pro-grams, Pacific Northwest National Laboratory (PNNL) periodically reviews and analyzes ITP pro-gram benefits. PNNL contacts vendors and users of ITP-sponsored technologies that have been commer-cialized, estimates the number of units that have penetrated the market, conducts engineering analyses to estimate energy savings from the newmore » technolo-gies, and estimates air pollution and carbon emission reductions. This paper discusses the results of PNNL’s most recent review (conducted in 2010). From 1976-2009, the commercialized technologies from ITP’s research and development programs and other activities have cumulatively saved 10.0 quadrillion Btu, with a net cost savings of $61.82 billion.« less

  10. U.S. Department of Energy’s Industrial Technology Program and Its Impacts

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

    Weakley, Steven A.; Roop, Joseph M.

    The U.S. Department of Energy’s Industrial Technologies Program (ITP) has been working with industry since 1976 to encourage the development and adoption of new, energy-efficient technologies. ITP has helped industry not only use energy and materials more efficiently but also improve environ-mental performance, product quality, and productivity. To help ITP determine the impacts of its pro-grams, Pacific Northwest National Laboratory (PNNL) periodically reviews and analyzes ITP pro-gram benefits. PNNL contacts vendors and users of ITP-sponsored technologies that have been commer-cialized, estimates the number of units that have penetrated the market, conducts engineering analyses to estimate energy savings from the newmore » technolo¬gies, and estimates air pollution and carbon emission reductions. This paper discusses the results of PNNL’s most recent review (conducted in 2008). From 1976-2007, the commercialized technologies from ITP’s research and development programs and other activities have cumulatively saved 6.17 quadrillion Btu, with a net cost savings of $63.0 billion.« less

  11. U. S. Department of Energy (DOE) Industrial Programs and Their Impacts

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

    Weakley, Steven A.; Roop, Joseph M.

    The U.S. Department of Energy's Industrial Technologies Program (ITP) has been working with industry since 1976 to encourage the development and adoption of new, energy-efficient technologies. ITP has helped industry not only use energy and materials more efficiently but also improve environmental performance, product quality, and productivity. To help ITP determine the impacts of its programs, Pacific Northwest National Laboratory (PNNL) periodically reviews and analyzes ITP program benefits. PNNL contacts vendors and users of ITP-sponsored technologies that have been commercialized, estimates the number of units that have penetrated the market, conducts engineering analyses to estimate energy savings from the newmore » technologies, and estimates air pollution and carbon emission reductions. This paper discusses the results of the most recent PNNL review (conducted in 2003). From 1976-2002, the commercialized technologies from ITP's R&D programs and other activities have cumulatively saved 3.7 quadrillion Btu, with a net cost savings of $14.6 billion.« less

  12. U.S. Department of Energy (DOE) Industrial Programs and Their Impacts

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

    Weakley, Steven A.; Roop, Joseph M.

    The U.S. Department of Energy’s Industrial Technologies Program (ITP) has been working with industry since 1976 to encourage the development and adoption of new, energy-efficient technologies. ITP has helped industry not only use energy and materials more efficiently but also improve environmental performance, product quality, and productivity. To help ITP determine the impacts of its programs, Pacific Northwest National Laboratory (PNNL) periodically reviews and analyzes ITP program benefits. PNNL contacts vendors and users of ITP-sponsored technologies that have been commercialized, estimates the number of units that have penetrated the market, conducts engineering analyses to estimate energy savings from the newmore » technologies, and estimates air pollution and carbon emission reductions. This paper discusses the results of the most recent PNNL review (conducted in 2005). From 1976-2004, the commercialized technologies from ITP’s research and development (R&D) programs and other activities have cumulatively saved 4.72 quadrillion Btu, with a net cost savings of $23.1 billion.« less

  13. Effects of an Employee Wellness Program on Physiological Risk Factors, Job Satisfaction, and Monetary Savings in a South Texas University

    ERIC Educational Resources Information Center

    Hamilton, Jacqueline

    2009-01-01

    An experimental study was conducted to investigate the effects of an Employee Wellness Program on physiological risk factors, job satisfaction, and monetary savings in a South Texas University. The non-probability sample consisted of 31 employees from lower income level positions. The employees were randomly assigned to the treatment group which…

  14. CNCC Craig Campus Geothermal Project: 82-well closed loop GHP well field to provide geothermal energy as a common utilitiy for a new community college campus

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

    Chevron Energy Solutions; Matt Rush; Scott Shulda

    Colorado Northwestern Community College (CNCC) is working collaboratively with recipient vendor Chevron Energy Solutions, an energy services company (ESCO), to develop an innovative GHP project at the new CNCC Campus constructed in 2010/2011 in Craig, Colorado. The purpose of the CNCC Craig Campus Geothermal Program scope was to utilize an energy performance contracting approach to develop a geothermal system with a shared closed-loop field providing geothermal energy to each building's GHP mechanical system. Additional benefits to the project include promoting good jobs and clean energy while reducing operating costs for the college. The project has demonstrated that GHP technology ismore » viable for new construction using the energy performance contracting model. The project also enabled the project team to evaluate several options to give the College a best value proposition for not only the initial design and construction costs but build high performance facilities that will save the College for many years to come. The design involved comparing the economic feasibility of GHP by comparing its cost to that of traditional HVAC systems via energy model, financial life cycle cost analysis of energy savings and capital cost, and finally by evaluating the compatibility of the mechanical design for GHP compared to traditional HVAC design. The project shows that GHP system design can be incorporated into the design of new commercial buildings if the design teams, architect, contractor, and owner coordinate carefully during the early phases of design. The public also benefits because the new CNCC campus is a center of education for the much of Northwestern Colorado, and students in K-12 programs (Science Spree 2010) through the CNCC two-year degree programs are already integrating geothermal and GHP technology. One of the greatest challenges met during this program was coordination of multiple engineering and development stakeholders. The leadership of Principle Investigator Pres. John Boyd of CNCC met this challenge by showing clear leadership in setting common goals and resolving conflicts early in the program.« less

  15. Qualification of Electrical Ground Support Equipment for New Space Programs

    NASA Technical Reports Server (NTRS)

    SotoToro, Felix A.; Vu, Bruce T.; Hamilton, Mark S.

    2011-01-01

    With the Space Shuttle program coming to an end, the National Aeronautics and Space Administration (NASA) is moving to a new space flight program that will allow expeditions beyond low earth orbit. The space vehicles required to comply with these missions will be carrying heavy payloads. This implies that the Earth departure stage capabilities must be of higher magnitudes, given the current propulsion technology. The engineering design of the new flight hardware comes with some structural, thermal, propulsion and other subsystems' challenges. Meanwhile, the necessary ground support equipment (GSE) used to test, validate, verify and process the flight hardware must withstand the new program specifications. This paper intends to provide the qualification considerations during implementation of new electrical GSE for space programs. A team of engineers was formed to embark on this task, and facilitate the logistics process and ensure that the electrical, mechanical and fluids subsystems conduct the proper level of testing. Ultimately, each subsystem must certify that each piece of ground support equipment used in the field is capable of withstanding the strenuous vibration, acoustics, environmental, thermal and Electromagnetic Interference (EMf) levels experienced during pre-launch, launch and post-launch activities. The benefits of capturing and sharing these findings will provide technical, cost savings and schedule impacts infon11ation to both the technical and management community. Keywords: Qualification; Testing; Ground Support Equipment; Electromagnetic Interference Testing; Vibration Testing; Acoustic Testing; Power Spectral Density.

  16. Software Helps Retrieve Information Relevant to the User

    NASA Technical Reports Server (NTRS)

    Mathe, Natalie; Chen, James

    2003-01-01

    The Adaptive Indexing and Retrieval Agent (ARNIE) is a code library, designed to be used by an application program, that assists human users in retrieving desired information in a hypertext setting. Using ARNIE, the program implements a computational model for interactively learning what information each human user considers relevant in context. The model, called a "relevance network," incrementally adapts retrieved information to users individual profiles on the basis of feedback from the users regarding specific queries. The model also generalizes such knowledge for subsequent derivation of relevant references for similar queries and profiles, thereby, assisting users in filtering information by relevance. ARNIE thus enables users to categorize and share information of interest in various contexts. ARNIE encodes the relevance and structure of information in a neural network dynamically configured with a genetic algorithm. ARNIE maintains an internal database, wherein it saves associations, and from which it returns associated items in response to a query. A C++ compiler for a platform on which ARNIE will be utilized is necessary for creating the ARNIE library but is not necessary for the execution of the software.

  17. Computer simulated building energy consumption for verification of energy conservation measures in network facilities

    NASA Technical Reports Server (NTRS)

    Plankey, B.

    1981-01-01

    A computer program called ECPVER (Energy Consumption Program - Verification) was developed to simulate all energy loads for any number of buildings. The program computes simulated daily, monthly, and yearly energy consumption which can be compared with actual meter readings for the same time period. Such comparison can lead to validation of the model under a variety of conditions, which allows it to be used to predict future energy saving due to energy conservation measures. Predicted energy saving can then be compared with actual saving to verify the effectiveness of those energy conservation changes. This verification procedure is planned to be an important advancement in the Deep Space Network Energy Project, which seeks to reduce energy cost and consumption at all DSN Deep Space Stations.

  18. A New Method to Directly Observe Tuberculosis Treatment: Skype Observed Therapy, a Patient-Centered Approach.

    PubMed

    Buchman, Tavora; Cabello, Celina

    Tuberculosis (TB) treatment completion is in part determined by patient's adherence to long-term drug regimens. To best ensure compliance, directly observed therapy (DOT) is considered the standard of practice. Nassau County Department of Health TB Control is responsible for providing DOT to patients with TB. Tuberculosis Control sought to use and evaluate Skype Observed Therapy (SOT) as an alternative to DOT for eligible patients. The evaluation included analysis of patient's acceptance and adherence to drug regimen using SOT. Tuberculosis Control assessed staff efficiency and cost savings for this program. Percentages of SOT of patients and successful SOT visits, mileage, and travel time savings. Twenty percent of the caseload used SOT and 100% of patients who were eligible opted in. Average SOT success was 79%. Total mileage savings and time saved were $9,929.07 and 614 hours. Because SOT saves cost and time and is a suitable alternative to DOT for patients, it should be considered as part of new policies and practices in TB control programs.

  19. Freight Wing Trailer Aerodynamics Final Technical Report

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

    Sean Graham

    2007-10-31

    Freight Wing Incorporated utilized the opportunity presented by a DOE category two Inventions and Innovations grant to commercialize and improve upon aerodynamic technology for semi-tuck trailers, capable of decreasing heavy vehicle fuel consumption, related environmental damage, and U.S. consumption of foreign oil. Major project goals included the demonstration of aerodynamic trailer technology in trucking fleet operations, and the development and testing of second generation products. A great deal of past scientific research has demonstrated that streamlining box shaped semi-trailers can significantly reduce a truck’s fuel consumption. However, significant design challenges have prevented past concepts from meeting industry needs. Freight Wingmore » utilized a 2003 category one Inventions and Innovations grant to develop practical solutions to trailer aerodynamics. Fairings developed for the front, rear, and bottom of standard semi-trailers together demonstrated a 7% improvement to fuel economy in scientific tests conducted by the Transportation Research Center (TRC). Operational tests with major trucking fleets proved the functionality of the products, which were subsequently brought to market. This category two grant enabled Freight Wing to further develop, test and commercialize its products, resulting in greatly increased understanding and acceptance of aerodynamic trailer technology. Commercialization was stimulated by offering trucking fleets 50% cost sharing on trial implementations of Freight Wing products for testing and evaluation purposes. Over 230 fairings were implemented through the program with 35 trucking fleets including industry leaders such as Wal-Mart, Frito Lay and Whole Foods. The feedback from these testing partnerships was quite positive with product performance exceeding fleet expectations in many cases. Fleet feedback also was also valuable from a product development standpoint and assisted the design of several second generation products intended to further improve efficiency, lower costs, and enhance durability. Resulting products demonstrated a 30% efficiency improvement in full scale wind tunnel tests. The fuel savings of our most promising product, the “Belly Fairing” increased from 4% to 6% in scientific track and operational tests. The project successfully demonstrated the economic feasibility of trailer aerodynamics and positioned the technology to realize significant public benefits. Scientific testing conducted with partners such as the EPA Smartway program and Transport Canada clearly validated the fuel and emission saving potential of the technology. The Smartway program now recommends trailer aerodynamics as a certified fuel saving technology and is offering incentives such as low interest loans. Trailer aerodynamics can save average trucks over 1,100 gallons of fuel an 13 tons of emissions every 100,000 miles, a distance many trucks travel annually. These fuel savings produce a product return on investment period of one to two years in average fleet operations. The economic feasibility of the products was validated by participating fleets, several of which have since completed large implementations or demonstrated an interest in volume orders. The commercialization potential of the technology was also demonstrated, resulting in a national distribution and manufacturing partnership with a major industry supplier, Carrier Transicold. Consequently, Freight Wing is well positioned to continue marketing trailer aerodynamics to the trucking industry. The participation of leading fleets in this project served to break down the market skepticism that represents a primary barrier to widespread industry utilization. The benefits of widespread utilization of the technology could be quite significant for both the transportation industry and the public. Trailer aerodynamics could potentially save the U.S. trucking fleet over a billion gallons of fuel and 20 million tons of emissions annually.« less

  20. Energy-Saving Opportunities for Manufacturing Companies, (English/Russian Fact Sheet) (Revised)

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

    Not Available

    This English/Russian brochure describes the Industrial Technologies Program Save Energy Now model and provides information on tools and resources to help manufacturing facilities reduce industrial energy intensity.

  1. Energy-Saving Opportunities for Manufacturing Companies, International Fact Sheet (Spanish)

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

    Not Available

    This English/Spanish fact sheet describes the Industrial Technologies Program Save Energy Now model and provides information on tools and resources to help manufacturing facilities reduce industrial energy intensity.

  2. Pollen-mediated gene flow and seed exchange in small-scale Zambian maize farming, implications for biosafety assessment

    NASA Astrophysics Data System (ADS)

    Bøhn, Thomas; Aheto, Denis W.; Mwangala, Felix S.; Fischer, Klara; Bones, Inger Louise; Simoloka, Christopher; Mbeule, Ireen; Schmidt, Gunther; Breckling, Broder

    2016-10-01

    Gene flow in agricultural crops is important for risk assessment of genetically modified (GM) crops, particularly in countries with a large informal agricultural sector of subsistence cultivation. We present a pollen flow model for maize (Zea mays), a major staple crop in Africa. We use spatial properties of fields (size, position) in three small-scale maize farming communities in Zambia and estimate rates of cross-fertilisation between fields sown with different maize varieties (e.g. conventional and transgene). As an additional factor contributing to gene flow, we present data on seed saving and sharing among farmers that live in the same communities. Our results show that: i) maize fields were small and located in immediate vicinity of neighboring fields; ii) a majority of farmers saved and shared seed; iii) modeled rates of pollen-mediated gene flow showed extensive mixing of germplasm between fields and farms and iv) as a result, segregation of GM and non-GM varieties is not likely to be an option in these systems. We conclude that the overall genetic composition of maize, in this and similar agricultural contexts, will be strongly influenced both by self-organised ecological factors (pollen flow), and by socially mediated intervention (seed recycling and sharing).

  3. Pollen-mediated gene flow and seed exchange in small-scale Zambian maize farming, implications for biosafety assessment

    PubMed Central

    Bøhn, Thomas; Aheto, Denis W.; Mwangala, Felix S.; Fischer, Klara; Bones, Inger Louise; Simoloka, Christopher; Mbeule, Ireen; Schmidt, Gunther; Breckling, Broder

    2016-01-01

    Gene flow in agricultural crops is important for risk assessment of genetically modified (GM) crops, particularly in countries with a large informal agricultural sector of subsistence cultivation. We present a pollen flow model for maize (Zea mays), a major staple crop in Africa. We use spatial properties of fields (size, position) in three small-scale maize farming communities in Zambia and estimate rates of cross-fertilisation between fields sown with different maize varieties (e.g. conventional and transgene). As an additional factor contributing to gene flow, we present data on seed saving and sharing among farmers that live in the same communities. Our results show that: i) maize fields were small and located in immediate vicinity of neighboring fields; ii) a majority of farmers saved and shared seed; iii) modeled rates of pollen-mediated gene flow showed extensive mixing of germplasm between fields and farms and iv) as a result, segregation of GM and non-GM varieties is not likely to be an option in these systems. We conclude that the overall genetic composition of maize, in this and similar agricultural contexts, will be strongly influenced both by self-organised ecological factors (pollen flow), and by socially mediated intervention (seed recycling and sharing). PMID:27694819

  4. Pollen-mediated gene flow and seed exchange in small-scale Zambian maize farming, implications for biosafety assessment.

    PubMed

    Bøhn, Thomas; Aheto, Denis W; Mwangala, Felix S; Fischer, Klara; Bones, Inger Louise; Simoloka, Christopher; Mbeule, Ireen; Schmidt, Gunther; Breckling, Broder

    2016-10-03

    Gene flow in agricultural crops is important for risk assessment of genetically modified (GM) crops, particularly in countries with a large informal agricultural sector of subsistence cultivation. We present a pollen flow model for maize (Zea mays), a major staple crop in Africa. We use spatial properties of fields (size, position) in three small-scale maize farming communities in Zambia and estimate rates of cross-fertilisation between fields sown with different maize varieties (e.g. conventional and transgene). As an additional factor contributing to gene flow, we present data on seed saving and sharing among farmers that live in the same communities. Our results show that: i) maize fields were small and located in immediate vicinity of neighboring fields; ii) a majority of farmers saved and shared seed; iii) modeled rates of pollen-mediated gene flow showed extensive mixing of germplasm between fields and farms and iv) as a result, segregation of GM and non-GM varieties is not likely to be an option in these systems. We conclude that the overall genetic composition of maize, in this and similar agricultural contexts, will be strongly influenced both by self-organised ecological factors (pollen flow), and by socially mediated intervention (seed recycling and sharing).

  5. Cost Savings from Palliative Care Teams and Guidance for a Financially Viable Palliative Care Program

    PubMed Central

    McCarthy, Ian M; Robinson, Chessie; Huq, Sakib; Philastre, Martha; Fine, Robert L

    2015-01-01

    Objectives To quantify the cost savings of palliative care (PC) and identify differences in savings according to team structure, patient diagnosis, and timing of consult. Data Sources Hospital administrative records on all inpatient stays at five hospital campuses from January 2009 through June 2012. Study Design The analysis matched PC patients to non-PC patients (separately by discharge status) using propensity score methods. Weighted generalized linear model regressions of hospital costs were estimated for the matched groups. Data Collection Data were restricted to patients at least 18 years old with inpatient stays of between 7 and 30 days. Variables available included patient demographics, primary and secondary diagnoses, hospital costs incurred for the inpatient stay, and when/if the patient had a PC consult. Principal Findings We found overall cost savings from PC of $3,426 per patient for those dying in the hospital. No significant cost savings were found for patients discharged alive; however, significant cost savings for patients discharged alive could be achieved for certain diagnoses, PC team structures, or if consults occurred within 10 days of admission. Conclusions Appropriately selected and timed PC consults with physician and RN involvement can help ensure a financially viable PC program via cost savings to the hospital. PMID:25040226

  6. Final Technical Report, reEnergize Program

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

    Wamstad-Evans, Kristi; Williams, Eric; Kubicek, Jason

    The reEnergize Program helped to build a market for residential and commercial energy evaluations and upgrades. The program provided incentives to encourage participants to save energy, save money, and make their homes and businesses more safe, healthy, and comfortable. As part of the Better Buildings Neighborhood Program (BBNP), the successful investment of this $10 million grant toward market development was the first grant funding collaboration between the cities of Omaha and Lincoln. Through more than three years of work, thousands of participants, contractors, and community members worked together to make the reEnergize Program a demonstration of how to “Build Energymore » Smart Communities.”« less

  7. The future of fully automated vehicles : opportunities for vehicle- and ride-sharing, with cost and emissions savings.

    DOT National Transportation Integrated Search

    2014-08-01

    Fully automated or autonomous vehicles (AVs) hold great promise for the future of transportation. By 2020 : Google, auto manufacturers and other technology providers intend to introduce self-driving cars to the public with : either limited or fully a...

  8. 48 CFR 48.102 - Policies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... VALUE ENGINEERING Policies and Procedures 48.102 Policies. (a) As required by 41 U.S.C. 1711, agencies shall establish and maintain cost-effective value engineering procedures and processes. Agencies shall... cost in accordance with 48.101(b)(2). However, there must be no sharing of value engineering savings in...

  9. Cataloging: Librarianship's Best Bargain.

    ERIC Educational Resources Information Center

    Morris, Dilys E.; Wool, Gregory

    1999-01-01

    Iowa State University's cost study proves academic librarians can keep cataloging in-house and save staff costs. Several factors play a role in the productivity surge at ISU: increasing use of shared cataloging; growth of online authoring files; expanding role of support staff; increasing automation of catalogers' work; and structural flattening…

  10. Darbepoetin alfa therapeutic interchange protocol for anemia in dialysis.

    PubMed

    Brophy, Donald F; Ripley, Elizabeth Bd; Kockler, Denise R; Lee, Seina; Proeschel, Lori A

    2005-11-01

    Erythropoiesis-stimulating proteins, such as erythropoietin alfa and darbepoetin alfa, have positively impacted anemia management. These medications improve patient outcomes and quality of life. Their costs, however, remain a major barrier for health systems. To evaluate the development, implementation, and cost-effectiveness of an inpatient therapeutic interchange protocol for erythropoiesis-stimulating proteins at a large, tertiary care, university-affiliated health system. Virginia Commonwealth University Health System (VCUHS) developed and implemented a therapeutic interchange program to convert therapy for all inpatients undergoing dialysis from erythropoietin alfa to darbepoetin alfa for treatment of chronic kidney disease-related anemia. An evaluation of the economic impact of this program on drug expenditures over a fiscal quarter (2003) was conducted using historical comparator data (2002). Preliminary evaluation of the program demonstrated cost-savings and reduced drug utilization of erythropoiesis-stimulating proteins in hospitalized dialysis patients. For the first quarter of 2003 compared with the first quarter of 2002, VCUHS realized a cost-savings of nearly 10,000 US dollars, which was related to the program's aggressive screening procedure. When these data were normalized for equal numbers of patients in each group receiving one of the drugs, the actual cost-savings was over 2000 US dollars. These cost-savings are largely due to reduced utilization of these expensive biotechnology products with implementation of a dosing protocol. VCUHS has successfully developed and implemented a darbepoetin alfa therapeutic interchange protocol for hospitalized dialysis patients. This has translated into reduced use of erythropoiesis-stimulating proteins, resulting in cost-savings for the health system.

  11. Energy-Saving Opportunities for Manufacturing Companies (English/Portuguese Brochure) (in English/Portuguese)

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

    Not Available

    This English/Portuguese brochure describes the Industrial Technologies Program Save Energy Now model and provides information on tools and resources to help manufacturing facilities reduce industrial energy intensity.

  12. Medicare Disease Management in Policy Context

    PubMed Central

    Linden, Ariel; Adler-Milstein, Julia

    2008-01-01

    Interim results of the Medicare health support (MHS) demonstration projects suggest that commercial disease management (DM) is unable to deliver short-term medical cost savings. This is not surprising given the current DM program focus on compliance with process measures that may only lead to cost savings in the long term. A program focused on reducing near-term hospitalizations is more likely to deliver savings during the initial 3-year phase of MHS. If the early trends in MHS are indicative of the final results, CMS will face the decision of whether to abandon commercial DM in favor of other chronic care management strategies. This article supports the upcoming assessment by describing the characteristics of the current commercial DM model that limit its ability to deliver short-term medical cost savings and the changes required to overcome these limitations. PMID:18567239

  13. Socialized medicine: a solution to the cost crisis in health care in the United States.

    PubMed

    Himmelstein, D U; Woolhandler, S

    1986-01-01

    Despite growing concern with cost containment, most health policy analysts have ignored vast potential savings on medically irrelevant spending for excess administration, profits, high physician incomes, marketing, and legal involvement in medicine. Indeed, many recent reforms encourage administrative hypertrophy, entrepreneurialism and litigation. A universal national health program could abolish billing and consequently the need for much of the administrative apparatus of health care, and decrease spending for profits and marketing. In this article we analyze the administrative savings that could be realized from instituting a Canadian-style national health insurance program or a national health service similar to that in Britain, and the potential savings from additional reforms to curtail profits, marketing and litigation. Our calculations based on 1983 data suggest that national health insurance would save $42.6 billion annually: $29.2 billion on health administration and insurance overhead, $4.9 billion on profits, $3.9 billion on marketing, and $4.6 billion on physician's incomes. A national health service would save $65.8 billion: $38.4 billion on health administration and insurance overhead, $4.9 billion on profits, $3.9 billion on marketing, and $18.6 billion on physician's incomes. Complete nationalization of all health related industries and reform of the malpractice system would save at least $87.2 billion per year. We conclude that a national health program, in addition to improving access to health care for the oppressed, could achieve cost containment without rationing of care.

  14. Long-term monitoring of Sacramento Shade program trees: tree survival, growth and energy-saving performance

    Treesearch

    Yekang Ko; Jun-Hak Lee; E. Gregory McPherson; Lara A. Roman

    2015-01-01

    Long-term survival and growth of urban forests are critical to achieve the targeted benefits of urban tree planting programs, such as building energy savings from tree shade. However, little is known about how trees perform in the long-term, especially in residential areas. Given this gap in the literature, we monitored 22-years of post-planting survival, growth, and...

  15. An Assessment Model for Energy Efficiency Program Planning in Electric Utilities: Case of the Pacific of Northwest U.S.A

    NASA Astrophysics Data System (ADS)

    Iskin, Ibrahim

    Energy efficiency stands out with its potential to address a number of challenges that today's electric utilities face, including increasing and changing electricity demand, shrinking operating capacity, and decreasing system reliability and flexibility. Being the least cost and least risky alternative, the share of energy efficiency programs in utilities' energy portfolios has been on the rise since the 1980s, and their increasing importance is expected to continue in the future. Despite holding great promise, the ability to determine and invest in only the most promising program alternatives plays a key role in the successful use of energy efficiency as a utility-wide resource. This issue becomes even more significant considering the availability of a vast number of potential energy efficiency programs, the rapidly changing business environment, and the existence of multiple stakeholders. This dissertation introduces hierarchical decision modeling as the framework for energy efficiency program planning in electric utilities. The model focuses on the assessment of emerging energy efficiency programs and proposes to bridge the gap between technology screening and cost/benefit evaluation practices. This approach is expected to identify emerging technology alternatives which have the highest potential to pass cost/benefit ratio testing procedures and contribute to the effectiveness of decision practices in energy efficiency program planning. The model also incorporates rank order analysis and sensitivity analysis for testing the robustness of results from different stakeholder perspectives and future uncertainties in an attempt to enable more informed decision-making practices. The model was applied to the case of 13 high priority emerging energy efficiency program alternatives identified in the Pacific Northwest, U.S.A. The results of this study reveal that energy savings potential is the most important program management consideration in selecting emerging energy efficiency programs. Market dissemination potential and program development and implementation potential are the second and third most important, whereas ancillary benefits potential is the least important program management consideration. The results imply that program value considerations, comprised of energy savings potential and ancillary benefits potential; and program feasibility considerations, comprised of program development and implementation potential and market dissemination potential, have almost equal impacts on assessment of emerging energy efficiency programs. Considering the overwhelming number of value-focused studies and the few feasibility-focused studies in the literature, this finding clearly shows that feasibility-focused studies are greatly understudied. The hierarchical decision model developed in this dissertation is generalizable. Thus, other utilities or power systems can adopt the research steps employed in this study as guidelines and conduct similar assessment studies on emerging energy efficiency programs of their interest.

  16. Estimated cost savings associated with the transfer of office-administered specialty pharmaceuticals to a specialty pharmacy provider in a Medical Injectable Drug program.

    PubMed

    Baldini, Christopher G; Culley, Eric J

    2011-01-01

    A large managed care organization (MCO) in western Pennsylvania initiated a Medical Injectable Drug (MID) program in 2002 that transferred a specific subset of specialty drugs from physician reimbursement under the traditional "buy-and-bill" model in the medical benefit to MCO purchase from a specialty pharmacy provider (SPP) that supplied physician offices with the MIDs. The MID program was initiated with 4 drugs in 2002 (palivizumab and 3 hyaluronate products/derivatives) growing to more than 50 drugs by 2007-2008. To (a) describe the MID program as a method to manage the cost and delivery of this subset of specialty drugs, and (b) estimate the MID program cost savings in 2007 and 2008 in an MCO with approximately 4.6 million members. Cost savings generated by the MID program were calculated by comparing the total actual expenditure (plan cost plus member cost) on medications included in the MID program for calendar years 2007 and 2008 with the total estimated expenditure that would have been paid to physicians during the same time period for the same medication if reimbursement had been made using HCPCS (J code) billing under the physician "buy-and-bill" reimbursement rates. For the approximately 50 drugs in the MID program in 2007 and 2008, the drug cost savings in 2007 were estimated to be $15.5 million (18.2%) or $290 per claim ($0.28 per member per month [PMPM]) and about $13 million (12.7%) or $201 per claim ($0.23 PMPM) in 2008. Although 28% of MID claims continued to be billed by physicians using J codes in 2007 and 22% in 2008, all claims for MIDs were limited to the SPP reimbursement rates. This MID program was associated with health plan cost savings of approximately $28.5 million over 2 years, achieved by the transfer of about 50 physician-administered injectable pharmaceuticals from reimbursement to physicians to reimbursement to a single SPP and payment of physician claims for MIDs at the SPP reimbursement rates.

  17. Borrowing to save: a critique of recent proposals to partially privatize Social Security.

    PubMed

    Dattalo, Patrick

    2007-07-01

    Concern over Social Security's forecasted long-run deficit is occurring at a time when the program has a short-term surplus. One proposed strategy to address this forecasted deficit is to allow the investment of a portion of payroll taxes into private savings accounts (PSAs). The author analyzes recent proposals for PSAs and concludes that PSAs are more likely to be a problem than a solution. Paradoxically, PSAs require the government to borrow to encourage current workers to save. The author recommends resources to help social workers remain informed about proposed program reforms and prepared to advocate for the concept of social insurance.

  18. Standardization and program effect analysis (Study 2.4). Volume 2: Equipment commonality analysis. [cost savings of using flight-proven components in designing spacecraft

    NASA Technical Reports Server (NTRS)

    Shiokari, T.

    1975-01-01

    The feasibility and cost savings of using flight-proven components in designing spacecraft were investigated. The components analyzed were (1) large space telescope, (2) stratospheric aerosol and gas equipment, (3) mapping mission, (4) solar maximum mission, and (5) Tiros-N. It is concluded that flight-proven hardware can be used with not-too-extensive modification, and significant savings can be realized. The cost savings for each component are presented.

  19. Private practice outcomes: validated outcomes data collection in private practice.

    PubMed

    Goldstein, Jack

    2010-10-01

    Improved patient care is related to validated outcome measures requiring the collection of three distinct data types: (1) demographics; (2) patient outcome measures; and (3) physician treatment. Previous impediments to widespread data collection have been: cost, office disruption, personnel requirements, physician motivation, data integration, and security. There are currently few means to collect data to be used for collaborative analysis. We therefore developed an inexpensive, patient-centric mechanism to reduce redundant data entry, limiting cost and personnel requirements. Using an intuitive touch-screen kiosk interface program, all data elements have been captured in a private practice setting since 2000. Developed for small to medium sized offices, this is scalable to larger organizations. Questionnaire navigation is patient driven, with demographics shared with EMR and billing systems. Integration of billing and EMR with outcomes minimizes cost and personnel time. Data are deidentified locally and may be centrally shared. Since data are entered by the patients, minimal personnel costs are incurred. Physician disincentives are minimized with cost reduction, time savings and ease of use. To date, we have collected high level data on most total joint patients, with excellent patient compliance. By addressing impediments to broad application, we may enable widespread local data collection in all practice settings. Data may be shared centrally, allowing comparative effectiveness research to become a reality. Future success will require broad physician participation, uniformity of data collected, and designation of a central site for receipt of data and its collaborative comparative analysis.

  20. 75 FR 54590 - Notice of 2010 National Organic Certification Cost-Share Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-08

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

  1. Cost Savings from Reduced Hospitalizations with Use of Home Noninvasive Ventilation for COPD.

    PubMed

    Coughlin, Steven; Peyerl, Fred W; Munson, Sibyl H; Ravindranath, Aditi J; Lee-Chiong, Teofilo L

    2017-03-01

    Although evidence suggests significant clinical benefits of home noninvasive ventilation (NIV) for management of severe chronic obstructive pulmonary disease (COPD), economic analyses supporting the use of this technology are lacking. To evaluate the economic impact of adopting home NIV, as part of a multifaceted intervention program, for severe COPD. An economic model was developed to calculate savings associated with the use of Advanced NIV (averaged volume assured pressure support with autoexpiratory positive airway pressure; Trilogy100, Philips Respironics, Inc., Murrysville, PA) versus either no NIV or a respiratory assist device with bilevel pressure capacity in patients with severe COPD from two distinct perspectives: the hospital and the payer. The model examined hospital savings over 90 days and payer savings over 3 years. The number of patients with severe COPD eligible for home Advanced NIV was user-defined. Clinical and cost data were obtained from a quality improvement program and published reports. Scenario analyses calculated savings for hospitals and payers covering different COPD patient cohort sizes. The hospital base case (250 patients) revealed cumulative savings of $402,981 and $449,101 over 30 and 90 days, respectively, for Advanced NIV versus both comparators. For the payer base case (100,000 patients), 3-year cumulative savings with Advanced NIV were $326 million versus no NIV and $1.04 billion versus respiratory assist device. This model concluded that adoption of home Advanced NIV with averaged volume assured pressure support with autoexpiratory positive airway pressure, as part of a multifaceted intervention program, presents an opportunity for hospitals to reduce COPD readmission-related costs and for payers to reduce costs associated with managing patients with severe COPD on the basis of reduced admissions. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  2. Unlocking the potential of smart grid technologies with behavioral science

    PubMed Central

    Sintov, Nicole D.; Schultz, P. Wesley

    2015-01-01

    Smart grid systems aim to provide a more stable and adaptable electricity infrastructure, and to maximize energy efficiency. Grid-linked technologies vary widely in form and function, but generally share common potentials: to reduce energy consumption via efficiency and/or curtailment, to shift use to off-peak times of day, and to enable distributed storage and generation options. Although end users are central players in these systems, they are sometimes not central considerations in technology or program design, and in some cases, their motivations for participating in such systems are not fully appreciated. Behavioral science can be instrumental in engaging end-users and maximizing the impact of smart grid technologies. In this paper, we present emerging technologies made possible by a smart grid infrastructure, and for each we highlight ways in which behavioral science can be applied to enhance their impact on energy savings. PMID:25914666

  3. Unlocking the potential of smart grid technologies with behavioral science.

    PubMed

    Sintov, Nicole D; Schultz, P Wesley

    2015-01-01

    Smart grid systems aim to provide a more stable and adaptable electricity infrastructure, and to maximize energy efficiency. Grid-linked technologies vary widely in form and function, but generally share common potentials: to reduce energy consumption via efficiency and/or curtailment, to shift use to off-peak times of day, and to enable distributed storage and generation options. Although end users are central players in these systems, they are sometimes not central considerations in technology or program design, and in some cases, their motivations for participating in such systems are not fully appreciated. Behavioral science can be instrumental in engaging end-users and maximizing the impact of smart grid technologies. In this paper, we present emerging technologies made possible by a smart grid infrastructure, and for each we highlight ways in which behavioral science can be applied to enhance their impact on energy savings.

  4. Unlocking the potential of smart grid technologies with behavioral science

    DOE PAGES

    Sintov, Nicole D.; Schultz, P. Wesley

    2015-04-09

    Smart grid systems aim to provide a more stable and adaptable electricity infrastructure, and to maximize energy efficiency. Grid-linked technologies vary widely in form and function, but generally share common potentials: to reduce energy consumption via efficiency and/or curtailment, to shift use to off-peak times of day, and to enable distributed storage and generation options. Although end users are central players in these systems, they are sometimes not central considerations in technology or program design, and in some cases, their motivations for participating in such systems are not fully appreciated. Behavioral science can be instrumental in engaging end-users and maximizingmore » the impact of smart grid technologies. In this study, we present emerging technologies made possible by a smart grid infrastructure, and for each we highlight ways in which behavioral science can be applied to enhance their impact on energy savings.« less

  5. The Role of Social Work Leadership: Mount Sinai Care, the Accountable Care Organization, and Population Health Management.

    PubMed

    Xenakis, Nancy

    2015-10-01

    In July 2012, The Mount Sinai Medical Center was selected by the Centers for Medicare and Medicaid to join the first cohort of Accountable Care Organizations (ACOs) in this country under its Medicare Shared Savings Program. A critical component of an ACO is care coordination of patients, which is a complex concept, intertwined with other concepts related to quality, delivery and organization of health care. This article provides an overview of the development, structure and functionality of Mount Sinai Care, the ACO of The Mount Sinai Health System, and how it was the beginning of its work in population health management. It describes the important role of social work leadership in the development and operation of its care coordination model. The model's successes and challenges and recommendations for future development of care coordination and population health management are outlined.

  6. Unlocking the potential of smart grid technologies with behavioral science

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

    Sintov, Nicole D.; Schultz, P. Wesley

    Smart grid systems aim to provide a more stable and adaptable electricity infrastructure, and to maximize energy efficiency. Grid-linked technologies vary widely in form and function, but generally share common potentials: to reduce energy consumption via efficiency and/or curtailment, to shift use to off-peak times of day, and to enable distributed storage and generation options. Although end users are central players in these systems, they are sometimes not central considerations in technology or program design, and in some cases, their motivations for participating in such systems are not fully appreciated. Behavioral science can be instrumental in engaging end-users and maximizingmore » the impact of smart grid technologies. In this study, we present emerging technologies made possible by a smart grid infrastructure, and for each we highlight ways in which behavioral science can be applied to enhance their impact on energy savings.« less

  7. Paying for College: Prepaid Tuition and College Savings Plans. ERIC Digest.

    ERIC Educational Resources Information Center

    Loane, Shannon

    To cover the costs of college, students and their families are using loans, grants, savings, and, increasingly, a specific type of college savings plan known as a "529." These planned are named after a Section of the Internal Revenue Code that confers tax exemption to qualified state tuition programs. There are two types of 529 plans:…

  8. The impact of patient assistance programs and the 340B Drug Pricing Program on medication cost.

    PubMed

    Castellon, Yelba M; Bazargan-Hejazi, Shahrzad; Masatsugu, Miles; Contreras, Roberto

    2014-02-01

    Patient assistance programs and the 340B Drug Pricing Program promise to improve the financial stability, better serve vulnerable patients, and decrease the burden of cost for uninsured patients. Our objective is to examine the financial impact that PAPs and the 340B Program have on improving medication cost. Retrospective analysis of medication dispensary data. Dispensary data for uninsured patients obtaining medications at 2 community health centers were collected from February 1 to February 29, 2012. Uninsured patients were divided into 2 samples: (1) patients receiving PAP medications and (2) patients receiving 340B medications. The main outcome measured was the patient's cost savings. Cost savings were calculated based on the amount a medication would have cost had it been purchased by patients at prices found on Epocrates software (drugstore.com). A paired sample t test model using continuous variables was utilized to calculate confidence intervals. A total of 1420 PAP and 2772 340B individual medications were dispensed to uninsured patients in February 2012. For patients receiving PAP medications the mean ± standard deviation (SD) for age = 52 ± 10. Average cost was $0.11 (95% CI, $0.04-$0.17) and average savings was $617.36 (95% Cl, $581.32-$653.40). For patients receiving 340B medications the mean ±SD for age = 50 ± 14. Average cost was $11.50 (95% CI, $10.55-$12.45). Average saving was $62.31 (95% CI, $57.99-$66.63). PAPs and 340B provide significant medication savings for uninsured patient. More research is needed to establish "best practices" for the successful integration of PAPs.

  9. How to save money on infant formula

    MedlinePlus

    ... from now, and those coupons will save you money. Sign up for newsletters, special programs, and deals on formula company websites. They often send out coupons and free samples. Ask your pediatrician for samples. Consider generic ...

  10. 12 CFR 209.4 - Amounts and payments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... number of shares required to be canceled and shall pay therefor a sum equal to the cash subscription paid... subscription. The total subscription of a member bank (other than a mutual savings bank) shall equal six... Reserve Bank capital stock subscription to equal six percent of the member bank's capital and surplus...

  11. Information Technology Wants to Be Free

    ERIC Educational Resources Information Center

    Poritz, Jonathan A.

    2012-01-01

    It makes sense for college and university faculty to ally with the free and open-source software community. They share common values. A marvelous additional benefit is that free software on campuses would significantly advance pedagogy and scholarship, increase efficiency, and save money. Only unquestioning obedience to market fundamentalism--or…

  12. 31 CFR 352.7 - Issues on exchange.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... States Savings Notes (Freedom Shares) at their current redemption values for Series HH bonds. Series E.... The total current redemption value of the eligible securities submitted for exchange in any one transaction was required to be $500 or more. If the current redemption value was an even multiple of $500...

  13. 31 CFR 352.7 - Issues on exchange.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... States Savings Notes (Freedom Shares) at their current redemption values for Series HH bonds. Series E.... The total current redemption value of the eligible securities submitted for exchange in any one transaction was required to be $500 or more. If the current redemption value was an even multiple of $500...

  14. 31 CFR 352.7 - Issues on exchange.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... States Savings Notes (Freedom Shares) at their current redemption values for Series HH bonds. Series E.... The total current redemption value of the eligible securities submitted for exchange in any one transaction was required to be $500 or more. If the current redemption value was an even multiple of $500...

  15. 31 CFR 352.7 - Issues on exchange.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... redemption value exceeded, but was not an even multiple of $500, the owner had the option either: (1) To add... United States Savings Notes (Freedom Shares) at their current redemption values for Series HH bonds...) Computation of issue price. The total current redemption value of the eligible securities submitted for...

  16. 31 CFR 352.7 - Issues on exchange.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... States Savings Notes (Freedom Shares) at their current redemption values for Series HH bonds. Series E.... The total current redemption value of the eligible securities submitted for exchange in any one transaction was required to be $500 or more. If the current redemption value was an even multiple of $500...

  17. Conservation: saving Florida's manatees

    USGS Publications Warehouse

    Bonde, Robert K.

    2008-01-01

    Robert K. Bonde of the U.S. Geological Survey writes about the protected population of manatees in Crystal River, Florida, including information about the threats they face as they migrate in and out of protected waters. Photographer Carol Grant shares images of "Angel," a newborn manatee she photographed early one winter morning.

  18. 48 CFR 1852.243-71 - Shared savings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... organizational support of a contract or group of contracts. These alternatives must result in a net reduction of... organizational support which are proposed to be changed. (2) A description of the difference between the current... make any structural or organizational changes in order to implement an approved CRP. (5) Government...

  19. Under the Green Thumb: Totalitarian Sustainability on Campus

    ERIC Educational Resources Information Center

    Kissel, Adam

    2010-01-01

    What's wrong with the sustainability movement, the author contends, is the uncritical homogenization of humanity. Sustainability advocates inevitably seek to homogenize people's deepest values, because their goal is to save Earth from ecological, economic, and social disaster. Everyone must participate--everyone must share the same key values and…

  20. 5 CFR 1653.4 - Calculating entitlements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... PROCESSES AFFECTING THRIFT SAVINGS PLAN ACCOUNTS Retirement Benefits Court Orders § 1653.4 Calculating... purchased as of the effective date; and (iii) Multiplying the price per share as of the payment date by the... estimate the amount of a payee's entitlement when it prepares the court order decision letter and will...

  1. Do savings mediate changes in adolescents’ future orientation and health-related outcomes? Findings from randomized experiment in Uganda

    PubMed Central

    Karimli, Leyla; Ssewamala, Fred M.

    2015-01-01

    Purpose This present study tests the proposition that an economic strengthening intervention for families caring for AIDS-orphaned adolescents would positively affect adolescent future orientation and psychosocial outcomes through increased asset-accumulation (in this case, by increasing family savings). Methods Using longitudinal data from the cluster-randomized experiment we ran generalized estimating equation (GEE) models with robust standard errors clustering on individual observations. To examine whether family savings mediate the effect of the intervention on adolescents’ future orientation and psychosocial outcomes, analyses were conducted in three steps: (1) testing the effect of intervention on mediator; (2) testing the effect of mediator on outcomes, controlling for the intervention; and (3) testing the significance of mediating effect using Sobel-Goodman method. Asymmetric confidence intervals for mediated effect were obtained through bootstrapping—to address the assumption of normal distribution. Results Results indicate that participation in a matched Child Savings Account program improved adolescents’ future orientation and psychosocial outcomes by reducing hopelessness, enhancing self-concept, and improving adolescents’ confidence about their educational plans. However, the positive intervention effect on adolescent future orientation and psychosocial outcomes was not transmitted through saving. In other words, participation in the matched Child Savings Account program improved adolescent future orientation and psychosocial outcomes regardless of its impact on reported savings. Conclusions Further research is necessary to understand exactly how participation in economic strengthening interventions, for example, those that employ matched Child Savings Accounts, shape adolescent future orientation and psychosocial outcomes: what, if not savings, transmits the treatment effect and how? PMID:26271162

  2. Budgetary impact of the utilization of buprenorphine/naloxone sublingual film and tablet for Medicaid in the United States.

    PubMed

    Asche, Carl V; Clay, Emilie; Kharitonova, Elizaveta; Zah, Vladimir; Ruby, Jane; Aballéa, Samuel

    2015-01-01

    The buprenorphine/naloxone combination for the treatment of opioid dependence is available in a film or tablet formulation. Recent retrospective studies demonstrated that treatment with the sublingual film formulation is associated with improved treatment retention and lower healthcare costs. In March 2013, generic buprenorphine/naloxone tablets were approved in the US. A budget impact model was built to compare healthcare expenditures for different market shares of sublingual film and tablet. A Markov model was developed to track a cohort of opioid dependent patients treated with sublingual film or tablet through the following treatment phases: initiation, maintenance, discontinuation, off-treatment and reinitiation. Transition probabilities and costs for each phase were estimated from the MarketScan Medicaid database for the period between 1 March 2010 and 30 June 2012. The total expenditure for the plan and expenditure per plan member per month were predicted over 5 years. Two market share scenarios were considered: 1) sublingual film is progressively replaced by generic tablet (current situation) and 2) the sublingual film holds a market share of 100%. Predicted total costs over 5 years were $6400 million when the sublingual film holds a market share of 100% (as per Scenario 2) which is lower than when sublingual film is progressively replaced by generic tablet (current situation as per Scenario 1) by $64 million. These savings were mostly driven by inpatient care ($56 million saved over 5 years), followed by emergency room care ($27 million) and pharmaceutical costs ($24 million). Costs of outpatient care attenuated the difference as they were predicted to be higher by $44 million in Scenario 2. The reduction in total cost per member per month reached $0.027 in the fifth year. Results were most sensitive to price rebates and to the probability of non-psychiatric hospitalization. While using the sublingual film formulation for more patients treated with buprenorphine/naloxone is predicted to increase outpatient care costs, it would generate savings in emergency care and hospitalizations. In the treatment of opioid dependence, total direct medical costs for Medicaid would be lower for sublingual film treated patients, at current drug prices.

  3. US DOE EECBG BBNP REPORT

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

    Driscoll, Brian; Conkey, Todd; Edgar, George

    2013-12-31

    The Wisconsin Energy Efficiency (WE2) Program delivered residential and commercial programming for the City of Milwaukee (Me2) and the City of Madison (Green Madison) as well as commercial only programming for the City of Racine (Re2). Direct incentives and loan products for homeowners and business owners were offered, with the goal to achieve at least 15 percent in energy savings. At the time of this report, there were more than 2,000 residential energy efficiency upgrades completed and more than 300 commercial energy efficiency upgrades completed. The average energy savings for the WE2 Program’s portfolio of residential and commercial projects exceedsmore » 15 percent and is closer to 30 percent energy savings. Combined energy savings of both residential and commercial activities were: 20,937,369 kWh; 1,018,907 Therms; and 31,655 gallons of heating oil; or at least 332,788 MMBTUs; or at least $3,444,828 in estimated energy costs saved. Conservative economic impact estimates include the employment of more than 100 residential auditors and contractors, more than 90 commercial contractors, and more than $41 million in total project costs expended in the targeted communities. WECC, along with the Partner Cities, attempted to create energy efficiency programming that helped to increase economic activity, increase workforce opportunities, and save energy in three of the largest communities in Wisconsin. Homeowners were assisted through the residential process by Energy Advocates, consultants, and contractors. Business owners were assisted through the commercial process by Program Advocates, contractors and trade allies. Contractors in both the residential and commercial programs were educated and trained by the many offerings provided by WECC. Together, all parties involved made the WE2 Program successful. The most prominent innovative approaches employed in the Me2 and Green Madison programs for residential retrofits were: use of a loan loss reserve approach to improve access to lower cost financing; a primary focus on “community-based” marketing and outreach through local organizations to attract program participants; use of Energy Advocates to facilitate homeowner understanding during participation of the retrofit process; increase in financial incentives, especially to achieve higher project savings; and additional building science and sales training for participating contractors, as well as the use of a Community Workforce Agreement (CWA). The most prominent innovative approaches used in the commercial building retrofit programs for the Me2, Green Madison and Re2 programs were: development and use of innovative customer financing through loan-loss reserves for small commercial building retrofits; cash collateral advance account for larger projects which mitigated the financial risk of lenders; and the ultimate development of a Commercial Property Assessed Clean Energy (C-PACE) program in the City of Milwaukee. Other approaches included: increased customer financial incentives, especially for small commercial projects, in excess of the incentives available from the Focus on Energy program. Each Partner City’s commercial program was built on existing Focus on Energy programming, which allowed the WE2 Program to leverage experience from Focus on Energy personnel to help promote participation, and encourage more extensive retrofits. Several legacy items will continue into the future, while there will be ongoing attempts to create a sustainable program. In the future, homeowners in Milwaukee and Madison will continue to have opportunities for incentives through the Focus on Energy program, as well as loan products being offered through Me2 and Green Madison. Similarly, business owners will continue to benefit from incentives through the Focus on Energy program, as well as loan products being offered through Me2 and Green Madison. Finally, the most recent development and implementation of C-PACE for large commercial building owners or business owners in Milwaukee may have substantial economic impacts. C-PACE may have similar impacts in Madison should they choose to implement the program in the near future. The WE2 Program’s immediate economic activity, workforce development, and energy savings coupled with long-term opportunities such as C-PACE provide a strong platform for the future, and could have only been created through meaningful collaboration.« less

  4. [Cost- effectiveness analysis of pneumococcal vaccination in Iceland].

    PubMed

    Björnsdóttir, Margrét

    2010-09-01

    Pneumococcus is a common cause of disease among children and the elderly. With the emergence of resistant serotypes, antibiotic treatment is getting limited. Many countries have therefore introduced a vaccination program among children against the most common serotypes. The aim of this study was to analyse cost-effectiveness of adding a vaccination program against pneumococcus in Iceland. A cost-effectiveness analysis was carried out from a societal perspective where the cost-effectiveness ratio ICER was estimated from the cost of each additional life and life year saved. The analyse was based on the year 2008 and all cost were calculated accordingly. The rate of 3% was used for net present-value calculation. Annual societal cost due to pneumococcus in Iceland was estimated to be 718.146.252 ISK if children would be vaccinated but 565.026.552 ISK if they would not be vaccinated. The additional cost due to the vaccination program was therefore 153.119.700 ISK . The vaccination program could save 0,669 lives among children aged 0-4 years old and 21.11 life years. The cost was 228.878.476 ISK for each additional life saved and 7.253.420 ISK for each additional life year saved. Given initial assumptions the results indicate that a vaccination programme against pneumococcal disease in Iceland would be cost effective.

  5. BioSAVE: display of scored annotation within a sequence context.

    PubMed

    Pollock, Richard F; Adryan, Boris

    2008-03-20

    Visualization of sequence annotation is a common feature in many bioinformatics tools. For many applications it is desirable to restrict the display of such annotation according to a score cutoff, as biological interpretation can be difficult in the presence of the entire data. Unfortunately, many visualisation solutions are somewhat static in the way they handle such score cutoffs. We present BioSAVE, a sequence annotation viewer with on-the-fly selection of visualisation thresholds for each feature. BioSAVE is a versatile OS X program for visual display of scored features (annotation) within a sequence context. The program reads sequence and additional supplementary annotation data (e.g., position weight matrix matches, conservation scores, structural domains) from a variety of commonly used file formats and displays them graphically. Onscreen controls then allow for live customisation of these graphics, including on-the-fly selection of visualisation thresholds for each feature. Possible applications of the program include display of transcription factor binding sites in a genomic context or the visualisation of structural domain assignments in protein sequences and many more. The dynamic visualisation of these annotations is useful, e.g., for the determination of cutoff values of predicted features to match experimental data. Program, source code and exemplary files are freely available at the BioSAVE homepage.

  6. BioSAVE: Display of scored annotation within a sequence context

    PubMed Central

    Pollock, Richard F; Adryan, Boris

    2008-01-01

    Background Visualization of sequence annotation is a common feature in many bioinformatics tools. For many applications it is desirable to restrict the display of such annotation according to a score cutoff, as biological interpretation can be difficult in the presence of the entire data. Unfortunately, many visualisation solutions are somewhat static in the way they handle such score cutoffs. Results We present BioSAVE, a sequence annotation viewer with on-the-fly selection of visualisation thresholds for each feature. BioSAVE is a versatile OS X program for visual display of scored features (annotation) within a sequence context. The program reads sequence and additional supplementary annotation data (e.g., position weight matrix matches, conservation scores, structural domains) from a variety of commonly used file formats and displays them graphically. Onscreen controls then allow for live customisation of these graphics, including on-the-fly selection of visualisation thresholds for each feature. Conclusion Possible applications of the program include display of transcription factor binding sites in a genomic context or the visualisation of structural domain assignments in protein sequences and many more. The dynamic visualisation of these annotations is useful, e.g., for the determination of cutoff values of predicted features to match experimental data. Program, source code and exemplary files are freely available at the BioSAVE homepage. PMID:18366701

  7. 76 FR 55000 - Notice of Agricultural Management Assistance Organic Certification Cost-Share Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-06

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

  8. 78 FR 5164 - Notice of Agricultural Management Assistance Organic Certification Cost-Share Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-24

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

  9. Verify by Genability - Providing Solar Customers with Accurate Reports of Utility Bill Cost Savings

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

    The National Renewable Energy Laboratory (NREL), partnering with Genability and supported by the U.S. Department of Energy's SunShot Incubator program, independently verified the accuracy of Genability's monthly cost savings.

  10. Personal finances of urology residents in Canada.

    PubMed

    Teichman, J M; Tongco, W; MacNeily, A E; Smart, M

    2000-12-01

    We examined how Urology residents in Canada manage their personal finances. A survey instrument was designed to elicit information on demographics, expenses, savings and incomes. The questionnaire was completed by 40 Urology residents attending the 2000 Queen's Urology Exam Skills Training (QUEST) program. Twenty-eight residents (70%) had educational debt (median debt $50 000). Seventeen residents (45%) paid credit card interest charges within the last year. Four residents (10%) maintained an unpaid credit card balance > $7500 at 17% annual interest rate. Twenty-six residents (67%) contributed to Registered Retirement Savings Program (RRSP) accounts. Seventeen residents (44%) contributed to non-RRSP retirement accounts. Nineteen residents (50%) budgeted expenses. Median resident income was $45 000. Thirteen residents (34%) had cash reserves < $250. Many residents save little, and incur substantial debt over and above educational loans. Many residents would benefit from instruction concerning prudent financial management. Residents should be informed of the consequences of low saving and high debt.

  11. A Step Towards Conservation for Interior Alaska Tribes

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

    Kimberly Carlo

    2012-07-07

    This project includes a consortium of tribes. The tribes include Hughes (representing the consortium) Birch Creek, Huslia, and Allakaket. The project proposed by Interior Regional Housing Authority (IRHA) on behalf of the villages of Hughes, Birch Creek, Huslia and Allakaket is to develop an energy conservation program relevant to each specific community, educate tribe members and provide the tools to implement the conservation plan. The program seeks to achieve both energy savings and provide optimum energy requirements to support each tribe's mission. The energy management program will be a comprehensive program that considers all avenues for achieving energy savings, frommore » replacing obsolete equipment, to the design and construction of energy conservation measures, the implementation of energy saving operation and maintenance procedures, the utilization of a community-wide building energy management system, and a commitment to educating the tribes on how to decrease energy consumption. With the implementation of this program and the development of an Energy Management Plan, these communities can then work to reduce the high cost of living in rural Alaska.« less

  12. Energy savings opportunity survey. FY85 Energy Engineering Analysis Program. Various locations, Eighth US Army, Korea. Final report

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

    NONE

    1987-03-01

    This study was prepared as part of the Engineering Energy Analysis Program (EEAP). The EEAP is a Department of Defense (DOD) program which was initiated in the late 1970`s in response to a Presidential Order. The program`s primary goal is to reduce energy consumption within the DOD thereby curbing dependence on foreign non-renewable energy sources, notably oil. The Energy Engineering Analysis Program (EEAP) is administrated by the U.S. Army Corps of Engineers through the Huntsville Division located in Huntsville, Alabama. The EEAP program effort in Korea has consisted of two major studies. The first study occured in 1981 and consistedmore » of basewide energy studies. The scope for these studies included looking at entire camps. The second effort under the EEAP program in Korea is this study. The scope of work for this study includes a total of 63 buildings located at 19 different camps throughout Korea from Taegu to the DMZ (see Figure 1). This study is properly known as an Energy Savings Opportunity Survey (ESOS). Since an ESOS is limited to examining individual buildings, energy savings projects are limited to the scale and complexity of the buildings within the study.« less

  13. ESTEEM - Encouraging School Transportation Effective Energy Management - Fuel Economy Management Handbook for Directors of Pupil Transportation, School District Administrators, Transportation Department Management.

    ERIC Educational Resources Information Center

    BRI Systems, Inc., Phoenix, AZ.

    This publication is a guide for school districts to reduce pupil transportation costs and save energy. The information presented is based upon: (1) energy saving programs implemented by school districts; (2) government and industry research efforts in fuel economy; (3) the successful experiences of commercial trucking fleets to save fuel; and (4)…

  14. Direct Government Lending: The Bottom Line. A Critique of GAO's Report on Guaranteed Student Loans versus Direct Lending and Revised Savings Estimates.

    ERIC Educational Resources Information Center

    Quick, Perry D.

    This report addresses the dollar savings described in the Government Accounting Office's (GAO) report supporting direct lending as opposed to the present guaranteed student loan program. The critique explains the changes in the GAO model assumptions and projections that are believed necessary to move from the original $4.8 billion savings to a…

  15. Looking Under the Hood of the Cadillac Tax.

    PubMed

    Glied, Sherry; Striar, Adam

    2016-06-01

    One effect of the Affordable Care Act's "Cadillac tax" (now delayed until 2020) is to undo part of the existing federal tax preference for employer-sponsored insurance. The specific features of this tax on high-cost health plans--notably, the inclusion of tax-favored savings vehicles such as health savings accounts (HSAs) in the formula for determining who is subject to the tax--are designed primarily to maximize revenue and minimize coverage disruptions, not to reduce health spending. Thus, at least initially, these savings accounts, rather than enrollee cost-sharing or other plan features, are likely to be affected most by the tax as employers act to limit their HSA contributions. Because high earners are the ones benefiting most from tax-preferred accounts, the high-cost plan tax will probably be more progressive than prior analyses have suggested, while having only a modest impact on total health spending.

  16. 76 FR 54999 - Notice of 2011 National Organic Certification Cost-Share Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-06

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

  17. Strategic Review Process for an Accountable Care Organization and Emerging Accountable Care Best Practices.

    PubMed

    Conway, Sarah J; Himmelrich, Sarah; Feeser, Scott A; Flynn, John A; Kravet, Steven J; Bailey, Jennifer; Hebert, Lindsay C; Donovan, Susan H; Kachur, Sarah G; Brown, Patricia M C; Baumgartner, William A; Berkowitz, Scott A

    2018-02-02

    Accountable Care Organizations (ACOs), like other care entities, must be strategic about which initiatives they support in the quest for higher value. This article reviews the current strategic planning process for the Johns Hopkins Medicine Alliance for Patients (JMAP), a Medicare Shared Savings Program Track 1 ACO. It reviews the 3 focus areas for the 2017 strategic review process - (1) optimizing care coordination for complex, at-risk patients, (2) post-acute care, and (3) specialty care integration - reviewing cost savings and quality improvement opportunities, associated best practices from the literature, and opportunities to leverage and advance existing ACO and health system efforts in each area. It then reviews the ultimate selection of priorities for the coming year and early thoughts on implementation. After the robust review process, key stakeholders voted to select interventions targeted at care coordination, post-acute care, and specialty integration including Part B drug and imaging costs. The interventions selected incorporate a mixture of enhancing current ACO initiatives, working collaboratively and synergistically on other health system initiatives, and taking on new projects deemed targeted, cost-effective, and manageable in scope. The annual strategic review has been an essential and iterative process based on performance data and informed by the collective experience of other organizations. The process allows for an evidence-based strategic plan for the ACO in pursuit of the best care for patients.

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

    NASA Astrophysics Data System (ADS)

    Korytárová, J.; Vaňková, L.

    2017-10-01

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

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

    Mittal, Sparsh; Zhang, Zhao

    With each CMOS technology generation, leakage energy consumption has been dramatically increasing and hence, managing leakage power consumption of large last-level caches (LLCs) has become a critical issue in modern processor design. In this paper, we present EnCache, a novel software-based technique which uses dynamic profiling-based cache reconfiguration for saving cache leakage energy. EnCache uses a simple hardware component called profiling cache, which dynamically predicts energy efficiency of an application for 32 possible cache configurations. Using these estimates, system software reconfigures the cache to the most energy efficient configuration. EnCache uses dynamic cache reconfiguration and hence, it does not requiremore » offline profiling or tuning the parameter for each application. Furthermore, EnCache optimizes directly for the overall memory subsystem (LLC and main memory) energy efficiency instead of the LLC energy efficiency alone. The experiments performed with an x86-64 simulator and workloads from SPEC2006 suite confirm that EnCache provides larger energy saving than a conventional energy saving scheme. For single core and dual-core system configurations, the average savings in memory subsystem energy over a shared baseline configuration are 30.0% and 27.3%, respectively.« less

  20. Cost-outcome analysis in injury prevention and control: eighty-four recent estimates for the United States.

    PubMed

    Miller, T R; Levy, D T

    2000-06-01

    The objectives of this study were to review cost-outcome analyses in injury prevention and control and estimate associated benefit-cost ratios and cost per quality-adjusted life-year. Medline and Internet search, bibliographic review, and federal agency contacts identified published and unpublished studies from 1987 to 1998 for the United States. Studies of low quality and analyses of occupational, air, rail, and water transport safety programs were excluded. Selected results were recomputed to increase discount rate, benefit category, and benefit estimate comparability and to update injury incidence rates. More than half of the 84 injury prevention measures reviewed yielded net societal cost savings. Twelve measures had costs that exceeded benefits. Of 33 road safety measures analyzed, 19 yielded net cost savings. Of 34 violence prevention approaches studied, 19 yielded net cost savings, whereas 8 had costs that exceeded benefits. Interventions with the highest benefit-cost ratios included juvenile delinquent therapy programs, fire-safe cigarettes, federal road and traffic safety program funding, lane markers painted on roads, post-mounted reflectors on hazardous curves, safety belts in front seats, safety belt laws with primary enforcement, child safety seats, child bicycle helmets, enforcement of laws against serving alcohol to the intoxicated, substance abuse treatment, brief medical interventions with heavy drinkers, and a comprehensive safe communities program in a low-income neighborhood. Studies of cost-saving measures do not exist for several injury types. Injury prevention often can reduce medical costs and save lives. Wider implementation of proven measures is warranted.

  1. Chapter 13: Assessing Persistence and Other Evaluation Issues Cross-Cutting Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

    Kurnik, Charles W; Violette, Daniel M.

    Addressing other evaluation issues that have been raised in the context of energy efficiency programs, this chapter focuses on methods used to address the persistence of energy savings, which is an important input to the benefit/cost analysis of energy efficiency programs and portfolios. In addition to discussing 'persistence' (which refers to the stream of benefits over time from an energy efficiency measure or program), this chapter provides a summary treatment of these issues -Synergies across programs -Rebound -Dual baselines -Errors in variables (the measurement and/or accuracy of input variables to the evaluation).

  2. A "Cap" on Medicaid: How Block Grants, Per Capita Caps, and Capped Allotments Might Fundamentally Change the Safety Net.

    PubMed

    Mager-Mardeusz, Haleigh; Lenz, Cosima; Kominski, Gerald F

    2017-04-01

    Changing the Medicaid program is a top priority for the Republican party. Common themes from GOP proposals include converting Medicaid from a jointly financed entitlement benefit to a form of capped federal financing. While proponents of this reform argue that it would provide greater flexibility and a more predictable budget for state governments, serious consequences would likely result for Medicaid enrollees and state governments. Under all three scenarios promoted by Republicans--block grants, capped allotments, and per capita caps—most states would face increased costs. For all three scenarios, the capped nature of the funding guarantees that the real value of funds would decrease in future years relative to what would be expected from growth under the current program. Although the federal government would undoubtedly realize savings from all three scenarios, the impact might lead states to reduce benefits and services, create waiting lists, impose cost-sharing on a traditionally low-income enrollee population, or impose other obstacles to coverage. Nationally, as many as 20.5 million Americans stand to lose coverage under the proposed Medicaid changes. In California, up to 6 million people could lose coverage if changes to the Medicaid program were coupled with the repeal of coverage for the expansion population.

  3. Impact of savings groups on the lives of the poor

    PubMed Central

    Karlan, Dean; Savonitto, Beniamino; Thuysbaert, Bram; Udry, Christopher

    2017-01-01

    Savings-led microfinance programs operate in poor rural communities in developing countries to establish groups that save and then lend out the accumulated savings to each other. Nonprofit organizations train villagers to create and lead these groups. In a clustered randomized evaluation spanning three African countries (Ghana, Malawi, and Uganda), we find that the promotion of these community-based microfinance groups leads to an improvement in household business outcomes and women’s empowerment. However, we do not find evidence of impacts on average consumption or other livelihoods. PMID:28270615

  4. Advances in volcano monitoring and risk reduction in Latin America

    NASA Astrophysics Data System (ADS)

    McCausland, W. A.; White, R. A.; Lockhart, A. B.; Marso, J. N.; Assitance Program, V. D.; Volcano Observatories, L. A.

    2014-12-01

    We describe results of cooperative work that advanced volcanic monitoring and risk reduction. The USGS-USAID Volcano Disaster Assistance Program (VDAP) was initiated in 1986 after disastrous lahars during the 1985 eruption of Nevado del Ruiz dramatizedthe need to advance international capabilities in volcanic monitoring, eruption forecasting and hazard communication. For the past 28 years, VDAP has worked with our partners to improve observatories, strengthen monitoring networks, and train observatory personnel. We highlight a few of the many accomplishments by Latin American volcano observatories. Advances in monitoring, assessment and communication, and lessons learned from the lahars of the 1985 Nevado del Ruiz eruption and the 1994 Paez earthquake enabled the Servicio Geológico Colombiano to issue timely, life-saving warnings for 3 large syn-eruptive lahars at Nevado del Huila in 2007 and 2008. In Chile, the 2008 eruption of Chaitén prompted SERNAGEOMIN to complete a national volcanic vulnerability assessment that led to a major increase in volcano monitoring. Throughout Latin America improved seismic networks now telemeter data to observatories where the decades-long background rates and types of seismicity have been characterized at over 50 volcanoes. Standardization of the Earthworm data acquisition system has enabled data sharing across international boundaries, of paramount importance during both regional tectonic earthquakes and during volcanic crises when vulnerabilities cross international borders. Sharing of seismic forecasting methods led to the formation of the international organization of Latin American Volcano Seismologists (LAVAS). LAVAS courses and other VDAP training sessions have led to international sharing of methods to forecast eruptions through recognition of precursors and to reduce vulnerabilities from all volcano hazards (flows, falls, surges, gas) through hazard assessment, mapping and modeling. Satellite remote sensing data-sharing facilitatescross-border identification and warnings of ash plumes for aviation. Overall, long-term strategies of data collection and experience-sharing have helped Latin American observatories improve their monitoring and create informed communities cognizant of vulnerabilities inherent in living near volcanoes.

  5. 78 FR 52131 - Notice of Funds Availability: Agricultural Management Assistance Organic Certification Cost-Share...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-22

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

  6. Cost effectiveness of recycling: A systems model

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

    Tonjes, David J., E-mail: david.tonjes@stonybrook.edu; Waste Reduction and Management Institute, School of Marine and Atmospheric Sciences, Stony Brook University, Stony Brook, NY 11794-5000; Center for Bioenergy Research and Development, Advanced Energy Research and Technology Center, Stony Brook University, 1000 Innovation Rd., Stony Brook, NY 11794-6044

    Highlights: • Curbside collection of recyclables reduces overall system costs over a range of conditions. • When avoided costs for recyclables are large, even high collection costs are supported. • When avoided costs for recyclables are not great, there are reduced opportunities for savings. • For common waste compositions, maximizing curbside recyclables collection always saves money. - Abstract: Financial analytical models of waste management systems have often found that recycling costs exceed direct benefits, and in order to economically justify recycling activities, externalities such as household expenses or environmental impacts must be invoked. Certain more empirically based studies have alsomore » found that recycling is more expensive than disposal. Other work, both through models and surveys, have found differently. Here we present an empirical systems model, largely drawn from a suburban Long Island municipality. The model accounts for changes in distribution of effort as recycling tonnages displace disposal tonnages, and the seven different cases examined all show that curbside collection programs that manage up to between 31% and 37% of the waste stream should result in overall system savings. These savings accrue partially because of assumed cost differences in tip fees for recyclables and disposed wastes, and also because recycling can result in a more efficient, cost-effective collection program. These results imply that increases in recycling are justifiable due to cost-savings alone, not on more difficult to measure factors that may not impact program budgets.« less

  7. 25 CFR 1000.400 - Can a Tribe/Consortium retain savings from programs?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... INTERIOR ANNUAL FUNDING AGREEMENTS UNDER THE TRIBAL SELF-GOVERNMENT ACT AMENDMENTS TO THE INDIAN SELF... an AFA is in effect. A Tribe/Consortium must use any savings that it realizes under an AFA, including...

  8. 25 CFR 1000.400 - Can a Tribe/Consortium retain savings from programs?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... INTERIOR ANNUAL FUNDING AGREEMENTS UNDER THE TRIBAL SELF-GOVERNMENT ACT AMENDMENTS TO THE INDIAN SELF... an AFA is in effect. A Tribe/Consortium must use any savings that it realizes under an AFA, including...

  9. 25 CFR 1000.400 - Can a Tribe/Consortium retain savings from programs?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... INTERIOR ANNUAL FUNDING AGREEMENTS UNDER THE TRIBAL SELF-GOVERNMENT ACT AMENDMENTS TO THE INDIAN SELF... an AFA is in effect. A Tribe/Consortium must use any savings that it realizes under an AFA, including...

  10. 25 CFR 1000.400 - Can a Tribe/Consortium retain savings from programs?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... INTERIOR ANNUAL FUNDING AGREEMENTS UNDER THE TRIBAL SELF-GOVERNMENT ACT AMENDMENTS TO THE INDIAN SELF... an AFA is in effect. A Tribe/Consortium must use any savings that it realizes under an AFA, including...

  11. Value-based insurance design: embracing value over cost alone.

    PubMed

    Fendrick, A Mark; Chernew, Michael E; Levi, Gary W

    2009-12-01

    The US healthcare system is in crisis, with documented gaps in quality, safety, access, and affordability. Many believe the solution to unsustainable cost increases is increased patient cost-sharing. From an overall cost perspective, reduced consumption of certain essential services may yield short-term savings but lead to worse health and markedly higher costs down the road--in complications, hospitalizations, and increased utilization. Value-based insurance design (VBID) can help plug the inherent shortfalls in "across-the-board" patient cost-sharing. Instead of focusing on cost or quality alone, VBID focuses on value, aligning the financial and nonfinancial incentives of the various stakeholders and complementing other current initiatives to improve quality and subdue costs, such as high-deductible consumer-directed health plans, pay-for-performance programs, and disease management. Mounting evidence, both peer-reviewed and empirical, indicates not only that VBID can be implemented, but also leads to desired changes in behavior. For all its documented successes and recognized promise, VBID is in its infancy and is not a panacea for the current healthcare crisis. However, the available research and documented experiences indicate that as an overall approach, and in its fully evolved and widely adopted form, VBID will promote a healthier population and therefore support cost-containment efforts by producing better health at any price point.

  12. Economics of an adolescent meningococcal conjugate vaccination catch-up campaign in the United States.

    PubMed

    Ortega-Sanchez, Ismael R; Meltzer, Martin I; Shepard, Colin; Zell, Elizabeth; Messonnier, Mark L; Bilukha, Oleg; Zhang, Xinzhi; Stephens, David S; Messonnier, Nancy E

    2008-01-01

    In June 2005, the Advisory Committee on Immunization Practices recommended the newly licensed quadrivalent meningococcal conjugate vaccine for routine use among all US children aged 11 years. A 1-time catch-up vaccination campaign for children and adolescents aged 11-17 years, followed by routine annual immunization of each child aged 11 years, could generate immediate herd immunity benefits. The objective of our study was to analyze the cost-effectiveness of a catch-up vaccination campaign with quadrivalent meningococcal conjugate vaccine for children and adolescents aged 11-17 years. We built a probabilistic model of disease burden and economic impacts for a 10-year period with and without a program of adolescent catch-up meningococcal vaccination, followed by 9 years of routine immunization of children aged 11 years. We used US age- and serogroup-specific surveillance data on incidence and mortality. Assumptions related to the impact of herd immunity were drawn from experience with routine meningococcal vaccination in the United Kingdom. We estimated costs per case, deaths prevented, life-years saved, and quality-adjusted life-years saved. With herd immunity, the catch-up and routine vaccination program for adolescents would prevent 8251 cases of meningococcal disease in a 10-year period (a 48% decrease). Excluding program costs, this catch-up and routine vaccination program would save US$551 million in direct costs and $920 million in indirect costs, including costs associated with permanent disability and premature death. At $83 per vaccinee, the catch-up vaccination would cost society approximately $223,000 per case averted, approximately $2.6 million per death prevented, approximately $127,000 per life-year saved, and approximately $88,000 per quality-adjusted life-year saved. Targeting counties with a high incidence of disease decreased the cost per life-year saved by two-thirds. Although costly, catch-up and routine vaccination of adolescents can have a substantial impact on meningococcal disease burden. Because of herd immunity, catch-up and routine vaccination cost per life-year saved could be up to one-third less than that previously assessed for routine vaccination of children aged 11 years.

  13. Medicaid-based child restraint system disbursement and education and the vaccines for children program: comparative cost-effectiveness.

    PubMed

    Goldstein, Jesse A; Winston, Flaura K; Kallan, Michael J; Branas, Charles C; Schwartz, J Sanford

    2008-01-01

    Low-income children are disproportionately at risk for preventable motor-vehicle injury. Many of these children are covered by Medicaid programs placing substantial economic burden on states. Child restraint systems (CRSs) have demonstrated efficacy in preventing death and injury among children in crashes but remain underutilized because of poor access and education. The objective of this study was to evaluate the cost-effectiveness of Medicaid-based reimbursement for CRS disbursement and education for low-income children and compare it with vaccinations covered under the Vaccines For Children (VFC) program. A cost-effectiveness analysis was performed of Medicaid reimbursement for CRS disbursement/education for low-income children based on data from public and private databases. Primary outcomes measured include cost per life-year saved, death, serious injury, and minor injury averted, as well as medical, parental work loss, and future productivity loss costs averted. Cost-effectiveness calculations were compared with published cost-effectiveness data for vaccinations covered under the VFC program. The adoption of a CRS disbursement/education program could prevent up to 2 deaths, 12 serious injuries, and 51 minor injuries per 100,000 low-income children annually. When fully implemented, the program could save Medicaid over $1 million per 100,000 children in direct medical costs while costing $13 per child per year after all 8 years of benefit. From the perspective of Medicaid, the program would cost $17,000 per life-year saved, $60,000 per serious injury prevented, and $560,000 per death averted. The program would be cost saving from a societal perspective. These data are similar to published vaccination cost-effectiveness data. Implementation of a Medicaid-funded CRS disbursement/education program was comparable in cost-effectiveness with federal vaccination programs targeted toward similar populations and represents an important potential strategy for addressing injury disparities among low-income children.

  14. Chapter 7: Refrigerator Recycling Evaluation Protocol. The Uniform Methods Project: Methods for Determining Energy-Efficiency Savings for Specific Measures

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

    Kurnik, Charles W.; Keeling, Josh; Bruchs, Doug

    Refrigerator recycling programs are designed to save energy by removing operable, albeit less efficient, refrigerators from service. By offering free pickup, providing incentives, and disseminating information about the operating cost of less efficient refrigerators, these programs are designed to encourage consumers to: - Limit the use of secondary refrigerators -Relinquish refrigerators previously used as primary units when they are replaced (rather than keeping the existing refrigerator as a secondary unit) -Prevent the continued use of less efficient refrigerators in another household through a direct transfer (giving it away or selling it) or indirect transfer (resale on the used appliance market).more » Commonly implemented by third-party contractors (who collect and decommission participating appliances), these programs generate energy savings through the retirement of inefficient appliances. The decommissioning process captures environmentally harmful refrigerants and foam, and enables recycling of the plastic, metal, and wiring components.« less

  15. Computer multitasking with Desqview 386 in a family practice.

    PubMed Central

    Davis, A E

    1990-01-01

    Computers are now widely used in medical practice for accounting and secretarial tasks. However, it has been much more difficult to use computers in more physician-related activities of daily practice. I investigated the Desqview multitasking system on a 386 computer as a solution to this problem. Physician-directed tasks of management of patient charts, retrieval of reference information, word processing, appointment scheduling and office organization were each managed by separate programs. Desqview allowed instantaneous switching back and forth between the various programs. I compared the time and cost savings and the need for physician input between Desqview 386, a 386 computer alone and an older, XT computer. Desqview significantly simplified the use of computer programs for medical information management and minimized the necessity for physician intervention. The time saved was 15 minutes per day; the costs saved were estimated to be $5000 annually. PMID:2383848

  16. Education and empowerment of the nursing assistant: validating their important role in skin care and pressure ulcer prevention, and demonstrating productivity enhancement and cost savings.

    PubMed

    Howe, Lynn

    2008-06-01

    This article details an educational program designed to utilize nonlicensed personnel (certified nursing assistants [CNAs] and nursing assistants [NAs]) in the prevention of pressure ulcers and improved skin care in a 250-bed acute care facility in a suburban setting. The article is divided into 2 parts: A and B. Part A addresses the educational program, which was part of a major initiative for improving patient outcomes that included a review and standardization of skin care products and protocols. Part B addresses productivity enhancement and cost savings experienced because of changing bathing and incontinence care products and procedures. The educational program included instruction on time-saving methods for increasing productivity in bathing and incontinence care, and effectively promoted the importance of proper skin care and pressure ulcer prevention techniques. Methods incorporated into the educational training targeted different reading and comprehension levels, ranging from the use of PowerPoint slides, hands-on return demonstration, and group discussion related to pressure ulcer staging and wound treatment. These educational methods provided the participants with significant reinforcement of each day's learning objectives. Productivity enhancement and cost savings are addressed in part B, as well as the results of a time-motion study. Because of the program, CNAs/NAs were empowered in their integral caregiver roles. This program was part of a larger, major process improvement initiative, but the rate of acquired pressure ulcers declined from 2.17% in 2002 to 1.71% in 2003. This educational program was considered a contributor to the improved patient outcomes.

  17. Impact of a New Palliative Care Program on Health System Finances: An Analysis of the Palliative Care Program Inpatient Unit and Consultations at Johns Hopkins Medical Institutions.

    PubMed

    Isenberg, Sarina R; Lu, Chunhua; McQuade, John; Chan, Kelvin K W; Gill, Natasha; Cardamone, Michael; Torto, Deirdre; Langbaum, Terry; Razzak, Rab; Smith, Thomas J

    2017-05-01

    Palliative care inpatient units (PCUs) can improve symptoms, family perception of care, and lower per-diem costs compared with usual care. In March 2013, Johns Hopkins Medical Institutions (JHMI) added a PCU to the palliative care (PC) program. We studied the financial impact of the PC program on JHMI from March 2013 to March 2014. This study considered three components of the PC program: PCU, PC consultations, and professional fees. Using 13 months of admissions data, the team calculated the per-day variable cost pre-PCU (ie, in another hospital unit) and after transfer to the PCU. These fees were multiplied by the number of patients transferred to the PCU and by the average length of stay in the PCU. Consultation savings were estimated using established methods. Professional fees assumed a collection rate of 50%. The total positive financial impact of the PC program was $3,488,863.17. There were 153 transfers to the PCU, 60% with cancer, and an average length of stay of 5.11 days. The daily loss pretransfer to the PCU of $1,797.67 was reduced to $1,345.34 in the PCU (-25%). The PCU saved JHMI $353,645.17 in variable costs, or $452.33 per transfer. Cost savings for PC consultations in the hospital, 60% with cancer, were estimated at $2,765,218. $370,000 was collected in professional fees savings. The PCU and PC program had a favorable impact on JHMI while providing expert patient-centered care. As JHMI moves to an accountable care organization model, value-based patient-centered care and increased intensive care unit availability are desirable.

  18. Effects of a Community-Based Fall Management Program on Medicare Cost Savings.

    PubMed

    Ghimire, Ekta; Colligan, Erin M; Howell, Benjamin; Perlroth, Daniella; Marrufo, Grecia; Rusev, Emil; Packard, Michael

    2015-12-01

    Fall-related injuries and health risks associated with reduced mobility or physical inactivity account for significant costs to the U.S. healthcare system. The widely disseminated lay-led A Matter of Balance (MOB) program aims to help older adults reduce their risk of falling and associated activity limitations. This study examined effects of MOB participation on health service utilization and costs for Medicare beneficiaries, as a part of a larger effort to understand the value of community-based prevention and wellness programs for Medicare. A controlled retrospective cohort study was conducted in 2012-2013, using 2007-2011 MOB program data and 2006-2013 Medicare data. It investigated program effects on falls and fall-related fractures, and health service utilization and costs (standardized to 2012 dollars), of 6,136 Medicare beneficiaries enrolled in MOB from 2007 through 2011. A difference-in-differences analysis was employed to compare outcomes of MOB participants with matched controls. MOB participation was associated with total medical cost savings of $938 per person (95% CI=$379, $1,498) at 1 year. Savings per person amounted to $517 (95% CI=$265, $769) for unplanned hospitalizations; $81 for home health care (95% CI=$20, $141); and $234 (95% CI=$55, $413) for skilled nursing facility care. Changes in the incidence of falls or fall-related fractures were not detected, suggesting that cost savings accrue through other mechanisms. This study suggests that MOB and similar prevention programs have the potential to reduce Medicare costs. Further research accounting for program delivery costs would help inform the development of Medicare-covered preventive benefits. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.

  19. A statistical analysis of the energy policy act of 2005, its changes to the daylight saving program, and impact on residential energy consumption

    NASA Astrophysics Data System (ADS)

    Murray, Patrick L.

    Government programs designed to decrease resource consumption, improve productivity and capitalize on extended daylight hours in the summer have been developed and implemented throughout the world for nearly three hundred years. In 2005, The United States government adopted an extended daylight savings program that increases the number of weeks where the country observes Daylight Saving Time (DST) from 31 to 35 weeks. The program took effect in March 2007. Arguments in support of DST programs highlight the portion of electricity consumption attributed to residential lighting in the evening hours. Adjusting clocks forward by one hour in summer months is believed to reduce electricity consumption due to lighting and therefore significantly reduce residential energy consumption during the period of DST. This paper evaluates the efficacy of the changes to DST resulting from the Energy Policy Act of 2005. The study focuses on changes to household electricity consumption during the extended four weeks of DST. Arizona, one of two states that continue to opt out of DST serves as the study's control for a comparison with neighboring states, Colorado, Nebraska, Nevada, New Mexico, Oklahoma, Texas and Utah. Results from the regression analysis of a Difference in Difference model indicate that contrary to evaluations by Congress and the Department of Energy, the four week period of Extended Daylight Saving Time does not produce a significant decrease in per capita electricity consumption in Southwestern states.

  20. 77 FR 18793 - Spectrum Sharing Innovation Test-Bed Pilot Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-28

    .... 120322212-2212-01] Spectrum Sharing Innovation Test-Bed Pilot Program AGENCY: National Telecommunications... Innovation Test-Bed pilot program to assess whether devices employing Dynamic Spectrum Access techniques can... Spectrum Sharing Innovation Test-Bed (Test-Bed) pilot program to examine the feasibility of increased...

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