Evaluation of Savings in Energy-Efficient Public Housing in the Pacific Northwest

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

Gordon, A.; Lubliner, M.; Howard, L.

2013-10-01

This report presents the results of an energy performance and cost-effectiveness analysis. The Salishan phase 7 and demonstration homes were compared to Salishan phase 6 homes built to 2006 Washington State Energy Code specifications 2. Predicted annual energy savings (over Salishan phase 6) was 19% for Salishan phase 7, and between 19-24% for the demonstration homes (depending on ventilation strategy). Approximately two-thirds of the savings are attributable to the DHP. Working with the electric utility provider, Tacoma Public Utilities, researchers conducted a billing analysis for Salishan phase 7.

Improving Building Energy Simulation Programs Through Diagnostic Testing (Fact Sheet)

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

Not Available

2012-02-01

New test procedure evaluates quality and accuracy of energy analysis tools for the residential building retrofit market. Reducing the energy use of existing homes in the United States offers significant energy-saving opportunities, which can be identified through building simulation software tools that calculate optimal packages of efficiency measures. To improve the accuracy of energy analysis for residential buildings, the National Renewable Energy Laboratory's (NREL) Buildings Research team developed the Building Energy Simulation Test for Existing Homes (BESTEST-EX), a method for diagnosing and correcting errors in building energy audit software and calibration procedures. BESTEST-EX consists of building physics and utility billmore » calibration test cases, which software developers can use to compare their tools simulation findings to reference results generated with state-of-the-art simulation tools. Overall, the BESTEST-EX methodology: (1) Tests software predictions of retrofit energy savings in existing homes; (2) Ensures building physics calculations and utility bill calibration procedures perform to a minimum standard; and (3) Quantifies impacts of uncertainties in input audit data and occupant behavior. BESTEST-EX is helping software developers identify and correct bugs in their software, as well as develop and test utility bill calibration procedures.« less

The effect of information on household water and energy use

NASA Astrophysics Data System (ADS)

Hans, Liesel

Water and Energy Utilities are faced with growing demand at a time when supply expansion is increasingly costly, inconsistent and taxing on the environment. Given that supply expansion is limited, to meet future needs utilities need demand-side management policies to result in more reliable and consistent consumer responsiveness. Currently, most households do not have access to the level or type of information needed to respond to price signals in a reliable and effective way. Advanced information technology solutions exist and are being increasingly adopted, but we need to know more about how the informational setting affects decision-making, consumption levels and price responsiveness. This research analyzes the effect of information on household water and energy consumption, which is a decision-making environment characterized by uncertainty and imperfect information. This study also analyzes additional complexities stemming from infrequent billing, non-linear pricing structures, and combined utility bills, each of which may dampen price signals. I first develop a theoretical model of decision-making under uncertainty. I use this model to illustrate the effect of more frequent information, which eliminates uncertainty about past decisions, on remaining decisions within the billing period. The model emphasizes the role of risk preferences and the realization of the uncertain quantity. On average, risk averse consumers will increase consumption when uncertainty is reduced; risk seeking consumers will do the opposite. Introduction of a non-linear rate structure induces behavior that makes individuals appear as if they are risk averse or risk seeking, despite their actual risk preferences. This model highlights the importance of modeling multiple decisions within a billing period and accounting for a spectrum of risk preferences. In Chapter 3, I create a computerized laboratory experiment designed to generate data used to test some of the hypotheses formulated in the theoretical model presented in Chapter 2. Results from the experiment show that, on average, individuals consume more when provided with more frequent information that resolves uncertainty about past decisions made within a single billing period. This result is driven by the fact that the majority of participants are risk averse or risk neutral. Risk seeking participants instead reduce use when facing less uncertainty. Also as predicted by the theoretical model in Chapter 2, combining behavior driven by risk preferences with the presence of an increasing block rate structure results in behavior that looks like consumers are targeting the block boundary. This experiment shows that providing more information may not lead to reduced use without other incentives, goal-setting, or mechanisms designed to help individuals process the information. In Chapter 4, I empirically analyze a ten-year household-level panel data set of monthly utility bills. A single utility provides electricity, natural gas and water services to its customers and therefore bills through a single utility bill. I first show that price responsiveness varies by the number and combination of services subscribed to by a given household. Second, through a price salience model I show that households are more responsive to the price of water when the water portion of the total bill is greater. When multiple services are contained on a single bill, the salience of any individual price signal is dampened. This study confirms that households are inelastic though not unresponsive to water prices. In order to make pricing policies more effective, utilities need to acknowledge that households may be responding to total utility costs (i.e., may respond to a high utility bill by reducing electricity use despite the true driver of the high bill) and will need to find ways to make quantity and price information more salient to their customers. Chapter 5 concludes this dissertation by summarizing the contributions of the research and possible extensions for future work. By improving the informational environment surrounding household water and energy use, there will be great capacity for households to use water and energy more efficiently and ultimately make choices that reduce residential water/energy consumption and yield benefits for customers, utilities, and the environment.

Are psychoanalytic billing practices ethical?

PubMed

Blackmon, W D

1993-01-01

The changing climate of "health care reform" and increased third-party intrusion into psychotherapy are raising challenges over the ethics of traditional psychoanalytic practices such as billing for missed sessions. The practice of billing for missed sessions is an integral part of some analytic psychotherapies and forms the basis of the field of operation of many therapies. When used in this way, the billing practices are unique in medicine in that only these therapies use billing as a part of treatment. This practice is used for a variety of practical reasons but especially to emphasize to patients that the therapy occurs in their internal lives and addresses the symbols they use in organizing their world view. The symbolic use of a time commitment and the obligation to pay for that commitment are necessary so as not to present the patient with a contaminated field of operation. In this way the practice is similar to many other areas of medicine, such as surgeries that are viewed as global procedures whose billing allows for time that is not actually spent in contact with patients. This paper discusses the clinical rationale for the ability to bill for missed sessions and its ethics in terms of the newer language of utilization review. By laying down the principle of billing as a practice parameter for an open-ended bundled service that is billed globally the author translates the practice into more modern utilization-review terminology.

Industry relationships are associated with performing a greater number of sinus balloon dilation procedures.

PubMed

Eloy, Jean Anderson; Svider, Peter F; Bobian, Michael; Harvey, Richard J; Gray, Stacey T; Baredes, Soly; Folbe, Adam J

2017-09-01

Industry outreach promotes awareness of novel technologies. However, concerns have been raised that such relationships may also unduly impact medical decision-making. Our objective in this study was to evaluate industry relationships among practitioners who frequently employ balloon dilation (BD), characterizing whether there is any association between financial relationships and BD utilization. Provider utilization data (FY-2014) was accessed for individuals billing BD procedures to Medicare, the largest healthcare payor in the United States. The names of individuals included in these data sets were cross-referenced with the Centers for Medicare and Medicaid Services Open Payment site to determine the extent of industry relationships during this same year. Individuals included in this analysis were organized by those with "significant" ($1,000 to $10,000) and "major" (> $10,000) industry relationships. Practice setting, training, and experience were also evaluated. Of the 302 otolaryngologists who billed enough BDs for inclusion in this data set, 99.3% were in private practice, 89.7% were board-certified, 8.3% had facial plastic and reconstructive fellowship training, and 1.3% had rhinology fellowship training. There was a significant increase in BDs performed with increasing BD company financial contributions (analysis of variance, p = 0.0003). Individuals without "significant" relationships with BD companies billed fewer BDs than those with at least "significant" (>$1,000) relationships (57.0 ± 4.3 vs 87.7 ± 10.0, p = 0.001). There is an association between receiving money from industry and the frequency with which otolaryngologists employ BD. Although our analysis demonstrates an association, these results in no way imply causation. Further analysis exploring the reasons for this association may be necessary. © 2017 ARS-AAOA, LLC.

A single question about a respondent's perceived financial ability to pay monthly bills explains more variance in health utility scores than absolute income and assets questions.

PubMed

Hanmer, Janel; Cherepanov, Dasha

2016-09-01

To evaluate a general question about ability to meet monthly bills as an alternative to direct questions about income and assets in health utility studies. We used data from the National Health Measurement Study-a US nationally representative telephone survey collected in 2005-2006. It included health utility measures (EuroQol-5D-3L, Health Utilities Index Mark 3, Short Form-6D, and Quality of Well-being Index) and household income, assets, and financial ability to meet monthly bills questions. Each utility score was regressed on: income and assets (Model 1); difficulty paying bills (DPB) (Model 2); income, assets, and DPB (Model 3). All models used survey weights and adjusted for demographics and education. Among 3666 respondents, as income and assets increased, DPB decreased. The DPB question had fewer missing values (n = 30) than income (n = 311) or assets (n = 373). Model 2 (DPB only) explained more variance in health utility than Model 1 (income and assets only). Including all measures (Model 3) had very modest improvement in R (2), e.g., values were 0.112 (Model 1), 0.166 (Model 2), and 0.175 (Model 3) for EuroQol-5D-3L. The single question on DPB yields more information and has less missing values than the traditionally used income and assets questions.

Changing Utilization of Noninvasive Diagnostic Imaging Over 2 Decades: An Examination Family-Focused Analysis of Medicare Claims Using the Neiman Imaging Types of Service Categorization System.

PubMed

Rosman, David A; Duszak, Richard; Wang, Wenyi; Hughes, Danny R; Rosenkrantz, Andrew B

2018-02-01

The objective of our study was to use a new modality and body region categorization system to assess changing utilization of noninvasive diagnostic imaging in the Medicare fee-for-service population over a recent 20-year period (1994-2013). All Medicare Part B Physician Fee Schedule services billed between 1994 and 2013 were identified using Physician/Supplier Procedure Summary master files. Billed codes for diagnostic imaging were classified using the Neiman Imaging Types of Service (NITOS) coding system by both modality and body region. Utilization rates per 1000 beneficiaries were calculated for families of services. Among all diagnostic imaging modalities, growth was greatest for MRI (+312%) and CT (+151%) and was lower for ultrasound, nuclear medicine, and radiography and fluoroscopy (range, +1% to +31%). Among body regions, service growth was greatest for brain (+126%) and spine (+74%) imaging; showed milder growth (range, +18% to +67%) for imaging of the head and neck, breast, abdomen and pelvis, and extremity; and showed slight declines (range, -2% to -7%) for cardiac and chest imaging overall. The following specific imaging service families showed massive (> +100%) growth: cardiac CT, cardiac MRI, and breast MRI. NITOS categorization permits identification of temporal shifts in noninvasive diagnostic imaging by specific modality- and region-focused families, providing a granular understanding and reproducible analysis of global changes in imaging overall. Service family-level perspectives may help inform ongoing policy efforts to optimize imaging utilization and appropriateness.

RDI's Wisdom Way Solar Village Final Report: Includes Utility Bill Analysis of Occupied Homes

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

Robb Aldrich, Steven Winter Associates

2011-07-01

In 2010, Rural Development, Inc. (RDI) completed construction of Wisdom Way Solar Village (WWSV), a community of ten duplexes (20 homes) in Greenfield, MA. RDI was committed to very low energy use from the beginning of the design process throughout construction. Key features include: 1. Careful site plan so that all homes have solar access (for active and passive); 2. Cellulose insulation providing R-40 walls, R-50 ceiling, and R-40 floors; 3. Triple-pane windows; 4. Airtight construction (~0.1 CFM50/ft2 enclosure area); 5. Solar water heating systems with tankless, gas, auxiliary heaters; 6. PV systems (2.8 or 3.4kWSTC); 7. 2-4 bedrooms, 1,100-1,700more » ft2. The design heating loads in the homes were so small that each home is heated with a single, sealed-combustion, natural gas room heater. The cost savings from the simple HVAC systems made possible the tremendous investments in the homes' envelopes. The Consortium for Advanced Residential Buildings (CARB) monitored temperatures and comfort in several homes during the winter of 2009-2010. In the Spring of 2011, CARB obtained utility bill information from 13 occupied homes. Because of efficient lights, appliances, and conscientious home occupants, the energy generated by the solar electric systems exceeded the electric energy used in most homes. Most homes, in fact, had a net credit from the electric utility over the course of a year. On the natural gas side, total gas costs averaged $377 per year (for heating, water heating, cooking, and clothes drying). Total energy costs were even less - $337 per year, including all utility fees. The highest annual energy bill for any home evaluated was $458; the lowest was $171.« less

Impact of Rate Design Alternatives on Residential Solar Customer Bills. Increased Fixed Charges, Minimum Bills and Demand-based Rates

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

Bird, Lori; Davidson, Carolyn; McLaren, Joyce

With rapid growth in energy efficiency and distributed generation, electric utilities are anticipating stagnant or decreasing electricity sales, particularly in the residential sector. Utilities are increasingly considering alternative rates structures that are designed to recover fixed costs from residential solar photovoltaic (PV) customers with low net electricity consumption. Proposed structures have included fixed charge increases, minimum bills, and increasingly, demand rates - for net metered customers and all customers. This study examines the electricity bill implications of various residential rate alternatives for multiple locations within the United States. For the locations analyzed, the results suggest that residential PV customers offset,more » on average, between 60% and 99% of their annual load. However, roughly 65% of a typical customer's electricity demand is non-coincidental with PV generation, so the typical PV customer is generally highly reliant on the grid for pooling services.« less

Development of an integrated utilities billing management system for the Navy Public Works Center San Diego, California

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

Monsabert, S. de; Lemmer, H.; Dinwiddie, D.

1995-10-01

In the past, most buildings, structures, and ship visits were not metered, and flat estimates were calculated based on various estimating techniques. The decomposition process was further complicated by the fact that many of the meters monitor consumption values only and do not provide demand or time of use data. This method of billing provides no incentives to the PWC customers to implement energy conservation programs, including load shedding, Energy Monitoring and Control Systems (EMCS), building shell improvements, low flow toilets and shower heads, efficient lighting systems, or other energy savings alternatives. Similarly, the method had no means of adjustmentmore » for seasonal or climatic variations outside of the norm. As an alternative to flat estimates, the Customized Utility Billing Integrated Control (CUBIC) system and the Graphical Data Input System (GDIS) were developed to better manage the data to the major claimant area users based on utilities usage factors, building size, weather data, and hours of operation. GDIS is a graphical database that assists PWC engineers in the development and maintenance of single-line utility diagrams of the facilities and meters. It functions as a drawing associate system and is written in AutoLISP for AutoCAD version 12. GDIS interprets the drawings and provides the facility-to-meter and meter-to-meter hierarchy data that are used by the CUBIC to allocate the billings. This paper reviews the design, development and implementation aspects of CUBIC/GDIS and discusses the benefits of this improved utilities management system.« less

Identifying Inefficient Single-Family Homes With Utility Bill Analysis: Preprint

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

Casey, S.; Krarti, M.; Bianchi, M.

2010-08-01

Differentiating between energy-efficient and inefficient single-family homes on a community scale helps identify and prioritize candidates for energy-efficiency upgrades. Prescreening diagnostic procedures can further retrofit efforts by providing efficiency information before a site-visit is conducted. We applied the prescreening diagnostic to a simulated community of homes in Boulder, Colorado and analyzed energy consumption data to identify energy-inefficient homes.

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

Cascade Apartments: Deep Energy Multifamily Retrofit

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

Gordon, A.; Mattheis, L.; Kunkle, R.

2014-02-01

In December of 2009-10, King County Housing Authority (KCHA) implemented energy retrofit improvements in the Cascade multifamily community, located in Kent, Washington (marine climate.)This research effort involved significant coordination from stakeholders KCHA, WA State Department of Commerce, utility Puget Sound Energy, and Cascade tenants. This report focuses on the following three primary BA research questions : 1. What are the modeled energy savings using DOE low income weatherization approved TREAT software? 2. How did the modeled energy savings compare with measured energy savings from aggregate utility billing analysis? 3. What is the Savings to Investment Ratio (SIR) of the retrofitmore » package after considering utility window incentives and KCHA capitol improvement funding.« less

Cascade Apartments - Deep Energy Multifamily Retrofit , Kent, Washington (Fact Sheet)

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

None, None

2014-02-01

In December of 2009-10, King County Housing Authority (KCHA) implemented energy retrofit improvements in the Cascade multifamily community, located in Kent, Washington (marine climate.)This research effort involved significant coordination from stakeholders KCHA, WA State Department of Commerce, utility Puget Sound Energy, and Cascade tenants. This report focuses on the following three primary BA research questions : 1. What are the modeled energy savings using DOE low income weatherization approved TREAT software? 2. How did the modeled energy savings compare with measured energy savings from aggregate utility billing analysis? 3. What is the Savings to Investment Ratio (SIR) of the retrofitmore » package after considering utility window incentives and KCHA capitol improvement funding.« less

Cascade Apartments: Deep Energy Multifamily Retrofit

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

Gordon, A.; Mattheis, L.; Kunkle, R.

2014-02-01

In December of 2009-10, King County Housing Authority (KCHA) implemented energy retrofit improvements in the Cascade multifamily community, located in Kent, Washington (marine climate.)This research effort involved significant coordination from stakeholders KCHA, WA State Department of Commerce, utility Puget Sound Energy, and Cascade tenants. This report focuses on the following three primary BA research questions: 1. What are the modeled energy savings using DOE low income weatherization approved TREAT software? 2. How did the modeled energy savings compare with measured energy savings from aggregate utility billing analysis? 3. What is the Savings to Investment Ratio (SIR) of the retrofit packagemore » after considering utility window incentives and KCHA capitol improvement funding.« less

There Oughta Be a Law.

ERIC Educational Resources Information Center

Lamkin, Leslie

1991-01-01

This article provides descriptions of various aspects of the three comprehensive energy bills pending before the U.S. Congress. All three bills assign nuclear energy a prominent role through support of the electric utility industry's stated goal of ordering a new nuclear energy plant by the mid-1990s. (JJK)

Model Legislation: Gifted and Talented.

ERIC Educational Resources Information Center

Foster, Andrew H.; And Others

This report presents a model state legislative bill to provide for the special needs of gifted and talented students. The model bill utilizes a "best practices" framework and attempts to be fiscally responsible and provide maximum flexibility while meeting the needs of gifted and talented students. The model legislation itself begins with a…

An Analysis of the Economic Effects of U.S. Energy Efficiency Standards

DTIC Science & Technology

1991-06-01

effect, with a supporting income effect. [Ref. 5:pg. 94] A recent study, by Hurst and White, highlights this consumer behavior and outlines the difficulty...of correlating economic savings from energy efficiency to consumer behavior . (Ref. 6:pg. 31] Conclusions from the study revealed that, on average... consumer behavior , utilities had developed consumer rebate programs rewarding efficient appliance purchasers with discounts on their monthly bills. [Ref

The Women in the Army Study Group

DTIC Science & Technology

1976-12-01

stereotypes (e.g., women belong in the home) and attitudes toward competency in women (e.g., women cannot do men’s work), are external to woman...governing the utilization of women. The responses were analyzed on an individual and collective basis with a view toward extracting unique...reviewed to include an analysis of the United States Congress view toward women in combat services as expressed in hearings on all major bills

New workers' compensation legislation: expected pharmaceutical cost savings.

PubMed

Wilson, Leslie; Gitlin, Matthew

2005-10-01

California Workers' Compensation (WC) system costs are under review. With recently approved California State Assembly Bill (AB) 749 and Senate Bill (SB) 228, an assessment of proposed pharmaceutical cost savings is needed. A large workers' compensation database provided by the California Workers' Compensation Institute (CWCI) and Medi-Cal pharmacy costs obtained from the State Drug Utilization Project are utilized to compare frequency, costs and savings to Workers' Compensation in 2002 with the new pharmacy legislation. Compared to the former California Workers' Compensation fee schedule, the newly implemented 100% Medi-Cal fee schedule will result in savings of 29.5% with a potential total pharmacy cost savings of $125 million. Further statistical analysis demonstrated that a large variability in savings across drugs could not be controlled with this drug pricing system. Despite the large savings in pharmaceuticals, inconsistencies between the two pharmaceutical payment systems could lead to negative incentives and uncertainty for long-term savings. Proposed alternative pricing systems could be considered. However, pain management implemented along with other cost containment strategies could more effectively reduce overall drug spending in the workers' compensation system.

Utilities on the info highway: Part two

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

Burkhart, L.A.

1994-05-15

This article describes federal government legislation to allow electric and gas utilities to provide telecommunications services. The final law will probably allow all utilities to provide telecommunication services, even those regulated by PUHCA. Details of House and Senate bills are described.

Culturally Responsive Collegiate Mathematics Education: Implications for African American Students

ERIC Educational Resources Information Center

Jett, Christopher C.

2013-01-01

In this article, the author utilizes the culturally congruent work of Gay (2010) and Ladson-Billings (2009) to highlight culturally responsive teaching as a viable option for African American students in higher education mathematics spaces. He offers translations of Gay and Ladson-Billings' work to Africana mathematics and argues that these…

Existing Whole-House Solutions Case Study: Bay Ridge Gardens - Mixed Humid Affordable Multifamily Housing Deep Energy Retrofit, Annapolis, Maryland

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

None

2013-10-01

Under this project, the BA-PIRC research team evaluated the installation, measured performance, and cost-effectiveness of efficiency upgrade measures for a tenant-in-place deep energy retrofit at the Bay Ridge multifamily development in Annapolis, Maryland. The design and construction phase of the Bay Ridge project was completed in August 2012. This case study summarizes system commissioning, short-term test results, utility bill data analysis, and analysis of real-time data collected over a one-year period after the retrofit was complete.

Uncertainties in the Value of Bill Savings from Behind-the-Meter, Residential Photovoltaic Systems: The Roles of Electricity Market Conditions, Retail Rate Design, and Net Metering

NASA Astrophysics Data System (ADS)

Darghouth, Naim Richard

Net metering has become a widespread policy mechanism in the U.S. for supporting customer adoption of distributed photovoltaics (PV), allowing customers with PV systems to reduce their electric bills by offsetting their consumption with PV generation, independent of the timing of the generation relative to consumption. Although net metering is one of the principal drivers for the residential PV market in the U.S., the academic literature on this policy has been sparse and this dissertation contributes to this emerging body of literature. This dissertation explores the linkages between the availability of net metering, wholesale electricity market conditions, retail rates, and the residential bill savings from behind-the-meter PV systems. First, I examine the value of the bill savings that customers receive under net metering and alternatives to net metering, and the associated role of retail rate design, based on current rates and a sample of approximately two hundred residential customers of California's two largest electric utilities. I find that the bill savings per kWh of PV electricity generated varies greatly, largely attributable to the increasing block structure of the California utilities' residential retail rates. I also find that net metering provides significantly greater bill savings than alternative compensation mechanisms based on avoided costs. However, retail electricity rates may shift as wholesale electricity market conditions change. I then investigate a potential change in market conditions -- increased solar PV penetrations -- on wholesale prices in the short-term based on the merit-order effect. This demonstrates the potential price effects of changes in market conditions, but also points to a number of methodological shortcomings of this method, motivating my usage of a long-term capacity investment and economic dispatch model to examine wholesale price effects of various wholesale market scenarios in the subsequent analysis. By developing three types of retail rates (a flat rate, a time-of-use rate, and real-time pricing) from these wholesale price profiles, I examine bill savings from PV generation for the ten wholesale market scenarios under net metering and an alternative to net metering where hourly excess PV generation is compensated at the wholesale price. Most generally, I challenge the common assertion that PV compensation is likely to stay constant (or rise) due to constant (or rising) retail rates, and find that future electricity market scenarios can drive substantial changes in residential retail rates and that these changes, in concert with variations in retail rate structures and PV compensation mechanisms, interact to place substantial uncertainty on the future value of bill savings from residential PV.

Medicare Utilization of Vertebral Augmentation 2001 to 2014: Effects of Randomized Clinical Trials and Guidelines on Vertebroplasty and Kyphoplasty.

PubMed

Degnan, Andrew J; Hemingway, Jennifer; Hughes, Danny R

2017-08-01

Vertebral fractures have a substantial impact on the health and quality of life of elderly individuals as one of the most common complications of osteoporosis. Vertebral augmentation procedures including vertebroplasty and kyphoplasty have been supported as means of reducing pain and mitigating disability associated with these fractures. However, use of vertebroplasty is debated, with negative randomized controlled trials published in 2009 and divergent clinical guidelines. The effect of changing evidence and guidelines on different practitioners' utilization of both kyphoplasty and vertebroplasty in the years after these developments and publication of data supporting their use is poorly understood. Using national aggregate Medicare claims data from 2002 through 2014, vertebroplasty and kyphoplasty procedures were identified by provider type. Changes in utilization by procedure type and provider were studied. Total vertebroplasty billing increased 101.6% from 2001 (18,911) through 2008 (38,123). Total kyphoplasty billing frequency increased 17.2% from 2006 (54,329) through 2008 (63,684). Vertebroplasty billing decreased 60.9% from 2008 through 2014 to its lowest value (14,898). Kyphoplasty billing decreased 8.4% from 2008 (63,684) through 2010 (58,346), but then increased 7.6% from 2010 to 2013 (62,804). Vertebroplasty billing decreased substantially beginning in 2009 and continued to decrease through 2014 despite publication of more favorable studies in 2010 to 2012, suggesting studies published in 2009 and AAOS guidelines in 2010 may have had a persistent negative effect. Kyphoplasty did not decrease as substantially and increased in more recent years, suggesting a clinical practice response to favorable studies published during this period. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Predicting hospital accounting costs

PubMed Central

Newhouse, Joseph P.; Cretin, Shan; Witsberger, Christina J.

1989-01-01

Two alternative methods to Medicare Cost Reports that provide information about hospital costs more promptly but less accurately are investigated. Both employ utilization data from current-year bills. The first attaches costs to utilization data using cost-charge ratios from the previous year's cost report; the second uses charges from current year's bills. The first method is the more accurate of the two, but even using it, only 40 percent of hospitals had predicted costs within plus or minus 5 percent of actual costs. The feasibility and cost of obtaining cost reports from a small, fast-track sample of hospitals should be investigated. PMID:10313352

Proven Performance of Seven Cold Climate Deep Retrofit Homes

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

Osser, R.; Neuhauser, K.; Ueno, K.

2012-06-01

Seven test homes located in Massachusetts are examined within this report. The retrofit strategies of each home are presented along with a comparison of the pre- and post-retrofit airtightness achieved by the group. Pre- and post-retrofit utility bills were collected; energy models were used to estimate pre-retrofit energy use when bills were unavailable.

AWARE@HOME: PROFITABLY INTEGRATING CONSERVATION INTO THE AMERICAN HOME

EPA Science Inventory

While American households are the most resource consuming in the world, they are unlikely to become more efficient users of public utilities because of: 1) large time delays between utility use and the receipt of utility bills; 2) the inconvenience of personally checking and ...

75 FR 44781 - Commission Information Collection Activities (FERC-582); Comment Request; Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-29

... ``Report/Form/ Annual Charges Report.'' Public utilities and power marketers subject to these annual... Commission issues bills for annual charges, and public utilities and power marketers then must pay the...

New Whole-House Solutions Case Study: Low-Cost Evaluation of Energy Savings at the Community Scale - Fresno, California

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

None

2014-10-01

In this project, IBACOS partnered with builder Wathen-Castanos Hybrid Homes to develop a simple and low-cost methodology by which community-scale energy savings can be evaluated based on results at the occupied test house level.Research focused on the builder and trade implementation of a whole-house systems integrated measures package and the actual utility usage in the houses at the community scale of production. Five occupants participated in this community-scale research by providing utility bills and information on occupancy and miscellaneous gas and electric appliance use for their houses. IBACOS used these utility data and background information to analyze the actual energymore » performance of the houses. Verification with measured data is an important component in predictive energy modeling. The actual utility bill readings were compared to projected energy consumption using BEopt with actual weather and thermostat set points for normalization.« less

Service Networks and Patterns of Utilization: Mental Health Programs, Indian Health Service (IHS). Volume 5: Billings Area, 1963-1973.

ERIC Educational Resources Information Center

Attneave, Carolyn L.; Beiser, Morton

The fifth volume in a 10-volume report on the historical development (1966-1973) of the 8 administrative Area Offices of the Indian Health Service (IHS) Mental Health Programs, this report presents information on the Billings Area Office. Included in this document are: (1) General Description (geography, demography, and transportation facilities…

Field evaluation and assessment of thermal energy storage for residential space heating

NASA Astrophysics Data System (ADS)

Hersh, H. N.

1982-02-01

A data base was developed based on two heating seasons and 45 test and 30 control homes in Maine and Vermont. Based on first analysis of monitored temperatures and electrical energy used for space heating, fuel bills and reports of users and utilities, the technical performance of TES ceramic and hydronic systems is deemed to be technically satisfactory and there is a high degree of customer acceptance and positive attitudes towards TES. Analysis of house data shows a high degree of variability in electric heat energy demand for a given degree-day. An analysis is underway to investigate relative differences in the efficiency of electricity utilization of storage and direct heating devices. The much higher price of storge systems relative to direct systems is an impediment to market penetration. A changing picture of rate structures may encourage direct systems at the expense of storage systems.

AB 1725: A Comprehensive Analysis.

ERIC Educational Resources Information Center

California Community Colleges, Sacramento. Board of Governors.

A summary and analysis is provided of California Assembly Bill (AB) 1725, a reform bill that provides new direction and support for the state's community colleges. The analysis addresses each of the eight sections of the bill: (1) mission, highlighting reforms related to mission statements, transfer core curriculum, remedial limits, articulation…

Portable XRF and principal component analysis for bill characterization in forensic science.

PubMed

Appoloni, C R; Melquiades, F L

2014-02-01

Several modern techniques have been applied to prevent counterfeiting of money bills. The objective of this study was to demonstrate the potential of Portable X-ray Fluorescence (PXRF) technique and the multivariate analysis method of Principal Component Analysis (PCA) for classification of bills in order to use it in forensic science. Bills of Dollar, Euro and Real (Brazilian currency) were measured directly at different colored regions, without any previous preparation. Spectra interpretation allowed the identification of Ca, Ti, Fe, Cu, Sr, Y, Zr and Pb. PCA analysis separated the bills in three groups and subgroups among Brazilian currency. In conclusion, the samples were classified according to its origin identifying the elements responsible for differentiation and basic pigment composition. PXRF allied to multivariate discriminate methods is a promising technique for rapid and no destructive identification of false bills in forensic science. Copyright © 2013 Elsevier Ltd. All rights reserved.

Multidose Botulinum Toxin A for Intralaryngeal Injection: A Cost Analysis.

PubMed

Gilbert, Mark R; Young, VyVy N; Smith, Libby J; Rosen, Clark A

2018-01-04

Botulinum toxin A (BtxA) injection is the mainstay treatment for laryngeal dystonias. BtxA product labeling states that reconstituted toxin should be used within 4 hours on a single patient despite several studies that have demonstrated multidose BtxA to be safe and effective. Many insurance carriers mandate the use of an outside pharmacy which necessitates a single-use approach. This study compares the cost savings of multidose BtxA for laryngeal dystonia compared to single-use. This is a retrospective review and projected cost savings analysis. Records and billing information were reviewed for patients receiving BtxA for intralaryngeal injection at a single laryngology division in 2015. Inclusion criteria included CPT 64617 or J0585; exclusion criteria included CPT 64616. The price of BtxA 100 unit vial for calculation was $670. A total of 142 patients were seen for intralaryngeal BtxA injection resulting in 337 visits over 1 year. The average BtxA dose per visit was 2.86 units with an average of 3.06 procedure visits per year. The calculated cost of BtxA treatment using a single vial approach was found to be $2,050 per patient per year. If billed instead for $7/unit with 5 units wastage charge per visit, the yearly per patient charge is $168. Single vial-use of BtxA injection thus represents a 1,118% price increase versus multidose use. When estimated for yearly prevalence of spasmodic dysphonia, multidose BtxA use would save almost $100 million annually. Multidose botulinum toxin A application utilizing per unit billing is significantly less expensive than per single-use vial billing and would save the health-care system significant amount of money without any sacrifice in safety or effectiveness. Copyright © 2018. Published by Elsevier Inc.

Student Veterans' College Experiences: Demographic Comparisons, Differences in Academic Experiences, and On-Campus Service Utilization

ERIC Educational Resources Information Center

Cate, Chris Andrew

2011-01-01

Background: The GI Bill has given United States military veterans the opportunity to afford and enroll in colleges and universities for nearly seventy years. In the Fall of 2009, the Post-9/11 GI Bill started helping a new generation of student veterans pay for their post-secondary education and earn degrees and certificates. The Post-9/11 GI Bill…

Fidelity and persistence of Ring-billed (Larus delawarensis) and Herring (Larus argentatus) gulls to wintering sites

USGS Publications Warehouse

Clark, Daniel E.; Koenen, Kiana K. G.; Whitney, Jillian J.; MacKenzie, Kenneth G.; DeStefano, Stephen

2016-01-01

While the breeding ecology of gulls (Laridae) has been well studied, their movements and spatial organization during the non-breeding season is poorly understood. The seasonal movements, winter-site fidelity, and site persistence of Ring-billed (Larus delawarensis) and Herring (L. argentatus) gulls to wintering areas were studied from 2008–2012. Satellite transmitters were deployed on Ring-billed Gulls (n = 21) and Herring Gulls (n = 14). Ten Ring-billed and six Herring gulls were tracked over multiple winters and > 300 wing-tagged Ring-billed Gulls were followed to determine winter-site fidelity and persistence. Home range overlap for individuals between years ranged between 0–1.0 (95% minimum convex polygon) and 0.31–0.79 (kernel utilization distributions). Ringbilled and Herring gulls remained at local wintering sites during the non-breeding season from 20–167 days and 74–161 days, respectively. The probability of a tagged Ring-billed Gull returning to the same site in subsequent winters was high; conversely, there was a low probability of a Ring-billed Gull returning to a different site. Ring-billed and Herring gulls exhibited high winter-site fidelity, but exhibited variable site persistence during the winter season, leading to a high probability of encountering the same individuals in subsequent winters.

Existing Whole-House Solutions Case Study: Cascade Apartments - Deep Energy Multifamily Retrofit

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

None

2014-02-01

In December of 2009-10, King County Housing Authority (KCHA) implemented energy retrofit improvements in the Cascade multifamily community, located in Kent, Washington, which resulted in annual energy cost savings of 22%, improved comfort and air quality for residents, and increased durability of the units. This research effort involved significant coordination from stakeholders KCHA, WA State Department of Commerce, utility Puget Sound Energy, and Cascade tenants. This report focuses on the following three primary Building America research questions: 1. What are the modeled energy savings using DOE low income weatherization approved TREAT software? 2. How did the modeled energy savings comparemore » with measured energy savings from aggregate utility billing analysis? 3. What is the Savings to Investment Ratio of the retrofit package after considering utility window incentives and KCHA capital improvement funding.« less

Tradeoffs of Using Administrative Claims and Medical Records to Identify the Use of Personalized Medicine for Patients with Breast Cancer

PubMed Central

Liang, Su-Ying; Phillips, Kathryn A.; Wang, Grace; Keohane, Carol; Armstrong, Joanne; Morris, William M.; Haas, Jennifer S.

2012-01-01

Background Administrative claims and medical records are important data sources to examine healthcare utilization and outcomes. Little is known about identifying personalized medicine technologies in these sources. Objectives To describe agreement, sensitivity, and specificity of administrative claims compared to medical records for two pairs of targeted tests and treatments for breast cancer. Research Design Retrospective analysis of medical records linked to administrative claims from a large health plan. We examined whether agreement varied by factors that facilitate tracking in claims (coding and cost) and that enhance medical record completeness (records from multiple providers). Subjects Women (35 – 65 years) with incident breast cancer diagnosed in 2006–2007 (n=775). Measures Use of human epidermal growth factor receptor 2 (HER2) and gene expression profiling (GEP) testing, trastuzumab and adjuvant chemotherapy in claims and medical records. Results Agreement between claims and records was substantial for GEP, trastuzumab, and chemotherapy, and lowest for HER2 tests. GEP, an expensive test with unique billing codes, had higher agreement (91.6% vs. 75.2%), sensitivity (94.9% vs. 76.7%), and specificity (90.1% vs. 29.2%) than HER2, a test without unique billing codes. Trastuzumab, a treatment with unique billing codes, had slightly higher agreement (95.1% vs. 90%) and sensitivity (98.1% vs. 87.9%) than adjuvant chemotherapy. Conclusions Higher agreement and specificity were associated with services that had unique billing codes and high cost. Administrative claims may be sufficient for examining services with unique billing codes. Medical records provide better data for identifying tests lacking specific codes and for research requiring detailed clinical information. PMID:21422962

Providing for consideration of the bill (H.R. 3826) to provide direction to the Administrator of the Environmental Protection Agency regarding the establishment of standards for emissions of any greenhouse gas from fossil fuel-fired electric utility generating units, and for other purposes, and providing for consideration of the bill (H.R. 4118) to amend the Internal Revenue Code of 1986 to delay the implementation of the penalty for failure to comply with the individual health insurance mandate.

THOMAS, 113th Congress

Rep. Burgess, Michael C. [R-TX-26

2014-03-04

House - 03/05/2014 On agreeing to the resolution Agreed to by recorded vote: 228 - 182 (Roll no. 94). (All Actions) Tracker: This bill has the status Agreed to in HouseHere are the steps for Status of Legislation:

Economic impact of dental hygienists on solo dental practices.

PubMed

Lazar, Vickie F; Guay, Albert H; Beazoglou, Tryfon J

2012-08-01

The fact that a significant percentage of dentists employ dental hygienists raises an important question: Are dental practices that utilize a dental hygienist structurally and operationally different from practices that do not? This article explores differences among dental practices that operate with and without dental hygienists. Using data from the American Dental Association's 2003 Survey of Dental Practice, a random sample survey of U.S. dentists, descriptive statistics were used to compare selected characteristics of solo general practitioners with and without dental hygienists. Multivariate regression analysis was used to estimate the effect of dental hygienists on the gross billings and net incomes of solo general practitioners. Differences in practice characteristics--such as hours spent in the practice and hours spent treating patients, wait time for a recall visit, number of operatories, square feet of office space, net income, and gross billings--were found between solo general practitioners who had dental hygienists and those who did not. Solo general practitioners with dental hygienists had higher gross billings. Higher gross billings would be expected, as would higher expenses. However, net incomes of those with dental hygienists were also higher. In contrast, the mean waiting time for a recall visit was higher among dentists who employed dental hygienists. Depending on personal preferences, availability of qualified personnel, etc., dentists who do not employ dental hygienists but have been contemplating that path may want to further research the benefits and opportunities that may be realized.

Energy survey study and report of hospitals in Chicago: Saint Anthony Hospital: Appendix A: Part 2, Final report

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

Not Available

1988-08-01

This study is part of a three-phased demonstration program to reduce energy consumption in hospitals through practical life-cycle/cost-effective modifications and alterations. Funds for the demonstration program are being provided by the American Hospital Association (AHA), the Department of Energy (DOE), and the Department of Health and Human Services (DHHS). A thorough study and evaluation of all building systems is made to identify the most cost effective approaches to energy conservation. The primary objective of the study is to investigate and analyze energy usage of the facility and to identify all life cycle, cost-effective changes required to effect a reduction inmore » energy consumption. On November 2, 1987, Consulting Consortium, Inc., was instructed to proceed with this analysis. Initial meetings were arranged with the hospital administrators to convey the purpose of the study and to request utility billing data, small scale floor plans of the facility, and to arrange for engineering walk-through surveys. The survey at St. Anthony was initiated on December 8, 1987. This report summarizes the findings together with data and information gathered during the course of that visit and other subsequent visits. This report describes the architectural, mechanical and electrical systems of the Saint Anthony Hospital. In addition, an analysis of the base year energy usage as derived from utility bills and statement of the current energy consumption trends for the hospital, and a list of recommendations for reducing energy consumption is included.« less

Air Distribution Retrofit Strategies for Affordable Housing

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

Dentz, Jordan; Conlin, Francis; Holloway, Parker

2014-03-01

In multifamily and attached buildings, traditional duct sealing methods are often impractical or costly and disruptive because of the difficulty in accessing leakage sites. In this project, two retrofit duct sealing techniques -- manually-applied sealants and injecting a spray sealant, were implemented in several low-rise multi-unit buildings. An analysis on the cost and performance of the two methods are presented. Each method was used in twenty housing units: approximately half of each group of units are single story and the remainder two-story. Results show that duct leakage to the outside was reduced by an average of 59% through the usemore » of manual methods, and by 90% in the units where the injected spray sealant was used. It was found that 73% of the leakage reduction in homes that were treated with injected spray sealant was attributable to the manual sealing done at boots, returns and the air handler. The cost of manually-applying sealant ranged from $275 to $511 per unit and for the injected spray sealant the cost was $700 per unit. Modeling suggests a simple payback of 2.2 years for manual sealing and 4.7 years for the injected spray sealant system. Utility bills were collected for one year before and after the retrofits. Utility bill analysis shows 14% and 16% energy savings using injected spray sealant system and hand sealing procedure respectively in heating season whereas in cooling season, energy savings using injected spray sealant system and hand sealing were both 16%.« less

Air Distribution Retrofit Strategies for Affordable Housing

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

Dentz, J.; Conlin, F.; Holloway, Parker

2014-03-01

In multifamily and attached buildings, traditional duct sealing methods are often impractical or costly and disruptive because of the difficulty in accessing leakage sites. In this project, two retrofit duct sealing techniques, manually-applied sealants and injecting a spray sealant, were implemented in several low-rise multiunit buildings. An analysis on the cost and performance of the two methods are presented. Each method was used in twenty housing units: approximately half of each group of units are single story and the remainder are two story. Results show that duct leakage to the outside was reduced by an average of 59% through themore » use of manual methods, and by 90% in the units where the injected spray sealant was used. It was found that 73% of the leakage reduction in homes that were treated with injected spray sealant was attributable to the manual sealing done at boots, returns and the air handler. The cost of manually-applying sealant ranged from $275 to $511 per unit and for the injected spray sealant the cost was $700 per unit. Modeling suggests a simple payback of 2.2 years for manual sealing and 4.7 years for the injected spray sealant system. Utility bills were collected for one year before and after the retrofits. Utility bill analysis shows 14% and 16% energy savings using injected spray sealant system and hand sealing procedure respectively in heating season whereas in cooling season, energy savings using injected spray sealant system and hand sealing were both 16%.« less

The School Facilities Children Are Forced to Attend.

ERIC Educational Resources Information Center

Hansen, Shirley J.

1993-01-01

As many as 25% of American school buildings are inadequate. However, many districts have reduced maintenance to pay utility bills. An active energy-management program can lower utility costs through efficient operation and maintenance practices and retrofits that pay back in less than three years. (MLF)

DOE Zero Energy Ready Home Case Study: Greenhill Contracting, Inc., Hickory Ridge

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

Pacific Northwest National Laboratory

Greenhill Contracting built this 3,912-ft2 house in Gardiner, New York, to the high-performance criteria of the DOE Zero Energy Ready Home (ZERH) program. A highly efficient air-source heat pump heats and cools the home’s interior, while the roof-mounted photovoltaic system offsets electricity usage to cut energy bills to nearly zero. Many months the home owners see a credit on their utility bill.

Evaluation of Savings in Energy-Efficient Public Housing in the Pacific Northwest

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

None

2013-10-01

This report presents the results of an energy performance and cost-effectiveness analysis. The Salishan phase 7 and demonstration homes were compared to Salishan phase 6 homes built to 2006 Washington State Energy Code specifications 2. Predicted annual energy savings (over Salishan phase 6) was 19% for Salishan phase 7, and between 19-24% for the demonstration homes (depending on ventilation strategy). Approximately two-thirds of the savings are attributable to the DHP. Working with the electric utility provider, Tacoma Public Utilities, researchers conducted a billing analysis for Salishan phase 7. Median energy use for the development is 11,000 kWh; annual energy costsmore » are $780, with a fair amount of variation dependent on size of home. Preliminary analysis of savings between Salishan 7 and previous phases (4 through 6) suggest savings of between 20 and 30 percent. A more comprehensive comparison between Salishan 7 and previous phases will take place in year two of this project.« less

Evaluation of Savings in Energy-Efficient Public Housing in the Pacific Northwest

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

Gordon, A.; Lubliner, M.; Howard, L.

2013-10-01

This report presents the results of an energy performance and cost-effectiveness analysis. The Salishan phase 7 and demonstration homes were compared to Salishan phase 6 homes built to 2006 Washington State Energy Code specifications 2. Predicted annual energy savings (over Salishan phase 6) was 19% for Salishan phase 7, and between 19-24% for the demonstration homes (depending on ventilationstrategy). Approximately two-thirds of the savings are attributable to the DHP. Working with the electric utility provider, Tacoma Public Utilities, researchers conducted a billing analysis for Salishan phase 7. Median energy use for the development is 11,000 kWh; annual energy costs aremore » $780, with a fair amount of variation dependent on size of home. Preliminary analysis of savings betweenSalishan 7 and previous phases (4 through 6) suggest savings of between 20 and 30 percent. A more comprehensive comparison between Salishan 7 and previous phases will take place in year two of this project.« less

The Relationships between Morphological Characteristics and Foraging Behavior in Four Selected Species of Shorebirds and Water Birds Utilizing Tropical Mudflats

PubMed Central

Norazlimi, Nor Atiqah; Ramli, Rosli

2015-01-01

A study was conducted to investigate the relationship between the physical morphology of shorebirds and water birds (i.e., Lesser adjutant (Leptoptilos javanicus), Common redshank (Tringa totanus), Whimbrel (Numenius phaeopus), and Little heron (Butorides striata)) and their foraging behavior in the mudflats area of Selangor, Peninsular Malaysia, from August 2013 to July 2014 by using direct observation techniques (using binoculars and a video recorder). The actively foraging bird species were watched, and their foraging activities were recorded for at least 30 seconds for up to a maximum of five minutes. A Spearman Rank Correlation highlighted a significant relationship between bill size and foraging time (R = 0.443, p < 0.05), bill size and prey size (R = −0.052, p < 0.05), bill size and probing depth (R = 0.42, p = 0.003), and leg length and water/mud depth (R = 0.706, p < 0.005). A Kruskal-Wallis Analysis showed a significant difference between average estimates of real probing depth of the birds (mm) and species (H = 15.96, p = 0.0012). Three foraging techniques were recorded: pause-travel, visual-feeding, and tactile-hunting. Thus, morphological characteristics of bird do influence their foraging behavior and strategies used when foraging. PMID:26345324

Recovery of Utility Fixed Costs: Utility, Consumer, Environmental and Economist Perspectives

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

Wood, Lisa; Hemphill, Ross; Howat, John

Utilities recover costs for providing electric service to retail customers through a combination of rate components that together comprise customers’ monthly electric bills. Rates and rate designs are set by state regulators and vary by jurisdiction, utility and customer class. In addition to the fundamental tenet of setting fair and reasonable rates, rate design balances economic efficiency, equity and fairness, customer satisfaction, utility revenue stability, and customer price and bill stability.1 At the most basic level, retail electricity bills in the United States typically include a fixed monthly customer charge — a set dollar amount regardless of energy usage —more » and a volumetric energy charge for each kilowatt-hour consumed.2 The energy charge may be flat across all hours, vary by usage level (for example, higher rates at higher levels of usage), or vary based on time of consumption.3 While some utility costs, such as fuel costs, clearly vary according to electricity usage, other costs are “fixed” over the short run — generally, those that do not vary over the course of a year. Depending on your point of view, and whether the state’s electricity industry has been restructured or remains vertically integrated, the set of costs that are “fixed” may be quite limited. Or the set may extend to all capacity costs for generation, transmission and distribution. In the long run, all costs are variable. In the context of flat or declining loads in some regions, utilities are proposing a variety of changes to retail rate designs, particularly for residential customers, to recover fixed costs. In this report, authors representing utility (Chapter 1), consumer (Chapter 2), environmentalist (Chapter 3) and economist (Chapter 4) perspectives discuss fixed costs for electric utilities and set out their principles for recovering those costs. The table on the next page summarizes each author’s relative preferences for various options for fixed cost recovery, some of which may be used in combination.4 The specific design of any ratemaking option matters crucially, so a general preference for a given option does not indicate support for any particular application.« less

The analysis of Taiwan's residential electricity demand under the electricity tariff policy

NASA Astrophysics Data System (ADS)

Chen, Po-Jui

In October 2013, the Taiwan Power Company (Taipower), the monopolized state utility service in Taiwan, implemented an electricity tariff adjustment policy to reduce residential electricity demand. Using bi-monthly billing data from 6,932 electricity consumers, this study examine how consumers respond to an increase in electricity prices. This study employs an empirical approach that takes advantage of quasi-random variation over a period of time when household bills were affected by a change in electricity price. The study found that this price increase caused a 1.78% decline in residential electricity consumption, implying a price elasticity of -0.19 for summer-season months and -0.15 for non-summer-season months. The demand for electricity is therefore relatively inelastic, likely because it is hard for people to change their electricity consumption behavior in the short-term. The results of this study highlight that demand-side management cannot be the only lever used to address Taiwan's forecasted decrease in electricity supply.

Measuring Humidity in the Charters of Freedom Encasements Using a Moisture Condensation Method

NASA Technical Reports Server (NTRS)

Burkett, Cecil G.; West, James W.; Levine, Joel S.

2004-01-01

The relative humidity of the atmosphere in the encasements containing the U.S. Constitution Pages 1 and 4, the Declaration of Independence, and the Bill of Rights was measured to be in the range of 55% to 61%. This value is significantly higher than the presumed relative humidity between 25 to 35 %, but is consistent with the measured samples extracted from Pages 2 and 3 of the U.S. Constitution. The cooling/condensation measurement technique used at NARA on July 23, 2001, and described in this paper to measure the water vapor content of the atmosphere in the hermetically sealed encasements containing the U. S. Constitution, the Declaration of Independence, and the Bill of Rights, proved to be a powerful new measurement technique. The cooling/condensation technique developed at NASA LaRC and utilized at NARA has important applications in the non-invasive measurement of relative humidity in the atmospheres of sealed encasements and could become a standard measurement technique in this type of analysis.

Customer Engagement in AEP gridSMART Residential Transactive System

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

Widergren, Steven E.; Marinovici, Maria C.; Fuller, Jason C.

— In 2013, AEP Ohio (AEP) operated a 5-minute real-time price (RTP) electricity market system on 4 distribution feeders as part of their gridSMART® demonstration project. The RTP households were billed for their electricity usage according to an RTP tariff approved by the Public Utility Commission of Ohio. They were given the incentive that their annual bill would be no greater than if they were on the flat-rate tariff, but they had financial incentives to shift consumption from high price periods to low price periods. Incentives were also available for response under high prices from local events, such as reachingmore » the distribution feeder capacity or a critical peak pricing event. An analysis of this transactive system experiment was completed in early 2014. This paper describes the incentive provided to the customer, the nature of their interaction with the smart thermostat that provided automated response to the transactive signal, and their level of satisfaction with the program.« less

Birth of the Four-Day Work Week.

ERIC Educational Resources Information Center

Hellyer, Lyle

Indian Hills Community College, faced with rising utility bills dues to inadequate insulation in the campus's older buildings, now utilizes a four-day week during the winter quarter as an energy conservation measure. Planning for the implementation of the four-day week, which began in 1976, was coordinated by an overall energy committee made up of…

76 FR 65196 - Privacy Act of 1974; Report of a New Routine Use for Selected CMS System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-20

... Medicare beneficiaries. This system utilizes data extraction tools to support accessing data by chronic... system is to collect and maintain billing and utilization data on Medicare beneficiaries enrolled in... Medicare program. 2. ``Medicare Drug Data Processing System (DDPS),'' System No. 09- 70-0553, last...

42 CFR 1007.1 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... context: Data mining is defined as the practice of electronically sorting Medicaid or other relevant data... and relationships within that data to identify aberrant utilization, billing, or other practices that...

42 CFR 1007.1 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... context: Data mining is defined as the practice of electronically sorting Medicaid or other relevant data... and relationships within that data to identify aberrant utilization, billing, or other practices that...

Low-Income Community Solar: Utility Return Considerations for Electric Cooperatives

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

Aznar, Alexandra Y; Gagne, Douglas A

The objective of this short report is to identify project structures that make low-income community solar projects more cost-effective, replicable, and scalable, for electric cooperative and municipal utilities. This report explores the tradeoffs between providing energy bill savings for low-income subscribers and utility project returns, as well as some of the key lessons learned from existing successful low-income community solar pilot projects.

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

Ruth, M.; Pratt, A.; Lunacek, M.

The combination of distributed energy resources (DER) and retail tariff structures to provide benefits to both utility consumers and the utilities is not well understood. To improve understanding, an Integrated Energy System Model (IESM) is being developed to simulate the physical and economic aspects of DER technologies, the buildings where they reside, and feeders servicing them. The IESM was used to simulate 20 houses with home energy management systems on a single feeder under a time-of-use (TOU) tariff to estimate economic and physical impacts on both the households and the distribution utilities. Home energy management systems (HEMS) reduce consumers’ electricmore » bills by precooling houses in the hours before peak electricity pricing. Utilization of HEMS reduce peak loads during high price hours but shifts it to hours with off-peak and shoulder prices, resulting in a higher peak load. used to simulate 20 houses with home energy management systems on a single feeder under a time-of-use (TOU) tariff to estimate economic and physical impacts on both the households and the distribution utilities. Home energy management systems (HEMS) reduce consumers’ electric bills by precooling houses in the hours before peak electricity pricing. Utilization of HEMS reduce peak loads during high price hours but shifts it to hours with off-peak and shoulder prices, resulting in a higher peak load.« less

Suicide rates in Canada before and after tightening firearm control laws.

PubMed

Lester, D; Leenaars, A

1993-06-01

In Canada, Bill C-51 was implemented in 1977 to restrict the use of firearms, providing a good opportunity to study the effects of gun control laws in the use of firearms for suicide. The present study examined the use of guns for suicide during the period prior to the bill and during the period after the passing of Bill C-51 to assess the association of the bill with suicide rates. Analysis showed a significant decreasing trend after passage of Bill C-51 on the firearm suicide rate in Canada and the percentage of suicides using firearms. The analysis supports the position that restricting easy access to lethal methods of suicide may assist in reducing suicide.

Ducts Sealing Using Injected Spray Sealant, Raleigh, North Carolina (Fact Sheet)

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

None, None

2014-03-01

In multifamily and attached buildings, traditional duct sealing methods are often impractical or costly and disruptive because of the difficulty in accessing leakage sites. In this project, two retrofit duct sealing techniques - manually-applied sealants and injecting a spray sealant, were implemented in several low-rise multi-unit buildings. An analysis on the cost and performance of the two methods are presented. Each method was used in twenty housing units: approximately half of each group of units are single story and the remainder two-story. Results show that duct leakage to the outside was reduced by an average of 59% through the usemore » of manual methods, and by 90% in the units where the injected spray sealant was used. It was found that 73% of the leakage reduction in homes that were treated with injected spray sealant was attributable to the manual sealing done at boots, returns and the air handler. The cost of manually-applying sealant ranged from $275 to $511 per unit and for the injected spray sealant the cost was $700 per unit. Modeling suggests a simple payback of 2.2 years for manual sealing and 4.7 years for the injected spray sealant system. Utility bills were collected for one year before and after the retrofits. Utility bill analysis shows 14% and 16% energy savings using injected spray sealant system and hand sealing procedure respectively in heating season whereas in cooling season, energy savings using injected spray sealant system and hand sealing were both 16%.« less

Draft New Home Specification Version 1.1

EPA Pesticide Factsheets

The intent of this specification is to reduce indoor and outdoor water usage in new residential homes, thereby lowering consumer utility bills and encouraging water and wastewater.infrastructure savings.

8 CFR 244.9 - Evidence.

Code of Federal Regulations, 2013 CFR

2013-01-01

... company. (ii) Rent receipts, utility bills (gas, electric, telephone, etc.), receipts, or letters from... United States showing name of school and period(s) of school attendance; (iv) Hospital or medical records...

8 CFR 244.9 - Evidence.

Code of Federal Regulations, 2012 CFR

2012-01-01

... company. (ii) Rent receipts, utility bills (gas, electric, telephone, etc.), receipts, or letters from... United States showing name of school and period(s) of school attendance; (iv) Hospital or medical records...

8 CFR 244.9 - Evidence.

Code of Federal Regulations, 2011 CFR

2011-01-01

... company. (ii) Rent receipts, utility bills (gas, electric, telephone, etc.), receipts, or letters from... United States showing name of school and period(s) of school attendance; (iv) Hospital or medical records...

8 CFR 244.9 - Evidence.

Code of Federal Regulations, 2014 CFR

2014-01-01

... company. (ii) Rent receipts, utility bills (gas, electric, telephone, etc.), receipts, or letters from... United States showing name of school and period(s) of school attendance; (iv) Hospital or medical records...

An analysis of state legislation on community trails.

PubMed

Eyler, Amy; Lankford, Tina; Chriqui, Jamie; Evenson, Kelly R; Kruger, Judy; Tompkins, Nancy; Voorhees, Carolyn; Zieff, Susan; Aytur, Semra; Brownson, Ross

2010-03-01

Trails provide opportunities for recreation, transportation and activity. The purpose of this article is to describe state legislation related to community trails, to analyze legislation content, and to evaluate legislation on inclusion of evidence-informed elements. State trail legislation from 2001 to 2008 was identified using online legislative databases. An analysis of evidence-informed elements included in the legislation was conducted. These elements included: funding, liability, accessibility, connectivity, and maintenance. Of the total 991 trail bills, 516 (52.0%) were appropriations bills, of which 167 (32.2%) were enacted. We analyzed 475 (48%) nonappropriation trail bills of which 139 (29.3%) were enacted. The percentage of enactment of appropriations bills decreased over time while enactment of nonappropriations trail bills increased. Over half of the nonappropriations trail bills included at least 1 evidence-informed element, most commonly funding. Few bills contained liability, connectivity, accessibility, or maintenance. There is opportunity for providing evidence-informed information to policy-makers to potentially influence bill content. The number of bills with a funding element demonstrates that fiscal support for trails is an important policy lever that state legislatures may use to support trails. Lastly, trails should be considered in over-all state-level physical activity legislation to provide opportunities for communities to be active.

8 CFR 1244.9 - Evidence.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) Duties with the company. (ii) Rent receipts, utility bills (gas, electric, telephone, etc.), receipts, or... the United States showing name of school and period(s) of school attendance; (iv) Hospital or medical...

8 CFR 1244.9 - Evidence.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) Duties with the company. (ii) Rent receipts, utility bills (gas, electric, telephone, etc.), receipts, or... the United States showing name of school and period(s) of school attendance; (iv) Hospital or medical...

8 CFR 1244.9 - Evidence.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) Duties with the company. (ii) Rent receipts, utility bills (gas, electric, telephone, etc.), receipts, or... the United States showing name of school and period(s) of school attendance; (iv) Hospital or medical...

8 CFR 1244.9 - Evidence.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) Duties with the company. (ii) Rent receipts, utility bills (gas, electric, telephone, etc.), receipts, or... the United States showing name of school and period(s) of school attendance; (iv) Hospital or medical...

47 CFR 36.372 - Marketing-Account 6610 (Class B telephone companies); Accounts 6611 and 6613 (Class A telephone...

Code of Federal Regulations, 2011 CFR

2011-10-01

... analysis of current billing for a representative period, excluding current billing on behalf of others and billing in connection with intercompany setttlements. Effective July 1, 2001 through June 30, 2012, all...

47 CFR 36.372 - Marketing-Account 6610 (Class B telephone companies); Accounts 6611 and 6613 (Class A telephone...

Code of Federal Regulations, 2010 CFR

2010-10-01

... analysis of current billing for a representative period, excluding current billing on behalf of others and billing in connection with intercompany setttlements. Effective July 1, 2001 through June 30, 2011, all...

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

Cost-utility analysis of individual psychosocial support interventions for breast cancer patients in a randomized controlled study.

PubMed

Arving, Cecilia; Brandberg, Yvonne; Feldman, Inna; Johansson, Birgitta; Glimelius, Bengt

2014-03-01

The aim was to explore the cost-utility in providing complementary individual psychosocial support to breast cancer patients compared with standard care (SC). Patients just starting adjuvant therapy (n = 168) at Uppsala University Hospital, Sweden, were consecutively included and randomized into three groups: psychosocial support from a specially trained nurse (INS), from a psychologist (IPS), or SC. Psychological effects and healthcare utilization were monitored during a 2-year period. The hospital billing system provided cost estimates. Quality-adjusted life years (QALYs) were calculated using health-related quality of life data from the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ C-30) translated into the Euro Quality of Life- 5-Dimensional classification. On the basis of the medical cost offset, a cost-utility analysis was performed. Health care utilization was mainly related to the breast cancer diagnosis and treatment. The intervention costs amounted to about €500 or 3% of the total costs. Total health care costs, including interventions cost, were lower in the INS (€18,670) and IPS (€20,419) groups than in the SC group (€25,800). The number of QALYs were also higher in the INS (1.52 QALY) and IPS (1.59 QALY) groups, compared with the SC group (1.43 QALY). The cost-utility analysis revealed that, during adjuvant treatment for breast cancer, the individual psychosocial support interventions provided here was cost effective because the health care costs were lower and QALYs were higher compared to SC alone. Copyright © 2013 John Wiley & Sons, Ltd.

Utilization of healthcare services and renewal of health insurance membership: evidence of adverse selection in Ghana.

PubMed

Duku, Stephen Kwasi Opoku; Asenso-Boadi, Francis; Nketiah-Amponsah, Edward; Arhinful, Daniel Kojo

2016-12-01

Utilization of healthcare in Ghana's novel National Health Insurance Scheme (NHIS) has been increasing since inception with associated high claims bill which threatens the scheme's financial sustainability. This paper investigates the presence of adverse selection by assessing the effect of healthcare utilization and frequency of use on NHIS renewal. Routine enrolment and utilization data from 2008 to 2013 in two regions in Ghana was analyzed. Pearson Chi-square test was performed to test if the proportion of insured who utilize healthcare in a particular year and renew membership the following year is significantly different from those who utilize healthcare and drop-out. Logistic regressions were estimated to examine the relationship between healthcare utilization and frequency of use in previous year and NHIS renewal in current year. We found evidence suggestive of the presence of adverse selection in the NHIS. Majority of insured who utilized healthcare renewed their membership whiles most of those who did not utilize healthcare dropped out. The likelihood of renewal was significantly higher for those who utilize healthcare than those who did not and also higher for those who make more health facility visits. The NHIS claims bill is high because high risk individuals who self-select into the scheme makes more health facility visits and creates financial sustainability problems. Policy makers should adopt pragmatic ways of enforcing mandatory enrolment so that low risk individuals remain enrolled; and sustainable ways of increasing revenue whiles ensuring that the societal objectives of the scheme are not compromised.

SAM International Case Studies: DPV Analysis in Mexico

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

McCall, James D

Presentation demonstrates the use of the System Advisor Model (SAM) in international analyses, specifically Mexico. Two analyses are discussed with relation to SAM modelling efforts: 1) Customer impacts from changes to net metering and billing agreements and 2) Potential benefits of PV for Mexican solar customers, the Mexican Treasury, and the environment. Along with the SAM analyses, integration of the International Utility Rate Database (I-URDB) with SAM and future international SAM work are discussed. Presentation was created for the International Solar Energy Society's (ISES) webinar titled 'International use of the NREL System Advisor Model (SAM) with case studies'.

Analysis and Development of Management Information Systems for Private Messes Afloat

DTIC Science & Technology

1988-03-01

the development phase emphasis was placed on a three step approach starting with an analysis of the requirements as established by... oper - ating the mess divided by number of mess members Total Mess Bill Due Total of old bills, current bill, mess share owed, and special assessment 46...TRANSPARENCY THE SYSTEM BEHAVIOR IS TRANSPARENT TO THE USER. THAT MEANS THAT THE USER CAN DEVELOP A CONSISTENT MODEL OF THE SYSTEM WHEN WORKING

An analysis of secondary road maintenance payments to Henrico and Arlington counties.

DOT National Transportation Integrated Search

2001-01-01

The purpose of this analysis was to respond to the requirements set forth in House Bill 30 from the 2000 Session of Virginia's General Assembly. Because of the legislative history regarding the language in the bill, the analysis was limited to mainte...

Understanding Building Infrastructure and Building Operation through DOE Asset Score Model: Lessons Learned from a Pilot Project

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

Wang, Na; Goel, Supriya; Gorrissen, Willy J.

2013-06-24

The U.S. Department of Energy (DOE) is developing a national voluntary energy asset score system to help building owners to evaluate the as-built physical characteristics (including building envelope, the mechanical and electrical systems) and overall building energy efficiency, independent of occupancy and operational choices. The energy asset score breaks down building energy use information by simulating building performance under typical operating and occupancy conditions for a given use type. A web-based modeling tool, the energy asset score tool facilitates the implementation of the asset score system. The tool consists of a simplified user interface built on a centralized simulation enginemore » (EnergyPlus). It is intended to reduce both the implementation cost for the users and increase modeling standardization compared with an approach that requires users to build their own energy models. A pilot project with forty-two buildings (consisting mostly offices and schools) was conducted in 2012. This paper reports the findings. Participants were asked to collect a minimum set of building data and enter it into the asset score tool. Participants also provided their utility bills, existing ENERGY STAR scores, and previous energy audit/modeling results if available. The results from the asset score tool were compared with the building energy use data provided by the pilot participants. Three comparisons were performed. First, the actual building energy use, either from the utility bills or via ENERGY STAR Portfolio Manager, was compared with the modeled energy use. It was intended to examine how well the energy asset score represents a building’s system efficiencies, and how well it is correlated to a building’s actual energy consumption. Second, calibrated building energy models (where they exist) were used to examine any discrepancies between the asset score model and the pilot participant buildings’ [known] energy use pattern. This comparison examined the end use breakdowns and more detailed time series data. Third, ASHRAE 90.1 prototype buildings were also used as an industry standard modeling approach to test the accuracy level of the asset score tool. Our analysis showed that the asset score tool, which uses simplified building simulation, could provide results comparable to a more detailed energy model. The buildings’ as-built efficiency can be reflected in the energy asset score. An analysis between the modeled energy use through the asset score tool and the actual energy use from the utility bills can further inform building owners about the effectiveness of their building’s operation and maintenance.« less

Electric utilities and telecommunications

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

Moeller, J.W.

1995-08-01

Part I of this article will provide some background on the involvement of electric utilities in telecommunications. It will discuss the Power Radio Services, under which the FCC regulates radio communications of electric utilities, the pole attachment statute of the Communications Act, which authorized the FCC to regulate attachments of cable television cables to electric utility poles, and a recent Department of Energy (DOE) report on the need for a demonstration on the use of telecommunications for DSM. Part I will also discuss several recent developments relative to the Power Radio Services and the pole attachment statute. Part II willmore » discuss electric utilities and telecommunications under PUHCA. It will outline the extensive and complex requirements of PUHCA that are applicable to public utility holding companies, as well as the specific requirements of PUHCA for the formation by public utility holding companies of subsidiaries to engage in telecommunications activities. It will also discuss the seven instances in the past decade in which the SEC has approved the formation by public utility holding companies of such subsidiaries. Part III of this article will discuss a principal obstacle to expanded electric utility involvement in telecommunications activities-a series of administrative and judicial decisions that illustrate the potential for dual regulation by the SEC and the FERC to result in confusion and inefficiencies. It will also discuss proposals in Congress to minimize this potential. Part IV will discuss House Bill 3636 and Senate Bill 1822 and their proposals to amend PUHCA to facilitate the formation or acquisition by public utility holding companies of non-utility subsidiaries to engage in telecommunications activities. It will also discuss their proposals to address the potential consequences of dual regulation by the SEC and the FERC of electric utilities involved in telecommunications.« less

Brownfields Utilization, Investment, and Local Development Act of 2013

THOMAS, 113th Congress

Sen. Lautenberg, Frank R. [D-NJ

2013-03-07

Senate - 06/05/2014 Placed on Senate Legislative Calendar under General Orders. Calendar No. 416. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Cost and resource utilization in cervical cancer management: a real-world retrospective cost analysis.

PubMed

Cromwell, I; Ferreira, Z; Smith, L; van der Hoek, K; Ogilvie, G; Coldman, A; Peacock, S J

2016-02-01

We set out to assess the health care resource utilization and cost of cervical cancer from the perspective of a single-payer health care system. Retrospective observational data for women diagnosed with cervical cancer in British Columbia between 2004 and 2009 were analyzed to calculate patient-level resource utilization patterns from diagnosis to death or 5-year discharge. Domains of resource use within the scope of this cost analysis were chemotherapy, radiotherapy, and brachytherapy administered by the BC Cancer Agency; resource utilization related to hospitalization and outpatient visits as recorded by the B.C. Ministry of Health; medically required services billed under the B.C. Medical Services Plan; and prescriptions dispensed under British Columbia's health insurance programs. Unit costs were applied to radiotherapy and brachytherapy, producing per-patient costs. The mean cost per case of treating cervical cancer in British Columbia was $19,153 (standard error: $3,484). Inpatient hospitalizations, at 35%, represented the largest proportion of the total cost (95% confidence interval: 32.9% to 36.9%). Costs were compared for subgroups of the total cohort. As health care systems change the way they manage, screen for, and prevent cervical cancer, cost-effectiveness evaluations of the overall approach will require up-to-date data for resource utilization and costs. We provide information suitable for such a purpose and also identify factors that influence costs.

Veterans Going to College: Evaluating the Impact of the Post-9/11 GI Bill on College Enrollment

ERIC Educational Resources Information Center

Zhang, Liang

2018-01-01

In this study, I used American Community Survey (ACS) 2005-2015 data to examine the enrollment effect of the Post-9/11 GI Bill; the analysis resulted in three main findings: First, although the New GI Bill has increased overall college enrollment by about 3 percentage points on average, the effect was much larger immediately after the bill's…

Assessment of consumption and expenditure data collected from energy suppliers against bill data obtained from interviewed households: Case study with 2009 RECS

EIA Publications

2013-01-01

By comparing the different data sources (survey respondents provide information about their household characteristics and energy use; interviewers used portable devices to scan the respondents’ utility bills), we hope to learn more about any limitations in the data that we collect, which we can then attempt to address. As such, this limited empirical study is an example of the research that EIA conducts to evaluate and subsequently improve on the quality of data that EIA collects.

Funny money: the attentional role of monetary feedback detached from expected value.

PubMed

Roper, Zachary J J; Vecera, Shaun P

2016-10-01

Stimuli associated with monetary reward can become powerful cues that effectively capture visual attention. We examined whether such value-driven attentional capture can be induced with monetary feedback in the absence of an expected cash payout. To this end, we implemented images of U.S. dollar bills as reward feedback. Participants knew in advance that they would not receive any money based on their performance. Our reward stimuli-$5 and $20 bill images-were thus dissociated from any practical utility. Strikingly, we observed a reliable attentional capture effect for the mere images of bills. Moreover, this finding generalized to Monopoly money. In two control experiments, we found no evidence in favor of nominal or symbolic monetary value. Hence, we claim that bill images are special monetary representations, such that there are strong associations between the defining visual features of bills and reward, probably due to a lifelong learning history. Together, we show that the motivation to earn cash plays a minor role when it comes to monetary rewards, while bill-defining visual features seem to be sufficient. These findings have the potential to influence human factor applications, such as gamification, and can be extended to novel value systems, such as the electronic cash Bitcoin being developed for use in mobile banking. Finally, our procedure represents a proof of concept on how images of money can be used to conserve expenditures in the experimental context.

Impact of Outpatient Rehabilitation Medicare Reimbursement Caps on Utilization and Cost of Rehabilitation Care After Ischemic Stroke: Do Caps Contain Costs?

PubMed

Simpson, Annie N; Bonilha, Heather S; Kazley, Abby S; Zoller, James S; Simpson, Kit N; Ellis, Charles

2015-11-01

To estimate the proportion of patients with ischemic stroke who fall within and above the total outpatient rehabilitation caps before and after the Balanced Budget Act of 1997 took effect; and to estimate the cost of poststroke outpatient rehabilitation cost and resource utilization in these patients before and after the implementation of the caps. Retrospective cohort study. Medicare reimbursement system. Medicare beneficiaries from the state of South Carolina: the 1997 stroke cohort sample (N=2667) and the 2004 stroke cohort sample (N=2679). Not applicable. Proportion of beneficiaries with bills within and above the cap before and after the cap was enacted, and total estimated 1-year rehabilitation Medicare payments before and after the cap. The proportion of patients with stroke exceeding the cap in 2004 after the Balanced Budget Act of 1997 was enacted was significantly lower (5.8%) than those in 1997 (9.5%) had there been a cap at that time (P=.004). However, when the proportion of individuals exceeding the cap among both the outpatient provider and facility files was examined, there was a greater proportion of patients with stroke in 2004 (64.6%) than in 1997 (31.9%) who exceeded the cap (P<.0001). The estimated average 1-year Medicare payments for rehabilitation services, when examining only the Part B outpatient provider bills, did not differ between the cohorts (P=.12), and in fact, decreased slightly from $1052 in 1997 to $833 in 2004. However, when examining rehabilitation costs using all available outpatient Medicare bills, the average estimated payments greatly increased (P<.0001) from $5691 in 1997 to $9606 in 2004. These findings suggest that billing practices may have changed after outpatient rehabilitation services caps were enacted by the Balanced Budget Act of 1997. Rehabilitation services billing may have shifted from Part B provider bills to being more frequently included in facility charges. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

State laws related to billing third parties for healthcare services at public STD clinics in the United States.

PubMed

Cramer, Ryan; Loosier, Penny S; Krasner, Andee; Kawatu, Jennifer

2018-02-07

Health departments (HDs) cite state laws as barriers to billing third parties for sexually transmitted disease (STD) services, but the association between legal/policy barriers and third party HD billing has not been examined. This study investigates the relationship between laws that may limit HDs' ability to bill, clinic perceptions of billing barriers, and billing practices. Two surveys (1) clinic managers [N=246], 2) STD program managers [N=63]) conducted via a multi-regional needs assessment of federally funded HD clinics' capacity to bill for STD services, billing/reimbursement practices, and perceived barriers were combined with an analysis of state laws regarding third party billing for STD services. Statistical analyses examined relationships between laws that may limit HDs' ability to bill, clinic perceptions, and billing practices. Clinic managers reported clinics were less likely to bill Medicaid and other third parties in jurisdictions with a state law limiting their ability to bill compared to respondents who billed neither or one payer (OR=0.31, CI=0.10,0.97) and cited practical concerns as a primary barrier to billing (OR=2.83 CI=1.50,5.37). STD program managers' reports that staff believed STD services should be free (OR=0.34, CI=0.13, 0.90) was associated with not billing (not sure versus no resistance to billing); confidentiality concerns was not a reported barrier to billing among either sample. Practical concerns and clinic staff beliefs that STD services should be free emerged as possible barriers to billing, and laws less so. Attempts to initiate HD billing for STD services may benefit from staff education as well as addressing perceived legal barriers and staff concerns.

Preventing Termination of Utility Services in Bankruptcy Act of 2014

THOMAS, 113th Congress

Rep. Conyers, John, Jr. [D-MI-13

2014-07-17

House - 09/02/2014 Referred to the Subcommittee on Regulatory Reform, Commercial And Antitrust Law. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

[The flexibilization of the Brazilian legislation on pesticides and the risks to human health: analysis of Bill of Law 3,200/2015].

PubMed

Almeida, Mirella Dias; Cavendish, Thais Araújo; Bueno, Priscila Campos; Ervilha, Iara Campos; Gregório, Luisa De Sordi; Kanashiro, Natiela Beatriz de Oliveira; Rohlfs, Daniela Buosi; Carmo, Thenille Faria Machado do

2017-07-27

This article aims to contribute to a reflection on pesticides, based on the Brazilian legal framework, from the perspective of protecting human health and the environment. This initiative is due to successive attempts to flexibilize the regulation of pesticides in Brazil, through bills of law in progress in the Brazilian National Congress. An analysis of Bill of Law 3,200/2015 was carried out. This bill of law represents a major setback to the legislative achievements for the regulation of pesticides, in order to alert to the risks to human health from exposure to these products and aggravated by other similar proposals.

An Analysis of the Billing and Bookkeeping Machine Operator Occupation.

ERIC Educational Resources Information Center

Six, Joseph E., Jr.

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the billing and bookkeeping machine operating occupation. The analysis was written in general terms due to the diversity in bookkeeping machines on the market, increasing number and variation of the tasks…

Some evidentiary considerations for physician billing.

PubMed

Rooks, Franklin J

2011-01-01

In a criminal prosecution for medical billing fraud alleging up-coding and overbilling, the government's evidence may encompass the practice's entire billings and draw inferences from them. In addition, fraud may be demonstrated through statistical analysis comparing a physician's billings relative to other providers of the same specialty. The Federal Rules of Evidence govern the admissibility of evidence during a trial, to provide fairness for both the prosecution and the defense. Physicians and practice managers should be well versed in the billing requirements and particularly careful when CPT codes are expressed in terms of "required times" as opposed to "typical times."

Analysis of Human Mobility Based on Cellular Data

NASA Astrophysics Data System (ADS)

Arifiansyah, F.; Saptawati, G. A. P.

2017-01-01

Nowadays not only adult but even teenager and children have then own mobile phones. This phenomena indicates that the mobile phone becomes an important part of everyday’s life. Based on these indication, the amount of cellular data also increased rapidly. Cellular data defined as the data that records communication among mobile phone users. Cellular data is easy to obtain because the telecommunications company had made a record of the data for the billing system of the company. Billing data keeps a log of the users cellular data usage each time. We can obtained information from the data about communication between users. Through data visualization process, an interesting pattern can be seen in the raw cellular data, so that users can obtain prior knowledge to perform data analysis. Cellular data processing can be done using data mining to find out human mobility patterns and on the existing data. In this paper, we use frequent pattern mining and finding association rules to observe the relation between attributes in cellular data and then visualize them. We used weka tools for finding the rules in stage of data mining. Generally, the utilization of cellular data can provide supporting information for the decision making process and become a data support to provide solutions and information needed by the decision makers.

Quantitative and qualitative analysis on the legislative production relating to healthcare in passage in the National Congress in the years 2007 and 2008.

PubMed

Santos, Viviane Cristina dos; Ferraz, Marcos Bosi

2013-01-01

The Federal Constitution of 1988 allowed the National Congress to contribute towards formulation of new public policies. The objective of this study was to analyze the legislative production that dealt with health issues that was in passage in the National Congress between January 2007 and December 2008. Descriptive-exploratory cross-sectional study with quantitative and qualitative approaches, conducted in a federal university. The analysis material for the study comprised 144 draft bills that were classified and subsequently randomly evaluated by 155 professionals working within the healthcare system. The analysis showed that the Workers' Party (PT) and Brazilian Democratic Movement Party (PMDB) were the parties that presented the largest proportions of the draft bills (12.5% and 11.1%); 25.4% of the draft bills were presented by congress members with academic qualifications within healthcare and only 1.4% of the draft bills became transformed into legal regulations. In questionnaire responses, 51.5% of the evaluators did not consider the draft bills to be viable, 40.6% did not consider them to be relevant and 52.5% said that if the draft bills were not approved it would not be harmful to Brazilian society. In analyzing the data from this study, it was noted that the legislative production relating to healthcare was low and the transformation rate from draft bill to legal regulation was negligible. The results from the evaluation showed that the quality of legislative production was impaired.

Resource utilization and disability outcome assessment of combat casualties from Operation Iraqi Freedom and Operation Enduring Freedom.

PubMed

Masini, Brendan D; Waterman, Scott M; Wenke, Joseph C; Owens, Brett D; Hsu, Joseph R; Ficke, James R

2009-04-01

Injuries are common during combat operations. The high costs of extremity injuries both in resource utilization and disability are well known in the civilian sector. We hypothesized that, similarly, combat-related extremity injuries, when compared with other injures from the current conflicts in Iraq and Afghanistan, require the largest percentage of medical resources, account for the greatest number of disabled soldiers, and have greater costs of disability benefits. Descriptive epidemiologic study and cost analysis. The Department of Defense Medical Metrics (M2) database was queried for the hospital admissions and billing data of a previously published cohort of soldiers injured in Iraq and Afghanistan between October 2001 and January 2005 and identified from the Joint Theater Trauma Registry. The US Army Physical Disability Administration database was also queried for Physical Evaluation Board outcomes for these soldiers, allowing calculation of disability benefit cost. Primary body region injured was assigned using billing records that gave a primary diagnosis International Classification of Diseases Ninth Edition code, which was corroborated with Joint Theater Trauma Registry injury mechanisms and descriptions for accuracy. A total of 1333 soldiers had complete admission data and were included from 1566 battle injuries not returned to duty of 3102 total casualties. Extremity-injured patients had the longest average inpatient stay at 10.7 days, accounting for 65% of the $65.3-million total inpatient resource utilization, 64% of the 464 patients found "unfit for duty," and 64% of the $170-million total projected disability benefit costs. Extrapolation of data yields total disability costs for this conflict, approaching $2 billion. Combat-related extremity injuries require the greatest utilization of resources for inpatient treatment in the initial postinjury period, cause the greatest number of disabled soldiers, and have the greatest projected disability benefit costs. This study highlights the need for continued or increased funding and support for military orthopaedic surgeons and extremity trauma research efforts.

Utility Tax Relief Program in the Netherlands

DTIC Science & Technology

2010-01-06

Management Command, Europe Region LQA Living Quarters Allowance VAT Value Added Tax INSPECTOR GENERAL DEPARTMENT OF DEFENSE 400 ARMY NAVY DRIVE...savings on their utility bills. However, for DOD civilians receiving Living Quarters Allowance ( LQA ),2 DOD realizes the cost savings through reduced... LQA payments, unless the civilian’s housing expenses exceed the maximum allowable LQA . 1 For the purpose of this report, DOD personnel refers to

Help My House Program Profile

EPA Pesticide Factsheets

Learn about Help My House, a program that helps participants reduce their utility bills by nearly 35 percent through low-cost loans for EE improvements. Learn more about the key features, approaches, funding sources, and achievements of this program.

Produced Water Utilization Act of 2009

THOMAS, 111th Congress

Rep. Hall, Ralph M. [R-TX-4

2009-01-13

Senate - 02/12/2009 Received in the Senate and Read twice and referred to the Committee on Energy and Natural Resources. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

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.

The gates open wide. [The Energy Policy Act of 1992

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

Burton, S.D.

1993-01-01

For independent electric producers, the new energy law opens wide the gate to the future. It does not give an entitlement or a subsidy; merely the freedom to expand - along with utilities - electricity's share of the next century's energy market. If anything, the new law, by removing investment barriers and creating the right to transmission access, affirms the potential of electrical generation and urges us all to get on with the job. It underscores the most powerful forces for future growth: the increasing demand for more electric power, greater production at less cost, and lessening demand on themore » environment's resources. With half-century-old barriers to broader production finally down, the real action now belongs to the regulators. It's one thing to pass a bill. It's quite another to make it work. The reform bill does not deregulate, but essentially defines public policy objectives (competitive markets), creates a framework to develop them, and vest responsibility for the regulation of the generation and sale of power where it belongs: with state public utility commissions and the FERC. It is going to be up to them to set the limits of the market, and to set the pace of expansion; in other words, to rearrange the play to achieve the bill's objective.« less

Estimating the extent and distribution of new-onset adult asthma in British Columbia using frequentist and Bayesian approaches.

PubMed

Beach, Jeremy; Burstyn, Igor; Cherry, Nicola

2012-07-01

We previously described a method to identify the incidence of new-onset adult asthma (NOAA) in Alberta by industry and occupation, utilizing Workers' Compensation Board (WCB) and physician billing data. The aim of this study was to extend this method to data from British Columbia (BC) so as to compare the two provinces and to incorporate Bayesian methodology into estimates of risk. WCB claims for any reason 1995-2004 were linked to physician billing data. NOAA was defined as a billing for asthma (ICD-9 493) in the 12 months before a WCB claim without asthma in the previous 3 years. Incidence was calculated by occupation and industry. In a matched case-referent analysis, associations with exposures were examined using an asthma-specific job exposure matrix (JEM). Posterior distributions from the Alberta analysis and estimated misclassification parameters were used as priors in the Bayesian analysis of the BC data. Among 1 118 239 eligible WCB claims the incidence of NOAA was 1.4%. Sixteen occupations and 44 industries had a significantly increased risk; six industries had a decreased risk. The JEM identified wood dust [odds ratio (OR) 1.55, 95% confidence interval (CI) 1.08-2.24] and animal antigens (OR 1.66, 95% CI 1.17-2.36) as related to an increased risk of NOAA. Exposure to isocyanates was associated with decreased risk (OR 0.57, 95% CI 0.39-0.85). Bayesian analyses taking account of exposure misclassification and informative priors resulted in posterior distributions of ORs with lower boundary of 95% credible intervals >1.00 for almost all exposures. The distribution of NOAA in BC appeared somewhat similar to that in Alberta, except for isocyanates. Bayesian analyses allowed incorporation of prior evidence into risk estimates, permitting reconsideration of the apparently protective effect of isocyanate exposure.

The Long and the Short of It: No Dietary Specialisation between Male and Female Western Sandpipers Despite Strong Bill Size Dimorphism

PubMed Central

Franks, Samantha E.; Fernández, Guillermo; Hodkinson, David J.; Kyser, T. Kurt; Lank, David B.

2013-01-01

Many bird species show spatial or habitat segregation of the sexes during the non-breeding season. One potential ecological explanation is that differences in bill morphology favour foraging niche specialisation and segregation. Western sandpipers Calidris mauri have pronounced bill size dimorphism, with female bills averaging 15% longer than those of males. The sexes differ in foraging behaviour and exhibit partial latitudinal segregation during the non-breeding season, with males predominant in the north and females in the south. Niche specialisation at a local scale might account for this broad geographic pattern, and we investigated whether longer-billed females and shorter-billed males occupy different foraging niches at 16 sites across the non-breeding range. We used stable-nitrogen (δ15N) isotope analysis of whole blood to test for dietary specialisation according to bill length and sex. Stable-nitrogen isotope ratios increase with trophic level. We predicted that δ15N values would increase with bill length and would be higher for females, which use a greater proportion of foraging behaviour that targets higher-trophic level prey. We used stable-carbon (δ13C) isotope analysis to test for habitat segregation according to bill length and sex. Stable-carbon isotope ratios vary between marine- and freshwater-influenced habitats. We predicted that δ13C values would differ between males and females if the sexes segregate between habitat types. Using a model selection approach, we found little support for a relationship between δ15N and either bill length or sex. There was some indication, however, that more marine δ13C values occur with shorter bill lengths. Our findings provide little evidence that male and female western sandpipers exhibit dietary specialisation as a function of their bill size, but indicate that the sexes may segregate in different habitats according to bill length at some non-breeding sites. Potential ecological factors underlying habitat segregation between sexes include differences in preferred habitat type and predation risk. PMID:24260305

42 CFR 421.501 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... licensed medical professional, for a billed item or service identified by data analysis techniques or probe... rate based on the results of a probe review prior to the initiation of complex medical review. Medical... licensed medical professional, for a billed item or service identified by data analysis techniques or probe...

42 CFR 421.501 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... licensed medical professional, for a billed item or service identified by data analysis techniques or probe... rate based on the results of a probe review prior to the initiation of complex medical review. Medical... licensed medical professional, for a billed item or service identified by data analysis techniques or probe...

42 CFR 421.501 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... licensed medical professional, for a billed item or service identified by data analysis techniques or probe... rate based on the results of a probe review prior to the initiation of complex medical review. Medical... licensed medical professional, for a billed item or service identified by data analysis techniques or probe...

NREL's OpenStudio Helps Design More Efficient Buildings (Fact Sheet)

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

Not Available

2014-07-01

The National Renewable Energy Laboratory (NREL) has created the OpenStudio software platform that makes it easier for architects and engineers to evaluate building energy efficiency measures throughout the design process. OpenStudio makes energy modeling more accessible and affordable, helping professionals to design structures with lower utility bills and less carbon emissions, resulting in a healthier environment. OpenStudio includes a user-friendly application suite that makes the U.S. Department of Energy's EnergyPlus and Radiance simulation engines easier to use for whole building energy and daylighting performance analysis. OpenStudio is freely available and runs on Windows, Mac, and Linux operating systems.

An Analysis of Senate Bill 170, Ohio's Plan to Equalize School Finance.

ERIC Educational Resources Information Center

Cornett, Charles F.

This document analyzes specific provisions of the Ohio bill that attempts to revise the state's system of school finance. The bill attempts to resolve differences in valuation, tax rate, and wealth while providing basic educational services as well as services to nonpublic schools and to handicapped and special students. On the negative side, the…

A Barking Dog That Never Bites? The British Sign Language (Scotland) Bill

ERIC Educational Resources Information Center

De Meulder, Maartje

2015-01-01

This article describes and analyses the pathway to the British Sign Language (Scotland) Bill and the strategies used to reach it. Data collection has been done by means of interviews with key players, analysis of official documents, and participant observation. The article discusses the bill in relation to the Gaelic Language (Scotland) Act 2005…

An Analysis of the Tuition Advance Fund Bill.

ERIC Educational Resources Information Center

National Association of Independent Colleges and Universities, Washington, DC. National Inst. of Independent Colleges and Universities.

The Tuition Advance Fund (TAF) bill is analyzed on theoretical economic grounds, and forecasts of the net costs of the proposed program up to 1990 are offered. The TAF bill proposes the establishment of a new system of college loans as an addition to existing programs to allow students to borrow tuition plus an allowance for other costs. Novel…

Utilizing Commercial Real Estate Owner and Investor Data to Analyze the Financial Performance of Energy Efficient, High-Performance Office Buildings

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

Cloutier, Deborah; Hosseini, Farshid; White, Andrew

Evidence has shown that owning and operating energy-efficient, high-performance, “green” properties results in multiple benefits including lower utility bills, higher rents, improved occupancy, and greater net operating income. However, it is difficult to isolate and control moderating factors to identify the specific drivers behind improved financial performance and value to investors that results from sustainability in real estate. DOE is interested in facilitating deeper investigation of the correlation between energy efficiency and financial performance, reducing data acquisition and matching challenges, and developing a stronger understanding of how sustainable design and energy efficiency impact value. DOE commissioned this pilot study tomore » test the logistical and empirical procedures required to establish a Commercial Real Estate Data Aggregation & Trends Analysis lab, determine the potential benefits available through the lab, and contribute to the existing body of evidence in this field.« less

Hydronic Heating Retrofits for Low-Rise Multifamily Buildings: Boiler Control Replacement and Monitoring

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

Dentz, J.; Henderson, H.; Varshney, K.

2014-09-01

The ARIES Collaborative, a U.S. Department of Energy Building America research team, partnered with NeighborWorks America affiliate Homeowners' Rehab Inc. (HRI) of Cambridge, Massachusetts, to study improvements to the central hydronic heating system in one of the nonprofit's housing developments. The heating controls in the three-building, 42-unit Columbia Cambridge Alliance for Spanish Tenants housing development were upgraded. Fuel use in the development was excessive compared to similar properties. A poorly insulated thermal envelope contributed to high energy bills, but adding wall insulation was not cost-effective or practical. The more cost-effective option was improving heating system efficiency. Efficient operation of themore » heating system faced several obstacles, including inflexible boiler controls and failed thermostatic radiator valves. Boiler controls were replaced with systems that offer temperature setbacks and one that controls heat based on apartment temperature in addition to outdoor temperature. Utility bill analysis shows that post-retrofit weather-normalized heating energy use was reduced by 10%-31% (average of 19%). Indoor temperature cutoff reduced boiler runtime (and therefore heating fuel consumption) by 28% in the one building in which it was implemented. Nearly all savings were obtained during night which had a lower indoor temperature cut off (68 degrees F) than day (73 degrees F). This implies that the outdoor reset curve was appropriately adjusted for this building for daytime operation. Nighttime setback of heating system supply water temperature had no discernable impact on boiler runtime or gas bills.« less

Technology Solutions Case Study: Boiler Control Replacement for Hydronically Heated Multifamily Buildings, Cambridge, Massachusetts

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

None

2014-11-01

The ARIES Collaborative, a U.S. Department of Energy Building America research team, partnered with NeighborWorks America affiliate Homeowners' Rehab Inc. (HRI) of Cambridge, Massachusetts, to study improvements to the central hydronic heating system in one of the nonprofit's housing developments. The heating controls in the three-building, 42-unit Columbia Cambridge Alliance for Spanish Tenants housing development were upgraded. Fuel use in the development was excessive compared to similar properties. A poorly insulated thermal envelope contributed to high energy bills, but adding wall insulation was not cost-effective or practical. The more cost-effective option was improving heating system efficiency, which faced several obstacles,more » including inflexible boiler controls and failed thermostatic radiator valves. Boiler controls were replaced with systems that offer temperature setbacks and one that controls heat based on apartment temperature in addition to outdoor temperature. Utility bill analysis shows that post-retrofit weather-normalized heating energy use was reduced by 10%-31% (average of 19%). Indoor temperature cutoff reduced boiler runtime (and therefore heating fuel consumption) by 28% in the one building in which it was implemented. Nearly all savings were obtained during night which had a lower indoor temperature cut off (68°F) than day (73° F). This implies that the outdoor reset curve was appropriately adjusted for this building for daytime operation. Nighttime setback of heating system supply water temperature had no discernable impact on boiler runtime or gas bills.« less

Diet of yellow-billed loons (Gavia adamsii) in Arctic lakes during the nesting season inferred from fatty acid analysis

USGS Publications Warehouse

Haynes, T B; Schmutz, Joel A.; Bromaghin, Jeffrey F.; Iverson, S J; Padula, V. M.; Rosenberger, A E

2015-01-01

Understanding the dietary habits of yellow-billed loons (Gavia adamsii) can give important insights into their ecology, however, studying the diet of loons is difficult when direct observation or specimen collection is impractical. We investigate the diet of yellow-billed loons nesting on the Arctic Coastal Plain of Alaska using quantitative fatty acid signature analysis. Tissue analysis from 26 yellow-billed loons and eleven prey groups (nine fish species and two invertebrate groups) from Arctic lakes suggests that yellow-billed loons are eating high proportions of Alaska blackfish (Dallia pectoralis), broad whitefish (Coregonus nasus) and three-spined stickleback (Gasterosteus aculeatus) during late spring and early summer. The prominence of blackfish in diets highlights the widespread availability of blackfish during the early stages of loon nesting, soon after spring thaw. The high proportions of broad whitefish and three-spined stickleback may reflect a residual signal from the coastal staging period prior to establishing nesting territories on lakes, when loons are more likely to encounter these species. Our analyses were sensitive to the choice of calibration coefficient based on data from three different species, indicating the need for development of loon-specific coefficients for future study and confirmation of our results. Regardless, fish that are coastally distributed and that successfully overwinter in lakes are likely key food items for yellow-billed loons early in the nesting season.

Seeing red: Americans driven into debt by medical bills. Results from a National Survey.

PubMed

Doty, Michelle M; Edwards, Jennifer N; Holmgren, Alyssa L

2005-08-01

New analysis of the 2003 Commonwealth Fund Biennial Health Insurance Survey reveals that an estimated 77 million Americans age 19 and older--nearly two of five (37%) adults--have difficulty paying medical bills, have accrued medical debt, or both. Working-age adults incur significantly higher rates of medical bill and debt problems than adults 65 and older, with rates highest among the uninsured. Even working-age adults who are continually insured have problems paying their medical bills and have medical debt. Unpaid medical bills and medical debt can limit access to health care: two-thirds of people with a medical bill or debt problem went without needed care because of cost--nearly three times the rate of those without these financial problems.

Determination of VA health care costs.

PubMed

Barnett, Paul G

2003-09-01

In the absence of billing data, alternative methods are used to estimate the cost of hospital stays, outpatient visits, and treatment innovations in the U.S. Department of Veterans Affairs (VA). The choice of method represents a trade-off between accuracy and research cost. The direct measurement method gathers information on staff activities, supplies, equipment, space, and workload. Since it is expensive, direct measurement should be reserved for finding short-run costs, evaluating provider efficiency, or determining the cost of treatments that are innovative or unique to VA. The pseudo-bill method combines utilization data with a non-VA reimbursement schedule. The cost regression method estimates the cost of VA hospital stays by applying the relationship between cost and characteristics of non-VA hospitalizations. The Health Economics Resource Center uses pseudo-bill and cost regression methods to create an encounter-level database of VA costs. Researchers are also beginning to use the VA activity-based cost allocation system.

To amend title 40, United States Code, to provide additional authority and definitions relating to public utility contracts.

THOMAS, 111th Congress

Rep. Schiff, Adam B. [D-CA-29

2009-01-06

House - 02/24/2009 Referred to the Subcommittee on Government Management, Organization, and Procurement. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

SUSTAINABLE HOUSING AT PINE RIDGE RESERVATION

EPA Science Inventory

The Pine Ridge Reservation, located in rural South Dakota is plagued with deteriorating infrastructure, poverty, lack of local employment, and high utility bills. Many of the residents, the Oglala Lakota Nation, live in mobile homes or substandard housing and spend nearly 25% of...

Differentiating sex and species of Western Grebes (Aechmophorus occidentalis) and Clark's Grebes (Aechmophorus clarkii) and their eggs using external morphometrics and discriminant function analysis

USGS Publications Warehouse

Hartman, C. Alex; Ackerman, Joshua T.; Eagles-Smith, Collin A.; Herzog, Mark

2016-01-01

In birds where males and females are similar in size and plumage, sex determination by alternative means is necessary. Discriminant function analysis based on external morphometrics was used to distinguish males from females in two closely related species: Western Grebe (Aechmophorus occidentalis) and Clark's Grebe (A. clarkii). Additionally, discriminant function analysis was used to evaluate morphometric divergence between Western and Clark's grebe adults and eggs. Aechmophorus grebe adults (n = 576) and eggs (n = 130) were sampled across 29 lakes and reservoirs throughout California, USA, and adult sex was determined using molecular analysis. Both Western and Clark's grebes exhibited considerable sexual size dimorphism. Males averaged 6–26% larger than females among seven morphological measurements, with the greatest sexual size dimorphism occurring for bill morphometrics. Discriminant functions based on bill length, bill depth, and short tarsus length correctly assigned sex to 98% of Western Grebes, and a function based on bill length and bill depth correctly assigned sex to 99% of Clark's Grebes. Further, a simplified discriminant function based only on bill depth correctly assigned sex to 96% of Western Grebes and 98% of Clark's Grebes. In contrast, external morphometrics were not suitable for differentiating between Western and Clark's grebe adults or their eggs, with correct classification rates of discriminant functions of only 60%, 63%, and 61% for adult males, adult females, and eggs, respectively. Our results indicate little divergence in external morphology between species of Aechmophorus grebes, and instead separation is much greater between males and females.

77 FR 4885 - Rural Business Investment Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-01

...-AA80 Rural Business Investment Program AGENCY: Rural Business-Cooperative Service and Rural Utilities... several technical amendments to correct the Rural Business Investment Program (RBIP) regulation, including one to conform to the 2008 Farm Bill provision that allows a Rural Business Investment Company two...

NREL Hosts Free Workshop on Winterizing Your Home

Science.gov Websites

Energy Laboratory (NREL) will describe ways to cut your utility bills this winter at a free workshop Oct strategies to keep the heat where it belongs - inside your home. Who: The workshop is free and open to the

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

President Obama

On October 27th, Baltimore Gas & Electric was selected to receive $200 million for Smart Grid innovation projects under the Recovery Act. Watch as members of their team, along with President Obama, explain how building a smarter grid will help consumers cut their utility bills, battle climate change and create jobs.

Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2009

THOMAS, 111th Congress

Sen. Harkin, Tom [D-IA

2009-03-17

Senate - 03/17/2009 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Medicare Long-Term CPAP Coverage Policy: A Cost-Utility Analysis

PubMed Central

Billings, Martha E.; Kapur, Vishesh K.

2013-01-01

Study Objectives: CPAP is an effective treatment for OSA that may reduce health care utilization and costs. Medicare currently reimburses the costs of long-term CPAP therapy only if the patient is adherent during a 90-day trial. If not, Medicare requires a repeat polysomnogram (PSG) and another trial which seems empirically not cost-effective. We modeled the cost-effectiveness of current Medicare policy compared to an alternative policy (clinic-only) without the adherence criterion and repeat PSG. Design: Cost-utility and cost-effectiveness analysis. Setting: U.S. Medicare Population. Patients or Participants: N/A. Interventions: N/A. Measurements and Results: We created a decision tree modeling (1) clinic only follow-up vs. (2) current Medicare policy. Costs were assigned based on Medicare reimbursement rates in 2012. Sensitivity analyses were conducted to test our assumptions. We estimated cumulative costs, overall adherence, and QALY gained for a 5-year time horizon from the perspective of Medicare as the payer. Current Medicare policy is more costly than the clinic-only policy but has higher net adherence and improved utility. Current Medicare policy compared to clinic-only policy costs $30,544 more per QALY. Conclusions: Current CMS policy promotes early identification of those more likely to adhere to CPAP therapy by requiring strict adherence standards. The policy effect is to deny coverage to those unlikely to use CPAP long-term and prevent wasted resources. Future studies are needed to measure long-term adherence in an elderly population with and without current adherence requirements to verify the cost-effectiveness of a policy change. Citation: Billings ME; Kapur VK. Medicare long-term CPAP coverage policy: a cost-utility analysis. J Clin Sleep Med 2013;9(10):1023-1029. PMID:24127146

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

A Historical Analysis of the G.I. Bill and Its Relationship to Higher Education.

ERIC Educational Resources Information Center

Olson, Keith W.

A study of the G.I. Bill's genesis and reception reveals the narrow interests it was originally intended to serve. Designed as a reward to servicemen and as a device to lessen the economic effects of demobilization, the Bill made a great impact upon American higher education. (1) It provided equality of opportunity unparalleled in the nation's…

Lawmakers vie to let utilities onto the info highway

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

Burkhart, L.A.

1994-03-15

Capitol Hill is alive with talk of the information superhighway and the need to amend the antiquated Communications Act of 1936. Electric and gas utilities hope that whatever bill is passed will allow them to provide telecommunications services and take part in the communication revolution. After all, the Clinton Administration's white paper on the issue advocates following a policy that would allow energy utilities to provide telephone services. Rep. Boucher has become a chief advocate of allowing electric utilities to compete in the cable television and telephone industries. Under the Public Utility Holding Company Act (PUHCA), electric utility holding companiesmore » whose operations cross state lines are prohibited from offering telecommunications services. Boucher's measure would amend PUHCA by removing those restrictions.« less

DOD fuel cell demonstration program

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

Holcomb, F.H.; Binder, M.J.; Taylor, W.R.

The supply of reliable, cost-effective electric power with minimal environmental impact is a constant concern of Department of Defense (DOD) installation energy personnel. Electricity purchased from the local utility is expensive and represents only about 30% of the original energy input at the generating station due to generation and distribution inefficiencies. Because of master metering and large air conditioning loads, the demand portion of the installation`s electric bill can be in excess of 50% of the total bill. While the electric utilities in the United States have a very good record of reliability, there is significant potential for improving themore » security of electrical power supplied by using on-site power generation. On-site, dispersed power generation can reduce power outages due to weather, terrorist activities, or lack of utility generating capacity. In addition, as increased emphasis is placed on global warming, acid rain, and air pollution in general, the development of clean, highly efficient power producing technologies is not only desirable, but mandatory. Since the majority of central heat plants on U.S. military installations are nearing the end of their useful life, there is an opportunity to replace outdated existing equipment with modem technologies.« less

Examination of Trends and Evidence-Based Elements in State Physical Education Legislation: A Content Analysis

ERIC Educational Resources Information Center

Eyler, Amy A.; Brownson, Ross C.; Aytur, Semra A.; Cradock, Angie L.; Doescher, Mark; Evenson, Kelly R.; Kerr, Jacqueline; Maddock, Jay; Pluto, Delores L.; Steinman, Lesley; Tompkins, Nancy O'Hara; Troped, Philip; Schmid, Thomas L.

2010-01-01

Objectives: To develop a comprehensive inventory of state physical education (PE) legislation, examine trends in bill introduction, and compare bill factors. Methods: State PE legislation from January 2001 to July 2007 was identified using a legislative database. Analysis included components of evidence-based school PE from the Community Guide and…

32 CFR 268.9 - Discussion of terms.

Code of Federal Regulations, 2011 CFR

2011-07-01

... customer country unless otherwise stated in the bill. Followup and reporting actions required by this part... central banks. (4) Other institutions (such as corporations, development banks, railways, and utilities... obligors.” (j) Program. “Program” is the law, international treaty, appropriation, or other authority under...

32 CFR 268.9 - Discussion of terms.

Code of Federal Regulations, 2014 CFR

2014-07-01

... customer country unless otherwise stated in the bill. Followup and reporting actions required by this part... central banks. (4) Other institutions (such as corporations, development banks, railways, and utilities... obligors.” (j) Program. “Program” is the law, international treaty, appropriation, or other authority under...

32 CFR 268.9 - Discussion of terms.

Code of Federal Regulations, 2012 CFR

2012-07-01

... customer country unless otherwise stated in the bill. Followup and reporting actions required by this part... central banks. (4) Other institutions (such as corporations, development banks, railways, and utilities... obligors.” (j) Program. “Program” is the law, international treaty, appropriation, or other authority under...

32 CFR 268.9 - Discussion of terms.

Code of Federal Regulations, 2013 CFR

2013-07-01

... customer country unless otherwise stated in the bill. Followup and reporting actions required by this part... central banks. (4) Other institutions (such as corporations, development banks, railways, and utilities... obligors.” (j) Program. “Program” is the law, international treaty, appropriation, or other authority under...

Saving Millions without Spending a Dime.

ERIC Educational Resources Information Center

Raman, Elizabeth

2003-01-01

Describes how the University of Hawaii at Hilo is using the $2.7 million it saved on utility bills during the past 5 years to repay campus energy improvements financed, installed, and maintained by an energy services company; the method is called energy savings performance contracting. (EV)

Energy Digest.

ERIC Educational Resources Information Center

Gaddy, Carol T., Ed.; Wells, Kathy, Ed.

This collection of reprints offers practical solutions, not readily available elsewhere, to everyday energy problems, such as high utility bills, insulating windows, getting more gas mileage, or buying a more efficient washer or refrigerator. The Arkansas Energy Office provides a weekly column of energy news and conservation tips to newspapers,…

Roofing: Don't Let What's Over Head Kill Your Bottom Line.

ERIC Educational Resources Information Center

Shannon, James W., Jr.

1983-01-01

A Colorado school district employs a professional consulting firm to give an unbiased opinion on the district's roofing needs. Built-up, single-ply, and modified asphalt roofing systems have all been utilized. Preventive maintenance keeps roofing bills to a minimum. (MLF)

Veterans' Mental Health in Higher Education Settings: Services and Clinician Education Needs.

PubMed

Niv, Noosha; Bennett, Lauren

2017-06-01

Utilization of the GI Bill and attendance at higher education institutions among student veterans have significantly increased since passage of the Post-9/11 GI Bill. Campus counseling centers should be prepared to meet the mental health needs of student veterans. This study identified the mental health resources and services that colleges provide student veterans and the education needs of clinical staff on how to serve student veterans. Directors of mental health services from 80 California colleges completed a semistructured phone interview. Few schools track the number, demographic characteristics, or presenting needs of student veterans who utilize campus mental health services or offer priority access or special mental health services for veterans. Directors wanted centers to receive education for an average of 5.8 veteran-related mental health topics and preferred workshops and lectures to handouts and online training. Significant training needs exist among clinical staff of campus mental health services to meet the needs of student veterans.

How sailfish use their bills to capture schooling prey.

PubMed

Domenici, P; Wilson, A D M; Kurvers, R H J M; Marras, S; Herbert-Read, J E; Steffensen, J F; Krause, S; Viblanc, P E; Couillaud, P; Krause, J

2014-06-07

The istiophorid family of billfishes is characterized by an extended rostrum or 'bill'. While various functions (e.g. foraging and hydrodynamic benefits) have been proposed for this structure, until now no study has directly investigated the mechanisms by which billfishes use their rostrum to feed on prey. Here, we present the first unequivocal evidence of how the bill is used by Atlantic sailfish (Istiophorus albicans) to attack schooling sardines in the open ocean. Using high-speed video-analysis, we show that (i) sailfish manage to insert their bill into sardine schools without eliciting an evasive response and (ii) subsequently use their bill to either tap on individual prey targets or to slash through the school with powerful lateral motions characterized by one of the highest accelerations ever recorded in an aquatic vertebrate. Our results demonstrate that the combination of stealth and rapid motion make the sailfish bill an extremely effective feeding adaptation for capturing schooling prey.

An inexpensive, interdisciplinary, methodology to conduct an impact study of homeless persons on hospital based services.

PubMed

Parker, R David; Regier, Michael; Brown, Zachary; Davis, Stephen

2015-02-01

Homelessness is a primary concern for community health. Scientific literature on homelessness is wide ranging and diverse. One opportunity to add to existing literature is the development and testing of affordable, easily implemented methods for measuring the impact of homeless on the healthcare system. Such methodological approaches rely on the strengths in a multidisciplinary approach, including providers, both healthcare and homeless services and applied clinical researchers. This paper is a proof of concept for a methodology which is easily adaptable nationwide, given the mandated implementation of homeless management information systems in the United States and other countries; medical billing systems by hospitals; and research methods of researchers. Adaptation is independent of geographic region, budget restraints, specific agency skill sets, and many other factors that impact the application of a consistent methodological science based approach to assess and address homelessness. We conducted a secondary data analysis merging data from homeless utilization and hospital case based data. These data detailed care utilization among homeless persons in a small, Appalachian city in the United States. In our sample of 269 persons who received at least one hospital based service and one homeless service between July 1, 2012 and June 30, 2013, the total billed costs were $5,979,463 with 10 people costing more than one-third ($1,957,469) of the total. Those persons were primarily men, living in an emergency shelter, with pre-existing disabling conditions. We theorize that targeted services, including Housing First, would be an effective intervention. This is proposed in a future study.

Medicare Cancer Screening in the Context of Clinical Guidelines: 2000 to 2012.

PubMed

Maroongroge, Sean; Yu, James B

2018-04-01

Cancer screening is a ubiquitous and controversial public health issue, particularly in the elderly population. Despite extensive evidence-based guidelines for screening, it is unclear how cancer screening has changed in the Medicare population over time. We characterize trends in cancer screening for the most common cancer types in the Medicare fee-for-service (FFS) program in the context of conflicting guidelines from 2000 to 2012. We performed a descriptive analysis of retrospective claims data from the Medicare FFS program based on billing codes. Our data include all claims for Medicare part B beneficiaries who received breast, colorectal (CRC), or prostate cancer screening from 2000 to 2012 based on billing codes. We utilize a Monte Carlo permutation method to detect changes in screening trends. In total, 231,416,732 screening tests were analyzed from 2000 to 2012, representing an average of 436.8 tests per 1000 beneficiaries per year. Mammography rates declined 7.4%, with digital mammography extensively replacing film. CRC cancer screening rates declined overall. As a percentage of all CRC screening tests, colonoscopy grew from 32% to 71%. Prostate screening rates increased 16% from 2000 to 2007, and then declined to 7% less than its 2000 rate by 2012. Both the aggressiveness of screening guidelines and screening rates for the Medicare FFS population peaked and then declined from 2000 to 2012. However, guideline publications did not consistently precede utilization trend shifts. Technology adoption, practical and financial concerns, and patient preferences may have also contributed to the observed trends. Further research should be performed on the impact of multiple, conflicting guidelines in cancer screening.

Balance billing under Medicare: protecting beneficiaries and preserving physician participation.

PubMed

Colby, D C; Rice, T; Bernstein, J; Nelson, L

1995-01-01

Medicare's experience with balance billing provides valuable lessons for policy making for national or state health care reform. Medicare developed several policies to encourage physicians to become participating providers who accept Medicare-allowed charges as payment in full. Only nonparticipating physicians are permitted to bill for additional amounts beyond that paid by Medicare, and there are limits on the amount of balance billing per claim. As shown by the analysis of claims presented in this article, Medicare has successfully provided financial protection to beneficiaries. In 1986, more than 60 percent of expenditures for physician services were on assigned claims for which there could be no balance billing; by 1990, 80 percent of expenditures were on assigned claims. Balance billing decreased by about 30 percent during the same period. Although these policies have been successful in reducing total expenditures for balance billing, they may not provide financial protection to the most economically vulnerable beneficiaries. Using survey and claims data, we found that the poor have lower balance billing expenditures for services provided by primary care physicians, but that there is no relationship between poverty status and balance billing expenditures for services of nonprimary care physicians. In addition, most low-income beneficiaries are liable for balance bills. Under health care reform, adoption of Medicare's incentive-based approach with mandatory assignment for the poor would allow for some choice based on price and would provide financial protection for all consumers.

Analysis of Corporate Average Fuel Economy (CAFE) Standards for Light Trucks and Increased Alternative Fuel Use

EIA Publications

2002-01-01

Sen. Frank Murkowski, the Ranking Minority Member of the Senate Committee on Energy and Natural Resources requested an analysis of selected portions of Senate Bill 1766 (S. 1766, the Energy Policy Act of 2002), House Resolution 4 (the Securing America's Future Energy Act of 2001) and Senate Bill 517 (S. 517, the Energy Policy Act of 2002). In response, the Energy Information Administration (EIA) has prepared a series of analyses showing the impacts of each of the selected provisions of the bills on energy supply, demand, and prices, macroeconomic variables where feasible, import dependence, and emissions.

RadNet Air Data From Billings, MT

EPA Pesticide Factsheets

This page presents radiation air monitoring and air filter analysis data for Billings, MT from EPA's RadNet system. RadNet is a nationwide network of monitoring stations that measure radiation in air, drinking water and precipitation.

Building America Case Study: Boiler Control Replacement for Hydronically Heated Multifamily Buildings, Cambridge, Massachusetts (Fact Sheet)

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

Not Available

2014-11-01

The ARIES Collaborative, a U.S. Department of Energy Building America research team, partnered with NeighborWorks America affiliate Homeowners' Rehab Inc. (HRI) of Cambridge, Massachusetts, to study improvements to the central hydronic heating system in one of the nonprofit's housing developments. The heating controls in the three-building, 42-unit Columbia Cambridge Alliance for Spanish Tenants housing development were upgraded. Fuel use in the development was excessive compared to similar properties. A poorly insulated thermal envelope contributed to high energy bills, but adding wall insulation was not cost-effective or practical. The more cost-effective option was improving heating system efficiency. Efficient operation of themore » heating system faced several obstacles, including inflexible boiler controls and failed thermostatic radiator valves. Boiler controls were replaced with systems that offer temperature setbacks and one that controls heat based on apartment temperature in addition to outdoor temperature. Utility bill analysis shows that post-retrofit weather-normalized heating energy use was reduced by 10%-31% (average of 19%). Indoor temperature cutoff reduced boiler runtime (and therefore heating fuel consumption) by 28% in the one building in which it was implemented. Nearly all savings were obtained during night which had a lower indoor temperature cut off (68 degrees F) than day (73 degrees F). This implies that the outdoor reset curve was appropriately adjusted for this building for daytime operation. Nighttime setback of heating system supply water temperature had no discernable impact on boiler runtime or gas bills.« less

24 CFR 2002.13 - Charges for interest and for unsuccessful searches; utilization of Debt Collection Act.

Code of Federal Regulations, 2010 CFR

2010-04-01

... charged in a timely fashion (i.e., within 30 days of the date of the billing), HUD may, under the authority of the Debt Collection Act and part 17, subpart C of this title, use consumer reporting agencies...

Alternative Fuels Data Center

Science.gov Websites

PG&E Pacific Gas & Electric (PG&E) customers are eligible for a $10,000 rebate for the , bring the Customer Information Form and a copy of a recent PG&E utility bill to a participating dealership. For more information, visit PG&E

The impact of gun control (Bill C-51) on suicide in Canada.

PubMed

Leenaars, Antoon A; Moksony, Ferenc; Lester, David; Wenckstern, Susanne

2003-01-01

Suicide is a multiply determined behavior, calling for diverse prevention efforts. Gun control has been proposed as an important component of society's response, and an opportunity for studying the effects of legislative gun control laws on suicide rates was provided by Canada's Criminal Law Amendment Act of 1977 (Bill C-51). This article reviews previous studies of the impact of this act on the total population of Canada and subpopulations by age and gender and, in addition, presents the results of 2 new studies: a different method of analysis, an interrupted time-series analysis, and the results of a multiple regression analysis that controls for some social variables. It appears that Bill C-51 may have had an impact on suicide rates, even after controls for social variables.

Patterns and predictors of enactment of state childhood obesity legislation in the United States: 2006-2009.

PubMed

Eyler, Amy A; Nguyen, Leah; Kong, Jooyoung; Yan, Yan; Brownson, Ross

2012-12-01

We developed a content review for state policies related to childhood obesity, and we have quantitatively described the predictors of enactment. We collected an inventory of 2006 through 2009 state legislation on 27 childhood obesity topics from legislative databases. We coded each bill for general information, topic content, and other appropriate components. We conducted a general descriptive analysis and 3 multilevel analyses using bill- and state-level characteristics to predict bill enactment. Common topics in the 27% of the bills that were enacted were community physical activity access, physical education, and school food policy. Committee and bipartisan sponsorship and having term limits significantly predicted enactment in at least 1 model. Bills with safe routes to school or health and nutrition content were twice as likely to be enacted. Bills containing product and menu labeling or soda and snack taxes were significantly less likely to be enacted. Bipartisan and committee support and term limits are important in bill enactment. Advocacy efforts can be tailored to increase awareness and sense of priority among policymakers.

Patterns and Predictors of Enactment of State Childhood Obesity Legislation in the United States: 2006–2009

PubMed Central

Nguyen, Leah; Kong, Jooyoung; Yan, Yan; Brownson, Ross

2012-01-01

Objectives. We developed a content review for state policies related to childhood obesity, and we have quantitatively described the predictors of enactment. Methods. We collected an inventory of 2006 through 2009 state legislation on 27 childhood obesity topics from legislative databases. We coded each bill for general information, topic content, and other appropriate components. We conducted a general descriptive analysis and 3 multilevel analyses using bill- and state-level characteristics to predict bill enactment. Results. Common topics in the 27% of the bills that were enacted were community physical activity access, physical education, and school food policy. Committee and bipartisan sponsorship and having term limits significantly predicted enactment in at least 1 model. Bills with safe routes to school or health and nutrition content were twice as likely to be enacted. Bills containing product and menu labeling or soda and snack taxes were significantly less likely to be enacted. Conclusions. Bipartisan and committee support and term limits are important in bill enactment. Advocacy efforts can be tailored to increase awareness and sense of priority among policymakers. PMID:23078482

Detection and Localization of Money Bills Concealed Behind Wooden Walls Using Compton Scattering

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

Wart, Jason A. van; Hussein, Esam M.A.; Waller, Edward J

2005-05-15

This work presents a portable device for detecting visually obscured contraband money bills that may be hidden within conventional household walls for the purpose of avoiding confiscation. The device utilizes the Compton backscattering of photons emitted from a collimated {sup 241}Am source. The scattered photons are detected with a thin NaI(Tl) detector, either over a wide field of view for surface scanning of the wall or within a confined view field for depth scanning. The design of the device was optimized for best density contrast and highest count rate for a given source activity. It was shown that the minimummore » detectable amount of contraband, with >95% confidence level, is 86 paper bills. The contraband was detectable when hidden in household walls made of gyprock or wooden paneling, even when masked by higher density materials such as metallic piping. The device's capability exceeded those of commercially available density-based portable contraband detectors.« less

Large Eddy Simulation of Engineering Flows: A Bill Reynolds Legacy.

NASA Astrophysics Data System (ADS)

Moin, Parviz

2004-11-01

The term, Large eddy simulation, LES, was coined by Bill Reynolds, thirty years ago when he and his colleagues pioneered the introduction of LES in the engineering community. Bill's legacy in LES features his insistence on having a proper mathematical definition of the large scale field independent of the numerical method used, and his vision for using numerical simulation output as data for research in turbulence physics and modeling, just as one would think of using experimental data. However, as an engineer, Bill was pre-dominantly interested in the predictive capability of computational fluid dynamics and in particular LES. In this talk I will present the state of the art in large eddy simulation of complex engineering flows. Most of this technology has been developed in the Department of Energy's ASCI Program at Stanford which was led by Bill in the last years of his distinguished career. At the core of this technology is a fully implicit non-dissipative LES code which uses unstructured grids with arbitrary elements. A hybrid Eulerian/ Largangian approach is used for multi-phase flows, and chemical reactions are introduced through dynamic equations for mixture fraction and reaction progress variable in conjunction with flamelet tables. The predictive capability of LES is demonstrated in several validation studies in flows with complex physics and complex geometry including flow in the combustor of a modern aircraft engine. LES in such a complex application is only possible through efficient utilization of modern parallel super-computers which was recognized and emphasized by Bill from the beginning. The presentation will include a brief mention of computer science efforts for efficient implementation of LES.

Health Care Costs for Adults With Congenital Heart Disease in the United States 2002 to 2012.

PubMed

Briston, David A; Bradley, Elisa A; Sabanayagam, Aarthi; Zaidi, Ali N

2016-08-15

More adults than children with congenital heart disease (CHD) are alive today. Few studies have evaluated adult congenital heart disease (ACHD) health care utilization in the United States. Data from the National Inpatient Sample from 2002 to 2012, using International Classification of Diseases, Ninth Revision, codes for moderate and complex CHD were analyzed. Hospital discharges, total billed and reimbursed amounts, length of stay, and gender/age disparities were evaluated. There was an increase in CHD discharges (moderate CHD: 4,742 vs 6,545; severe CHD: 807 vs 1,115) and total billed and reimbursed dollar amounts across all CHD (billed: $2.7 vs $7.0 billion, 155% increase; reimbursed: $1.3 vs $2.3 billion, 99% increase) and in the ACHD subgroup (billed: $543 million vs $1.5 billion, 178% increase; reimbursed: $221 vs $433 million, 95% increase). Women comprised more discharges in 2002 but not in 2012 (men:women, 2002: 6,503 vs 7,805; 2012: 7,715 vs 7,200, p = 0.39). Gender-based billed amounts followed similar trends (2002: $263 vs $280 million; 2012: $845 vs $662 million, p = 0.006) as did reimbursements (2002: $108 vs $114 million; 2012: $243 vs $190 million, p = 0.008). All age subgroups demonstrated increased health care expenditures, including the >44 versus 18- to 44-year-old age subgroup (billed: $618 vs $347 million, p <0.001; reimbursed: $136 vs $75 million, p <0.001). Our results reveal increased ACHD billed and reimbursed amounts and hospital discharges with a shift in gender-based ACHD hospitalizations: men now account for more hospitalizations in the United States. In conclusion, increased health care expenditure in older patients with ACHD is likely to increase further as health care system use and costs continue to grow. Copyright © 2016 Elsevier Inc. All rights reserved.

Energy Information Resources.

ERIC Educational Resources Information Center

Gaddy, Carol T., Ed.; Wells, Kathy, Ed.

This document was published with the small energy user in mind--the student writing a term paper, the homemaker seeking tips on cutting utility bills, the elderly, farmers, small business owners, factory managers, and Arkansans in all walks of life. Although the volume contains a significant selection of books, magazines, films, and organizations…

NEW CONCEPTS IN TEACHER UTILIZATION.

ERIC Educational Resources Information Center

ESSEX, MARTIN

THE PRESENT CONCERN WITH UPGRADING OF THE DISADVANTAGED IS LISTED AS FOURTH IN A SERIES OF EDUCATIONAL REVOLUTIONS, THE OTHERS BEING (1) HORACE MANN'S COMMON SCHOOL, (2) THE KALAMAZOO DECISION, OPENING SECONDARY EDUCATION TO THE MASSES, AND (3) THE G.I. BILL BREAKTHROUGH IN HIGHER EDUCATION AFTER WORLD WAR II. THE PRESENT SITUATION IS…

The Road to Culturally Relevant Science: Exploring How Teachers Navigate Change in Pedagogy

ERIC Educational Resources Information Center

Johnson, Carla C.

2011-01-01

In this study, two middle-school teachers who participated in a professional development program utilizing the transformative professional development (TPD) model are followed as they embarked upon becoming culturally relevant science teachers of Hispanic students. Using Ladson-Billings (1994) theory of culturally relevant pedagogy, teacher…

49 CFR 1312.4 - Filing of tariffs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... of pages transmitted; (iii) The filing fee enclosed, the account number to be billed, or the credit card to be charged; (iv) The transmittal number if the filer utilizes transmittal numbers; and (v) If the filing fee is charged to a credit card, the credit card number and expiration date, and an...

Evaluating Community College Personnel: A Research Report.

ERIC Educational Resources Information Center

Deegan, William L.; And Others

A statewide survey was conducted of local evaluation policies, procedures, and problems of implementing evaluation programs on the campuses of California community colleges. The following areas were studied: (1) the process of development of the evaluation program; (2) procedures utilized in the first year of implementing Senate Bill 696…

77 FR 27777 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-11

... include the bundling of separately billed drugs, clinical laboratory tests, and other items ``to maximum... the estimated burden; (3) ways to enhance the quality, utility, and clarity of the information to be... Quality Incentive Program (QIP); Use: The Medicare Prescription Drug Improvement, and Modernization Act of...

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

Not Available

Dollars saved through energy efficiency can directly impact your bottom line. Whether you are planning for a major renovation or upgrading individual pieces of building equipment, these improvements can help reduce operating costs, save on utility bills, and boost profits. This fact sheet provides guidelines for SBA lenders to understand the value of financing energy efficiency investments.

49 CFR 1312.4 - Filing of tariffs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... of pages transmitted; (iii) The filing fee enclosed, the account number to be billed, or the credit card to be charged; (iv) The transmittal number if the filer utilizes transmittal numbers; and (v) If the filing fee is charged to a credit card, the credit card number and expiration date, and an...

49 CFR 1312.4 - Filing of tariffs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... of pages transmitted; (iii) The filing fee enclosed, the account number to be billed, or the credit card to be charged; (iv) The transmittal number if the filer utilizes transmittal numbers; and (v) If the filing fee is charged to a credit card, the credit card number and expiration date, and an...

49 CFR 1312.4 - Filing of tariffs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... of pages transmitted; (iii) The filing fee enclosed, the account number to be billed, or the credit card to be charged; (iv) The transmittal number if the filer utilizes transmittal numbers; and (v) If the filing fee is charged to a credit card, the credit card number and expiration date, and an...

49 CFR 1312.4 - Filing of tariffs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... of pages transmitted; (iii) The filing fee enclosed, the account number to be billed, or the credit card to be charged; (iv) The transmittal number if the filer utilizes transmittal numbers; and (v) If the filing fee is charged to a credit card, the credit card number and expiration date, and an...

77 FR 2542 - Information Collection Being Reviewed by the Federal Communications Commission

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-18

...; (b) the accuracy of the Commission's burden estimate; (c) ways to enhance the quality, utility, and... set-aside capacity is available; (c) Rates associated with technical and studio costs; (d) If... billing and collection services to leased access programmers unless they can demonstrate the existence of...

17 CFR 256.01-10 - Billing procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... accounts prescribed by the regulatory authorities to which it is subject. Each month a statement shall be rendered to the associate company containing a summary of the accounts by work order by which the charges...) UNIFORM SYSTEM OF ACCOUNTS FOR MUTUAL SERVICE COMPANIES AND SUBSIDIARY SERVICE COMPANIES, PUBLIC UTILITY...

We got a new digital electric meter. Our usage went up 123%. Our Bill went up 65%

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

Honebein, Peter C.

2010-03-15

There is no question that smart meters are a benefit to utilities, in terms of operational efficiency. But headlines like this one are frightening. They suggest a significant misunderstanding of the technology, marketing, and customer experience surrounding this worthwhile innovation. (author)

A La Buena: Living Better. Bilingual Adult Proficiency Level Materials for Everyday Living.

ERIC Educational Resources Information Center

Smith, Philip D., Jr.; And Others

These bilingual English/Spanish Adult Proficiency Materials comprise three adult education courses in these areas: consumer education, health, and nutrition. Part 1, Consumer Education, covers these topics: money management, credit, frauds, consumer complaints, housing, utility bills, saving energy, banking, insurance (car, health, life), buying a…

A critical analysis of the End of Life Choice Bill 2013.

PubMed

Richmond, David E

2014-07-04

This paper aims to alert medical practitioners to the legal and ethical problems that passage of the End of Life Choice Bill (which seeks to legalise euthanasia and physician-assisted suicide) would have for them in New Zealand. Although sponsor MP Maryan Street withdrew the Bill on political grounds in October 2013, she has pledged to reintroduce the Bill after the next Parliamentary elections and remains committed to its objectives. A clause by clause analysis of the Bill was undertaken from a clinical perspective, following the sequence of requesting, validating, providing and reporting episodes of euthanasia or physician-assisted suicide rather than following the administrative sequence in which the Bill has been drawn up for Parliamentary debate. Where possible, the experience of other jurisdictions where these end of life options are legal has been drawn upon to enable inferences to be drawn as to the likely effects of the legislation. The analysis supporting this paper reveals that the legislation would: make it possible for virtually any person over the age of 18 to request and receive euthanasia provided they took care in the way they phrased the request, expose medical practitioners who attempted to deter applicants too vigorously to the possibility of legal action on the grounds of attempting to frustrate the applicant's wishes, compromise the ability of practitioners to opt out on conscience grounds, allow the easy circumvention of reporting requirements for each event, provide minimal protection against some people suffering euthanasia without consent or request, and exempt medical practitioners providing euthanasia services from prosecution for any action in the provision of such services, even if they were negligent. The branch of medical practice that specialises in killing people would be the least regulated of all. If passed into legislation, the End of Life Choice Bill will create the most momentous changes to clinical practice and the regulation of certain professional activities of medical practitioners that this country has ever seen. Whether they choose to be or not, sooner or later every medical practitioner will be affected by the legislation. It therefore behoves every medical practitioner to examine and understand this Bill and its implications.

Aircraft Survivability. Fall 2011

DTIC Science & Technology

2011-01-01

test the Mi-24 Hind, UH - 60 , and AH-64 Longbow rotorcraft. Bill also sat on the source selection boards for the Utility Tactical Transport Aircraft...medical evacuation (MEDEVAC, UH -60As and Air Force HH- 60s ), RW Attack (Army AH-64s and Marine AH-1s), RW Observation (Army OH-58s), and RW Utility... UH - 60s and UH -1s). Only a very small percentage of the incidents involved fixed wing aircraft with most of those involving C-130 variants that

Electricity, water, and natural gas consumption of a residential house in Canada from 2012 to 2014.

PubMed

Makonin, Stephen; Ellert, Bradley; Bajić, Ivan V; Popowich, Fred

2016-06-07

With the cost of consuming resources increasing (both economically and ecologically), homeowners need to find ways to curb consumption. The Almanac of Minutely Power dataset Version 2 (AMPds2) has been released to help computational sustainability researchers, power and energy engineers, building scientists and technologists, utility companies, and eco-feedback researchers test their models, systems, algorithms, or prototypes on real house data. In the vast majority of cases, real-world datasets lead to more accurate models and algorithms. AMPds2 is the first dataset to capture all three main types of consumption (electricity, water, and natural gas) over a long period of time (2 years) and provide 11 measurement characteristics for electricity. No other such datasets from Canada exist. Each meter has 730 days of captured data. We also include environmental and utility billing data for cost analysis. AMPds2 data has been pre-cleaned to provide for consistent and comparable accuracy results amongst different researchers and machine learning algorithms.

Electricity, water, and natural gas consumption of a residential house in Canada from 2012 to 2014

PubMed Central

Makonin, Stephen; Ellert, Bradley; Bajić, Ivan V.; Popowich, Fred

2016-01-01

With the cost of consuming resources increasing (both economically and ecologically), homeowners need to find ways to curb consumption. The Almanac of Minutely Power dataset Version 2 (AMPds2) has been released to help computational sustainability researchers, power and energy engineers, building scientists and technologists, utility companies, and eco-feedback researchers test their models, systems, algorithms, or prototypes on real house data. In the vast majority of cases, real-world datasets lead to more accurate models and algorithms. AMPds2 is the first dataset to capture all three main types of consumption (electricity, water, and natural gas) over a long period of time (2 years) and provide 11 measurement characteristics for electricity. No other such datasets from Canada exist. Each meter has 730 days of captured data. We also include environmental and utility billing data for cost analysis. AMPds2 data has been pre-cleaned to provide for consistent and comparable accuracy results amongst different researchers and machine learning algorithms. PMID:27271937

Implementing a School-Located Vaccination Program in Denver Public Schools.

PubMed

Shlay, Judith C; Rodgers, Sarah; Lyons, Jean; Romero, Scott; Vogt, Tara M; McCormick, Emily V

2015-08-01

School-located vaccination (SLV) offers an opportunity to deliver vaccines to students, particularly those without a primary care provider. This SLV program offered 2 clinics at each of 20 elementary schools (influenza vaccine) and 3 clinics at each of 7 middle/preschool-eighth-grade schools (adolescent platform plus catch-up vaccines) during the 2009-2010 and 2010-2011 school years. Established programmatic processes for immunization delivery in an outreach setting were used. Billing and vaccine inventory management processes were developed. Vaccines from the federal Vaccines for Children program were used for eligible students. Third-party payers were billed for insured students; parents were not billed for services. The proportion of enrolled students who received at least 1 dose of vaccine increased from year 1 to year 2 (elementary: 28% to 31%; middle: 12% to 19%). Issues identified and addressed included program planning with partners, development and implementation of billing processes, development of a solution to adhere to the Family Educational Rights and Privacy Act requirements, development and utilization of an easy-to-comprehend consent form, and implementation of standard work procedures. This SLV program offered an alternative approach for providing vaccinations to students outside of the primary care setting. To be successful, ongoing partnerships are needed. © 2015, American School Health Association.

Electricity Bill Savings from Residential Photovoltaic Systems: Sensitivities to Changes in Future Electricity Market Conditions

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

Darghouth, Naim; Barbose, Galen; Wiser, Ryan

2013-01-09

Customer-sited photovoltaic (PV) systems in the United States are often compensated at the customer’s underlying retail electricity rate through net metering. Calculations of the customer economics of PV, meanwhile, often assume that retail rate structures and PV compensation mechanisms will not change and that retail electricity prices will increase (or remain constant) over time, thereby also increasing (or keeping constant) the value of bill savings from PV. Given the multitude of potential changes to retail rates and PV compensation mechanisms in the future, however, understanding how such changes might impact the value of bill savings from PV is critical formore » policymakers, regulators, utilities, the solar industry, and potential PV owners, i.e., any stakeholder interested in understanding uncertainties in and potential changes to the long-term customer economics of PV. This scoping study investigates the impact of, and interactions among, three key sources of uncertainty in the future value of bill savings from customer-sited PV, focusing in particular on residential customers. These three sources of uncertainty are: changes to electricity market conditions that would affect retail electricity prices, changes to the types of retail rate structures available to residential customers with PV, and shifts away from standard net-metering toward other compensation mechanisms for residential PV.« less

State formulating lifeline program

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

Not Available

1978-09-01

The Board of Public Utilities (BPU) of New Jersey is formulating a lifeline program which would provide low-income and elderly customers with reduced utility rates. It is estimated that 30% of the households in New Jersey will qualify for the program. While the legislation calls for the lowest effective rate of any customer class, each utility would have its own lifeline program because of differing rates among utility companies. Eligibility requirements would be applied statewide. The utilities will fund the new program by restructuring the existing rates for regular customers. In which case lifeline recipients' rate would decrease while regularmore » customers' bills would increase. Eventually, the BPU expects to fund about 10% of the senior citizens' portion of the program with the state's casino gambling revenues.« less

Energy Evaluation of a New Construction Pilot Community: Fresno, California

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

Burdick, A.; Poerschke, A.; Rapport, A.

2014-06-01

A new construction pilot community was constructed by builder-partner Wathen-Castanos Hybrid Homes (WCHH) based on a single occupied test house that was designed to achieve greater than 30% energy savings with respect to the House Simulation Protocols (Hendron, Robert; Engebrecht, Cheryn (2010). Building America House Simulation Protocols. Golden, CO: National Renewable Energy Laboratory). Builders face several key problems when implementing a whole-house systems integrated measures package (SIMP) from a single test house into multiple houses. Although a technical solution already may have been evaluated and validated in an individual test house, the potential exists for constructability failures at the communitymore » scale. This report addresses factors of implementation and scalability at the community scale and proposes methodologies by which community-scale energy evaluations can be performed based on results at the occupied test house level. Research focused on the builder and trade implementation of a SIMP and the actual utility usage in the houses at the community scale of production. Five occupants participated in this community-scale research by providing utility bills and information on occupancy and miscellaneous gas and electric appliance use for their houses. IBACOS used these utility data and background information to analyze the actual energy performance of the houses. Verification with measured data is an important component in predictive energy modeling. The actual utility bill readings were compared to projected energy consumption using BEopt with actual weather and thermostat set points for normalization.« less

Building America Case Study: Low-Cost Evaluation of Energy Savings at the Community Scale, Fresno, California (Fact Sheet)

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

Not Available

2014-10-01

A new construction pilot community was constructed by builder-partner Wathen-Castanos Hybrid Homes (WCHH) based on a single occupied test house that was designed to achieve greater than 30% energy savings with respect to the House Simulation Protocols (Hendron, Robert; Engebrecht, Cheryn (2010). Building America House Simulation Protocols. Golden, CO: National Renewable Energy Laboratory.). Builders face several key problems when implementing a whole-house systems integrated measures package (SIMP) from a single test house into multiple houses. Although a technical solution already may have been evaluated and validated in an individual test house, the potential exists for constructability failures at the communitymore » scale. This report addresses factors of implementation and scalability at the community scale and proposes methodologies by which community-scale energy evaluations can be performed based on results at the occupied test house level. Research focused on the builder and trade implementation of a SIMP and the actual utility usage in the houses at the community scale of production. Five occupants participated in this community-scale research by providing utility bills and information on occupancy and miscellaneous gas and electric appliance use for their houses. IBACOS used these utility data and background information to analyze the actual energy performance of the houses. Verification with measured data is an important component in predictive energy modeling. The actual utility bill readings were compared to projected energy consumption using BEopt with actual weather and thermostat set points for normalization.« less

Modelling the Effects of Teacher Demand Factors on Teacher Understaffing in Public Secondary Schools in Kenya

ERIC Educational Resources Information Center

Wamukuru, David Kuria

2016-01-01

The secondary school teacher labour market faces many challenges including, escalating teacher wage bill, teacher shortages that occur alongside teacher surpluses, inadequate teacher distribution and inefficient teacher utilization. There is the need therefore to understand the effects of the factors determining demand for secondary school…

ResStock - Targeting Energy and Cost Savings for U.S. Homes | NREL

Science.gov Websites

ResStock - Targeting Energy and Cost Savings for U.S. Homes Science and Technology Highlights Highlights in Research & Development ResStock - Targeting Energy and Cost Savings for U.S. Homes Key discovered $49 billion in potential annual utility bill savings through cost-effective energy efficiency

Existing Whole-House Solutions Case Study: Habitat for Humanity of Palm Beach County, Lake Worth, Florida

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

none,

2012-03-01

PNNL and Florida Solar Energy Center worked with Habitat for Humanity of Palm Beach County to upgrade an empty 1996 home with a 14.5 SEER AC, heat pump water heater, CFLs, more attic insulation, and air sealing to cut utility bills $872 annually.

Electronic Mail: Defining a Role for the U.S. Postal Service.

ERIC Educational Resources Information Center

McLaughlin, John F.

Threatened by competitive diversification and by increasing costs, the United States Postal Service has investigated two potential cost reducing systems: (1) a microsystem which would provide electronic facsimile transmission between major markets and (2) a macrosystem which could take digital input such as utility bills and deliver a hardcopy to…

Challenges on the Front Lines: Serving Today's Student Veterans

ERIC Educational Resources Information Center

Taylor, Alexander; Parks, Rodney; Edwards, Ashley

2016-01-01

In recent years, veterans have enrolled at higher education institutions in vastly increasingly numbers to utilize their Post-9/11 GI Bill benefits. In response to this influx, universities have established a variety of resources and support systems designed to serve the needs of student veterans. There has also been heightened attention toward…

Faces of the Recovery Act: The Impact of Smart Grid

ScienceCinema

President Obama

2017-12-09

On October 27th, Baltimore Gas & Electric was selected to receive $200 million for Smart Grid innovation projects under the Recovery Act. Watch as members of their team, along with President Obama, explain how building a smarter grid will help consumers cut their utility bills, battle climate change and create jobs.

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

Allgood, Tiffany L.; Sorter, Andy

The Coeur d'Alene Tribe's Energy Efficiency Feasibility Study (EEFS) is the culminating document that compiles the energy efficiency and building performance assessment and project prioritization process completed on 36 Tribally owned and operated facilities within Tribal lands. The EEFS contains sections on initial findings, utility billing analyses, energy conservation measures and prioritization and funding sources and strategies for energy project implementation.

27 CFR 478.124 - Firearms transaction record.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the firearms. (c)(1) Prior to making an over-the-counter transfer of a firearm to a nonlicensee who is... form the documentation used. Examples of acceptable documentation include utility bills or a lease... making an over-the-counter transfer of a shotgun or rifle under the provisions contained in § 478.96(c...

27 CFR 478.124 - Firearms transaction record.

Code of Federal Regulations, 2012 CFR

2012-04-01

... the firearms. (c)(1) Prior to making an over-the-counter transfer of a firearm to a nonlicensee who is... form the documentation used. Examples of acceptable documentation include utility bills or a lease... making an over-the-counter transfer of a shotgun or rifle under the provisions contained in § 478.96(c...

NREL to Host Range of Activities for Energy Awareness Month

Science.gov Websites

Host Range of Activities for Energy Awareness Month Events devoted to energy savings Golden, Colo., Sept. 20, 2000 - Visitors will get an inside look at advanced energy technologies and learn tips for cutting utility bills when the U.S. Department of Energy's National Renewable Energy

77 FR 46213 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-02

.... Monitoring Impact of FY 2012 Policy Changes and Certain SNF Practices A. RUG Distributions B. Group Therapy... Common Procedure Coding System HR-III Hybrid Resource Utilization Groups, Version 3 IHS IGI (Information... OCN OMB Control Number OMB Office of Management and Budget OMRA Other Medicare-Required Assessment PPS...

Effects of Alaska Oil and Natural Gas Provisions of H. R. 4 and S. 1766 on U.S. Energy Markets

EIA Publications

2002-01-01

On December 20, 2001, Sen. Frank Murkowski, the Ranking Minority Member of the Senate Committee on Energy and Natural Resources requested an analysis of selected portions of Senate Bill 1766 (S. 1766, the Energy Policy Act of 2002) and House Bill H.R. 4 (the Securing America's Future Energy Act of 2001). In response, the Energy Information Administration (EIA) has prepared a series of analyses showing the impacts of each of the selected provisions of the bills on energy supply, demand, and prices, macroeconomic variables where relevant, import dependence, and emissions. The analysis provided is based on the Annual Energy Outlook 2002 (AEO2002) midterm forecasts of energy supply, demand, and prices through 2020.

Selected accounts receivable performance statistics for radiology practices: an analysis of the adjusted collection percentage and days charges in accounts receivable.

PubMed

Cergnul, John J; Russell, Philip J; Sunshine, Jonathan H

2005-12-01

To provide comparative data and analysis with respect to accounts receivable management performance criteria. Data from 3 sources were analyzed: the Radiology Business Management Association's (RBMA) 2003 Accounts Receivable Performance Survey; the RBMA's 2003 Accounts Receivable Survey; and Hogan and Sunshine's 2004 Radiology article "Financial Ratios in Diagnostic Radiology Practices: Variability and Trends," the data for which were drawn primarily from the ACR's 1999 Survey of Practices. The RBMA surveyed (via e-mail and postal mail) only its members, with response rates of 15% and 9%, respectively. The ACR's survey response rate was 66%, via postal mail, and was distributed without regard to the RBMA membership status of the practice manager or even whether the practice employed a practice manager. Comparison among the survey results provided information on trends. Median practice professional component adjusted collection percentage (ACP) deteriorated from 87.3% to 85.1% between the RBMA surveys. Practices limited to global fee billing faired much better when performing their billing in house, as opposed to using a billing service, with mean ACPs of 91.2% and 79.4%, respectively. Days charges in accounts receivable 2004 mean results for professional component billing and global fee billing were nearly identical at 56.11 and 55.54 days, respectively. The 2003 RBMA survey reported 63.74 days for professional component billing and 77.33 days for global fee billing. The improvement from 2003 to 2004 was highly significant for both professional component billing and global fee billing. The 2004 RBMA survey also reflected a rather dramatic improvement in days charges in accounts receivable compared with Hogan and Sunshine's results, which showed a mean of 69 days charges in accounts receivable. The conflicting trends between ACP performance and days charges in accounts receivable performance may be explained by the increasing sophistication of accounts receivable management processes (improving days charges in accounts receivable) and the deterioration in the general economy between survey periods (decreasing ACPs). Additionally, generally better accounts receivable management performance was experienced by practices employing RBMA members (RBMA survey participants) compared with those that may or may not have employed RBMA members (ACR survey participants).

Financial impact of emergency department ultrasound.

PubMed

Soremekun, Olanrewaju A; Noble, Vicki E; Liteplo, Andrew S; Brown, David F M; Zane, Richard D

2009-07-01

There is limited information on the financial implications of an emergency department ultrasound (ED US) program. The authors sought to perform a fiscal analysis of an integrated ED US program. A retrospective review of billing data was performed for fiscal year (FY) 2007 for an urban academic ED with an ED US program. The ED had an annual census of 80,000 visits and 1,101 ED trauma activations. The ED is a core teaching site for a 4-year emergency medicine (EM) residency, has 35 faculty members, and has 24-hour availability of all radiology services including formal US. ED US is utilized as part of evaluation of all trauma activations and for ED procedures. As actual billing charges and reimbursement rates are institution-specific and proprietary information, relative value units (RVUs) and reimbursement based on the Centers for Medicare & Medicaid Services (CMS) 2007 fee schedule (adjusted for fixed diagnosis-related group [DRG] payments and bad debt) was used to determine revenue generated from ED US. To estimate potential volume, assumptions were made on improvement in documentation rate for diagnostic scans (current documentation rates based on billed volume versus diagnostic studies in diagnostic image database), with no improvements assumed for procedural ED US. Expenses consist of three components-capital costs, training costs, and ongoing operational costs-and were determined by institutional experience. Training costs were considered sunken expenses by this institution and were thus not included in the original return on investment (ROI) calculation, although for this article a second ROI calculation was done with training cost estimates included. For the purposes of analysis, certain key assumptions were made. We utilized a collection rate of 45% and hospitalization rates (used to adjust for fixed DRG payments) of 33% for all diagnostic scans, 100% for vascular access, and 10% for needle placement. An optimal documentation rate of 95% was used to estimate potential revenue. In FY 2007, 486 limited echo exams of abdomen (current procedural terminology [CPT] 76705) and 480 limited echo cardiac exams were performed (CPT 93308) while there were 78 exams for US-guided vascular access (CPT 76937) and 36 US-guided needle placements when performing paracentesis, thoracentesis, or location of abscess for drainage (CPT 76492). Applying the 2007 CMS fee schedule and above assumptions, the revenue generated was 578 RVUs and $35,541 ($12,934 in professional physician fees and $22,607 in facility fees). Assuming optimal documentation rates for diagnostic ED US scans, ED US could have generated 1,487 RVUs and $94,593 ($33,953 in professional physician fees and $60,640 in facility fees). Program expenses include an initial capital expense (estimated at $120,000 for two US machines) and ongoing operational costs ($68,640 per year to cover image quality assurance review, continuing education, and program maintenance). Based on current revenue, there would be an annual operating loss, and thus an ROI cannot be calculated. However, if potential revenue is achieved, the annual operating income will be $22,846 per year with an ROI of 4.9 years to break even with initial investment. Determining an ROI is a required procedure for any business plan for establishing an ED US program. Our analysis demonstrates that an ED US program that captures charges for trauma and procedural US and achieves the potential billing volume breaks even in less than 5 years, at which point it would generate a positive margin.

Approaching 4 Decades of Legislation in the National Family Planning Program: An Analysis of Title X's History From 1970 to 2008

PubMed Central

Daley, Ellen M.; Perrin, Kay M.; Mahan, Charles S.; Buhi, Eric R.

2011-01-01

Family planning is an important public health activity. Title X (Pub L No. 91-572), enacted in 1970, remains the only national family planning program in the United States dedicated to providing voluntary and confidential services to all individuals. We conducted a thematic analysis of Title X's legislative history. Of 293 federal bills included in the legislative history, only 20 (6.8%) were enacted into law. Regardless of the proposed challenges, limited changes have been adopted. Except for technical amendments, bills involving restrictions accounted for the highest percentage of enacted bills, demonstrating efforts to undermine reproductive health rights. Title X requires political will and bipartisan support if it is to continue to protect individuals' reproductive rights. PMID:21940931

Temporal Patterns of Behavior from the Scheduling of Psychology Quizzes

ERIC Educational Resources Information Center

Jarmolowicz, David P.; Hayashi, Yusuke; St. Peter Pipkin, Claire

2010-01-01

Temporal patterns of behavior have been observed in real-life performances such as bill passing in the U.S. Congress, in-class studying, and quiz taking. However, the practical utility of understanding these patterns has not been evaluated. The current study demonstrated the presence of temporal patterns of quiz taking in a university-level…

REAR DETAIL OF RIGHT ENGINE AND WING. THRUST REVERSER REMAINS ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

REAR DETAIL OF RIGHT ENGINE AND WING. THRUST REVERSER REMAINS OPEN. MECHANICS JONI BAINE (R) AND BILL THEODORE(L) OPEN FLAP CARRIAGE ACCESS WITH AN IMPACT GUN. THEY WILL CHECK TRANSMISSION FLUID AND OIL THE JACK SCREW. AT FAR LEFT UTILITY MECHANICS BEGIN BODY POLISHING. - Greater Buffalo International Airport, Maintenance Hangar, Buffalo, Erie County, NY

Response of timber growth and avian communities to quality vegetation management in mid-rotation crp pine plantations

Treesearch

Brandon G. Sladek; Ian A. Munn; L. Wes Burder; Scott D. Roberts

2006-01-01

Provisions of the 2002 Farm Bill gave Conservation Reserve Program (CRP) participants greater flexibility to implement mid-contract management activities that encourage wildlife habitat improvement and timber production. Quality Vegetation Management (QVM) is one such technique that utilizes the selective herbicide Imazapyr and prescribed burning. Timber growth (d.b.h...

The Importance of Interaction in Web-Based Education: A Program-Level Case Study of Online MBA Courses

ERIC Educational Resources Information Center

Su, Bude; Bonk, Curtis J.; Magjuka, Richard J.; Liu, Xiaojing; Lee, Seung-hee

2005-01-01

Though interaction is often billed as a significant component of successful online learning, empirical evidence of its importance as well as practical guidance or specific interaction techniques continue to be lacking. In response, this study utilizes both quantitative and qualitative data to investigate how instructors and students perceive the…

An Investigation of Racial and/or Ethnic Minority Teacher Candidates' Strengths Awareness and Utilization

ERIC Educational Resources Information Center

Chen, Hui

2012-01-01

There is a consensus among researchers that teachers from diverse linguistic, cultural, and ethnic backgrounds contribute to American education (Dee, 2004; Easton-Brooks, Lewis, & Yang, 2010; Irvine, 2003; Irvine & Fenwick, 2011; Ladson-Billings, 2005; Lu, 2005; Talbert-Johnson, 2001). There is also a call for teacher educators to recognize what…

Comprehensive Services Tailored for the Transitional Success of Veterans in Higher Education

ERIC Educational Resources Information Center

Lange, Dustin D.; Sears, Susann Heft; Osborne, Nicholas J.

2016-01-01

It is estimated that in the next decade, over two million veterans and dependents will utilize the Post-9/11 GI Bill for postsecondary education. Most colleges already possess the resources that veterans need to successfully transition and persist, though this subpopulation of learners also require services that are tailored to their…

8 CFR 245.15 - Adjustment of status of certain Haitian nationals under the Haitian Refugee Immigrant Fairness...

Code of Federal Regulations, 2010 CFR

2010-01-01

..., unless the Director refers the applicant for a personal interview at a local Service office as provided... records; (ii) Rental receipts; (iii) Utility bill receipts; (iv) Any other dated receipts; (v) Personal...) Adjudication of HRIFA applications filed with the Service—(1) Referral for interview. Except as provided in...

8 CFR 1245.15 - Adjustment of status of certain Haitian nationals under the Haitian Refugee Immigrant Fairness...

Code of Federal Regulations, 2010 CFR

2010-01-01

..., unless the Director refers the applicant for a personal interview at a local Service office as provided... records; (ii) Rental receipts; (iii) Utility bill receipts; (iv) Any other dated receipts; (v) Personal...) Adjudication of HRIFA applications filed with the Service—(1) Referral for interview. Except as provided in...

AB 540: Tuition Waiver Policy in California: How Student Services Professionals Influence College Access for Undocumented Students

ERIC Educational Resources Information Center

Wang, Lynn J.

2018-01-01

This was an exploratory qualitative study utilizing tenets of phenomenology to examine the lived experiences of front-line student services professionals in Admissions and Financial Aid and their dilemmas in interpreting and implementing California Assembly Bill 540 (2001) in their interactions with undocumented students. Front-line student…

To amend the DNA Analysis Backlog Elimination Act of 2000 to provide for Debbie Smith grants for auditing sexual assault evidence backlogs, and for other purposes.

THOMAS, 112th Congress

Sen. Cornyn, John [R-TX

2012-05-24

Senate - 01/02/2013 Message on House action received in Senate and at desk: House amendments to Senate bill. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

Ecological Modernization and the US Farm Bill: The Case of the Conservation Security Program

ERIC Educational Resources Information Center

Lenihan, Martin H.; Brasier, Kathryn J.

2010-01-01

This paper examines the debate surrounding the inception of the Conservation Security Program (CSP) under the 2002 US Farm Bill as a possible expression of ecological modernization by examining the discursive contributions made by official actors, social movement organizations, and producer organizations. Based on this analysis, the CSP embodies…

Politicizing Sociology through a Bill of Rights Learning Module

ERIC Educational Resources Information Center

Sweet, Stephen

2009-01-01

Writers in this journal have presented a number of strategies that sociology teachers can use to facilitate the expression--and serious analysis--of unpopular opinions. This article contributes to this dialog by illustrating the application of a Bill of Rights learning module. In this module, students are expected to create a document that…

Gender identification of Caspian Terns using external morphology and discriminant function analysis

USGS Publications Warehouse

Ackerman, Joshua T.; Takekawa, John Y.; Bluso, J.D.; Yee, J.L.; Eagles-Smith, Collin A.

2008-01-01

Caspian Tern (Sterna caspia) plumage characteristics are sexually monochromatic and gender cannot easily be distinguished in the field without extensive behavioral observations. We assessed sexual size dimorphism and developed a discriminant function to assign gender in Caspian Terns based on external morphology. We collected and measured Caspian Terns in San Francisco Bay, California, and confirmed their gender based on necropsy and genetic analysis. Of the eight morphological measurements we examined, only bill depth at the gonys and head plus bill length differed between males and females with males being larger than females. A discriminant function using both bill depth at the gonys and head plus bill length accurately assigned gender of 83% of terns for which gender was known. We improved the accuracy of our discriminant function to 90% by excluding individuals that had less than a 75% posterior probability of correctly being assigned to gender. Caspian Terns showed little sexual size dimorphism in many morphometries, but our results indicate they can be reliably assigned to gender in the field using two morphological measurements.

Hospital cost structure in the USA: what's behind the costs? A business case.

PubMed

Chandra, Charu; Kumar, Sameer; Ghildayal, Neha S

2011-01-01

Hospital costs in the USA are a large part of the national GDP. Medical billing and supplies processes are significant and growing contributors to hospital operations costs in the USA. This article aims to identify cost drivers associated with these processes and to suggest improvements to reduce hospital costs. A Monte Carlo simulation model that uses @Risk software facilitates cost analysis and captures variability associated with the medical billing process (administrative) and medical supplies process (variable). The model produces estimated savings for implementing new processes. Significant waste exists across the entire medical supply process that needs to be eliminated. Annual savings, by implementing the improved process, have the potential to save several billion dollars annually in US hospitals. The other analysis in this study is related to hospital billing processes. Increased spending on hospital billing processes is not entirely due to hospital inefficiency. The study lacks concrete data for accurately measuring cost savings, but there is obviously room for improvement in the two US healthcare processes. This article only looks at two specific costs associated with medical supply and medical billing processes, respectively. This study facilitates awareness of escalating US hospital expenditures. Cost categories, namely, fixed, variable and administrative, are presented to identify the greatest areas for improvement. The study will be valuable to US Congress policy makers and US healthcare industry decision makers. Medical billing process, part of a hospital's administrative costs, and hospital supplies management processes are part of variable costs. These are the two major cost drivers of US hospitals' expenditures that were examined and analyzed.

How sailfish use their bills to capture schooling prey

PubMed Central

Domenici, P.; Wilson, A. D. M.; Kurvers, R. H. J. M.; Marras, S.; Herbert-Read, J. E.; Steffensen, J. F.; Krause, S.; Viblanc, P. E.; Couillaud, P.; Krause, J.

2014-01-01

The istiophorid family of billfishes is characterized by an extended rostrum or ‘bill’. While various functions (e.g. foraging and hydrodynamic benefits) have been proposed for this structure, until now no study has directly investigated the mechanisms by which billfishes use their rostrum to feed on prey. Here, we present the first unequivocal evidence of how the bill is used by Atlantic sailfish (Istiophorus albicans) to attack schooling sardines in the open ocean. Using high-speed video-analysis, we show that (i) sailfish manage to insert their bill into sardine schools without eliciting an evasive response and (ii) subsequently use their bill to either tap on individual prey targets or to slash through the school with powerful lateral motions characterized by one of the highest accelerations ever recorded in an aquatic vertebrate. Our results demonstrate that the combination of stealth and rapid motion make the sailfish bill an extremely effective feeding adaptation for capturing schooling prey. PMID:24759865

Homophobia as a barrier to comprehensive media coverage of the Ugandan anti-homosexual bill.

PubMed

Strand, Cecilia

2012-01-01

The Ugandan Anti-Homosexuality Bill of October 2009 caused an international outcry and sparked intense debate in the local media. This article explores to what degree a discriminatory social environment manifests itself in the Ugandan print media and discusses the potential implications for media's coverage of contentious policy options such as the Anti-Homosexuality Bill. A content analysis of 115 items from two daily newspapers (the government-owned New Vision and the privately owned the Daily Monitor, between October and December 2009) indicates the existence of two separate house styles; this is in spite of the fact that both newspapers reproduce the surrounding society's homophobia, albeit with different frequency. Unlike the New Vision, the Daily Monitor includes coverage on homophobia and discrimination, as well as provides space for criticism of the Bill. By acknowledging discrimination and its negative impact, the newspaper de-legitimizes homophobia and problematizes the proposed Anti-homosexuality Bill for their readers.

A PBOM configuration and management method based on templates

NASA Astrophysics Data System (ADS)

Guo, Kai; Qiao, Lihong; Qie, Yifan

2018-03-01

The design of Process Bill of Materials (PBOM) holds a hinge position in the process of product development. The requirements of PBOM configuration design and management for complex products are analysed in this paper, which include the reuse technique of configuration procedure and urgent management need of huge quantity of product family PBOM data. Based on the analysis, the function framework of PBOM configuration and management has been established. Configuration templates and modules are defined in the framework to support the customization and the reuse of configuration process. The configuration process of a detection sensor PBOM is shown as an illustration case in the end. The rapid and agile PBOM configuration and management can be achieved utilizing template-based method, which has a vital significance to improve the development efficiency for complex products.

Additional Analysis of the ESTCP Discrimination Study Data at Camp Sibert, Alabama. Project 200504: Practical Discrimination Strategies for Application to Live Sites

DTIC Science & Technology

2008-10-20

Dr. Stephen Billings Dr. Leonard Pasion Sky Research, Inc) Laurens Beran UBC-GIF Approved for public release; distribution...Sites 5. FUNDING NUMBERS Contract # W912HQ-05-C-0018 6. AUTHOR(S) Dr. Stephen Billings, Dr. Leonard Pasion (Sky Research, Inc.) Laurens Beran...representative of the test datasets. ESTCP MM-0504: Additional Analysis of Camp Sibert Data Sky Research Inc October 2008 References [1] L.R. Pasion , N

Laboratory cost control and financial management software.

PubMed

Mayer, M

1998-02-09

Economical constraints within the health care system advocate the introduction of tighter control of costs in clinical laboratories. Detailed cost information forms the basis for cost control and financial management. Based on the cost information, proper decisions regarding priorities, procedure choices, personnel policies and investments can be made. This presentation outlines some principles of cost analysis, describes common limitations of cost analysis, and exemplifies use of software to achieve optimized cost control. One commercially available cost analysis software, LabCost, is described in some detail. In addition to provision of cost information, LabCost also serves as a general management tool for resource handling, accounting, inventory management and billing. The application of LabCost in the selection process of a new high throughput analyzer for a large clinical chemistry service is taken as an example for decisions that can be assisted by cost evaluation. It is concluded that laboratory management that wisely utilizes cost analysis to support the decision-making process will undoubtedly have a clear advantage over those laboratories that fail to employ cost considerations to guide their actions.

Financial viability, benefits and challenges of employing a nurse practitioner in general practice.

PubMed

Helms, Christopher; Crookes, Jo; Bailey, David

2015-04-01

This case study examines the financial viability, benefits and challenges of employing a primary healthcare (PHC) nurse practitioner (NP) in a bulk-billing healthcare cooperative in the Australian Capital Territory. There are few empirical case reports in the Australian literature that demonstrate financial sustainability of this type of healthcare professional in primary healthcare. This case study demonstrates that the costs of employing a PHC-NP in general practice are offset by direct and indirect Medicare billings generated by the PHC-NP, resulting in a cost-neutral healthcare practitioner. The success of this model relies on bidirectional collaborative working relationships amongst general practitioners and NPs. PHC-NPs should have a generalist scope of practice and specialist expertise in order to maximise their utility within the general practice environment.

Are There Spillover Effects from the GI Bill? The Mental Health of Wives of Korean War Veterans.

PubMed

Vable, Anusha M; Kawachi, Ichiro; Canning, David; Glymour, M Maria; Jimenez, Marcia P; Subramanian, S V

2016-01-01

The Korean War GI Bill provided economic benefits for veterans, thereby potentially improving their health outcomes. However potential spillover effects on veteran wives have not been evaluated. Data from wives of veterans eligible for the Korean War GI Bill (N = 128) and wives of non-veterans (N = 224) from the Health and Retirement Study were matched on race and coarsened birth year and childhood health using coarsened exact matching. Number of depressive symptoms in 2010 (average age = 78) were assessed using a modified, validated Center for Epidemiologic Studies-Depression Scale. Regression analyses were stratified into low (mother < 8 years schooling / missing data, N = 95) or high (mother ≥ 8 years schooling, N = 257) childhood socio-economic status (cSES) groups, and were adjusted for birth year and childhood health, as well as respondent's educational attainment in a subset of analyses. Husband's Korean War GI Bill eligibility did not predict depressive symptoms among veteran wives in pooled analysis or cSES stratified analyses; analyses in the low cSES subgroup were underpowered (N = 95, β = -0.50, 95% Confidence Interval: (-1.35, 0.35), p = 0.248, power = 0.28). We found no evidence of a relationship between husband's Korean War GI Bill eligibility and wives' mental health in these data, however there may be a true effect that our analysis was underpowered to detect.

Opportunities for improving legislative public health policy in Rhode Island through evidence-based education.

PubMed

Bourdeau, Moise; Winter, Ronald; Marshall, Robert

2013-10-01

The Rhode Island General Assembly considers nearly 3000 bills yearly--spanning the entire range of issues related to state government and legislative policy. This review analyzes the modest number of 40 "health-related" bills introduced during the 2009 session. It is often not clear to what extent these proposals consistently received analysis by both informed and independent organizations or experts regarding their "evidence-based" foundations. Only 25 of these bills received a committee hearing, and eventually become law. Hence, there may be a reasonable opportunity for expert, non-partisan organizations to provide the General Assembly with information related to proposed legislation on a routine or "as requested" basis. This study provides a systematic analysis of this degree of effort based on data regarding health- related legislation proposed during the 2009 session of the RI General Assembly.

Effects of Home Energy Management Systems on Distribution Utilities and Feeders Under Various Market Structures: Preprint

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

Ruth, Mark; Pratt, Annabelle; Lunacek, Monte

2015-07-17

The combination of distributed energy resources (DER) and retail tariff structures to provide benefits to both utility consumers and the utilities is poorly understood. To improve understanding, an Integrated Energy System Model (IESM) is being developed to simulate the physical and economic aspects of DER technologies, the buildings where they reside, and feeders servicing them. The IESM was used to simulate 20 houses with home energy management systems on a single feeder under a time of use tariff to estimate economic and physical impacts on both the households and the distribution utilities. HEMS reduce consumers’ electric bills by precooling housesmore » in the hours before peak electricity pricing. Household savings are greater than the reduction utility net revenue indicating that HEMS can provide a societal benefit providing tariffs are structured so that utilities remain solvent. Utilization of HEMS reduce peak loads during high price hours but shifts it to hours with off-peak and shoulder prices and resulting in a higher peak load.« less

A Descriptive Study of Students with Disabilities at Montana State University Billings

ERIC Educational Resources Information Center

Dell, Thomas Francis

2013-01-01

The purpose of this study was to describe and analyze how the characteristics of age, major and type of disabilities for students who received services through Disability Support Services at Montana State University-Billings have changed from 1999 to 2011. Furthermore, this analysis contrasted local trends for types of disabilities with national…

What Does C-51 Mean for Academic Freedom & Campus Free Speech? CAUT Analysis of Bill C-51

ERIC Educational Resources Information Center

Canadian Association of University Teachers, 2015

2015-01-01

Bill C-51, the Canadian federal government's "Anti-Terrorism Act," has sparked serious concerns about the potential impact on the basic civil liberties of all Canadians. The proposed legislation would establish criminal offences that infringe upon the right to free expression. Security agencies would be granted unprecedented and…

Bonneville, Power Administration Timing System

NASA Technical Reports Server (NTRS)

Martin, Kenneth E.

1996-01-01

Time is an integral part of the Bonneville Power Administration's (BPA) operational systems. Generation and power transfers are planned in advance. Utilities coordinate with each other by making these adjustments on a timed schedule. Price varies with demand, so billing is based on time. Outages for maintenance are scheduled to assure they do not interrupt reliable power delivery. Disturbance records are aligned with recorded timetags for analysis and comparison with related information. Advanced applications like traveling wave fault location and real-time phase measurement require continuous timing with high precision. Most of BPA is served by a Central Time System (CTS) at the Dittmer Control Center near Portland, OR. This system keeps time locally and supplies time to both the control center systems and field locations via a microwave signal. It is kept synchronized to national standard time and coordinated with interconnected utilities. It is the official BPA time. Powwer system control and operation is described, followed by a description of BPA timing systems including CTS, the Fault Location Acquisition Reporter, time dissemination, and phasor measurements. References are provided for further reading.

Predicting and understanding law-making with word vectors and an ensemble model.

PubMed

Nay, John J

2017-01-01

Out of nearly 70,000 bills introduced in the U.S. Congress from 2001 to 2015, only 2,513 were enacted. We developed a machine learning approach to forecasting the probability that any bill will become law. Starting in 2001 with the 107th Congress, we trained models on data from previous Congresses, predicted all bills in the current Congress, and repeated until the 113th Congress served as the test. For prediction we scored each sentence of a bill with a language model that embeds legislative vocabulary into a high-dimensional, semantic-laden vector space. This language representation enables our investigation into which words increase the probability of enactment for any topic. To test the relative importance of text and context, we compared the text model to a context-only model that uses variables such as whether the bill's sponsor is in the majority party. To test the effect of changes to bills after their introduction on our ability to predict their final outcome, we compared using the bill text and meta-data available at the time of introduction with using the most recent data. At the time of introduction context-only predictions outperform text-only, and with the newest data text-only outperforms context-only. Combining text and context always performs best. We conducted a global sensitivity analysis on the combined model to determine important variables predicting enactment.

Resources for Shaping Collective Bargaining Laws to Meet the Special Needs of Higher Education. Special Report No. 18.

ERIC Educational Resources Information Center

Academic Collective Bargaining Information Service, Washington, DC.

At least 10 additional states, as of Febraury 1975, and the Congress of the United States are shaping bills that, should they become law, will enable teachers and other professionals employed by public colleges and universities to utilize collective bargaining as an instrument for determining wages, hours, and other conditions of employment. Many…

Evaluation of the Veterans' Education and Training Service (VETS) Program of the National League of Cities and U.S. Conference of Mayors.

ERIC Educational Resources Information Center

Scheflen, Kenneth C.; Brandewie, Robert J.

The document evaluates the impact of the Veterans' Education and Training Service (VETS) program on G.I. Bill utilization rates. The VETS program is designed to increase enrollments of educationally and economically disadvantaged veterans in Veterans' Administration education and training programs. Statistical data on veterans and descriptive data…

Recruitment Strategies for Women in Nontraditional Careers. Adapted from Fair Recruitment Model and Strategies.

ERIC Educational Resources Information Center

Stitt, Beverly; Stitt, Tom

This guide presents 21 one- or two-page recruitment strategies for women in nontraditional careers. Each entry includes sections on what, when, where, who, and how. Strategies included are: (1) attention-getter giveaways; (2) bias-fee brochure; (3) bias-free slide-tape; (4) "bring a friend" day; (5) brochures with utility bills; (6) craftperson…

To direct the Secretary of Health and Human Services to review utilization of diabetes screening benefits and make recommendations on outreach programs with respect to such benefits, and for other purposes.

THOMAS, 111th Congress

Rep. Space, Zachary T. [D-OH-18

2010-07-30

Senate - 09/29/2010 Received in the Senate and Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

Sokaogon Chippewa Community Emission-Free and Treaty Resource Protection Clean Energy Initiative

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

Quade, Ron

Final Report for DOE project DE-IE0000036 The Sokaogon Chippewa Community received a tribal clean energy initiative grant and installed a community wide solar system estimated to produce 606 kw of carbon free clean energy on seventeen (17) tribal buildings and three (3) residential homes significantly reducing the tribes’ energy bills over the life of the system, potentially saving the tribe up to $2.7 million in energy savings over a thirty (30) year time span. Fifteen (15) solar installations utilized aluminum roof-top mounting systems while two (2) installations utilized a ground mount aluminum racking system.

A 194 kilowatt solar photovoltaic flat panel power system for the combined Beverly High School/C. H. Patten Vocational High School, Beverly, Massachusetts

NASA Astrophysics Data System (ADS)

Addiss, R. R., Jr.; Lawson, P. A.

1980-06-01

The design and performance of a photovoltaic power system is discussed. The 194 kW system consists of the photovoltaic array, the inverter/control subsystem, the building and utility interface, and the monitoring subsystem. The photovoltaic array consists of 56 separate subarrays of 112 photovoltaic modules each, deployed in rows on the southerly facing slope north of the school building. The wiring scheme permits individual modules to be disconnected without a radical change in subarray output current. Power is transmitted at 4160 V from the inverters and a step up transformer to the main 4160 V utility feed line in the school. Separate metering measures power bought and sold. At the optimum tilt angle of 40 deg, the array provides 232 MWH of AC energy annually, or 17 percent of the school load. The immediate impact is an $8000 saving in the annual utility bill. Levelized busbar energy costs are reduced from $2/kWH to $1/kWH when site specific parameters are used in the analysis instead of the JPL specified nominal values. A fault detection and isolation scheme which can find a single modulus failure is incorporated into the monitoring subsystem.

Defining care products to finance health care in the Netherlands.

PubMed

Westerdijk, Machiel; Zuurbier, Joost; Ludwig, Martijn; Prins, Sarah

2012-04-01

A case-mix project started in the Netherlands with the primary goal to define a complete set of health care products for hospitals. The definition of the product structure was completed 4 years later. The results are currently being used for billing purposes. This paper focuses on the methodology and techniques that were developed and applied in order to define the casemix product structure. The central research question was how to develop a manageable product structure, i.e., a limited set of hospital products, with acceptable cost homogeneity. For this purpose, a data warehouse with approximately 1.5 million patient records from 27 hospitals was build up over a period of 3 years. The data associated with each patient consist of a large number of a priori independent parameters describing the resource utilization in different stages of the treatment process, e.g., activities in the operating theatre, the lab and the radiology department. Because of the complexity of the database, it was necessary to apply advanced data analysis techniques. The full analyses process that starts from the database and ends up with a product definition consists of four basic analyses steps. Each of these steps has revealed interesting insights. This paper describes each step in some detail and presents the major results of each step. The result consists of 687 product groups for 24 medical specialties used for billing purposes.

Pediatric primary care psychologists' reported level of integration, billing practices, and reimbursement frequency.

PubMed

Riley, Andrew R; Grennan, Allison; Menousek, Kathryn; Hoffses, Kathryn W

2018-03-01

Integration of psychological services into pediatric primary care is increasingly common, but models of integration vary with regard to their level of coordination, colocation, and integration. High-integration models may provide some distinct advantages, such as preventative care and brief consultation for subclinical behavior concerns; however, psychologists face barriers to seeking reimbursement for these services. Alternatives to traditional psychotherapy and psychological testing codes, specifically Health & Behavior (H&B) codes, have been proposed as 1 method for supporting integrated care. The aim of this study was to investigate the relationships between psychologists' reported billing practices, reimbursement rates, and model of integration in pediatric primary care. As part of a larger survey study, 55 psychologists working in pediatric primary care reported on characteristics of their practice's model of integration, billing practices, and frequency of reimbursement for consultative services. Compared with those who categorized their integrated care model as colocated, psychologists who endorsed working in integrated models reported a significantly higher usage of H&B codes and more frequent reimbursement for consultations. Overall, use of H&B codes was associated with higher reported levels of coordination and integration. Survey results showed a clear pattern of higher integration being associated with greater utilization of H&B codes and better reimbursement for consultation activities. These results underscore the importance of establishing and maintaining billing and reimbursement systems that adequately support integrated care. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Boundary-Layer Control: In Memory of Bill Reynolds

NASA Astrophysics Data System (ADS)

Kim, John

2004-11-01

Professor Bill Reynolds (1933-2004) inspired many students and colleagues with his never-ending curiosity and thought-provoking ideas. Bill's relentless energy, together with his hallmark can-do character and do-it-yourself attitude, led to many seminal contributions to mechanical engineering in general, and fluid mechanics in particular. He has left a lasting impact on many of us, especially for those who had the privilege of working closely with him. Some of my current work on boundary-layer control, the use of neural networks in particular, were inspired by many discussions with Bill. He was among the first to see the potential of control-theoretic approaches for flow control, which has become the main thrust of my current research. Without his continued encouragement, I would not have been deeply involved in this line of research; and perhaps, we would not have seen the current flurry of research activities in applying modern control theories to flow control. In memory of Bill Reynolds, who himself has contributed much to flow control, an analysis of boundary-layer control from a linear system perspective will be presented.

Adaptive bill morphology for enhanced tool manipulation in New Caledonian crows

PubMed Central

Matsui, Hiroshi; Hunt, Gavin R.; Oberhofer, Katja; Ogihara, Naomichi; McGowan, Kevin J.; Mithraratne, Kumar; Yamasaki, Takeshi; Gray, Russell D.; Izawa, Ei-Ichi

2016-01-01

Early increased sophistication of human tools is thought to be underpinned by adaptive morphology for efficient tool manipulation. Such adaptive specialisation is unknown in nonhuman primates but may have evolved in the New Caledonian crow, which has sophisticated tool manufacture. The straightness of its bill, for example, may be adaptive for enhanced visually-directed use of tools. Here, we examine in detail the shape and internal structure of the New Caledonian crow’s bill using Principal Components Analysis and Computed Tomography within a comparative framework. We found that the bill has a combination of interrelated shape and structural features unique within Corvus, and possibly birds generally. The upper mandible is relatively deep and short with a straight cutting edge, and the lower mandible is strengthened and upturned. These novel combined attributes would be functional for (i) counteracting the unique loading patterns acting on the bill when manipulating tools, (ii) a strong precision grip to hold tools securely, and (iii) enhanced visually-guided tool use. Our findings indicate that the New Caledonian crow’s innovative bill has been adapted for tool manipulation to at least some degree. Early increased sophistication of tools may require the co-evolution of morphology that provides improved manipulatory skills. PMID:26955788

Kill Bill! Ugandan human rights organizations' attempts to influence the media's coverage of the Anti-Homosexuality Bill.

PubMed

Strand, Cecilia

2011-09-01

The Ugandan Anti-Homosexuality Bill of October 2009 caused an international outcry and sparked intense debate in the local and international media. Particularly contentious was its proposal to impose the death penalty for acts of 'aggravated homosexuality'. Through a quantitative content analysis of 176 items from two main daily newspapers, the government-owned New Vision and the privately-owned Daily Monitor, over the period October 2009-June 2010, combined with qualitative interviews with human rights defenders in Uganda, this study explores attempts made by local human rights advocates to influence the media's coverage of the Bill and the extent to which these attempts were successful. The study finds that while there are significant differences between the frequency of reporting on the Bill in the two newspapers, both papers devoted little editorial space to the public health and human rights concerns put forward by local human rights organizations. Despite Uganda's recent and often lauded history of openly addressing HIV/AIDS, human right organizations' attempts to highlight the Bill's potentially adverse effects on the country's ability to tackle the epidemic effectively were only partially successful and, interestingly, awarded much less attention than the potential human rights implications of the proposed change in legislation.

Capitation of public mental health services in Colorado: a five-year follow-up of system-level effects.

PubMed

Bloom, Joan R; Wang, Huihui; Kang, Soo Hyang; Wallace, Neal T; Hyun, Jenny K; Hu, Teh-wei

2011-02-01

Capitated Medicaid mental health programs have reduced costs over the short term by lowering the utilization of high-cost inpatient services. This study examined the five-year effects of capitated financing in community mental health centers (CMHCs) by comparing not-for-profit with for-profit programs. Data were from the Medicaid billing system in Colorado for the precapitation year (1994) and a shadow billing system for the postcapitation years (1995-1999). In a panel design, a random-effect approach estimated the impact of two financing systems on service utilization and cost while adjusting for all the covariates. Consistent with predictions, in both the for-profit and the not-for-profit CMHCs, relative to the precapitation year, there were significant reductions in each postcapitation year in high-cost treatments (inpatient treatment) for all but one comparison (not-for-profit CMHCs in 1999). Also consistent with predictions, the for-profit programs realized significant reductions in cost per user for both outpatient services and total services. In the not-for-profit programs, there were no significant changes in cost per user for total services; a significant reduction in cost per user for outpatient services was found only in the first two years, 1995 and 1996). The evidence suggests that different strategies were used by the not-for-profit and for-profit programs to control expenditures and utilization and that the for-profit programs were more successful in reducing cost per user.

A Method to Test Model Calibration Techniques

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

Judkoff, Ron; Polly, Ben; Neymark, Joel

This paper describes a method for testing model calibration techniques. Calibration is commonly used in conjunction with energy retrofit audit models. An audit is conducted to gather information about the building needed to assemble an input file for a building energy modeling tool. A calibration technique is used to reconcile model predictions with utility data, and then the 'calibrated model' is used to predict energy savings from a variety of retrofit measures and combinations thereof. Current standards and guidelines such as BPI-2400 and ASHRAE-14 set criteria for 'goodness of fit' and assume that if the criteria are met, then themore » calibration technique is acceptable. While it is logical to use the actual performance data of the building to tune the model, it is not certain that a good fit will result in a model that better predicts post-retrofit energy savings. Therefore, the basic idea here is that the simulation program (intended for use with the calibration technique) is used to generate surrogate utility bill data and retrofit energy savings data against which the calibration technique can be tested. This provides three figures of merit for testing a calibration technique, 1) accuracy of the post-retrofit energy savings prediction, 2) closure on the 'true' input parameter values, and 3) goodness of fit to the utility bill data. The paper will also discuss the pros and cons of using this synthetic surrogate data approach versus trying to use real data sets of actual buildings.« less

A Method to Test Model Calibration Techniques: Preprint

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

Judkoff, Ron; Polly, Ben; Neymark, Joel

This paper describes a method for testing model calibration techniques. Calibration is commonly used in conjunction with energy retrofit audit models. An audit is conducted to gather information about the building needed to assemble an input file for a building energy modeling tool. A calibration technique is used to reconcile model predictions with utility data, and then the 'calibrated model' is used to predict energy savings from a variety of retrofit measures and combinations thereof. Current standards and guidelines such as BPI-2400 and ASHRAE-14 set criteria for 'goodness of fit' and assume that if the criteria are met, then themore » calibration technique is acceptable. While it is logical to use the actual performance data of the building to tune the model, it is not certain that a good fit will result in a model that better predicts post-retrofit energy savings. Therefore, the basic idea here is that the simulation program (intended for use with the calibration technique) is used to generate surrogate utility bill data and retrofit energy savings data against which the calibration technique can be tested. This provides three figures of merit for testing a calibration technique, 1) accuracy of the post-retrofit energy savings prediction, 2) closure on the 'true' input parameter values, and 3) goodness of fit to the utility bill data. The paper will also discuss the pros and cons of using this synthetic surrogate data approach versus trying to use real data sets of actual buildings.« less

Are There Spillover Effects from the GI Bill? The Mental Health of Wives of Korean War Veterans

PubMed Central

Vable, Anusha M.; Kawachi, Ichiro; Canning, David; Glymour, M. Maria; Jimenez, Marcia P.; Subramanian, S. V.

2016-01-01

Background The Korean War GI Bill provided economic benefits for veterans, thereby potentially improving their health outcomes. However potential spillover effects on veteran wives have not been evaluated. Methods Data from wives of veterans eligible for the Korean War GI Bill (N = 128) and wives of non-veterans (N = 224) from the Health and Retirement Study were matched on race and coarsened birth year and childhood health using coarsened exact matching. Number of depressive symptoms in 2010 (average age = 78) were assessed using a modified, validated Center for Epidemiologic Studies-Depression Scale. Regression analyses were stratified into low (mother < 8 years schooling / missing data, N = 95) or high (mother ≥ 8 years schooling, N = 257) childhood socio-economic status (cSES) groups, and were adjusted for birth year and childhood health, as well as respondent’s educational attainment in a subset of analyses. Results Husband’s Korean War GI Bill eligibility did not predict depressive symptoms among veteran wives in pooled analysis or cSES stratified analyses; analyses in the low cSES subgroup were underpowered (N = 95, β = -0.50, 95% Confidence Interval: (-1.35, 0.35), p = 0.248, power = 0.28). Conclusions We found no evidence of a relationship between husband’s Korean War GI Bill eligibility and wives’ mental health in these data, however there may be a true effect that our analysis was underpowered to detect. PMID:27186983

Energy: the states' response in 1978

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

Mackey, Earl S.

A compilation of all state legislative energy enactments for legislature, in 1978 is presented. It provides source material to legislators and their staff. Each bill is separated into one or more of the 37 major subject categories. Broad categories cover public utilities; tax exemption; tax application; franchise protection; conservation; resource development; solar easements; mineral extraction regulation; management; emergency powers; anti-trust; anit-environment; and miscellaneous legislation.

Friends of Bill W.: The Stories of How Eight Men Found "A New Pair of Glasses" through Transformational Learning

ERIC Educational Resources Information Center

Turley, Matthew William

2011-01-01

In this qualitative study the primary researcher utilized research methods of heuristic phenomenology in order to better understand the experience of recovery for a group of male participants. The purpose of this study was to aid the primary researcher in better understanding his own experience of recovery from alcoholism, as well as to add to the…

Assessing the Debt: George W. Bush's Legacy and the Future of Public Education under Barack Obama

ERIC Educational Resources Information Center

Means, Alex; Taylor, Kendall

2010-01-01

This article utilizes Gloria Ladson-Billings' notion of educational debt in order to explore the historical, economic, and cultural politics of education reform under George W. Bush and Barack Obama. It tracks the No Child Left Behind Act across a number of fields in order to claim that Bush's expansion of the educational debt should be understood…

24 CFR Appendix to Part 971 - Methodology of Comparing Cost of Public Housing With Cost of Tenant-Based Assistance

Code of Federal Regulations, 2012 CFR

2012-04-01

... bills directly to the utility company, then the development's monthly operating cost per occupied unit... Authority and its affected developments. c. As an example of estimating development operating costs from PHA... divided by 270, the product of 22.5 and 12, to give a cost per unit month of $222. C. Accrual The monthly...

Examining Parent-Teacher Communication in School Systems through the Use of Emergent Technologies

ERIC Educational Resources Information Center

Trevino, Rodrigo

2012-01-01

Technology has become a part of the fabric of the lives of people, whether it be communicating with a loved one on the other side of the world or paying a utility bill via the Internet. Most people have experienced some level of technology integration into their life. An inescapable rite of passage for most people in developed countries is the…

Home Performance with ENERGY STAR: Utility Bill Analysis on Homes Participating in Austin Energy's Program

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

Belzer, D.; Mosey, G.; Dagher, L.

2008-01-01

Home Performance with ENERGY STAR (HPwES) is a jointly managed program of the U.S. Department of Energy (DOE) and the U.S. Environmental Protection Agency (EPA). This program focuses on improving energy efficiency in existing homes via a whole-house approach to assessing and improving a home's energy performance, and helping to protect the environment. As a local sponsor for HPwES, Austin Energy's HPwES program offers a complete home energy assessment and a list of recommendations for efficiency improvements, along with cost estimates. The owner can choose to implement only one or the complete set of energy conservation measures. Austin Energy facilitatesmore » the process by providing economic incentives to the homeowner through its HPwES Loan program and its HPwES Rebate program. In 2005, the total number of participants in both programs was approximately 1,400. Both programs are only available for improvements made by a participating HPwES contractor. The individual household billing data - encompassing more than 7,000 households - provided by Austin Energy provides a rich data set to estimate the impacts of its HPwES program. The length of the billing histories is sufficient to develop PRISM-type models of electricity use based on several years of monthly bills before and after the installation of the conservation measures. Individual household savings were estimated from a restricted version of a PRISM-type regression model where the reference temperature to define cooling (or heating degree days) was estimated along with other parameters. Because the statistical quality of the regression models varies across individual households, three separate samples were used to measure the aggregate results. The samples were distinguished on the basis of the statistical significance of the estimated (normalized) cooling consumption. A normalized measure of cooling consumption was based on average temperatures observed over the most recent nine-year period ending in 2006. This study provided a statistically rigorous approach to incorporating the variability of expected savings across the households in the sample together with the uncertainty inherent in the regression models used to estimate those savings. While the impact of the regression errors was found to be relatively small in these particular samples, this approach may be useful in future studies using individual household billing data. The median percentage savings for the largest sample of 6,000 households in the analysis was 32%, while the mean savings was 28%. Because the number of households in the sample is very large, the standard error associated with the mean percentage savings are very small, less than 1%. A conservative statement of the average savings is that is falls in the range of 25% to 30% with a high level of certainty. This preliminary analysis provides robust estimates of average program savings, but offers no insight into how savings may vary by type of conservation measure or whether savings vary by the amount of cooling electricity used prior to undertaking the measure. Follow-up researchers may want to analyze the impacts of specific ECMs. Households that use electricity for heating might also be separately analyzed. In potential future work several methodological improvements could also be explored. As mentioned in Section 2, there was no formal attempt to clean the data set of outliers and other abnormal patterns of billing data prior to the statistical analysis. The restriction of a constant reference temperature might also be relaxed. This approach may provide evidence as to whether any 'take-back' efforts are present, whereby thermostat settings are lowered during the summer months after the measures are undertaken (reflected in lower reference temperatures in the post-ECM period). A more extended analysis may also justify the investment in and use of the PRISM software package, which may provide more diagnostic measures with respect to the reference temperature. PRISM also appears to contain some built-in capability to detect outliers and other anomalous data points.« less

Wound center facility billing: A retrospective analysis of time, wound size, and acuity scoring for determining facility level of service.

PubMed

Fife, Caroline E; Walker, David; Farrow, Wade; Otto, Gordon

2007-01-01

Outpatient wound center facility reimbursement for Medicare beneficiaries can be a challenge to determine and obtain. To compare methods of calculating facility service levels for outpatient wound centers and to demonstrate the advantages of an acuity-based billing system (one that incorporates components of facility work that is non-reimbursable by procedure codes and that represents an activity-based costing approach to medical billing), a retrospective study of 5,098 patient encounters contained in a wound care-specific electronic medical record database was conducted. Approximately 500 patient visits to the outpatient wound center of a Texas regional hospital between April 2003 and November 2004 were categorized by service level in documentation and facility management software. Visits previously billed using a time-based system were compared to the Centers for Medicare and Medicaid Services' proposed three-tiered wound size-based system. The time-based system also was compared to an acuity-based scoring system. The Pearson correlation coefficient between billed level of service by time and estimated level of service by acuity was 0.442 and the majority of follow-up visits were billed as Level 3 and above (on a time level of 1 to 5) , confirming that time is not a surrogate for actual work performed. Wound size also was found to be unrelated to service level (Pearson correlation = 0.017) and 97% of wound areas were < 100 cm2. The acuity-based scoring system produced a near-normal distribution of results, producing more mid-range billings than extremes; no other method produced this distribution. Hospital-based outpatient wound centers should develop, review, and refine acuity score-based models on which to determine billed level of service.

Genetic variation and bill size dimorphism in a passerine bird, the reed bunting Emberiza schoeniclus.

PubMed

Grapputo, A; Pilastro, A; Marin, G

1998-09-01

In passerine birds morphological differentiation in bill size within species is not commonly observed. Bill size is usually associated with a trophic niche, and strong differences in it may reflect the process of genetic differentiation and, possibly, speciation. We used both mitochondrial DNA (mtDNA) and nuclear microsatellites to study genetic variation between two subspecies of reed bunting, Emberiza schoeniclus schoeniclus and E.s. intermedia, along their distributional boundary in western Europe. These two subspecies are characterized by a high dimorphism in bill size and, although breeding populations of the two subspecies are found very close to each other in northern Italy, apparently no interbreeding occurs. The observed morphological pattern between the two subspecies may be maintained by geographically varying selective forces or, alternatively, may be the result of a long geographical separation followed by a secondary contact. MtDNA sequences of cytochrome b and ND5 (515 bp) showed little variation and did not discriminate between the two subspecies, indicating a divergence time of less than 500 000 years. The analysis of four microsatellite loci suggested a clear, although weak, degree of genetic differentiation in the large- and small-billed populations, as indicated by FST and RST values and genetic distances. The correlation between bill size and genetic distance between populations remained significant after accounting for the geographical distances between sampling localities. Altogether, these results indicate a very recent genetic differentiation between the two bill morphs and suggest that a strong selection for large bills in the southern part of the breeding range is probably involved in maintaining the geographical differentiation of this species.

Educational Benefits Analysis. An Examination of the Effects of G.I. Bill Educational Benefits on Service Accessions.

ERIC Educational Resources Information Center

Eisenman, Richard L.; And Others

A study was done to (1) examine the impact of terminating the G.I. Bill in respect to the number, quality, and representativeness of Service accessions (supply of volunteers for military services), and (2) provide a means for measuring the relative costs and benefits of alternative educational programs which might be needed to sustain military…

Awareness and Observance of Patient Rights from the Perspective of Iranian Patients: A Systematic Review and Meta-Analysis

PubMed Central

Abedi, Ghassem; Shojaee, Jalil; Moosazadeh, Mahmood; Rostami, Farideh; Nadi, Aliasghar; Abedini, Ehsan; Palenik, Charles John; Askarian, Mehrdad

2017-01-01

Background: Recipients of healthcare services have rights, which must be acknowledged and protected. Such rights include observance of acceptable patient physical, mental, spiritual, and social needs guided by commonly accepted rules and regulations. The objective of this study was to conduct a systematic review and meta-analysis of awareness rates and observance of patient rights in Iran from the perspective of the patient. Methods: In this study, various references such as Medline (PubMed), Scopus, Scientific Information Database (SID), Google scholar, Magiran, and IranMedex were searched (from August to December 2015). Heterogeneity was assessed using the Q statistic. English and Persian search keywords and combinations included terms such as “patient bill of rights, patient rights, Iranian patient bill of rights, and Persian patient rights.” A meta-analysis of the primary search sources was accomplished using STATA (version 11.0). Results: Initial review included 20 articles of which 12 assessed observance rates of patient rights and three described service awareness rates of recipients concerning their personal rights. Five articles covered both topics and had an estimated 54.2% coverage based on the results of meta-analysis and the random-effects model with the heterogeneity. Conclusion: An Observance rate of patient bills of rights was considered somewhat adequate. However, contradictions in findings noted in this study suggest deficiencies do exist and need to be resolved. There appears a need to better describe and increase awareness rates of healthcare services by patients concerning their own bill of rights. PMID:28533570

Incremental analysis of the reengineering of an outpatient billing process: an empirical study in a public hospital

PubMed Central

2013-01-01

Background A smartcard is an integrated circuit card that provides identification, authentication, data storage, and application processing. Among other functions, smartcards can serve as credit and ATM cards and can be used to pay various invoices using a ‘reader’. This study looks at the unit cost and activity time of both a traditional cash billing service and a newly introduced smartcard billing service in an outpatient department in a hospital in Taipei, Taiwan. Methods The activity time required in using the cash billing service was determined via a time and motion study. A cost analysis was used to compare the unit costs of the two services. A sensitivity analysis was also performed to determine the effect of smartcard use and number of cashier windows on incremental cost and waiting time. Results Overall, the smartcard system had a higher unit cost because of the additional service fees and business tax, but it reduced patient waiting time by at least 8 minutes. Thus, it is a convenient service for patients. In addition, if half of all outpatients used smartcards to pay their invoices, along with four cashier windows for cash payments, then the waiting time of cash service users could be reduced by approximately 3 minutes and the incremental cost would be close to breaking even (even though it has a higher overall unit cost that the traditional service). Conclusions Traditional cash billing services are time consuming and require patients to carry large sums of money. Smartcard services enable patients to pay their bill immediately in the outpatient clinic and offer greater security and convenience. The idle time of nurses could also be reduced as they help to process smartcard payments. A reduction in idle time reduces hospital costs. However, the cost of the smartcard service is higher than the cash service and, as such, hospital administrators must weigh the costs and benefits of introducing a smartcard service. In addition to the obvious benefits of the smartcard service, there is also scope to extend its use in a hospital setting to include the notification of patient arrival and use in other departments. PMID:23763904

Incremental analysis of the reengineering of an outpatient billing process: an empirical study in a public hospital.

PubMed

Chu, Kuan-Yu; Huang, Chunmin

2013-06-13

A smartcard is an integrated circuit card that provides identification, authentication, data storage, and application processing. Among other functions, smartcards can serve as credit and ATM cards and can be used to pay various invoices using a 'reader'. This study looks at the unit cost and activity time of both a traditional cash billing service and a newly introduced smartcard billing service in an outpatient department in a hospital in Taipei, Taiwan. The activity time required in using the cash billing service was determined via a time and motion study. A cost analysis was used to compare the unit costs of the two services. A sensitivity analysis was also performed to determine the effect of smartcard use and number of cashier windows on incremental cost and waiting time. Overall, the smartcard system had a higher unit cost because of the additional service fees and business tax, but it reduced patient waiting time by at least 8 minutes. Thus, it is a convenient service for patients. In addition, if half of all outpatients used smartcards to pay their invoices, along with four cashier windows for cash payments, then the waiting time of cash service users could be reduced by approximately 3 minutes and the incremental cost would be close to breaking even (even though it has a higher overall unit cost that the traditional service). Traditional cash billing services are time consuming and require patients to carry large sums of money. Smartcard services enable patients to pay their bill immediately in the outpatient clinic and offer greater security and convenience. The idle time of nurses could also be reduced as they help to process smartcard payments. A reduction in idle time reduces hospital costs. However, the cost of the smartcard service is higher than the cash service and, as such, hospital administrators must weigh the costs and benefits of introducing a smartcard service. In addition to the obvious benefits of the smartcard service, there is also scope to extend its use in a hospital setting to include the notification of patient arrival and use in other departments.

Analysis Methods for Post Occupancy Evaluation of Energy-Use in High Performance Buildings Using Short-Term Monitoring

NASA Astrophysics Data System (ADS)

Singh, Vipul

2011-12-01

The green building movement has been an effective catalyst in reducing energy demands of buildings and a large number of 'green' certified buildings have been in operation for several years. Whether these buildings are actually performing as intended, and if not, identifying specific causes for this discrepancy falls into the general realm of post-occupancy evaluation (POE). POE involves evaluating building performance in terms of energy-use, indoor environmental quality, acoustics and water-use; the first aspect i.e. energy-use is addressed in this thesis. Normally, a full year or more of energy-use and weather data is required to determine the actual post-occupancy energy-use of buildings. In many cases, either measured building performance data is not available or the time and cost implications may not make it feasible to invest in monitoring the building for a whole year. Knowledge about the minimum amount of measured data needed to accurately capture the behavior of the building over the entire year can be immensely beneficial. This research identifies simple modeling techniques to determine best time of the year to begin in-situ monitoring of building energy-use, and the least amount of data required for generating acceptable long-term predictions. Four analysis procedures are studied. The short-term monitoring for long-term prediction (SMLP) approach and dry-bulb temperature analysis (DBTA) approach allow determining the best time and duration of the year for in-situ monitoring to be performed based only on the ambient temperature data of the location. Multivariate change-point (MCP) modeling uses simulated/monitored data to determine best monitoring period of the year. This is also used to validate the SMLP and DBTA approaches. The hybrid inverse modeling method-1 predicts energy-use by combining a short dataset of monitored internal loads with a year of utility-bills, and hybrid inverse method-2 predicts long term building performance using utility-bills only. The results obtained show that often less than three to four months of monitored data is adequate for estimating the annual building energy use, provided that the monitoring is initiated at the right time, and the seasonal as well as daily variations are adequately captured by the short dataset. The predictive accuracy of the short data-sets is found to be strongly influenced by the closeness of the dataset's mean temperature to the annual average temperature. The analysis methods studied would be very useful for energy professionals involved in POE.

Energy Burden and the Need for Integrated Low-Income Housing and Energy Policy.

PubMed

Hernández, Diana; Bird, Stephen

2010-11-01

Using detailed sociological and public health qualitative interview data, we demonstrate that energy poverty is more pervasive, and results in a greater energy burden for low-income tenants, than many policymakers would assume. This is due in part to a lack of funding, policy non-coordination, and a lack of understanding of the social and economic benefits of energy conservation, energy education, and flexible utility billing policies. Examining LIHEAP, weatherization, utility, and housing assistance policies, we suggest that a coordinated, regional approach to home energy and housing policy that integrates programs in each area will provide a more coherent policy solution.

Retail wheeling - users, utilities and power producers

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

Kubacki, J. Jr.

1996-12-31

Information is outlined on the retail wheeling of electric power. Topics discussed include: SEL mission; average cost per kWh; retail pilot programs; retail wheeling activity; key tasks for industrials; power marketer quote; retail wheeling strategic planning; metered customer load profile; proposed ISO regions; conjunctive billing; interconnection areas; FERC order 888; open access same time information systems; transmission inferconnections; suppliers of energy and capacity; self-generation; FERC Form 714; rebundling unbundled services; key variables: load factor; energy and capacity; metering today; competitive industry configuration; power cost reduction: strategic planning; real-time pricing; prime sources of leverage; likeliness of switching utilities; and Strategic Energymore » Ltd.« less

Three empirical essays on energy and labor economics

NASA Astrophysics Data System (ADS)

Chow, Melissa

This dissertation analyzes the differences between private and non-private firms in two contexts. Chapters 1 and 2 examine the electricity industry in the United States and the motivation behind electric utilities' usage of demand side management programs. The first chapter focuses on load management programs, which decrease electricity demand during the peak hours of the day. It looks into the impact of a plausibly exogenous decrease in natural gas prices on the utilization and capacity of these programs. The second chapter analyzes the relationship between electricity market deregulation and electric utilities' energy efficiency activity. The third chapter investigates the impact of Chinese enterprise restructuring on employment, wage bills, and productivity. All three chapters show that different objectives due to ownership type lead to differences in firm behavior.

Education, Racism, and the Military: A Critical Race Theory Analysis of the GI Bill and Its Implications for African Americans in Higher Education

ERIC Educational Resources Information Center

Mencke, Bernadette Kristine Buchanan

2010-01-01

This study examined the impact of the Serviceman's Readjustment Act of 1944 (the GI Bill) on African Americans' quest for higher education. The central question guiding this study follows: Why has higher education been so elusive for African Americans? With reference to this question, the following sub-questions were addressed: (1) How can the…

Changes in Suicide Methods in Quebec between 1987 and 2000: The Possible Impact of Bill C-17 Requiring Safe Storage of Firearms

ERIC Educational Resources Information Center

Caron, Jean; Julien, Marie; Huang, Jean Hua

2008-01-01

This study presents the changes in the overall and firearm suicide rates for Quebec (Canada) before and after Bill C-17, which was implemented to secure safe storage of firearms. It covers 20,009 suicide cases reported to the coroner's office. Interrupted time series analysis is used to compare suicide rates in the two periods. Firearm suicide…

Evolution/Creationism Controversy: Analysis of Past and Current Policies in Public Schools and the Practice of Allowing Students to Opt out of Learning Evolution Concepts

ERIC Educational Resources Information Center

Speake, Jacquelyn Hoffmann

2011-01-01

Recent anti-evolution legislation, in the form of Academic Freedom bills, has been introduced in many state legislatures over the last three years. The language in the proposed Academic Freedom bills may allow different interpretations of what can be taught in the science classrooms, and possibly spur parents to take advantage of their perceived…

An Analysis Of Cyber Security And How It Is Affecting A Contract Writing System, Seaport

DTIC Science & Technology

2016-06-01

CONTRACT WRITING SYSTEM, SEAPORT June 2016 By: Bill Turner Daniel Belcher Danielle Allen Advisors: Raymond Jones Stacy McQuage...A CONTRACT WRITING SYSTEM, SEAPORT 5. FUNDING NUMBERS 6. AUTHOR(S) Bill Turner, Daniel Belcher, & Danielle Allen 7. PERFORMING ORGANIZATION NAME(S...business support for the DOD—specifically, the contract writing system SeaPort. Is cybersecurity becoming too restrictive, making the ability to support the

Predicting and understanding law-making with word vectors and an ensemble model

PubMed Central

Nay, John J.

2017-01-01

Out of nearly 70,000 bills introduced in the U.S. Congress from 2001 to 2015, only 2,513 were enacted. We developed a machine learning approach to forecasting the probability that any bill will become law. Starting in 2001 with the 107th Congress, we trained models on data from previous Congresses, predicted all bills in the current Congress, and repeated until the 113th Congress served as the test. For prediction we scored each sentence of a bill with a language model that embeds legislative vocabulary into a high-dimensional, semantic-laden vector space. This language representation enables our investigation into which words increase the probability of enactment for any topic. To test the relative importance of text and context, we compared the text model to a context-only model that uses variables such as whether the bill’s sponsor is in the majority party. To test the effect of changes to bills after their introduction on our ability to predict their final outcome, we compared using the bill text and meta-data available at the time of introduction with using the most recent data. At the time of introduction context-only predictions outperform text-only, and with the newest data text-only outperforms context-only. Combining text and context always performs best. We conducted a global sensitivity analysis on the combined model to determine important variables predicting enactment. PMID:28489868

"The Goddamndest, Toughest Voting Rights Bill": Critical Race Theory and the Voting Rights Act of 1965

ERIC Educational Resources Information Center

Crowley, Ryan M.

2013-01-01

The author utilized Critical Race Theory (CRT) to examine the passage of the US Voting Rights Act (VRA) of 1965 in an effort to disrupt the simplistic, uncritical understandings of the US Civil Rights Movement common to school texts while also arguing for the ongoing importance of the VRA in a time when voting rights for people of color are under…

Practical strategies for developing the business case for hospital glycemic control teams.

PubMed

Magee, Michelle F; Beck, Adam

2008-09-01

Many business models may be used to make the business case for support of a multidisciplinary team to implement targeted glucose control in the hospital. Models may be hospital-supported or self-supporting. In the former, the hospital provides financial support based on improved documentation opportunities, reduction in length of stay, and improved resource utilization. In the latter, clinical revenues for diabetes management offsets costs of salary, fringe benefits, and overheads. A combination of these strategies may also be used. The business plan presented to administration must justify return on investment. It is imperative to involve hospital administration, particularly representatives from coding, billing, and finance, in the development of the business plan. The business case for hospital support will be based on opportunities related to improving accuracy of documentation and coding for diabetes-related diagnoses, including level of control and complications present, on reduction in length of stay and on optimization of resource utilization through reduction in morbidity and mortality (cost aversion). The case for revenue generation through billing for clinical services will be based on opportunities to increase the provision of glycemic management services in the hospital. Examples from the literature and of analyses to support each of these models are presented. (c) 2008 Society of Hospital Medicine.

'The biggest car crash in NHS history': the media portrayal of GP pay before and after the introduction of the Health and Social Care Bill 2011.

PubMed

Balkham, Adam; Alderson, Sarah

2017-01-01

The introduction of the Health and Social Care Bill (2011) changed the role of GPs to include commissioning of health services. Aim This study aimed to identify any differences in the media portrayal of GPs before and after the introduction of the Bill. We retrospectively searched four British newspapers over the period 2009-2013 using the media database Nexis. In order to directly compare the findings of the study with the work of Tanner et al., articles relating to GP pay were analysed using thematic analysis. Themes were identified and each article was scored to determine whether it portrayed GPs positively or negatively. GPs were portrayed slightly less negatively after the introduction of the Bill. The theme of 'high salaries' persisted despite reference to 'pay freezes'. References to decreased trust in the patient-doctor relationship appeared after the introduction of the Bill. Negative portrayal of GP pay has continued and a lack of trust in GPs has started to be portrayed. This trend may exacerbate the low morale amongst the profession and difficulties in recruiting and retaining GPs.

Structural controls on ground-water conditions and estimated aquifer properties near Bill Williams Mountain, Williams, Arizona

USGS Publications Warehouse

Pierce, Herbert A.

2001-01-01

As of 1999, surface water collected and stored in reservoirs is the sole source of municipal water for the city of Williams. During 1996 and 1999, reservoirs reached historically low levels. Understanding the ground-water flow system is critical to managing the ground-water resources in this part of the Coconino Plateau. The nearly 1,000-meter-deep regional aquifer in the Redwall and Muav Limestones, however, makes studying or utilizing the resource difficult. Near-vertical faults and complex geologic structures control the ground-water flow system on the southwest side of the Kaibab Uplift near Williams, Arizona. To address the hydrogeologic complexities in the study area, a suite of techniques, which included aeromagnetic, gravity, square-array resistivity, and audiomagnetotelluric surveys, were applied as part of a regional study near Bill Williams Mountain. Existing well data and interpreted geophysical data were compiled and used to estimate depths to the water table and to prepare a potentiometric map. Geologic characteristics, such as secondary porosity, coefficient of anisotropy, and fracture-strike direction, were calculated at several sites to examine how these characteristics change with depth. The 14-kilometer-wide, seismically active northwestward-trending Cataract Creek and the northeastward-trending Mesa Butte Fault systems intersect near Bill Williams Mountain. Several north-south-trending faults may provide additional block faulting north and west of Bill Williams Mountain. Because of the extensive block faulting and regional folding, the volcanic and sedimentary rocks are tilted toward one or more of these faults. These faults provide near-vertical flow paths to the regional water table. The nearly radial fractures allow water that reaches the regional aquifer to move away from the Bill Williams Mountain area. Depth to the regional aquifer is highly variable and depends on location and local structures. On the basis of interpreted audiomagnetotelluric and square-array resistivity sounding curves and limited well data, depths to water may range from 450 to 1,300 meters.

[The introduction of generic pharmaceutical products into Galicia].

PubMed

Verdejo González, A; López-Lázaro, L; Rodríguez Moreno, C; Piñeiro Lago, B; Pereira Martínez, M L

1999-11-30

To know the evolution of the introduction of generic drugs (GDs) in Galicia. Secondarily, to evaluate its potential impact on pharmaceutical expenditure. Descriptive study of GDs utilization. Cost-minimization analysis. Galician autonomous region, year 1998. Using data from the prescription billing registry of Social Security we have selected the active ingredients corresponding to GDs with prescriptions in Galicia in 1997. We have analyzed the data for their oral single substance preparations by quarters. Consumption in DHDs of allopurinol, atenolol, captopril, naproxen and ranitidine remained stable during 1998. The market share for their GDs in quantitative terms relative to both total consumption of the active ingredients and to their pharmaceutical equivalents, showed an overall growing trend. The maximum observed value was seen for ranitidine at last quarter. Total expenditure (in final customer prices) during 1998 on the selected active substances was higher than 1864 million pesetas. Potential savings afforded by substitution for the lowest price GD prescribed in Galicia would reach 427 million pesetas. GDs market penetration in Galicia during 1998 was limited but increasing. Its utilization may afford estimated savings of 21-28% of the cost for the selected drugs. However, the expenditure on the above drugs was just 2.7% of total pharmaceutical expenditure.

David Grant Medical Center energy use baseline and integrated resource assessment

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

Richman, E.E.; Hoshide, R.K.; Dittmer, A.L.

1993-04-01

The US Air Mobility Command (AMC) has tasked Pacific Northwest Laboratory (PNL) with supporting the US Department of Energy (DOE) Federal Energy Management Program`s (FEMP) mission to identify, evaluate, and assist in acquiring all cost-effective energy resource opportunities (EROs) at the David Grant Medical Center (DGMC). This report describes the methodology used to identify and evaluate the EROs at DGMC, provides a life-cycle cost (LCC) analysis for each ERO, and prioritizes any life-cycle cost-effective EROs based on their net present value (NPV), value index (VI), and savings to investment ratio (SIR or ROI). Analysis results are presented for 17 EROsmore » that involve energy use in the areas of lighting, fan and pump motors, boiler operation, infiltration, electric load peak reduction and cogeneration, electric rate structures, and natural gas supply. Typical current energy consumption is approximately 22,900 MWh of electricity (78,300 MBtu), 87,600 kcf of natural gas (90,300 MBtu), and 8,300 gal of fuel oil (1,200 MBtu). A summary of the savings potential by energy-use category of all independent cost-effective EROs is shown in a table. This table includes the first cost, yearly energy consumption savings, and NPV for each energy-use category. The net dollar savings and NPV values as derived by the life-cycle cost analysis are based on the 1992 federal discount rate of 4.6%. The implementation of all EROs could result in a yearly electricity savings of more than 6,000 MWh or 26% of current yearly electricity consumption. More than 15 MW of billable load (total billed by the utility for a 12-month period) or more than 34% of current billed demand could also be saved. Corresponding natural gas savings would be 1,050 kcf (just over 1% of current consumption). Total yearly net energy cost savings for all options would be greater than $343,340. This value does not include any operations and maintenance (O&M) savings.« less

David Grant Medical Center energy use baseline and integrated resource assessment

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

Richman, E.E.; Hoshide, R.K.; Dittmer, A.L.

1993-04-01

The US Air Mobility Command (AMC) has tasked Pacific Northwest Laboratory (PNL) with supporting the US Department of Energy (DOE) Federal Energy Management Program's (FEMP) mission to identify, evaluate, and assist in acquiring all cost-effective energy resource opportunities (EROs) at the David Grant Medical Center (DGMC). This report describes the methodology used to identify and evaluate the EROs at DGMC, provides a life-cycle cost (LCC) analysis for each ERO, and prioritizes any life-cycle cost-effective EROs based on their net present value (NPV), value index (VI), and savings to investment ratio (SIR or ROI). Analysis results are presented for 17 EROsmore » that involve energy use in the areas of lighting, fan and pump motors, boiler operation, infiltration, electric load peak reduction and cogeneration, electric rate structures, and natural gas supply. Typical current energy consumption is approximately 22,900 MWh of electricity (78,300 MBtu), 87,600 kcf of natural gas (90,300 MBtu), and 8,300 gal of fuel oil (1,200 MBtu). A summary of the savings potential by energy-use category of all independent cost-effective EROs is shown in a table. This table includes the first cost, yearly energy consumption savings, and NPV for each energy-use category. The net dollar savings and NPV values as derived by the life-cycle cost analysis are based on the 1992 federal discount rate of 4.6%. The implementation of all EROs could result in a yearly electricity savings of more than 6,000 MWh or 26% of current yearly electricity consumption. More than 15 MW of billable load (total billed by the utility for a 12-month period) or more than 34% of current billed demand could also be saved. Corresponding natural gas savings would be 1,050 kcf (just over 1% of current consumption). Total yearly net energy cost savings for all options would be greater than $343,340. This value does not include any operations and maintenance (O M) savings.« less

High utilizers of medical care: a crucial subgroup among somatizing patients.

PubMed

Hiller, Wolfgang; Fichter, Manfred M

2004-04-01

Patients with somatoform disorders (SFD) are likely to overutilize healthcare services. This study investigates (a) whether extraordinarily high medical costs can be predicted from patient characteristics or psychopathology, and (b) whether high-utilizing patients respond differently to cognitive-behavioral treatment. We compared 42 SFD high utilizers with 53 SFD average utilizers and 29 patients suffering from other than SFD mental disorders. High utilization was defined by healthcare expenditures of > or = 2500 euros during the past 2 years. Costs were computed from medical and billing records of health insurance companies. Somatization distress, hypochondriasis, depression, dysfunctional cognitions related to bodily symptoms, general psychopathology, personality profiles, and psychosocial disabilities were assessed before treatment. High utilizers had higher levels of self- and observer-rated illness behavior, self-perceived bodily weakness, and psychosocial disabilities. Although they did not report more somatization symptoms, their subjective symptom distress was higher. There were no differences between high and average utilizers concerning general psychopathology, DSM-IV comorbidity, and personality profiles. Treatment improvements were similar. High- and average-utilizing somatizers represent distinguishable subgroups. The results emphasize the importance of mechanisms specifically related to SFD and may enhance the early detection of patients who are likely to develop overutilization. Copyright 2004 Elsevier Inc.

Credit card fraud detection using neural network and geolocation

NASA Astrophysics Data System (ADS)

Gulati, Aman; Dubey, Prakash; MdFuzail, C.; Norman, Jasmine; Mangayarkarasi, R.

2017-11-01

The most acknowledged payment mode is credit card for both disconnected and online mediums in today's day and age. It facilitates cashless shopping everywhere in the world. It is the most widespread and reasonable approach with regards to web based shopping, paying bills, what's more, performing other related errands. Thus danger of fraud exchanges utilizing credit card has likewise been expanding. In the Current Fraud Detection framework, false exchange is recognized after the transaction is completed. As opposed to the current system, the proposed system presents a methodology which facilitates the detection of fraudulent exchanges while they are being processed, this is achieved by means of Behaviour and Locational Analysis(Neural Logic) which considers a cardholder's way of managing money and spending pattern. A deviation from such a pattern will then lead to the system classifying it as suspicious transaction and will then be handled accordingly.

Building America Case Study: Performance and Costs of Ductless Heat Pumps in Marine Climate High-Performance Homes: Habitat for Humanity -- The Woods, Tacoma, Washington

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

The Woods is a Habitat for Humanity (HFH) community of ENERGY STAR Homes (c) Northwest (ESHNW)-certified homes located in the marine climate of Tacoma/Pierce County, Washington. This research report builds on an earlier preliminary draft 2014 BA report, and includes significant billing analysis and cost effectiveness research from a collaborative, ongoing Ductless Heat Pump (DHP) research effort for Tacoma Public Utilities (TPU) and Bonneville Power Administration (BPA). This report focuses on the results of field testing, modeling, and monitoring of ductless mini-split heat pump hybrid heating systems in seven homes built and first occupied at various times between September 2013more » and October 2014. The report also provides WSU documentation of high-performance home observations, lessons learned, and stakeholder recommendations for builders of affordable high-performance housing such as HFH.« less

Energy conservation and the residential and commercial sector

NASA Technical Reports Server (NTRS)

1975-01-01

A detailed analysis of energy conservation actions relevant to the residential and commercial sector has led to the conclusion that the potential for savings is great. The task will not be easy, however, since many of the actions require significant life style changes that are difficult to accomplish. Furthermore, many of the conservation actions cited as instant solutions to the energy crisis are those with only mid to long term potential, such as solar energy or heat pumps. Three significant conservation approaches are viable: adjusting price structure, mandating actions, and educating consumers. The first two appear to be the most feasible. But they are not without a price. Higher utility bills adversely affect the poor and the elderly on fixed incomes. Likewise, strict mandatory measures can be quite distasteful. But the effect of alternatives, such as voluntary savings accomplished through education processes, is minimal in a nation without a true conservation ethic.

Modeling Integrated Water-User Decisions with Intermittent Supplies

NASA Astrophysics Data System (ADS)

Lund, J. R.; Rosenberg, D.

2006-12-01

We present an economic-engineering method to estimate urban water use demands with intermittent water supplies. A two-stage, probabilistic optimization formulation includes a wide variety of water supply enhancement and conservation actions that individual households can adopt to meet multiple water quality uses with uncertain water availability. We embed the optimization in Monte-Carlo simulations to show aggregate effects at a utility (citywide) scale for a population of user conditions and decisions. Parametric analysis provides derivations of supply curves to subsidize conservation, demand responses to alternative pricing, and customer willingness-to-pay to avoid shortages. Results show a good empirical fit for the average and distribution of billed residential water use in Amman, Jordan. Additional outputs give likely market penetration rates for household conservation actions, associated water savings, and subsidies required to entice further adoption. We discuss new insights to size, target, market, and finance conservation programs and interpret a demand curve with block pricing.

A Patient-specific Approach to Hospital Cost Accounting

PubMed Central

Macdonald, Larry K.; Reuter, Louis F.

1973-01-01

The hospital facilities and manpower used for the various procedures of a delivery suite are identified and measured as the basis for determining individual patient costs. The method of measuring staff and facility requirements, including the “cost of readiness” and the cost of inherent inefficiencies, generates detailed information that can be used in determining utilization ranges for budgeting decisions, for planning space needs, for personnel scheduling, and for patient billing. PMID:4269322

Assessment of the U.S. Department of Energy's Home Energy Scoring Tool

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

Roberts, David; Merket, Noel; Polly, Ben

2012-07-01

The National Renewable Energy Laboratory (NREL) conducted a series of assessments of the U.S. Department of Energy's (DOE) proposed Home Energy Scoring Tool (HEST). This report is an assessment of the 4/27/2012 release of HEST. Predictions of electric and natural gas consumption were compared with weather-normalized utility billing data for a mixture of newer and older homes located in Oregon, Wisconsin, Minnesota, North Carolina and Texas.

The Social Acceptance of Community Solar: A Portland Case Study

NASA Astrophysics Data System (ADS)

Weaver, Anne

Community solar is a renewable energy practice that's been adopted by multiple U.S. states and is being considered by many more, including the state of Oregon. A recent senate bill in Oregon, called the "Clean Electricity and Coal Transition Plan", includes a provision that directs the Oregon Public Utility Commission to establish a community solar program for investor-owned utilities by late 2017. Thus, energy consumers in Portland will be offered participation in community solar projects in the near future. Community solar is a mechanism that allows ratepayers to experience both the costs and benefits of solar energy while also helping to offset the proportion of fossil-fuel generated electricity in utility grids, thus aiding climate change mitigation. For community solar to achieve market success in the residential sector of Portland, ratepayers of investor-owned utilities must socially accept this energy practice. The aim of this study was to forecast the potential social acceptance of community solar among Portland residents by measuring willingness to participate in these projects. Additionally, consumer characteristics, attitudes, awareness, and knowledge were captured to assess the influence of these factors on intent to enroll in community solar. The theory of planned behavior, as well as the social acceptance, diffusion of innovation, and dual-interest theories were frameworks used to inform the analysis of community solar adoption. These research objectives were addressed through a mixed-mode survey of Portland residents, using a stratified random sample of Portland neighborhoods to acquire a gradient of demographics. 330 questionnaires were completed, yielding a 34.2% response rate. Descriptive statistics, binomial logistic regression models, and mean willingness to pay were the analyses conducted to measure the influence of project factors and demographic characteristics on likelihood of community solar participation. Roughly 60% of respondents exhibited interest in community solar enrollment. The logistic regression model revealed the percent change in utility bill (essentially the rate of return on the community solar investment) as a dramatically influential variable predicting willingness to participate. Community solar project scenarios also had a strong influence on willingness to participate: larger, cheaper, and distant projects were preferred over small and expensive local projects. Results indicate that community solar project features that accentuate affordability are most important to energy consumers. Additionally, demographic characteristics that were strongly correlated with willingness to enroll were politically liberal ideologies, higher incomes, current enrollment in green utility programs, and membership in an environmental organization. Thus, the market acceptance of community solar in Portland will potentially be broadened by emphasizing affordability over other features, such as community and locality. Additionally, I explored attitudinal influences on interest in community solar by conducting exploratory factor analysis on attitudes towards energy, climate change, and solar barriers and subsequently conducting binomial logistic regression models. Results found that perceiving renewable energy as environmentally beneficial was positively correlated with intent to enroll in community solar, which supported the notion that environmental attitudes will lead to environmental behaviors. The logistic regression model also revealed a negative correlation between community solar interest and negative attitudes towards renewable energy. Perceptions of solar barriers were mild, indicating that lack of an enabling mechanism may be the reason solar continues to be underutilized in this region.

Association between awareness of patient rights and patient's education, seeing bill, and age: a cross-sectional study.

PubMed

Yaghobian, Mahbobeh; Kaheni, Sima; Danesh, Mahmonir; Rezayi Abhari, Farideh

2014-02-17

Considering the controversial results of previous reports on awareness of bill of patients' rights in different regions, as well as the fact that no report is available on the awareness of patients of their rights in teaching hospitals of Sari, we conducted the present study. This is a cross-sectional Study conducted in teaching hospitals of Sari in 2011. The study population consisted of 336 patients recruited from 4 hospitals affiliated with Mazandaran University of Medical Sciences in Sari, through calculating the selection quota of each hospital. Data were collected through face-to-face interview on discharge, using a two-section questionnaire based on the bill of patient rights and with verified reliability and validity. Data analysis was accomplished on SPSS soft- ware version 10. 55.4% of patients were women and 44.6% were men. The patients' mean age was 40.93 ± 15.04 years and the mean length of stay was 4.6 ± 3.34 days. Most patients had elementary education (36%) or were illiterate (25%). The majority (63.4%) had not seen the bill of patients' rights. 58.9% had poor knowledge, 12% had intermediate knowledge, and 29.1% had good knowledge. As for the articles of the bill, the poorest awareness correlated to the 9th article (the right to participate or refrain from participating in research). We found a significant relationship between awareness of the bill, and the patient's education, seeing the bill, and age (p < 0.0005). The results of the present study indicate that patients are not sufficiently aware of their rights, and this problem requires comprehensive planning to be resolved.

Association between Awareness of Patient Rights and Patient’s Education, Seeing Bill, and Age: A Cross-Sectional Study

PubMed Central

Yaghobian, Mahbobeh; Kaheni, Sima; Danesh, Mahmonir; Abhari, Farideh Rezayi

2014-01-01

Background: Considering the controversial results of previous reports on awareness of bill of patients’ rights in different regions, as well as the fact that no report is available on the awareness of patients of their rights in teaching hospitals of Sari, we conducted the present study. Materials and Methods: This is a cross-sectional Study conducted in teaching hospitals of Sari in 2011. The study population consisted of 336 patients recruited from 4 hospitals affiliated with Mazandaran University of Medical Sciences in Sari, through calculating the selection quota of each hospital. Data were collected through face-to-face interview on discharge, using a two-section questionnaire based on the bill of patient rights and with verified reliability and validity. Data analysis was accomplished on SPSS soft- ware version 10. Results: 55.4% of patients were women and 44.6% were men. The patients’ mean age was 40.93 ± 15.04 years and the mean length of stay was 4.6 ± 3.34 days. Most patients had elementary education (36%) or were illiterate (25%). The majority (63.4%) had not seen the bill of patients’ rights. 58.9% had poor knowledge, 12% had intermediate knowledge, and 29.1% had good knowledge. As for the articles of the bill, the poorest awareness correlated to the 9th article (the right to participate or refrain from participating in research). We found a significant relationship between awareness of the bill, and the patient’s education, seeing the bill, and age (p<0.0005). Conclusion: The results of the present study indicate that patients are not sufficiently aware of their rights, and this problem requires comprehensive planning to be resolved. PMID:24762346

Analysis of S.139, the Climate Stewardship Act of 2003

EIA Publications

2003-01-01

On January 9, 2003, Senators John McCain and Joseph I. Lieberman introduced Senate Bill 139 (S.139), the Climate Stewardship Act of 2003, in the U.S. Senate. S.139 would require the Administrator of the U.S. Environmental Protection Agency (EPA) to promulgate regulations to limit greenhouse gas emissions. On January 28, 2003, Senator James M. Inhofe requested that the Energy Information Administration (EIA) perform a comprehensive analysis of S.139. On April 2, 2003, Senators McCain and Lieberman, cosponsors of S.139, made a further request for analyses of their bill. This Service Report responds to both requests.

Utilization of cardiac computed tomography angiography and outpatient invasive coronary angiography in Ontario, Canada.

PubMed

Roifman, Idan; Rezai, Mohammad R; Wijeysundera, Harindra C; Chow, Benjamin J W; Wright, Graham A; Tu, Jack V

2015-01-01

Cardiac computed tomography angiography (coronary CTA) has emerged as a non-invasive method of diagnosing coronary artery disease. The extent of utilization and uptake of this technology since initiation of its funding by the government of Ontario is unknown. The aim of our study was to examine coronary CTA utilization and the rates of elective invasive coronary angiography and revascularization before and after funding initiation. We studied all coronary CTAs performed on adults in Ontario after initiation of funding. We also used an interrupted time series analysis to compare the average monthly rates of invasive angiography and revascularization before and after initiation of funding. There was an initial steep increase in age-and sex-standardized rates of coronary CTA from 5.0 to 11.4/100,000 over the first two quarters after funding initiation. Afterwards, there was a gradual increase in utilization from 11.4 to 17.1/100,000 over two subsequent calendar years. There was a significant reduction in both the mean monthly outpatient invasive coronary angiography (from 20.7 to 19.9 per 100,000 (p = 0.0004)) and revascularization (from 4.9 to 4.4 per 100,000 (p < 0.0001)) rates in the three years following introduction of the coronary CTA billing code as compared to the three prior to its introduction. Since the introduction of coronary CTA funding in Ontario, there has been a steady and controlled increase in its utilization. The increasing use of coronary CTA was associated with a reduction in both the rates of invasive angiography and revascularization. Copyright © 2015 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Burden of alcohol-related injuries on radiology services at a level I trauma center.

PubMed

Roudsari, Bahman; Psoter, Kevin J; Mack, Christopher; Vavilala, Monica S; Jarvik, Jeffrey G

2012-10-01

The purpose of our study was to evaluate the burden of alcohol-related injuries on a radiology department at a level 1 trauma center. We linked the trauma registry (2005-2009) of Harborview Medical Center to billing department data and extracted patient demographic and injury-related characteristics and the radiology services provided. Multivariate negative binomial analysis was used to evaluate the association between blood alcohol concentration (BAC) and CT and MRI utilization rates. A total of 125,776 CT and 4681 MRI examinations were performed on 27,274 patients during the study period. Higher BAC was generally associated with higher utilization rates for all types of CT even after adjusting for potential confounding variables. Compared with patients with a BAC of 0, the greatest increases in utilization were observed in individuals with a BAC of 240 mg/dL or more for head CT (incidence rate ratio [IRR], 1.43; 95% CI, 1.32-1.54), cervical spine (IRR, 1.45; 95% CI, 1.32-1.58), and maxillofacial (IRR, 1.66; 95% CI, 1.42-1.95), with no increase observed for MRI. This association was more prominent in less severely injured patients with utilization rates for head CT (IRR, 1.83; 95% CI, 1.56-2.13), abdomen (IRR, 1.46; 95% CI, 1.32-1.63), and thorax (IRR, 1.57; 95% CI, 1.30-1.89) in individuals with a BAC of 240 mg/dL or more compared with those with a BAC of 0. Higher BAC was associated with increased CT utilization for most body region-specific CT scans and was more strongly associated in patients with less severe injuries. Any guideline that could potentially decrease unnecessary imaging for patients with alcohol-involved injuries would represent a cost-saving strategy.

Comparison of administrative/billing data to expected protocol-mandated chemotherapy exposure in children with acute myeloid leukemia: A report from the Children's Oncology Group.

PubMed

Miller, Tamara P; Troxel, Andrea B; Li, Yimei; Huang, Yuan-Shung; Alonzo, Todd A; Gerbing, Robert B; Hall, Matt; Torp, Kari; Fisher, Brian T; Bagatell, Rochelle; Seif, Alix E; Sung, Lillian; Gamis, Alan; Rubin, David; Luger, Selina; Aplenc, Richard

2015-07-01

Recently investigators have used analysis of administrative/billing datasets to answer clinical and pharmacoepidemiology questions in pediatric oncology. However, the accuracy of pharmacy data from administrative/billing datasets have not yet been evaluated. The primary objective of this study was to determine the concordance of Pediatric Health Information System (PHIS) administrative/billing chemotherapy data with Children's Oncology Group (COG) protocol-mandated chemotherapy and to assess the implications of this level of concordance for further PHIS research. Data from 384 pediatric patients (1,060 courses of chemotherapy) with acute myeloid leukemia treated on COG clinical trial AAML0531 were previously merged with PHIS data. PHIS chemotherapy administrative/billing data were reviewed for the first three courses of chemotherapy. Accuracy was assessed using three metrics: recognizability of chemotherapy pattern by course, chemotherapy administration pattern by individual medication, and concordance with the number of days of protocol-defined chemotherapy. The chemotherapy pattern was recognizable in 87.3% of courses when course-wide accuracy was assessed. Chemotherapy administration pattern varied by medication. Cytarabine had perfect concordance 70.9% of the time, daunorubicin had perfect concordance 77.4% of the time, and etoposide had perfect concordance 67.8% of the time. The accuracy of chemotherapy administrative/billing data supports the continued use of PHIS data for epidemiology studies as long as investigators perform data quality control checks and evaluate each specific medication prior to undertaking definitive analyses. © 2015 Wiley Periodicals, Inc.

Home Performance with ENERGY STAR: Utility Bill Analysis on Homes Participating in Austin Energy's Program

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

Belzer, D.; Mosey, G.; Plympton, P.

2007-07-01

Home Performance with ENERGY STAR (HPwES) is a jointly managed program of the U.S. Department of Energy (DOE) and the U.S. Environmental Protection Agency (EPA). This program focuses on improving energy efficiency in existing homes via a whole-house approach to assessing and improving a home's energy performance, and helping to protect the environment. As one of HPwES's local sponsors, Austin Energy's HPwES program offers a complete home energy analysis and a list of recommendations for efficiency improvements, along with cost estimates. To determine the benefits of this program, the National Renewable Energy Laboratory (NREL) collaborated with the Pacific Northwest Nationalmore » Laboratory (PNNL) to conduct a statistical analysis using energy consumption data of HPwES homes provided by Austin Energy. This report provides preliminary estimates of average savings per home from the HPwES Loan Program for the period 1998 through 2006. The results from this preliminary analysis suggest that the HPwES program sponsored by Austin Energy had a very significant impact on reducing average cooling electricity for participating households. Overall, average savings were in the range of 25%-35%, and appear to be robust under various criteria for the number of households included in the analysis.« less

National Tobacco Policy and Youth Smoking Reduction Act. Report of the Committee on Commerce, Science, and Transportation on S.1415 Together with Additonal Views. United States Senate, 105th Congress, 2d Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Commerce, Science, and Transportation.

The purposes of Senate bill S.1415 concerning youth smoking are reviewed and a favorable report with an amendment is provided. The background and need for the legislation is analyzed and the legislative history, including hearings and testimony, is summarized. An analysis of Sections 1-10 is presented individually. Discussion of the bill follows…

Implementation of a Shared Resource Financial Management System

PubMed Central

Caldwell, T.; Gerlach, R.; Israel, M.; Bobin, S.

2010-01-01

CF-6 Norris Cotton Cancer Center (NCCC), an NCI-designated Comprehensive Cancer Center at Dartmouth Medical School, administers 12 Life Sciences Shared Resources. These resources are diverse and offer multiple products and services. Previous methods for tracking resource use, billing, and financial management were time consuming, error prone and lacked appropriate financial management tools. To address these problems, we developed and implemented a web-based application with a built-in authorization system that uses Perl, ModPerl, Apache2, and Oracle as the software infrastructure. The application uses a role-based system to differentiate administrative users with those requesting services and includes many features requested by users and administrators. To begin development, we chose a resource that had an uncomplicated service, a large number of users, and required the use of all of the applications features. The Molecular Biology Core Facility at NCCC fit these requirements and was used as a model for developing and testing the application. After model development, institution wide deployment followed a three-stage process. The first stage was to interview the resource manager and staff to understand day-to-day operations. At the second stage, we generated and tested customized forms defining resource services. During the third stage, we added new resource users and administrators to the system before final deployment. Twelve months after deployment, resource administrators reported that the new system performed well for internal and external billing and tracking resource utilization. Users preferred the application's web-based system for distribution of DNA sequencing and other data. The sample tracking features have enhanced day-to-day resource operations, and an on-line scheduling module for shared instruments has proven a much-needed utility. Principal investigators now are able to restrict user spending to specific accounts and have final approval of the invoices before the billing, which has significantly reduced the number of unpaid invoices.

Costs and utilization of end-stage glaucoma patients receiving visual rehabilitation care: a US multisite retrospective study.

PubMed

Gieser, David K; Tracy Williams, R; O'Connell, William; Pasquale, Louis R; Rosenthal, Bruce P; Walt, John G; Katz, Laura M; Siegartel, Lisa R; Wang, Lujing; Rosenblatt, Lisa C; Stern, Lee S; Doyle, John J

2006-10-01

Glaucoma is a prevalent ophthalmologic disease and leading cause of blindness. A retrospective analysis was conducted to evaluate resources and costs for end-stage glaucoma patients receiving visual rehabilitation care (VRC). A chart review was conducted in 3 United States VRC centers. Charts of patients with primary open-angle glaucoma as the primary cause of vision loss (1998 to 2003) were selected, yielding 81 records. Data were collected from patient-level billing and reimbursement records (ophthalmologist/optometrist visits, glaucoma medications, procedures, and specialized low-vision and glaucoma-related services). Visual rehabilitation services included utilization of low-vision devices, assessment of daily functioning, orientation and mobility training, and patient counseling. Mean age at baseline was 72.7 years [standard deviation (SD)=17.2, range: 29 to 95]. Of those with known sex (n=77), 55.8% were women. Medicare was the payer type for most patients (59.3%), whereas 20% had Medicaid. Mean number of visits was 7.1 (SD=6.1) in year 1 and 3.7 (SD=4.2) in year 2, for an annual mean of 5.4 (SD=5.0) visits overall. Total mean cost per patient in year 1 was greater than year 2 [$2170 (SD=$2252) vs. $1202 (SD=$1080), respectively]; of the total 2-year costs, 15% were VRC, 37% ophthalmology care, and 48% pharmacy. Analysis of nonpharmacy costs revealed that VRC accounted for 28% and ophthalmology for 72%. End-stage glaucoma is associated with appreciable resource utilization and costs, because of both vision rehabilitation and ophthalmology care. Advanced primary open-angle glaucoma has a substantial cost-of-illness, warranting improved management in early stages of disease.

Frequent users of rural primary care: comparisons with randomly selected users.

PubMed

Mehl-Madrona, L E

1998-01-01

Frequent users of primary care have not been adequately characterized. The unique characteristics of this population was sought--why they come so often, what their care costs, and whether psychosocial factors play a role in their high utilization of health care. The billing system of a rural primary care clinic was used to find the frequency of visits for all patients attending the clinic for the previous 12 months. The 211 most frequent visitors were selected. A comparison group of 250 patients was drawn from the billing records using a random number generator. Charts were reviewed to compare diagnoses (by frequency), number of procedures, amount billed for care, amount received from those billings, number of psychotropic medications prescribed, and response to medication. A subgroup of each group was interviewed to confirm chart review findings and to inquire about personal reasons for coming to the clinic. Compared with patients who were random users, patients who were frequent users were more likely to come from the younger and older age groups, they averaged significantly more emergency department visits and visits to other specialists (P < 0.0001), and they had more mental health problems diagnosed (P < 0.01). Significantly more frequent users were insured by Medicaid and fewer were insured by Medicare. They had more detailed office visits and more laboratory tests. They received twice as much psychotherapy and had a higher percentage of problem-focused office visits. Chart audits and interviews of selected patients revealed that many nonmedical reasons were related to visits in addition to psychosocial stressors. Nonmedical factors are important among the most frequent users of a primary care clinic. Proposals to improve care for frequent users should consider the psychosocial needs of this population.

Healthcare resource utilization following switch or discontinuation in multiple sclerosis patients on disease modifying drugs.

PubMed

Reynolds, Matthew W; Stephen, Reejis; Seaman, Chris; Rajagopalan, Kitty

2010-03-01

The objective of this study was to explore the cost and utilization in the period following discontinuations or switches of disease modifying drugs (DMDs) for patients with multiple sclerosis (MS). Secondary objectives included an assessment of the time to switch or discontinuation from index DMD treatment. Cases were defined as a billed MS diagnosis in continuously enrolled patients initiated with interferon-beta1a IM, interferon-beta1b SC, glatiramer acetate, and interferon-beta1a SC found in the PharMetrics Patient-Centric Database. Information on patient demographics, diagnoses, procedures, pharmacy-dispensed drugs, and costs was extracted; reasons for discontinuation and expenses outside of the healthcare system were not available. Treatment discontinuations and switches between study drugs were defined using pharmacy prescription patterns and analyzed by descriptive and regression methods. The non-pharmacy medical costs in the 18 months following switching or discontinuation were compared to the costs in a randomly selected similar period for those patients who did not switch or discontinue these agents. A total of 5,772 MS patients were continuously enrolled and were treated with one or more of the four drugs of interest, and about half of these patients switched drugs or discontinued treatment for at least 90 days. Patients initiated with interferon-beta1b SC were more likely to discontinue treatment compared to interferon-beta1a IM users. Non-pharmaceutical medical costs were highest for those switching treatments followed by those discontinuing DMDs in the 18 months following a switch or discontinuation, compared to persistent users of these drugs. Interferon beta1b SC initiators had higher costs following changes or discontinuations, while glatiramer acetate and interferon-beta1a SC users had lower subsequent costs compared to interferon-beta1a IM users. Unfortunately, the reasons for stopping the initial treatment cannot be determined from analysis of an administrative claims database. Also, the MS cases followed in this analysis are billing diagnostic events unconfirmed through a review of medical records or other data sources. The results are unstratified in terms of severity and thus while treatment patterns may vary for patients with different types of MS (e.g., progressive vs. relapsing-remitting), this cannot be examined in this analysis. Changing or discontinuing DMDs is common among MS patients and is associated with higher non-pharmaceutical medical costs that vary based on the initiating drug and other demographics characteristics.

19 CFR 24.3a - CBP bills; interest assessment on bills; delinquency; notice to principal and surety.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 1 2013-04-01 2013-04-01 false CBP bills; interest assessment on bills... PROCEDURE § 24.3a CBP bills; interest assessment on bills; delinquency; notice to principal and surety. (a) Due date of CBP bills. CBP bills for supplemental duties, taxes and fees(increased or additional...

19 CFR 24.3a - CBP bills; interest assessment on bills; delinquency; notice to principal and surety.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 1 2014-04-01 2014-04-01 false CBP bills; interest assessment on bills... PROCEDURE § 24.3a CBP bills; interest assessment on bills; delinquency; notice to principal and surety. (a) Due date of CBP bills. CBP bills for supplemental duties, taxes and fees(increased or additional...

Environmental, energy and natural resources status report for the 101st Congress. Special report

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

Not Available

1990-11-01

Contents: environmental, energy and natural resources status report for the 101st Congress; abandoned-mine fees passed in budget bill; cleanup effort and NRC fees boosted; other measures stall; Strategic Petroleum Reserve to grow to 1 billion barrels; circle of poison provisions cut in farm bill conference; congress clears landmark oil spill liability legislation; motor fuels tax tops massive debt reduction measure; Bush plans to sign massive clean air bill; global climate change bill passes at session end; lots of conservation provisions in farm bill; tongass bill moves; loggers and owls remain stalemated; major reform bills on parks, land fund and blmmore » wither; coastal zone, great lakes, barrier bills beat deadline; modified tuna bill clears congress; Arizona, Alaska, Nevada wilderness bills approved; bills passed on asbestos, transport, waste reduction; bills passed on alternative power, low-income energy aid; numerous money bills clear Congress at the last minute; EPA-to-cabinet bill dies; DOD to fund environment research.« less

In Sickness and in Debt: Do Mounting Medical Bills Predict Payday Loan Debt?

PubMed

Bickham, Trey; Lim, Younghee

2015-01-01

Cash-strapped families sometimes turn to small, short-term loans with exorbitant fees—payday loans—to cope with mounting medical bills. Given that about three-fourths of payday loan customers are repeat borrowers, consumer advocates and policymakers have increasingly raised voices of concern about the use of payday loans to finance various household expenses, including, among other things, medical bills. The present study hypothesized that increases in medical debt are associated with increases in payday loan debt among a sample of Chapter 7 bankruptcy filers. The results of a multivariate tobit regression analysis showed that medical debt was associated with increased payday loan debt, controlling for various types of debt and other socioeconomic variables. This article concludes with implications of the results for social work policy- and direct-practice.

Advance Care Planning in an Accountable Care Organization Is Associated with Increased Advanced Directive Documentation and Decreased Costs.

PubMed

Bond, William F; Kim, Minchul; Franciskovich, Chris M; Weinberg, Jason E; Svendsen, Jessica D; Fehr, Linda S; Funk, Amy; Sawicki, Robert; Asche, Carl V

2018-04-01

Advance care planning (ACP) documents patient wishes and increases awareness of palliative care options. To study the association of outpatient ACP with advanced directive documentation, utilization, and costs of care. This was a case-control study of cases with ACP who died matched 1:1 with controls. We used 12 months of data pre-ACP/prematch and predeath. We compared rates of documentation with logit model regression and conducted a difference-in-difference analysis using generalized linear models for utilization and costs. Medicare beneficiaries attributed to a large rural-suburban-small metro multisite accountable care organization from January 2013 to April 2016, with cross reference to ACP facilitator logs to find cases. The presence of advance directive forms was verified by chart review. Cost analysis included all utilization and costs billed to Medicare. We matched 325 cases and 325 controls (51.1% female and 48.9% male, mean age 81). 320/325 (98.5%) ACP versus 243/325 (74.8%) of controls had a Healthcare Power of Attorney (odds ratio [OR] 21.6, 95% CI 8.6-54.1) and 172/325(52.9%) ACP versus 145/325 (44.6%) controls had Practitioner Orders for Life Sustaining Treatment (OR 1.40, 95% CI 1.02-1.90) post-ACP/postmatch. Adjusted results showed ACP cases had fewer inpatient admissions (-0.37 admissions, 95% CI -0.66 to -0.08), and inpatient days (-3.66 days, 95% CI -6.23 to -1.09), with no differences in hospice, hospice days, skilled nursing facility use, home health use, 30-day readmissions, or emergency department visits. Adjusted costs were $9,500 lower in the ACP group (95% CI -$16,207 to -$2,793). ACP increases documentation and was associated with a reduction in overall costs driven primarily by a reduction in inpatient utilization. Our data set was limited by small numbers of minorities and cancer patients.

Practice management.

PubMed

Althausen, Peter L; Mead, Lisa

2014-07-01

The practicing orthopaedic traumatologist must have a sound knowledge of business fundamentals to be successful in the changing healthcare environment. Practice management encompasses multiple topics including governance, the financial aspects of billing and coding, physician extender management, ancillary service development, information technology, transcription utilization, and marketing. Some of these are universal, but several of these areas may be most applicable to the private practice of medicine. Attention to each component is vital to develop an understanding of the intricacies of practice management.

Family Housing Metering Test. A Test Program to Determine the Feasibility of Installing Utility Meters in Military Family Housing, Developing Energy Ceilings, and Operating a Penalty Billing System for Occupants Who Overconsume Energy. Volume II. Appendices.

DTIC Science & Technology

1980-03-01

implementation. 5.2 NORM PAMPHLET The norm pamphlet is a short, picture-oriented brochure to introduce military housing occupants to the use of the energy...tne final version of the pamplet , feedbaci roejrdiag the. draf t version sill be solicited from the fiefl test par- ticipants. rhe followlag is a rouga

What is the Impact of Utility Demand Charges on a DCFC host

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

Francfort, James Edward

The PEV Electric Vehicle Supply Equipment (EVSE) delivered by The EV Project included both AC Level 2 and DCFC units. Over 100 of these dual-port Blink DC fast chargers were deployed by The EV Project. These DCFCs were installed in workplaces and in publicly accessible locations near traffic hubs, retail centers, parking lots, restaurants, and similar locations. The Blink DCFC is capable of charging at power up to 60 kW. Its dual-port design sequences the charge from one port to the other, delivering power to only one of two vehicles connected at a time. The actual power delivered through amore » port is determined by the PEV’s on-board battery management system (BMS). Both the power and the total energy used to recharge a PEV can represent a significant cost for the charging site host. Many electric utilities impose fees for power demand as part of their commercial rate structure. The demand charge incurred by a customer is related to the peak power used during a monthly billing cycle. This is in contrast to the cumulative total energy usage that is the more familiar utility charge seen for most residential services. A demand charge is typically assessed for the highest average power over any 15 minute interval during the monthly billing cycle. One objective of The EV Project was to identify and elucidate the motivations and barriers to potential DCFC site hosts. The application of electric utility demand charges is one such potential barrier. This subject was introduced in the paper: DC Fast Charge - Demand Charge Reduction1. It discussed demand charge impact in general terms in order to focus on potential mitigation actions. This paper identifies specific cases in order to quantify the impact of demand charges on EV Project DCFC hosts.« less

Sexing California gulls using morphometrics and discriminant function analysis

USGS Publications Warehouse

Herring, Garth; Ackerman, Joshua T.; Eagles-Smith, Collin A.; Takekawa, John Y.

2010-01-01

A discriminant function analysis (DFA) model was developed with DNA sex verification so that external morphology could be used to sex 203 adult California Gulls (Larus californicus) in San Francisco Bay (SFB). The best model was 97% accurate and included head-to-bill length, culmen depth at the gonys, and wing length. Using an iterative process, the model was simplified to a single measurement (head-to-bill length) that still assigned sex correctly 94% of the time. A previous California Gull sex determination model developed for a population in Wyoming was then assessed by fitting SFB California Gull measurement data to the Wyoming model; this new model failed to converge on the same measurements as those originally used by the Wyoming model. Results from the SFB discriminant function model were compared to the Wyoming model results (by using SFB data with the Wyoming model); the SFB model was 7% more accurate for SFB California gulls. The simplified DFA model (head-to-bill length only) provided highly accurate results (94%) and minimized the measurements and time required to accurately sex California Gulls.

Mapping landscape phenology preference of yellow-billed cuckoo with AVHRR data

USGS Publications Warehouse

Wallace, Cynthia S.A.; Villarreal, Miguel; van Riper, Charles

2013-01-01

We mapped habitat for threatened Yellow-billed Cuckoo (Coccycus americanus occidentalis) in the State of Arizona using the temporal greenness dynamics of the landscape, or the landscape phenology. Landscape phenometrics were derived from Advanced Very High Resolution Radiometer (AVHRR) Normalized Difference Vegetation Index (NDVI) data for 1998 and 1999 by using Fourier harmonic analysis to analyze the waveform of the annual NDVI profile at each pixel. We modeled the spatial distribution of Yellow-billed Cuckoo habitat by coupling the field data of Cuckoo presence or absence and point-based samples of riparian and cottonwood-willow vegetation types with satellite phenometrics for 1998. Models were validated using field and satellite data collected in 1999. The results indicate that Yellow-billed Cuckoo occupy locations within their preferred habitat that exhibit peak greenness after the start of the summer monsoon and are greener and more dynamic than “average” habitat. Identification of preferred phenotypes within recognized habitat areas can be used to refine habitat models, inform predictions of habitat response to climate change, and suggest adaptation strategies.

[Woman's experience with the choice of the Billings Ovulation Method].

PubMed

de Magalhães, Adriana Cristina; Pereira, Daliane da Silva Alves; Jardim, Danúbia Mariane Barbosa; Caillaux, Michelle; Sales, Vinícius Bernardo Lemos

2013-01-01

This is a case study with a qualitative approach, carried out between February and November 2010 with 10 women, mean age of 34 years old, users of this Billings Ovulation Method (MOB) for over than two years, with the objective of understand the experience of women by choosing the MOB. Data was obtained from interviews, and analyzed through content analysis technique. The categories of analysis showed that the reasons for the choices of the MOB were: religion; natural method, and benefits of self-knowledge. It was concluded that women show confidence in carrying out the method, that it brings benefits for users and that there is a need for professional guidance for its correct practice.

A distributed algorithm for demand-side management: Selling back to the grid.

PubMed

Latifi, Milad; Khalili, Azam; Rastegarnia, Amir; Zandi, Sajad; Bazzi, Wael M

2017-11-01

Demand side energy consumption scheduling is a well-known issue in the smart grid research area. However, there is lack of a comprehensive method to manage the demand side and consumer behavior in order to obtain an optimum solution. The method needs to address several aspects, including the scale-free requirement and distributed nature of the problem, consideration of renewable resources, allowing consumers to sell electricity back to the main grid, and adaptivity to a local change in the solution point. In addition, the model should allow compensation to consumers and ensurance of certain satisfaction levels. To tackle these issues, this paper proposes a novel autonomous demand side management technique which minimizes consumer utility costs and maximizes consumer comfort levels in a fully distributed manner. The technique uses a new logarithmic cost function and allows consumers to sell excess electricity (e.g. from renewable resources) back to the grid in order to reduce their electric utility bill. To develop the proposed scheme, we first formulate the problem as a constrained convex minimization problem. Then, it is converted to an unconstrained version using the segmentation-based penalty method. At each consumer location, we deploy an adaptive diffusion approach to obtain the solution in a distributed fashion. The use of adaptive diffusion makes it possible for consumers to find the optimum energy consumption schedule with a small number of information exchanges. Moreover, the proposed method is able to track drifts resulting from changes in the price parameters and consumer preferences. Simulations and numerical results show that our framework can reduce the total load demand peaks, lower the consumer utility bill, and improve the consumer comfort level.

End-Use Load and Conservation Assessment Program : Co-Instrumentation Test of Two Microcomputer-Based Energy Monitoring Systems.

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

Fishbaugher, M. J.

1985-05-01

The decreasing cost of microcomputers along with improvements in power metering circuitry have changed the way in which electrical energy use is monitored. Although utilities still rely on kilowatt-hour (kWh) meters for billing purposes, a microcomputer-based monitoring system is used when greater temporal and end-use resolution is desired. Because these types of monitoring systems will be used increasingly in large-scale conservation and end-use studies, it is important that their performance be analyzed to determine their accuracy. A co-instrumentation test was devised in which two such microcomputer-based monitoring systems made simultaneous measurements of electrical end-uses in two commercial buildings. The analysismore » of the co-instrumentation data aids in the evaluation of microcomputer-based monitoring systems used for end-use measurements. Separate and independent data loggers were used to measure the same loads simultaneously. In addition to these two systems, a utility billing meter measured the total energy use in each building during the co-instrumentation test. The utility's meters provided a relatively accurate standard by which the performance of both loggers could be judged. The comparison between the SCL and PNL microcomputer-based loggers has shown that power measurement techniques directly affect system performance. The co-instrumentation test has shown that there are certain standards that a monitoring system must meet if it is to perform well. First, it is essential to calibrate a microcomputer-based logger against a known standard load before the system is installed. Second, a microcomputer-based system must have some way of accounting for power factors. Recent advances in power metering circuitry have made it relatively easy to apply these power factors automatically in real time.« less

Accreditation status and geographic location of outpatient vascular testing facilities among Medicare beneficiaries: the VALUE (Vascular Accreditation, Location & Utilization Evaluation) study.

PubMed

Rundek, Tatjana; Brown, Scott C; Wang, Kefeng; Dong, Chuanhui; Farrell, Mary Beth; Heller, Gary V; Gornik, Heather L; Hutchisson, Marge; Needleman, Laurence; Benenati, James F; Jaff, Michael R; Meier, George H; Perese, Susana; Bendick, Phillip; Hamburg, Naomi M; Lohr, Joann M; LaPerna, Lucy; Leers, Steven A; Lilly, Michael P; Tegeler, Charles; Alexandrov, Andrei V; Katanick, Sandra L

2014-10-01

There is limited information on the accreditation status and geographic distribution of vascular testing facilities in the US. The Centers for Medicare & Medicaid Services (CMS) provide reimbursement to facilities regardless of accreditation status. The aims were to: (1) identify the proportion of Intersocietal Accreditation Commission (IAC) accredited vascular testing facilities in a 5% random national sample of Medicare beneficiaries receiving outpatient vascular testing services; (2) describe the geographic distribution of these facilities. The VALUE (Vascular Accreditation, Location & Utilization Evaluation) Study examines the proportion of IAC accredited facilities providing vascular testing procedures nationally, and the geographic distribution and utilization of these facilities. The data set containing all facilities that billed Medicare for outpatient vascular testing services in 2011 (5% CMS Outpatient Limited Data Set (LDS) file) was examined, and locations of outpatient vascular testing facilities were obtained from the 2011 CMS/Medicare Provider of Services (POS) file. Of 13,462 total vascular testing facilities billing Medicare for vascular testing procedures in a 5% random Outpatient LDS for the US in 2011, 13% (n=1730) of facilities were IAC accredited. The percentage of IAC accredited vascular testing facilities in the LDS file varied significantly by US region, p<0.0001: 26%, 12%, 11%, and 7% for the Northeast, South, Midwest, and Western regions, respectively. Findings suggest that the proportion of outpatient vascular testing facilities that are IAC accredited is low and varies by region. Increasing the number of accredited vascular testing facilities to improve test quality is a hypothesis that should be tested in future research. © The Author(s) 2014.

Utility of a near real-time emergency department syndromic surveillance system to track injuries in New York City.

PubMed

Seil, Kacie; Marcum, Jennifer; Lall, Ramona; Stayton, Catherine

2015-12-01

The New York City emergency department (ED) syndromic surveillance (SS) system provides near real-time data on the majority of ED visits. The utility of ED SS for injury surveillance has not been thoroughly evaluated. We created injury syndromes based on ED chief complaint information and evaluated their utility compared to administrative billing data. Six injury syndromes were developed: traffic-related injuries to pedal cyclists, pedestrians, and motor vehicle occupants; fall-related injuries; firearm-related injuries; and assault-related stabbings. Daily injury counts were compared for ED SS and the administrative billing data for years 2008-2010. We examined characteristics of injury trends and patterns between the two systems, calculating descriptive statistics for temporal patterns and Pearson correlation coefficients (r) for temporal trends. We also calculated proportions of demographic and geospatial patterns for both systems. Although daily volume of the injuries varied between the two systems, the temporal patterns were similar (all r values for daily volume exceeded 0.65). Comparisons of injuries by time of day, day of week, and quarter of year demonstrated high agreement between the two systems-the majority had an absolute percentage point difference of 2.0 or less. Distributions of injury by sex and age group also aligned well. Distribution of injury by neighborhood of residence showed mixed results-some neighborhood comparisons showed a high level of agreement between systems, while others were less successful. As evidenced by the strong positive correlation coefficients and the small absolute percentage point differences in our comparisons, we conclude that ED SS captures temporal trends and patterns of injury-related ED visits effectively. The system could be used to identify changes in injury patterns, allowing for situational awareness during emergencies, timely response, and public messaging.

Carotenoid-based bill colour is an integrative signal of multiple parasite infection in blackbird

NASA Astrophysics Data System (ADS)

Biard, Clotilde; Saulnier, Nicolas; Gaillard, Maria; Moreau, Jérôme

2010-11-01

In the study of parasite-mediated sexual selection, there has been controversial evidence for the prediction that brighter males should have fewer parasites. Most of these studies have focused on one parasite species. Our aim was to investigate the expression of carotenoid-based coloured signals in relation to patterns of multiple parasite infections, to determine whether colour reflects parasite load of all parasite species, or whether different relationships might be found when looking at each parasite species independently. We investigated the relationship between bill colour, body mass and plasma carotenoids and parasite load (feather chewing lice, blood parasite Plasmodium sp., intestinal parasites cestodes and coccidia) in the blackbird ( Turdus merula). Bill colour on its own appeared to be a poor predictor of parasite load when investigating its relationships with individual parasite species. Variation in parasite intensities at the community level was summarised using principal component analysis to derive synthetic indexes of relative parasite species abundance and absolute parasite load. The relative abundance of parasite species was strongly related to bill colour, plasma carotenoid levels and body mass: birds with relatively more cestodes and chewing lice and relatively less Plasmodium and coccidia had a more colourful bill, circulated more carotenoids and were heavier. These results suggest that bill colour more accurately reflects the relative intensities of parasite infection, rather than one-by-one relationships with parasites or absolute parasite burden. Investigating patterns of multiple parasite infection would thus improve our understanding of the information conveyed by coloured signals on parasite load.

Reimbursement for emergency department electrocardiography and radiograph interpretations: what is it worth for the emergency physician.

PubMed

Wu, Tina; Bell, Mark R; Blakeman, James R; Edwards, Irv; Mallon, William K

2009-08-01

Physician reimbursement laws for diagnostic interpretive services require that only those services provided contemporaneously and /or contribute directly to patient care can be billed for. Despite these regulations, cardiologists and radiologists in many hospitals continue to bill for ECG and plain film diagnostic services performed in the emergency department (ED). The reimbursement value of this care, which is disconnected in time and place from the ED patient encounter, is unknown. In a California community ED with a 32,000 annual census, the emergency physicians (EPs) alone, by contract, bill for all ECG readings and plain film interpretations when the radiologists are not available to provide contemporaneous readings. To determine the impact of this billing practice on actual EP reimbursement we undertook an analysis that allows calculation of physician reimbursement from billing data. An IRB-approved analysis of 12 months of billing data cleansed of all patient identifiers was undertaken for 2003. From the data we created a descriptive study with itemized breakdown of reimbursement for radiograph and ECG interpretive services (procedures) and the gross resultant physician income. In 2003 EPs at this hospital treated patients during 32,690 ED visits. Total group income in 2003 for radiographs was $173,555 and $91,025 for ECGs, or $19/EP hour and $6/EP hour respectively. For the average full-time EP, the combined total is $2537/month or $30,444 per annum, per EP. This is $8/ED visit (averaged across all patients). As EP-reimbursement is challenged by rising malpractice premiums, uninsured patients, HMO contracts, unfunded government mandates and state budgetary shortfalls, EPs are seeking to preserve their patient services and resultant income. They should also be reimbursed for those services and the liability that they incur. The reimbursement value of ECGs and plain film interpretations to the practicing EP is substantial. In the ED studied, it represents $30,444 gross income per full-time EP annually. Plain film interpretation services produce three times the hourly revenue of ECG reading at the hospital studied.

Implementation of an acute care emergency surgical service: a cost analysis from the surgeon’s perspective

PubMed Central

Anantha, Ram Venkatesh; Parry, Neil; Vogt, Kelly; Jain, Vipan; Crawford, Silvie; Leslie, Ken

2014-01-01

Background Acute care surgical services provide comprehensive emergency general surgical care while potentially using health care resources more efficiently. We assessed the volume and distribution of emergency general surgery (EGS) procedures before and after the implementation of the Acute Care and Emergency Surgery Service (ACCESS) at a Canadian tertiary care hospital and its effect on surgeon billings. Methods This single-centre retrospective case–control study compared adult patients who underwent EGS procedures between July and December 2009 (pre-ACCESS), to those who had surgery between July and December 2010 (post-ACCESS). Case distribution was compared between day (7 am to 3 pm), evening (3 pm to 11 pm) and night (11 pm to 7 am). Frequencies were compared using the χ2 test. Results Pre-ACCESS, 366 EGS procedures were performed: 24% during the day, 55% in the evening and 21% at night. Post-ACCESS, 463 operations were performed: 55% during the day, 36% in the evening and 9% at night. Reductions in night-time and evening EGS were 57% and 36% respectively (p < 0.001). Total surgeon billings for operations pre- and post-ACCESS were $281 066 and $287 075, respectively: remuneration was $6008 higher post-ACCESS for an additional 97 cases (p = 0.003). Using cost-modelling analysis, post-ACCESS surgeon billing for appendectomies, segmental colectomies, laparotomies and cholecystectomies all declined by $67 190, $125 215, $66 362, and $84 913, respectively (p < 0.001). Conclusion Acute care surgical services have dramatically shifted EGS from nighttime to daytime. Cost-modelling analysis demonstrates that these services have cost-savings potential for the health care system without reducing overall surgeon billing. PMID:24666462

Implementation of an acute care emergency surgical service: a cost analysis from the surgeon's perspective.

PubMed

Anantha, Ram Venkatesh; Parry, Neil; Vogt, Kelly; Jain, Vipan; Crawford, Silvie; Leslie, Ken

2014-04-01

Acute care surgical services provide comprehensive emergency general surgical care while potentially using health care resources more efficiently. We assessed the volume and distribution of emergency general surgery (EGS) procedures before and after the implementation of the Acute Care and Emergency Surgery Service (ACCESS) at a Canadian tertiary care hospital and its effect on surgeon billings. This single-centre retrospective case-control study compared adult patients who underwent EGS procedures between July and December 2009 (pre-ACCESS), to those who had surgery between July and December 2010 (post-ACCESS). Case distribution was compared between day (7 am to 3 pm), evening (3 pm to 11 pm) and night (11 pm to 7 am). Frequencies were compared using the χ(2) test. Pre-ACCESS, 366 EGS procedures were performed: 24% during the day, 55% in the evening and 21% at night. Post-ACCESS, 463 operations were performed: 55% during the day, 36% in the evening and 9% at night. Reductions in night-time and evening EGS were 57% and 36% respectively (p < 0.001). Total surgeon billings for operations pre- and post-ACCESS were $281 066 and $287 075, respectively: remuneration was $6008 higher post-ACCESS for an additional 97 cases (p = 0.003). Using cost-modelling analysis, post-ACCESS surgeon billing for appendectomies, segmental colectomies, laparotomies and cholecystectomies all declined by $67 190, $125 215, $66 362, and $84 913, respectively (p < 0.001). Acute care surgical services have dramatically shifted EGS from nighttime to daytime. Cost-modelling analysis demonstrates that these services have cost-savings potential for the health care system without reducing overall surgeon billing.

Anonymization of Administrative Billing Codes with Repeated Diagnoses Through Censoring

PubMed Central

Tamersoy, Acar; Loukides, Grigorios; Denny, Joshua C.; Malin, Bradley

2010-01-01

Patient-specific data from electronic medical records (EMRs) is increasingly shared in a de-identified form to support research. However, EMRs are susceptible to noise, error, and variation, which can limit their utility for reuse. One way to enhance the utility of EMRs is to record the number of times diagnosis codes are assigned to a patient when this data is shared. This is, however, challenging because releasing such data may be leveraged to compromise patients’ identity. In this paper, we present an approach that, to the best of our knowledge, is the first that can prevent re-identification through repeated diagnosis codes. Our method transforms records to preserve privacy while retaining much of their utility. Experiments conducted using 2676 patients from the EMR system of the Vanderbilt University Medical Center verify that our method is able to retain an average of 95.4% of the diagnosis codes in a common data sharing scenario. PMID:21347085

Therapy Caps and Variation in Cost of Outpatient Occupational Therapy by Provider, Insurance Status, and Geographic Region.

PubMed

Pergolotti, Mackenzi; Lavery, Jessica; Reeve, Bryce B; Dusetzina, Stacie B

This article describes the cost of occupational therapy by provider, insurance status, and geographic region and the number of visits allowed and out-of-pocket costs under proposed therapy caps. This retrospective, population-based study used Medicare Provider Utilization and Payment Data for occupational therapists billing in 2012 and 2013 (Ns = 3,662 and 3,820, respectively). We examined variations in outpatient occupational therapy services with descriptive statistics and the impact of therapy caps on occupational therapy visits and patient out-of-pocket costs. Differences in cost between occupational and physical therapists were minimal. The most frequently billed service was therapeutic exercises. Wisconsin had the most inflated outpatient costs in both years. Under the proposed therapy cap, patients could receive an evaluation plus 12-14 visits. . Wide variation exists in potential patient out-of-pocket costs for occupational therapy services on the basis of insurance coverage and state. Patients without insurance pay a premium. Copyright © 2018 by the American Occupational Therapy Association, Inc.

Therapy Caps and Variation in Cost of Outpatient Occupational Therapy by Provider, Insurance Status, and Geographic Region

PubMed Central

Pergolotti, Mackenzi; Lavery, Jessica; Reeve, Bryce B.; Dusetzina, Stacie B.

2018-01-01

OBJECTIVE. This article describes the cost of occupational therapy by provider, insurance status, and geographic region and the number of visits allowed and out-of-pocket costs under proposed therapy caps. METHOD. This retrospective, population-based study used Medicare Provider Utilization and Payment Data for occupational therapists billing in 2012 and 2013 (Ns = 3,662 and 3,820, respectively). We examined variations in outpatient occupational therapy services with descriptive statistics and the impact of therapy caps on occupational therapy visits and patient out-of-pocket costs. RESULTS. Differences in cost between occupational and physical therapists were minimal. The most frequently billed service was therapeutic exercises. Wisconsin had the most inflated outpatient costs in both years. Under the proposed therapy cap, patients could receive an evaluation plus 12–14 visits. DISCUSSION. Wide variation exists in potential patient out-of-pocket costs for occupational therapy services on the basis of insurance coverage and state. Patients without insurance pay a premium. PMID:29426383

An Integrated Cardiology Patient Management System

PubMed Central

Kiely, F. Michael

1988-01-01

An integrated clinical database has been developed for all diagnostic cardiac services at Vancouver General Hospital. The system is installed on a Data General MV/10000 computer and utilizes the Flagship Application Generator from EPIC Systems Corp. Clinical information, as well as demographic and administrative data, is collected. The system features a custom menu for each user, whose selections provide direct access to the desired functional modules. The intention is to collect data from all the diagnostic areas of the Division of Cardiology, viz., Cardiac Ultrasound, Cardiac Catheterization Laboratory, Pacemaker Clinic and Electrocardiology (including 24 hour ambulatory EKGs and exercise testing). Automated links to the hospital's Admitting/Discharge/Transfer and Billing/Accounts Receivable systems have been implemented over the hospital's local area network. The system is used to produce routine reports of test results, patient billings, and departmental workload statistics. Inquiry functions permit the rapid location of patient records and produce an integrated profile of cardiology activity. In addition, selective searches of the data are available for research and/or other purposes.

Historic and contemporary mercury exposure and potential risk to yellow-billed loons (Gavia adamsii) breeding in Alaska and Canada

USGS Publications Warehouse

Evers, David C.; Schmutz, Joel A.; Basu, Niladri; DeSorbo, Christopher R.; Fair, Jeff; Gray, Carrie E.; Paruk, James D.; Perkins, Marie; Regan, Kevin; Uher-Koch, Brian D.; Wright, Kenneth G.

2014-01-01

The Yellow-billed Loon (Gavia adamsii) is one of the rarest breeding birds in North America. Because of the small population size and patchy distribution, any stressor to its population is of concern. To determine risks posed by environmental mercury (Hg) loads, we captured 115 Yellow-billed Loons between 2002 and 2012 in the North American Arctic and sampled their blood and/or feather tissues and collected nine eggs. Museum samples from Yellow-billed Loons also were analyzed to examine potential changes in Hg exposure over time. An extensive database of published Hg concentrations and associated adverse effects in Common Loons (G. immer) is highly informative and representative for Yellow-billed Loons. Blood Hg concentrations reflect dietary uptake of methylmercury (MeHg) from breeding areas and are generally considered near background levels if less than 1.0 µg/g wet weight (ww). Feather (grown at wintering sites) and egg Hg concentrations can represent a mix of breeding and wintering dietary uptake of MeHg. Based on Common Loon studies, significant risk of reduced reproductive success generally occurs when adult Hg concentrations exceed 2.0 µg/g ww in blood, 20.0 µg/g fresh weight (fw) in flight feathers and 1.0 µg/g ww in eggs. Contemporary mercury concentrations for 176 total samples (across all study sites for 115 Yellow-billed Loons) ranged from 0.08 to 1.45 µg/g ww in blood, 3.0 to 24.9 µg/g fw in feathers and 0.21 to 1.23 µg/g ww in eggs. Mercury concentrations in blood, feather and egg tissues indicate that some individual Yellow-billed Loons in breeding populations across North America are at risk of lowered productivity resulting from Hg exposure. Most Yellow-billed Loons breeding in Alaska overwinter in marine waters of eastern Asia. Although blood Hg concentrations from most breeding loons in Alaska are within background levels, some individuals exhibit elevated feather and egg Hg concentrations, which likely indicate the uptake of MeHg originating from eastern Asia. Feather Hg concentrations tended to be highest in individuals overwintering farthest west (closer to Asia). A retrospective analysis of museum specimens (n = 25) found a two-fold increase in Yellow-billed Loon feather Hg concentrations from the pre-1920s (as early as 1845) to the present. The projected increase in Hg deposition (approximately four-fold by 2050) along with the uncertainty of Hg being released through the thawing of permafrost and Arctic sea ice suggest that Hg body burdens in Yellow-billed Loons may increase. These findings indicate that Hg is a current and potentially increasing environmental stressor for the Yellow-billed Loon and possibly other Nearctic-Palearctic migrant birds.

Three essays in energy economics

NASA Astrophysics Data System (ADS)

Kim, Dae-Wook

Deregulation in electricity and natural gas market in an attempt to alleviate market power of privately owned utilities is widespread throughout the United States. Beginning with Gollop and Roberts (1979), a number of empirical studies have allowed the data to identify industry competition and marginal cost levels by estimating the firms' first order condition within a conjectural variations framework. The first chapter of my dissertation uses direct measures of marginal cost for the California electricity market to measure the extent to which estimated mark-ups and marginal costs are biased. My results suggest that the New Empirical Industrial Organization technique poorly estimates the level of mark-ups and the sensitivity of marginal cost to cost shifters. The second chapter takes advantage of the market structure of electricity and natural gas varies in the United States. The goal of the chapter is to analyze whether combined-billed residential households of electricity and natural gas firms face information costs associated with determining the portion of their monthly energy bill attributed to natural gas consumption and the portion attributed to electricity consumption. However, if households are unable to determine whether an increase in their energy bill is the result of an increase in the price of electricity or an increase in the price of natural gas, they act as if electricity and natural gas were complements. I find that own-price elasticities are smaller in absolute terms in combined-billed markets, while cross-price elasticities are more positive, compared to separate-billed markets; both of these results are consistent with the presence of information costs. In chapter 3, I provide an empirical evidence of the impact of variations in ownership, regulation and market structure on the electric and natural gas markets in the United States. My results suggest that the private firms in electricity markets are associated with higher prices than public firms. I further find that dual-product firms in the natural gas industry tend to charge less than single product firms. Finally, my results suggest that merger activities in natural gas markets are associated with higher rates after controlling cost and demand.

Tobacco control interest groups and their influence on parliamentary committees in Canada.

PubMed

Hastie, Robyn E; Kothari, Anita R

2009-01-01

The aim of this study was to determine how tobacco control interest groups influence tobacco policy decision-making through submissions and presentations to parliamentary committees. A qualitative content analysis was used to examine the presentations and submissions on tobacco-related legislation made to parliamentary committees between 1996 and 2004. The sample was identified from the public list of tobacco-related bills tabled in both the House of Commons and the Senate; the Government of Canada website and LEGISinfo were used to determine which committee reviewed the relevant bill. Committee clerks were asked to send submissions and presentations related to specific bills identified through LEGISinfo. Submissions and presentations were scanned and entered into QSR N6 software for coding. The coding instrument was adapted from previous studies employing qualitative content analysis. Montini and Bero's recommendations were used to evaluate the submissions and presentations. Tobacco control interest groups did present scientific evidence to support tobacco control. However, they underused credible witnesses to present information at meetings. The topics presented by tobacco control interests groups were usually relevant to the bill being discussed. Tobacco control interest groups employed some of the strategies suggested by Montini and Bero in their attempt to influence parliamentary committees through submissions and presentations. They did include scientific evidence in their submissions; however, they could improve their strategies in the area of using credible witnesses, such as scientists and medical experts. Incorporating Montini and Bero's recommendations into lobbying efforts may increase success in influencing committees.

Radiometry rocks

NASA Astrophysics Data System (ADS)

Harvey, James E.

2012-10-01

Professor Bill Wolfe was an exceptional mentor for his graduate students, and he made a major contribution to the field of optical engineering by teaching the (largely ignored) principles of radiometry for over forty years. This paper describes an extension of Bill's work on surface scatter behavior and the application of the BRDF to practical optical engineering problems. Most currently-available image analysis codes require the BRDF data as input in order to calculate the image degradation from residual optical fabrication errors. This BRDF data is difficult to measure and rarely available for short EUV wavelengths of interest. Due to a smooth-surface approximation, the classical Rayleigh-Rice surface scatter theory cannot be used to calculate BRDFs from surface metrology data for even slightly rough surfaces. The classical Beckmann-Kirchhoff theory has a paraxial limitation and only provides a closed-form solution for Gaussian surfaces. Recognizing that surface scatter is a diffraction process, and by utilizing sound radiometric principles, we first developed a linear systems theory of non-paraxial scalar diffraction in which diffracted radiance is shift-invariant in direction cosine space. Since random rough surfaces are merely a superposition of sinusoidal phase gratings, it was a straightforward extension of this non-paraxial scalar diffraction theory to develop a unified surface scatter theory that is valid for moderately rough surfaces at arbitrary incident and scattered angles. Finally, the above two steps are combined to yield a linear systems approach to modeling image quality for systems suffering from a variety of image degradation mechanisms. A comparison of image quality predictions with experimental results taken from on-orbit Solar X-ray Imager (SXI) data is presented.

To provide for a land exchange with the Trinity Public Utilities District of Trinity County, California, involving the transfer of land to the Bureau of Land Management and the Six Rivers National Forest in exchange for National Forest System land in the Shasta-Trinity National Forest, and for other purposes.

THOMAS, 112th Congress

Rep. Herger, Wally [R-CA-2

2011-03-29

Senate - 07/24/2012 Received in the Senate and Read twice and referred to the Committee on Energy and Natural Resources. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

Methodology to Assess No Touch Audit Software Using Field Data

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

Cai, Jie; Braun, James E.; Langner, M. Rois

The research presented in this report builds upon these previous efforts and proposes a set of tests to assess no touch audit tools using real utility bill and on-site data. The proposed assessment methodology explicitly investigates the behaviors of the monthly energy end uses with respect to outdoor temperature, i.e., the building energy signature, to help understand the Tool's disaggregation accuracy. The project team collaborated with Field Diagnosis Services, Inc. (FDSI) to identify appropriate test sites for the evaluation.

Retail battle for conservation dollars

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

McCaughey, J.

1981-07-16

Large companies are entering the profitable retail market with conservation equipment and services that will compete for a share of the $10 to $80 billion Americans will spend on energy efficiency this year. Energy centers and clinics are also opening around the country to market products and compete with the utilities for energy audit business. The new retailing efforts are counting on homeowners' willingness to spend money to lower their energy bills. The smaller companies hope to hold their own against competition from large corporations. (DCK)

DOE Zero Energy Ready Home Case Study: Green Extreme Homes & Carl Franklin Homes — First DOE Zero Energy Ready Home Retrofit, Garland, TX

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

none,

This builder was honored with an Affordable Builder award in the 2014 Housing Innovation Awards, for the first retrofit home certified to the DOE Zero Energy Ready home requirements.The 60-year-old, three-bedroom ranch home is expected to save its homeowner more than $1,000 a year in utility bills compared to a home built to the current 2009 International Energy Conservation Code.

Validating Savings Claims of Cold Climate Zero Energy Ready Homes

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

Williamson, J.; Puttagunta, S.

This report details the validation methods used to analyze consumption at each of these homes. It includes a detailed end-use examination of consumptions from the following categories: 1) Heating, 2) Cooling, 3) Lights, Appliances, and Miscellaneous Electric Loads (LAMELS) along with Domestic Hot Water Use, 4) Ventilation, and 5) PV generation. A utility bill disaggregation method, which allows a crude estimation of space conditioning loads based on outdoor air temperature, was also performed and the results compared to the actual measured data.

The Posse Comitatus Act: A Study of Restrictions on Military Enforcement of Civil Law

DTIC Science & Technology

1984-01-01

passed because the proposal was a rider to an Army appropriations bill.1 1 No matter what the reason, the -- Navy has never been added to the wording of...nation’s enemies, are never to be used against their civilian countrymen, no matter how expedient their utilization may seem.1 Although addressing a period...which the President may order federal troop intervention in civil matters . This regulation devotes one section to emergencies and states field commanders

Financial ratios in diagnostic radiology practices: variability and trends.

PubMed

Hogan, Christopher; Sunshine, Jonathan H

2004-03-01

To evaluate variation in financial ratios for radiology practices nationwide and trends in these ratios and in payments. In 1999, the American College of Radiology surveyed radiology practices by mail. The final response rate was 66%. Weighting was used to make responses representative of all radiology practices in the United States. Self-reported financial ratios (payments, charges, accounts receivable turnover) were analyzed; 449 responses had usable data on these ratios. Comparison with results of a similar 1992 survey and combined analysis with Medicare data on billed charges provided information on trends. All measures of payment collections declined sharply from 1992 to 1999, with the gross collections rate (revenues as percentage of billed charges) decreasing from 71% to 55%. Average payment for a typical radiology service decreased approximately 4% in dollar terms or approximately 19% in inflation-adjusted terms. In 1999, nonmetropolitan practices appeared to fare better than others. Among insurers, Medicaid stood out as a low and slow payer, but neither managed care nor Medicare had a consistent effect on financial ratios. The gross collections rate varied substantially across geographic areas, as did, in an inverse pattern, the level of billed charges. One-quarter of practices had accounts receivable equal to 90 or more days of billings. The opposing geographic pattern of billed charges and gross collection rate suggests that geographic variation in the latter is driven more by variation in billed charges than by variation in payment levels. Radiologists saw a substantial decrease in the real (inflation-adjusted) value of payment per service during the 1990s. The large fraction of practices with accounts receivable of 90 or more days of billings-a level considered potentially imprudent by financial management advisors-suggests that many practices should improve financial management and that state prompt-payment laws have not had a substantial positive effect. Copyright RSNA, 2004

31 CFR 206.3 - Billing policy and procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., DISBURSEMENTS, AND OPERATION OF THE CASH MANAGEMENT IMPROVEMENTS FUND § 206.3 Billing policy and procedures. The billing process is considered an integral part of an effective cash management collection program. In those situations where bills are required and the failure to bill would affect the cash flow, bills will...

31 CFR 206.3 - Billing policy and procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., DISBURSEMENTS, AND OPERATION OF THE CASH MANAGEMENT IMPROVEMENTS FUND § 206.3 Billing policy and procedures. The billing process is considered an integral part of an effective cash management collection program. In those situations where bills are required and the failure to bill would affect the cash flow, bills will...

31 CFR 206.3 - Billing policy and procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., DISBURSEMENTS, AND OPERATION OF THE CASH MANAGEMENT IMPROVEMENTS FUND § 206.3 Billing policy and procedures. The billing process is considered an integral part of an effective cash management collection program. In those situations where bills are required and the failure to bill would affect the cash flow, bills will...

31 CFR 206.3 - Billing policy and procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., DISBURSEMENTS, AND OPERATION OF THE CASH MANAGEMENT IMPROVEMENTS FUND § 206.3 Billing policy and procedures. The billing process is considered an integral part of an effective cash management collection program. In those situations where bills are required and the failure to bill would affect the cash flow, bills will...

Performance and Costs of Ductless Heat Pumps in Marine-Climate High-Performance Homes -- Habitat for Humanity The Woods

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

Lubliner, Michael; Howard, Luke; Hales, David

The Woods is a Habitat for Humanity (HFH) community of ENERGY STAR Homes Northwest (ESHNW)-certified homes located in the marine climate of Tacoma/Pierce County, Washington. This research report builds on an earlier preliminary draft 2014 BA report, and includes significant billing analysis and cost effectiveness research from a collaborative, ongoing Ductless Heat Pump (DHP)research effort for Tacoma Public Utilities (TPU) and Bonneville Power Administration (BPA). This report focuses on the results of field testing, modeling, and monitoring of ductless mini-split heat pump hybrid heating systems in seven homes built and first occupied at various times between September 2013 and Octobermore » 2014. The report also provides WSU documentation of high-performance home observations, lessons learned, and stakeholder recommendations for builders of affordable high-performance housing such as HFH. Tacoma Public Utilities (TPU) and Bonneville Power Administration (BPA). This report focuses on the results of field testing, modeling, and monitoring of ductless mini-split heat pump hybrid heating systems in seven homes built and first occupied at various times between September 2013 and October 2014. The report also provides WSU documentation of high-performance home observations, lessons learned, and stakeholder recommendations for builders of affordable high-performance housing such as HFH.« less

47 CFR 64.2401 - Truth-in-Billing Requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., charges on the bill. Common carriers must prominently display on each bill a toll-free number or numbers by which subscribers may inquire or dispute any charges on the bill. A carrier may list a toll-free... her telephone bill, but instead accesses that bill only by e-mail or internet, the carrier may comply...

47 CFR 64.2401 - Truth-in-Billing Requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., charges on the bill. Common carriers must prominently display on each bill a toll-free number or numbers by which subscribers may inquire or dispute any charges on the bill. A carrier may list a toll-free... her telephone bill, but instead accesses that bill only by e-mail or internet, the carrier may comply...

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

Doris, Elizabeth; Stout, Sherry; Peterson, Kimberly

This technical report discusses the effectiveness of the Jamaica Public Service Company Limited Net-Billing Pilot Program. The National Renewable Energy Laboratory (NREL) collected and analyzed data from a wide range of stakeholders, conducted in-country research, and compared program elements to common interconnection practices to form programmatic recommendations for the Jamaica context. NREL finds that the net-billing pilot program has successfully contributed to the support of the emerging solar market in Jamaica with the interconnection of 80 systems under the program for a total of 1.38 megawatts (MW) at the time of original analysis.

77 FR 46717 - Export Trade Certificate of Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-06

... Competition and Economic Analysis (``OCEA'') of the International Trade Administration, Department of Commerce... and Economic Analysis, International Trade Administration, (202) 482-5131 (this is not a toll-free... of Competition and Economic Analysis. [FR Doc. 2012-19117 Filed 8-3-12; 8:45 am] BILLING CODE 3510-DR...

47 CFR 64.2401 - Truth-in-Billing Requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

.... Common carriers must prominently display on each bill a toll-free number or numbers by which subscribers may inquire or dispute any charges on the bill. A carrier may list a toll-free number for a billing... telephone bill, but instead accesses that bill only by e-mail or internet, the carrier may comply with this...

Microgrid Design Analysis Using Technology Management Optimization and the Performance Reliability Model

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

Stamp, Jason E.; Eddy, John P.; Jensen, Richard P.

Microgrids are a focus of localized energy production that support resiliency, security, local con- trol, and increased access to renewable resources (among other potential benefits). The Smart Power Infrastructure Demonstration for Energy Reliability and Security (SPIDERS) Joint Capa- bility Technology Demonstration (JCTD) program between the Department of Defense (DOD), Department of Energy (DOE), and Department of Homeland Security (DHS) resulted in the pre- liminary design and deployment of three microgrids at military installations. This paper is focused on the analysis process and supporting software used to determine optimal designs for energy surety microgrids (ESMs) in the SPIDERS project. There aremore » two key pieces of software, an ex- isting software application developed by Sandia National Laboratories (SNL) called Technology Management Optimization (TMO) and a new simulation developed for SPIDERS called the per- formance reliability model (PRM). TMO is a decision support tool that performs multi-objective optimization over a mixed discrete/continuous search space for which the performance measures are unrestricted in form. The PRM is able to statistically quantify the performance and reliability of a microgrid operating in islanded mode (disconnected from any utility power source). Together, these two software applications were used as part of the ESM process to generate the preliminary designs presented by SNL-led DOE team to the DOD. Acknowledgements Sandia National Laboratories and the SPIDERS technical team would like to acknowledge the following for help in the project: * Mike Hightower, who has been the key driving force for Energy Surety Microgrids * Juan Torres and Abbas Akhil, who developed the concept of microgrids for military instal- lations * Merrill Smith, U.S. Department of Energy SPIDERS Program Manager * Ross Roley and Rich Trundy from U.S. Pacific Command * Bill Waugaman and Bill Beary from U.S. Northern Command * Tarek Abdallah, Melanie Johnson, and Harold Sanborn of the U.S. Army Corps of Engineers Construction Engineering Research Laboratory * Colleagues from Sandia National Laboratories (SNL) for their reviews, suggestions, and participation in the work.« less

Ontario pharmacists' crisis over Bill 16: A missed opportunity?

PubMed

Rosenthal, Meagen; Austin, Zubin; Tsuyuki, Ross T

2012-01-01

In 2010, the Ontario government brought forward Bill 16, which, among other things, removed pharmacists' professional allowances. While many would disagree with this unilateral action by the Ontario government, it also could have served as a crisis for change towards patient-centred care. We sought to examine the response of the pharmacy profession in Ontario to this crisis as it relates to the vision outlined in the Blueprint for Pharmacy. We systematically examined publicly available responses to Schedule 5 of Ontario's Bill 16 during the period from April to June 16, 2010. A rapid textual analysis of the data using tag or word clouds and a qualitative content analysis were performed on all of the data collected. The rapid textual analysis revealed that the most frequently used terms were "pharmacist," "pharmacy" and "professional allowances"; the least used were "layoffs," "service cuts" and "patient care." Content analysis revealed 4 themes: the desire to maintain the status quo of practice, a focus on the business of pharmacy, pharmacy stakeholders' perceptions of government's attitude towards the profession and changes to patient services. It is notable that patient care was almost completely absent from the discussion, a reflection that our profession has not embraced patient-centred care. This also represents a missed opportunity - a crisis that could have been used to move the profession towards the Blueprint's vision. We thought that the Blueprint had already achieved this consensus, but the Ontario experience has shown that this may not be the case.

Oregon's Senate Bill 560: practical policy lessons for nurse advocates.

PubMed

Gilson Sistrom, Maria

2010-02-01

In response to striking rates of childhood obesity in Oregon, advocates led by a nurse lobbyist proposed legislation in 2005 to regulate junk foods in public schools. Several theories propose to explain the policy-making process, yet Senate Bill 560 (SB 560) followed a twisted course through rule making, legislative and political processes that are not well articulated in policy theory. Three overlapping mechanisms were identified in content analysis of documents and interviews with participants in the SB 560 policy process. Strategically placed legislative "banana peels," proponents' amateur advocacy, and legislative outflanking by professional lobbyists more fully characterize this policy process and better account for the failure of SB 560. Subsequent passage of the Oregon Healthy School Foods bill in the more politically conducive 2007 legislature suggest that advocacy and incremental change frameworks are less predictive of successful passage than is the ability to take advantage of political opportunities to change public health policy.

Eggs and Abortion: "Women-Protective" Language Used by Opponents in Legislative Debates over Reproductive Health.

PubMed

Jesudason, Sujatha; Weitz, Tracy

2015-01-01

In this paper we undertake an examination of the presence of similar "women-protective" discourses in policy debates occurring over two bills on reproductive-related topics considered during the 2013 California legislature session. The first bill (AB154), now signed into law, allows nurse practitioners, certified nurse midwives, and physician assistants to perform first-trimester aspiration abortions. The second bill (AB926), had it passed, would remove the prohibition on paying women for providing eggs to be used for research purposes. Using frame analysis we find evidence of similar protective arguments by opponents of both bills, although these advocates do not share ideological positions on abortion rights or women's autonomy. In the case of AB154, anti-abortion advocates use language and frames that call for protecting the health of women against the imputed interests of the "abortion industry." In the case of AB926, feminists and pro-choice advocates evoke similar frameworks for the protection of women against the interests of the "medical research industry." Both sides argue for the "protection of women," from opposing positions on the rights and autonomy of women in relationship to reproductive freedom. © 2015 American Society of Law, Medicine & Ethics, Inc.

Research without billing data. Econometric estimation of patient-specific costs.

PubMed

Barnett, P G

1997-06-01

This article describes a method for computing the cost of care provided to individual patients in health care systems that do not routinely generate billing data, but gather information on patient utilization and total facility costs. Aggregate data on cost and utilization were used to estimate how costs vary with characteristics of patients and facilities of the US Department of Veterans Affairs. A set of cost functions was estimated, taking advantage of the department-level organization of the data. Casemix measures were used to determine the costs of acute hospital and long-term care. Hospitalization for medical conditions cost an average of $5,642 per US Health Care Financing Administration diagnosis-related group weight; surgical hospitalizations cost $11,836. Nursing home care cost $197.33 per day, intermediate care cost $280.66 per day, psychiatric care cost $307.33 per day, and domiciliary care cost $111.84 per day. Outpatient visits cost an average of $90.36. These estimates include the cost of physician services. The econometric method presented here accounts for variation in resource use caused by casemix that is not reflected in length of stay and for the effects of medical education, research, facility size, and wage rates. Data on non-Veteran's Affairs hospital stays suggest that the method accounts for 40% of the variation in acute hospital care costs and is superior to cost estimates based on length of stay or diagnosis-related group weight alone.

Solar Schools Assessment and Implementation Project: Financing Options for Solar Installations on K-12 Schools

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

Coughlin, J.; Kandt, A.

This report focuses on financial options developed specifically for renewable energy and energy efficiency projects in three California public school districts. Solar energy systems installed on public schools have a number of benefits that include utility bill savings, reductions in greenhouse gas emissions (GHGs) and other toxic air contaminants, job creation, demonstrating environmental leadership, and creating learning opportunities for students. In the 2011 economic environment, the ability to generate general-fund savings as a result of reducing utility bills has become a primary motivator for school districts trying to cut costs. To achieve meaningful savings, the size of the photovoltaic (PV)more » systems installed (both individually on any one school and collectively across a district) becomes much more important; larger systems are required to have a material impact on savings. Larger PV systems require a significant financial commitment and financing therefore becomes a critical element in the transaction. In simple terms, school districts can use two primary types of ownership models to obtain solar installations and cost savings across a school district. The PV installations can be financed and owned directly by the districts themselves. Alternatively, there are financing structures whereby another entity, such as a solar developer or its investors, actually own and operate the PV systems on behalf of the school district. This is commonly referred to as the 'third-party ownership model.' Both methods have advantages and disadvantages that should be weighed carefully.« less

Analytical optimization of demand management strategies across all urban water use sectors

NASA Astrophysics Data System (ADS)

Friedman, Kenneth; Heaney, James P.; Morales, Miguel; Palenchar, John

2014-07-01

An effective urban water demand management program can greatly influence both peak and average demand and therefore long-term water supply and infrastructure planning. Although a theoretical framework for evaluating residential indoor demand management has been well established, little has been done to evaluate other water use sectors such as residential irrigation in a compatible manner for integrating these results into an overall solution. This paper presents a systematic procedure to evaluate the optimal blend of single family residential irrigation demand management strategies to achieve a specified goal based on performance functions derived from parcel level tax assessor's data linked to customer level monthly water billing data. This framework is then generalized to apply to any urban water sector, as exponential functions can be fit to all resulting cumulative water savings functions. Two alternative formulations are presented: maximize net benefits, or minimize total costs subject to satisfying a target water savings. Explicit analytical solutions are presented for both formulations based on appropriate exponential best fits of performance functions. A direct result of this solution is the dual variable which represents the marginal cost of water saved at a specified target water savings goal. A case study of 16,303 single family irrigators in Gainesville Regional Utilities utilizing high quality tax assessor and monthly billing data along with parcel level GIS data provide an illustrative example of these techniques. Spatial clustering of targeted homes can be easily performed in GIS to identify priority demand management areas.

Variation in outpatient consultant physician fees in Australia by specialty and state and territory.

PubMed

Freed, Gary L; Allen, Amy R

2017-03-06

To determine the mean, median and 10th and 90th percentile levels of fees and out-of-pocket costs to the patient for an initial consultation with a consultant physician; to determine any differences in fees and bulk-billing rates between specialties and between states and territories. Analysis of 2015 Medicare claims data for an initial outpatient appointment with a consultant physician (Item 110) in 11 medical specialties representative of common adult non-surgical medical care (cardiology, endocrinology, gastroenterology, geriatric medicine, haematology, immunology/allergy, medical oncology, nephrology, neurology, respiratory medicine and rheumatology). Mean, median, 10th and 90th percentile levels for consultant physician fees and out-of-pocket costs, by medical specialty and state or territory; bulk-billing rate, by medical specialty and state/territory. Bulk-billing rates varied between specialties, with only haematology and medical oncology bulk-billing more than half of initial consultations. Bulk-billing rates also varied between states and territories, with rates in the Northern Territory (76%) nearly double those elsewhere. Most private consultations require a significant out-of-pocket payment by the patient, and these payments varied more than fivefold in some specialties. Without data on quality of care in private outpatient services, the rationale for the marked variations in fees within specialties is unknown. As insurers are prohibited from providing cover for the costs of outpatient care, the impact of out-of-pocket payments on access to private specialist care is unknown.

Using Derivative Contracts to Mitigate Water Utility Financial Risks

NASA Astrophysics Data System (ADS)

Characklis, G. W.; Zeff, H.

2012-12-01

As developing new supply capacity has become increasingly expensive and difficult to permit, utilities have become more reliant on temporary demand management programs, such as outdoor water use restrictions, for ensuring reliability during drought. However, a significant fraction of water utility income is often derived from the volumetric sale of water, and such restrictions can lead to substantial revenue losses. Given that many utilities set prices at levels commensurate with recovering costs, these revenue losses can leave them financially vulnerable to budgetary shortfalls during drought. This work explores approaches for mitigating drought-related revenue losses through the use of third-party financial insurance contracts based on weather derivatives. Two different types of contracts are developed, and their efficacy is compared against two more traditional forms of financial hedging used by water utilities: drought surcharges and contingency funds (i.e. self insurance). Strategies involving each of these approaches, as well as their use in combination, are applied under conditions facing the water utility serving Durham, North Carolina. A multi-reservoir model provides information on the scale and timing of droughts, with the financial effects of these events simulated using detailed data derived from utility billing records. Results suggest that third-party derivative contracts, either independently or in combination with more traditional hedging tools (i.e. surcharges, contingency funds), can provide an effective means of reducing a utility's financial vulnerability to drought.

Managing water utility financial risks through third-party index insurance contracts

NASA Astrophysics Data System (ADS)

Zeff, Harrison B.; Characklis, Gregory W.

2013-08-01

As developing new supply capacity has become increasingly expensive and difficult to permit (i.e., regulatory approval), utilities have become more reliant on temporary demand management programs, such as outdoor water use restrictions, for ensuring reliability during drought. However, a significant fraction of water utility income is often derived from the volumetric sale of water, and such restrictions can lead to substantial revenue losses. Given that many utilities set prices at levels commensurate with recovering costs, these revenue losses can leave them financially vulnerable to budgetary shortfalls. This work explores approaches for mitigating drought-related revenue losses through the use of third-party financial insurance contracts based on streamflow indices. Two different types of contracts are developed, and their efficacy is compared against two more traditional forms of financial hedging used by water utilities: Drought surcharges and contingency funds (i.e., self-insurance). Strategies involving each of these approaches, as well as their use in combination, are applied under conditions facing the water utility serving Durham, North Carolina. A multireservoir model provides information on the scale and timing of droughts, and the financial effects of these events are simulated using detailed data derived from utility billing records. Results suggest that third-party index insurance contracts, either independently or in combination with more traditional hedging tools, can provide an effective means of reducing a utility's financial vulnerability to drought.

12 CFR 535.5 - State exemptions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... an individual, corporation, or other business organization. § 535.12 Unfair credit contract... account based on balances for days in billing cycles that precede the most recent billing cycle as a...) Limitations for first billing cycle and subsequent billing cycles—(1) First billing cycle. During the first...

The formation method of the feature space for the identification of fatigued bills

NASA Astrophysics Data System (ADS)

Kang, Dongshik; Oshiro, Ayumu; Ozawa, Kenji; Mitsui, Ikugo

2014-10-01

Fatigued bills make a trouble such as the paper jam in a bill handling machine. In the discrimination of fatigued bills using an acoustic signal, the variation of an observed bill sound is considered to be one of causes in misclassification. Therefore a technique has demanded in order to make the classification of fatigued bills more efficient. In this paper, we proposed the algorithm that extracted feature quantity of bill sound from acoustic signal using the frequency difference, and carried out discrimination experiment of fatigued bill money by Support Vector Machine(SVM). The feature quantity of frequency difference can represent the frequency components of an acoustic signal is varied by the fatigued degree of bill money. The generalization performance of SVM does not depend on the size of dimensions of the feature space, even in a high dimensional feature space such as bill-acoustic signals. Furthermore, SVM can induce an optimal classifier which considers the combination of features by the virtue of polynomial kernel functions.

Techno-economıc Analysıs of Evacuated Tube Solar Water Heater usıng F-chart Method

NASA Astrophysics Data System (ADS)

Fayaz, H.; Rahim, N. A.; Saidur, R.; Hasanuzzaman, M.

2018-05-01

Solar thermal utilization, especially the application of solar water heater technology, has developed rapidly in recent decades. Solar water heating systems based on thermal collector alone or connected with photovoltaic called as photovoltaic-thermal (PVT) are practical applications to replace the use of electrical water heaters but weather dependent performance of these systems is not linear. Therefore on the basis of short term or average weather conditions, accurate analysis of performance is quite difficult. The objective of this paper is to show thermal and economic analysis of evacuated tube collector solar water heaters. Analysis done by F-Chart shows that evacuated tube solar water heater achieves fraction value of 1 to fulfil hot water demand of 150liters and above per day for a family without any auxiliary energy usage. Evacuated tube solar water heater show life cycle savings of RM 5200. At water set temperature of 100°C, RM 12000 is achieved and highest life cycle savings of RM 6100 at the environmental temperature of 18°C are achieved. Best thermal and economic performance is obtained which results in reduction of household greenhouse gas emissions, reduction of energy consumption and saves money on energy bills.

The Emergy Perspective of Sustainable Trends in Puerto Rico ...

EPA Pesticide Factsheets

Emergy analysis quantifies the direct and indirect contributions of nature to human systems providing a sustainability assessment framework, which couples economic growth within biophysical constraints. In this study, Puerto Rico's sustainability was assessed with emergy flow dynamics from 1960 to 2013. During this period, the island shifted from an agriculture-based economy to an industrial base of manufacture and services (1960–1970). The emergy analysis indicated an exponential decline in sustainability during this period. From 1975 to 1992, the island became more industrialized and imported more goods and services. Since 1998, although more renewable production such as forest regeneration occurred, the rapid industrialization heavily relied on imported fossil fuels, goods, and services, resulting in a system that has not been self-sufficient, nor sustainable. The latest economic crisis and the most recently passed financial rescue bill represent an opportunity to redirect Puerto Rico towards a sustainable path with policies that decrease the ratio of imported y to exported emergy, and strategies that encourage efficient use of resources and local production based on the utilization of renewable sources within this U.S. territory. This study developed and explored a framework and indices using emergy analysis to holistically reflect the condition of a regional system like Puerto Rico and its sustainability over the past 50 years, determine if the island is

46 CFR 67.527 - Application for filing and recording bills of sale and instruments in the nature of a bill of sale.

Code of Federal Regulations, 2010 CFR

2010-10-01

... instruments in the nature of a bill of sale. 67.527 Section 67.527 Shipping COAST GUARD, DEPARTMENT OF....527 Application for filing and recording bills of sale and instruments in the nature of a bill of sale. An application fee is charged for filing and recording bills of sale and instruments in the nature of...

46 CFR 67.527 - Application for filing and recording bills of sale and instruments in the nature of a bill of sale.

Code of Federal Regulations, 2011 CFR

2011-10-01

... instruments in the nature of a bill of sale. 67.527 Section 67.527 Shipping COAST GUARD, DEPARTMENT OF....527 Application for filing and recording bills of sale and instruments in the nature of a bill of sale. An application fee is charged for filing and recording bills of sale and instruments in the nature of...

46 CFR 67.527 - Application for filing and recording bills of sale and instruments in the nature of a bill of sale.

Code of Federal Regulations, 2012 CFR

2012-10-01

... instruments in the nature of a bill of sale. 67.527 Section 67.527 Shipping COAST GUARD, DEPARTMENT OF....527 Application for filing and recording bills of sale and instruments in the nature of a bill of sale. An application fee is charged for filing and recording bills of sale and instruments in the nature of...

46 CFR 67.527 - Application for filing and recording bills of sale and instruments in the nature of a bill of sale.

Code of Federal Regulations, 2014 CFR

2014-10-01

... instruments in the nature of a bill of sale. 67.527 Section 67.527 Shipping COAST GUARD, DEPARTMENT OF....527 Application for filing and recording bills of sale and instruments in the nature of a bill of sale. An application fee is charged for filing and recording bills of sale and instruments in the nature of...

46 CFR 67.527 - Application for filing and recording bills of sale and instruments in the nature of a bill of sale.

Code of Federal Regulations, 2013 CFR

2013-10-01

... instruments in the nature of a bill of sale. 67.527 Section 67.527 Shipping COAST GUARD, DEPARTMENT OF....527 Application for filing and recording bills of sale and instruments in the nature of a bill of sale. An application fee is charged for filing and recording bills of sale and instruments in the nature of...

Compensation of hospital-based physicians.

PubMed Central

Steinwald, B

1983-01-01

This study is concerned with methods of compensating hospital-based physicians (HBPs) in five medical specialties: anesthesiology, pathology, radiology, cardiology, and emergency medicine. Data on 2232 nonfederal, short-term general hospitals came from a mail questionnaire survey conducted in Fall 1979. The data indicate that numerous compensation methods exist but these methods, without much loss of precision, can be reduced to salary, percentage of department revenue, and fee-for-service. When HBPs are compensated by salary or percentage methods, most patient billing is conducted by the hospital. In contrast, most fee-for-service HBPs bill their patients directly. Determinants of HBP compensation methods are investigated via multinomial logit analysis. This analysis indicates that choice of HBP compensation methods are investigated via multinomial logit analysis. This analysis indicates that choice of HBP compensation methods is sensitive to a number of hospital characteristics and attributes of both the hospital and physicians' services markets. The empirical findings are discussed in light of past conceptual and empirical research on physician compensation, and current policy issues in the health services sector. PMID:6841112

Community health center provider ability to identify, treat and account for the social determinants of health: a card study.

PubMed

Lewis, Joy H; Whelihan, Kate; Navarro, Isaac; Boyle, Kimberly R

2016-08-27

The social determinants of health (SDH) are conditions that shape the overall health of an individual on a continuous basis. As momentum for addressing social factors in primary care settings grows, provider ability to identify, treat and assess these factors remains unknown. Community health centers care for over 20-million of America's highest risk populations. This study at three centers evaluates provider ability to identify, treat and code for the SDH. Investigators utilized a pre-study survey and a card study design to obtain evidence from the point of care. The survey assessed providers' perceptions of the SDH and their ability to address them. Then providers filled out one anonymous card per patient on four assigned days over a 4-week period, documenting social factors observed during encounters. The cards allowed providers to indicate if they were able to: provide counseling or other interventions, enter a diagnosis code and enter a billing code for identified factors. The results of the survey indicate providers were familiar with the SDH and were comfortable identifying social factors at the point of care. A total of 747 cards were completed. 1584 factors were identified and 31 % were reported as having a service provided. However, only 1.2 % of factors were associated with a billing code and 6.8 % received a diagnosis code. An obvious discrepancy exists between the number of identifiable social factors, provider ability to address them and documentation with billing and diagnosis codes. This disparity could be related to provider inability to code for social factors and bill for related time and services. Health care organizations should seek to implement procedures to document and monitor social factors and actions taken to address them. Results of this study suggest simple methods of identification may be sufficient. The addition of searchable codes and reimbursements may improve the way social factors are addressed for individuals and populations.

Probabilistic techniques for obtaining accurate patient counts in Clinical Data Warehouses

PubMed Central

Myers, Risa B.; Herskovic, Jorge R.

2011-01-01

Proposal and execution of clinical trials, computation of quality measures and discovery of correlation between medical phenomena are all applications where an accurate count of patients is needed. However, existing sources of this type of patient information, including Clinical Data Warehouses (CDW) may be incomplete or inaccurate. This research explores applying probabilistic techniques, supported by the MayBMS probabilistic database, to obtain accurate patient counts from a clinical data warehouse containing synthetic patient data. We present a synthetic clinical data warehouse (CDW), and populate it with simulated data using a custom patient data generation engine. We then implement, evaluate and compare different techniques for obtaining patients counts. We model billing as a test for the presence of a condition. We compute billing’s sensitivity and specificity both by conducting a “Simulated Expert Review” where a representative sample of records are reviewed and labeled by experts, and by obtaining the ground truth for every record. We compute the posterior probability of a patient having a condition through a “Bayesian Chain”, using Bayes’ Theorem to calculate the probability of a patient having a condition after each visit. The second method is a “one-shot” approach that computes the probability of a patient having a condition based on whether the patient is ever billed for the condition Our results demonstrate the utility of probabilistic approaches, which improve on the accuracy of raw counts. In particular, the simulated review paired with a single application of Bayes’ Theorem produces the best results, with an average error rate of 2.1% compared to 43.7% for the straightforward billing counts. Overall, this research demonstrates that Bayesian probabilistic approaches improve patient counts on simulated patient populations. We believe that total patient counts based on billing data are one of the many possible applications of our Bayesian framework. Use of these probabilistic techniques will enable more accurate patient counts and better results for applications requiring this metric. PMID:21986292

Associations Among Indicators of Depression in Medicaid-Eligible Community-Dwelling Older Adults

PubMed Central

Byma, Elizabeth A.

2013-01-01

Purpose: The purpose of this research was to examine associations among 2 separate Minimum Data Set-Home Care (MDS-HC) depression measures (the Depression Rating Scale [DRS] and medical diagnosis of depression) with billed antidepressant medications in Medicaid paid claim files. Design and Methods: The sample for this cross-sectional research included 3,041 Medicaid-eligible older adult participants in a Home and Community Based Waiver Program and used data from the MDS-HC, Version 1 and Medicaid Paid Claim Files. Sensitivity and specificity analyses, receiver operating characteristic (ROC) curve analysis, and t tests were utilized. Results: DRS scoring indicated that 15.4% of participants had behaviors indicative of depression, whereas 42% had a medical diagnosis of depression noted in the MDS-HC. Of those with a medical diagnosis of depression, 51% had a prescribed antidepressant medication. ROC analysis suggested that the DRS was a poor distinguisher of participants with and without a medical diagnosis of depression or prescribed antidepressant medications. Implications: Approximately half of Medicaid-eligible older adults medically diagnosed with depression were treated pharmacologically. Longitudinal research is recommended to assess responsiveness of the DRS over time to pharmacological and psychotherapeutic interventions for depression. PMID:23103523

The Case for Intelligent Propulsion Control for Fast Engine Response

NASA Technical Reports Server (NTRS)

Litt, Jonathan S.; Frederick, Dean K.; Guo, Ten-Huei

2009-01-01

Damaged aircraft have occasionally had to rely solely on thrust to maneuver as a consequence of losing hydraulic power needed to operate flight control surfaces. The lack of successful landings in these cases inspired research into more effective methods of utilizing propulsion-only control. That research demonstrated that one of the major contributors to the difficulty in landing is the slow response of the engines as compared to using traditional flight control. To address this, research is being conducted into ways of making the engine more responsive under emergency conditions. This can be achieved by relaxing controller limits, adjusting schedules, and/or redesigning the regulators to increase bandwidth. Any of these methods can enable faster response at the potential expense of engine life and increased likelihood of stall. However, an example sensitivity analysis revealed a complex interaction of the limits and the difficulty in predicting the way to achieve the fastest response. The sensitivity analysis was performed on a realistic engine model, and demonstrated that significantly faster engine response can be achieved compared to standard Bill of Material control. However, the example indicates the need for an intelligent approach to controller limit adjustment in order for the potential to be fulfilled.

Incentive Pass-through for Residential Solar Systems in California

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

Dong, C. G.; Wiser, Ryan; Rai, Varun

2014-10-01

The deployment of solar photovoltaic (PV) systems has grown rapidly over the last decade, partly because of various government incentives. In the United States, among the largest and longest-running incentives have been those established in California. Building on past research, this report addresses the still-unanswered question: to what degree have the direct PV incentives in California been passed through from installers to consumers? This report helps address this question by carefully examining the residential PV market in California (excluding a certain class of third-party-owned PV systems) and applying both a structural-modeling approach and a reduced-form regression analysis to estimate themore » incentive pass-through rate. The results suggest an average pass-through rate of direct incentives of nearly 100%, though with regional differences among California counties. While these results could have multiple explanations, they suggest a relatively competitive market and well-functioning subsidy program. Further analysis is required to determine whether similar results broadly apply to other states, to other customer segments, to all third-party-owned PV systems, or to all forms of financial incentives for solar (considering not only direct state subsidies, but also utility electric bill savings and federal tax incentives).« less

Urban Telemedicine Enables Equity in Access to Acute Illness Care.

PubMed

Ronis, Sarah D; McConnochie, Kenneth M; Wang, Hongyue; Wood, Nancy E

2017-02-01

Children with care for acute illness available through the Health-e-Access telemedicine model at childcare and schools were previously found to have 22% less emergency department (ED) use than counterparts without this service, but they also had 24% greater acute care use overall. We assessed the hypothesis that increased utilization reflected improved access among impoverished inner-city children to a level experienced by more affluent suburban children. This observational study compared utilization among children without and with telemedicine access, beginning in 1993, ending in 2007, and based on 84,287 child-months of billing claims-based observation. Health-e-Access Telemedicine was initiated in stepwise manner over 187 study-months among 74 access sites (childcare, schools, community centers), beginning in month 105. Children dwelled in inner city, rest-of-city Rochester, NY, or in surrounding suburbs. Rate of total acute care visits (office, ED, telemedicine) was measured as visits per 100 child-years. Observed utilization rates were adjusted in multivariate analysis for age, sex, insurance type, and season of year. When both suburban and inner-city children lacked telemedicine access, overall acute illness visits were 75% greater among suburban than inner-city children (suburban:inner-city rate ratio 1.75, p < 0.0001). After telemedicine became available to inner-city children, their overall acute visits approximated those of suburban children (suburban:inner-city rate ratio 0.80, p = 0.07), whereas acute visits among suburban children remained at least (worst-case comparison) 56% greater than inner-city children without telemedicine (rate ratio 1.56, p < 0.0001). At baseline, overall acute illness utilization of suburban children exceeded that of inner-city children. Overall utilization for inner-city children increased with telemedicine to that of suburban children at baseline. Without telemedicine, however, inner-city use remained substantially less than for suburban counterparts. Health-e-Access Telemedicine redressed socioeconomic disparities in acute care access in the Rochester area, thus contributing to a more equitable community.

Bill Livingood | NREL

Science.gov Websites

Bill Livingood Photo of Bill Livingood Bill Livingood Group Manager, Commercial Buildings manager of the commercial buildings research team, he oversees the development of next generation

14 CFR 1215.115 - Payment and billing.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of all standard pre-launch services such as mission planning, documentation, link analysis, testing, computer, human resources, etc., with the exception of TDRSS operational services, will be paid to the...

Primordial Dwarfism

MedlinePlus

... Topics Gait & Motion Analysis Genetic Disorders Limb Length Discrepancy Orthopedics Orthotics Primordial Dwarfism Locations & Doctors About Primordial ... Sign-In » Patient-Family Resources Insurance We Accept Pay My Bill Financial Assistance Medical Records Support Services ...

A Regional Analysis of U.S. Insurance Reimbursement Guidelines for Massage Therapy.

PubMed

Miccio, Robin S; Cowen, Virginia S

2018-03-01

Massage techniques fall within the scope of many different health care providers. Physical therapists, occupational therapists, and chiropractors receive insurance reimbursement for health care services, including massage. Although many patients pay out of pocket for massage services, it is unclear how the insurance company reimbursement policies factor provider qualifications into coverage. This project examined regional insurance reimbursement guidelines for massage therapy in relation to the role of the provider of massage services. A qualitative content analysis was used to explore guidelines for 26 health insurance policies across seven US companies providing coverage in the northeastern United States. Publicly available information relevant to massage was obtained from insurance company websites and extracted into a dataset for thematic analysis. Data obtained included practice guidelines, techniques, and provider requirements. Information from the dataset was coded and analyzed using descriptive statistics. Of the policies reviewed, 23% explicitly stated massage treatments were limited to 15-minute increments, 19% covered massage as one part of a comprehensive rehabilitation plan, and 27% required physician prescription. Massage techniques mentioned as qualifying for reimbursement included: Swedish, manual lymphatic drainage, mobilization/manipulation, myofascial release, and traction. Chiropractors, physical therapists, and occupational therapists could directly bill for massage. Massage therapists were specifically excluded as covered providers for seven (27%) policies. Although research supports massage for the treatment of a variety of conditions, the provider type has not been separately addressed. The reviewed policies that served the Northeastern states explicitly stated massage therapists could not bill insurance companies directly. The same insurance companies examined reimbursement for massage therapists in their western U.S. state policies. Other health care providers were able to bill directly for massage services to companies that did not accept direct billing by massage therapists. The specific exclusion of massage therapists as eligible providers violates the Affordable Care Act's non-discriminatory provision. Massage therapists should continue to advocate for reimbursement privileges to spur wider acceptance of massage therapy in health care.

Obituary: William A. Rense (1914-2008)

NASA Astrophysics Data System (ADS)

Cushman, Glen

2009-12-01

On March 28, 2008, the space research community lost another of its pioneers. William A. Rense, professor emeritus of physics at the University of Colorado in Boulder, who died in Estes Park, Colorado, following complications from cancer. He was 94. Bill, as he was widely known, was born in 1914 in Massillon, Ohio, the son of German immigrants. His was a large family - five brothers and one sister. His father, Joseph Rense, worked for the city of Cleveland while his mother, Rosalia (Luther) Rense was a housewife. As a child, Bill developed a love of astronomy which led him to earn a bachelor's degree in physics and astronomy from Case Western Reserve University in Cleveland, followed by master's and PhD degrees in physics at Ohio State University. He held teaching positions at Rutgers, University of Miami (Florida), Texas A & M, and Louisiana State University before taking his final appointment at CU in 1949. While teaching at LSU, he met and in 1942 married Wanda (Childs) Rense. In addition to teaching physics at CU, Bill did research in CU's Upper Air Laboratory. His early work there included studies of polarized light and its implications for the analysis of zodiacal light. He and his co-workers also began developing instrumentation to be flown above the Earth's atmosphere in sounding rockets. In 1952 he obtained the first photographic spectrogram of the solar Lyman-alpha line of hydrogen (121.6nm). This work was followed in 1956 by the first full disk spectroheliogram in Lyman-alpha. These results could not have been possible without the use of pointing control systems for sounding rockets. These "sun trackers" kept the payloads pointed at the sun long enough for the measurements to be made, and CU was a pioneer in their development. The expanding research venue led the Upper Air Laboratory to be renamed the Laboratory for Atmospheric and Space Physics (LASP), and Bill Rense was its first director. He continued his research into the properties of the solar atmosphere with high resolution observations of He I and He II (58.4 and 30.4 nm) and O I (130.5nm), as well as terrestrial atmospheric absorption measurements, utilizing the sun as an Extreme Ultraviolet source. In the meantime, the pointing control business proved to be so popular that it was transferred to a then-small local business owned by Ball Brothers Research Corporation. It is now the Ball Aerospace and Technologies Corporation. Bill retired from CU in 1980. He had a successful and productive career at LASP, but teaching was his first love. Besides teaching undergraduates, he trained graduate students and post-doctoral fellows in the latest research techniques. His family recalls the joy he took in teaching honors classes at their home in Boulder as well as the many letters he received from the students he inspired. He had a constantly enquiring mind and loved to share his curiosity with others, whether the subject was beat frequencies heard on a jet plane or stellar constellations seen from Estes Park. Bill was a devoted amateur naturalist and kept detailed records of the weather and of the first appearances of birds and flowers observed at his summer cabin in Allenspark, Colorado. One of his earliest publications concerned the nighttime observation of migrating birds, seen as they flew in front of the moon. It is a technique employed by birders as far back as 1902 and still used today. Working in collaboration with George H. Lowery, Curator of the Museum of Zoology at LSU, Bill established the observational ground rules that would enable ornithologists to determine the compass heading, altitude and density of birds along their nocturnal flyways. When people are asked what Bill Rense was like, a word that frequently comes up is "courtly". In all his transactions with other people, Bill was unfailingly soft spoken and gracious. When confronted with a profoundly bad idea, his typical response would be to say, "Well - that's different." In a field sometimes dominated by large egos, his unassuming manner may have been what made him stand out as a teacher and as a friend. A quote from Alexander Pope seems to fit him: "True politeness consists in being easy one's self, and in making everyone about one as easy as one can. William A. Rense is survived by his wife, Wanda Rense of Estes Park, Colorado, and three sons: William of Estes Park, John of Anchorage, Alaska, and Charles of Los Alamos, New Mexico. A memorial service was held on April 2, 2008, at Good Samaritan Village, Estes Park.

Ambulatory Data System: A Case Study in the Compliance, Utilization and Data Accuracy of the Ambulatory Data System at Naval Hospital, Camp Lejeune, North Carolina

DTIC Science & Technology

1999-06-07

25 percent more days each year than are men’s activities, and women are bedridden 35 percent more days than men because of infectious diseases... respiratory problems, digestive disease, injuries, and other chronic conditions (Blumenthal, 1995). Not only are Americans living longer, they are requiring...requirements” (ADS, 1998). Functionally , ADS is a form-based data collection tool similar to the "master bills" used in civilian health care practices. For the

Optimal Sizing of a Solar-Plus-Storage System for Utility Bill Savings and Resiliency Benefits

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

Simpkins, Travis; Anderson, Kate; Cutler, Dylan

Solar-plus-storage systems can achieve significant utility savings in behind-the-meter deployments in buildings, campuses, or industrial sites. Common applications include demand charge reduction, energy arbitrage, time-shifting of excess photovoltaic (PV) production, and selling ancillary services to the utility grid. These systems can also offer some energy resiliency during grid outages. It is often difficult to quantify the amount of resiliency that these systems can provide, however, and this benefit is often undervalued or omitted during the design process. We propose a method for estimating the resiliency that a solar-plus-storage system can provide at a given location. We then present an optimizationmore » model that can optimally size the system components to minimize the lifecycle cost of electricity to the site, including the costs incurred during grid outages. The results show that including the value of resiliency during the feasibility stage can result in larger systems and increased resiliency.« less

Optimal Sizing of a Solar-Plus-Storage System For Utility Bill Savings and Resiliency Benefits: Preprint

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

Simpkins, Travis; Anderson, Kate; Cutler, Dylan

Solar-plus-storage systems can achieve significant utility savings in behind-the-meter deployments in buildings, campuses, or industrial sites. Common applications include demand charge reduction, energy arbitrage, time-shifting of excess photovoltaic (PV) production, and selling ancillary services to the utility grid. These systems can also offer some energy resiliency during grid outages. It is often difficult to quantify the amount of resiliency that these systems can provide, however, and this benefit is often undervalued or omitted during the design process. We propose a method for estimating the resiliency that a solar-plus-storage system can provide at a given location. We then present an optimizationmore » model that can optimally size the system components to minimize the lifecycle cost of electricity to the site, including the costs incurred during grid outages. The results show that including the value of resiliency during the feasibility stage can result in larger systems and increased resiliency.« less

Laboratory Testing of Demand-Response Enabled Household Appliances

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

Sparn, B.; Jin, X.; Earle, L.

2013-10-01

With the advent of the Advanced Metering Infrastructure (AMI) systems capable of two-way communications between the utility's grid and the building, there has been significant effort in the Automated Home Energy Management (AHEM) industry to develop capabilities that allow residential building systems to respond to utility demand events by temporarily reducing their electricity usage. Major appliance manufacturers are following suit by developing Home Area Network (HAN)-tied appliance suites that can take signals from the home's 'smart meter,' a.k.a. AMI meter, and adjust their run cycles accordingly. There are numerous strategies that can be employed by household appliances to respond tomore » demand-side management opportunities, and they could result in substantial reductions in electricity bills for the residents depending on the pricing structures used by the utilities to incent these types of responses.The first step to quantifying these end effects is to test these systems and their responses in simulated demand-response (DR) conditions while monitoring energy use and overall system performance.« less

Laboratory Testing of Demand-Response Enabled Household Appliances

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

Sparn, B.; Jin, X.; Earle, L.

2013-10-01

With the advent of the Advanced Metering Infrastructure (AMI) systems capable of two-way communications between the utility's grid and the building, there has been significant effort in the Automated Home Energy Management (AHEM) industry to develop capabilities that allow residential building systems to respond to utility demand events by temporarily reducing their electricity usage. Major appliance manufacturers are following suit by developing Home Area Network (HAN)-tied appliance suites that can take signals from the home's 'smart meter,' a.k.a. AMI meter, and adjust their run cycles accordingly. There are numerous strategies that can be employed by household appliances to respond tomore » demand-side management opportunities, and they could result in substantial reductions in electricity bills for the residents depending on the pricing structures used by the utilities to incent these types of responses. The first step to quantifying these end effects is to test these systems and their responses in simulated demand-response (DR) conditions while monitoring energy use and overall system performance.« less

12 CFR 226.13 - Billing error resolution. 27

Code of Federal Regulations, 2010 CFR

2010-01-01

... statement of a computational or similar error of an accounting nature that is made by the creditor. (6) A... least 20 days before the end of the billing cycle for which the statement was required. (b) Billing... applicable, within 2 complete billing cycles (but in no event later than 90 days) after receiving a billing...

What Every Student Should Know about the Bill of Rights.

ERIC Educational Resources Information Center

Petracca, Mark P.

1990-01-01

Traces the history of the Bill of Rights. Delineates the early arguments proposed for and against the Bill of Rights. Discusses the recent Ronald Reagan-Edwin Meese attack on the applicability of the Bill of Rights. Identifies seven items that every student should know about the Bill of Rights. (RW)

49 CFR 360.3 - Filing fees.

Code of Federal Regulations, 2014 CFR

2014-10-01

... month and a billing cycle. The billing date is the date that the bill is prepared and printed. The.... A bill for each account which has activity or an unpaid balance during the billing cycle will be...) The court in which the bankruptcy petition was filed; (C) The type of bankruptcy proceeding; (D) The...

12 CFR 810.1 - Description of Federal Financing Bank bills.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Description of Federal Financing Bank bills. 810.1 Section 810.1 Banks and Banking FEDERAL FINANCING BANK FEDERAL FINANCING BANK BILLS § 810.1 Description of Federal Financing Bank bills. (a) General. Federal Financing Bank bills are bearer obligations...

KSC-2009-3291

NASA Image and Video Library

2009-05-27

CAPE CANAVERAL, Fla. – Gathering on stage for the groundbreaking ceremony for the joint NASA and Florida Power & Light, or FPL, solar power project at NASA's Kennedy Space Center are Florida Rep. Bill Posey, Eric Draper, deputy director of Audubon of Florida, Sen. Bill Nelson, Florida Rep. Suzanne Kosmas, Armando Olivera, president and CEO of FPL, Center Director Bob Cabana and Pam Rauch, vice president of External Affairs for FPL. FPL, Florida's largest electric utility, will build and maintain two solar photovoltaic power generation systems at Kennedy. One will produce an estimated 10 megawatts of emissions-free power for FPL customers, which is enough energy to serve roughly 1,100 homes. The second is a one-megawatt solar power facility that will provide renewable energy directly to Kennedy. The FPL facilities at NASA will help provide Florida residents and America's space program with new sources of clean energy that will cut reliance on fossil fuels and improve the environment by reducing greenhouse gas emissions. The one megawatt facility also will help NASA meet its goal for use of power generated from renewable energy. Photo credit: NASA/Kim Shiflett

LIMITED GEOGRAPHIC VARIATION IN THE VOCALIZATIONS OF THE ENDANGERED THICK-BILLED PARROT: IMPLICATIONS FOR CONSERVATION STRATEGIES

PubMed Central

Guerra, Jaime E.; Cruz-Nieto, Javier; Ortiz-Maciel, Sonia Gabriela; Wright, Timothy F.

2012-01-01

The populations of many species are declining worldwide, and conservation efforts struggle to keep pace with extinction rates. Conservation biologists commonly employ strategies such as translocation and reintroduction, which move individuals of endangered species from one part of their range to another. Because individuals from endangered populations are nonexpendable, identifying any potential barriers to the establishment of viable populations prior to release of individuals should be a priority. This study evaluates the potential for learned communication signals to constrain conservation strategies such as reintroduction in an endangered species, the Thick-billed Parrot (Rhynchopsitta pachyrhyncha). We conducted vocal surveys at three geographically distinct breeding populations in the Sierra Madre Occidental of Chihuahua, Mexico. Acoustic analyses utilizing both spectrogram cross-correlations and parameter measurements from spectrograms revealed no significant differences among the three sites in two common call types. Calls did vary among individuals within a site. The apparent lack of significant geographic variation across sampled sites suggests that differences in learned communication signals are unlikely to pose a barrier to the integration of translocated individuals from different populations into newly established populations. PMID:22307993

Fatigue Level Estimation of Bill Based on Acoustic Signal Feature by Supervised SOM

NASA Astrophysics Data System (ADS)

Teranishi, Masaru; Omatu, Sigeru; Kosaka, Toshihisa

Fatigued bills have harmful influence on daily operation of Automated Teller Machine(ATM). To make the fatigued bills classification more efficient, development of an automatic fatigued bill classification method is desired. We propose a new method to estimate bending rigidity of bill from acoustic signal feature of banking machines. The estimated bending rigidities are used as continuous fatigue level for classification of fatigued bill. By using the supervised Self-Organizing Map(supervised SOM), we estimate the bending rigidity from only the acoustic energy pattern effectively. The experimental result with real bill samples shows the effectiveness of the proposed method.

Incentive-compatible demand-side management for smart grids based on review strategies

NASA Astrophysics Data System (ADS)

Xu, Jie; van der Schaar, Mihaela

2015-12-01

Demand-side load management is able to significantly improve the energy efficiency of smart grids. Since the electricity production cost depends on the aggregate energy usage of multiple consumers, an important incentive problem emerges: self-interested consumers want to increase their own utilities by consuming more than the socially optimal amount of energy during peak hours since the increased cost is shared among the entire set of consumers. To incentivize self-interested consumers to take the socially optimal scheduling actions, we design a new class of protocols based on review strategies. These strategies work as follows: first, a review stage takes place in which a statistical test is performed based on the daily prices of the previous billing cycle to determine whether or not the other consumers schedule their electricity loads in a socially optimal way. If the test fails, the consumers trigger a punishment phase in which, for a certain time, they adjust their energy scheduling in such a way that everybody in the consumer set is punished due to an increased price. Using a carefully designed protocol based on such review strategies, consumers then have incentives to take the socially optimal load scheduling to avoid entering this punishment phase. We rigorously characterize the impact of deploying protocols based on review strategies on the system's as well as the users' performance and determine the optimal design (optimal billing cycle, punishment length, etc.) for various smart grid deployment scenarios. Even though this paper considers a simplified smart grid model, our analysis provides important and useful insights for designing incentive-compatible demand-side management schemes based on aggregate energy usage information in a variety of practical scenarios.

Ontario pharmacists' crisis over Bill 16: A missed opportunity?

PubMed Central

Rosenthal, Meagen; Austin, Zubin; Tsuyuki, Ross T.

2012-01-01

Introduction: In 2010, the Ontario government brought forward Bill 16, which, among other things, removed pharmacists' professional allowances. While many would disagree with this unilateral action by the Ontario government, it also could have served as a crisis for change towards patient-centred care. We sought to examine the response of the pharmacy profession in Ontario to this crisis as it relates to the vision outlined in the Blueprint for Pharmacy. Methods: We systematically examined publicly available responses to Schedule 5 of Ontario's Bill 16 during the period from April to June 16, 2010. A rapid textual analysis of the data using tag or word clouds and a qualitative content analysis were performed on all of the data collected. Results: The rapid textual analysis revealed that the most frequently used terms were “pharmacist,” “pharmacy” and “professional allowances”; the least used were “layoffs,” “service cuts” and “patient care.” Content analysis revealed 4 themes: the desire to maintain the status quo of practice, a focus on the business of pharmacy, pharmacy stakeholders' perceptions of government's attitude towards the profession and changes to patient services. Discussion: It is notable that patient care was almost completely absent from the discussion, a reflection that our profession has not embraced patient-centred care. This also represents a missed opportunity — a crisis that could have been used to move the profession towards the Blueprint's vision. We thought that the Blueprint had already achieved this consensus, but the Ontario experience has shown that this may not be the case. PMID:23509486

Health care access and utilization among children of single working and nonworking mothers in the United States.

PubMed

Clarke, Tainya C; Arheart, Kristopher L; Muennig, Peter; Fleming, Lora E; Caban-Martinez, Alberto J; Dietz, Noella; Lee, David J

2011-01-01

To examine indicators of health care access and utilization among children of working and nonworking single mothers in the United States, the authors used data on unmarried women participating in the 1997-2008 National Health Interview Survey who financially supported children under 18 years of age (n = 21,842). Stratified by maternal employment, the analyses assessed health care access and utilization for all children. Outcome variables included delayed care, unmet care, lack of prescription medication, no usual place of care, no well-child visit, and no doctor's visit. The analyses reveal that maternal employment status was not associated with health care access and utilization. The strongest predictors of low access/utilization included no health insurance and intermittent health insurance in the previous 12 months, relative to those with continuous private health insurance coverage (odds ratio ranges 3.2-13.5 and 1.3-10.3, respectively). Children with continuous public health insurance compared favorably with those having continuous private health insurance on three of six access/utilization indicators (odds ratio range 0.63-0.85). As these results show, health care access and utilization for the children of single mothers are not optimal. Passage of the U.S. Healthcare Reform Bill (HR 3590) will probably increase the number of children with health insurance and improve these indicators.

16 CFR 308.7 - Billing and collection for pay-per-call services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... purchase. (vi) A computation error or similar error of an accounting nature on a billing statement of a... before the end of the billing cycle for which the statement was required. (viii) A reflection on a... billing cycles of the billing entity (in no event later than ninety (90) days) after receiving the notice...

19 CFR 24.3a - CBP bills; interest assessment; delinquency; notice to principal and surety.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 1 2012-04-01 2012-04-01 false CBP bills; interest assessment; delinquency....3a CBP bills; interest assessment; delinquency; notice to principal and surety. Link to an amendment published at 77 FR 17332, Mar. 26, 2012. (a) Due date of CBP bills. CBP bills for supplemental duties, taxes...

Advance Care Planning in an Accountable Care Organization Is Associated with Increased Advanced Directive Documentation and Decreased Costs

PubMed Central

Kim, Minchul; Franciskovich, Chris M.; Weinberg, Jason E.; Svendsen, Jessica D.; Fehr, Linda S.; Funk, Amy; Sawicki, Robert; Asche, Carl V.

2018-01-01

Abstract Background: Advance care planning (ACP) documents patient wishes and increases awareness of palliative care options. Objective: To study the association of outpatient ACP with advanced directive documentation, utilization, and costs of care. Design: This was a case–control study of cases with ACP who died matched 1:1 with controls. We used 12 months of data pre-ACP/prematch and predeath. We compared rates of documentation with logit model regression and conducted a difference-in-difference analysis using generalized linear models for utilization and costs. Setting/subjects: Medicare beneficiaries attributed to a large rural-suburban-small metro multisite accountable care organization from January 2013 to April 2016, with cross reference to ACP facilitator logs to find cases. Measurements: The presence of advance directive forms was verified by chart review. Cost analysis included all utilization and costs billed to Medicare. Results: We matched 325 cases and 325 controls (51.1% female and 48.9% male, mean age 81). 320/325 (98.5%) ACP versus 243/325 (74.8%) of controls had a Healthcare Power of Attorney (odds ratio [OR] 21.6, 95% CI 8.6–54.1) and 172/325(52.9%) ACP versus 145/325 (44.6%) controls had Practitioner Orders for Life Sustaining Treatment (OR 1.40, 95% CI 1.02–1.90) post-ACP/postmatch. Adjusted results showed ACP cases had fewer inpatient admissions (−0.37 admissions, 95% CI −0.66 to −0.08), and inpatient days (−3.66 days, 95% CI −6.23 to −1.09), with no differences in hospice, hospice days, skilled nursing facility use, home health use, 30-day readmissions, or emergency department visits. Adjusted costs were $9,500 lower in the ACP group (95% CI −$16,207 to −$2,793). Conclusions: ACP increases documentation and was associated with a reduction in overall costs driven primarily by a reduction in inpatient utilization. Our data set was limited by small numbers of minorities and cancer patients. PMID:29206564

The effects of fee bundling on dental utilization.

PubMed Central

Porter, J; Coyte, P C; Barnsley, J; Croxford, R

1999-01-01

OBJECTIVE: To examine dental utilization following an adjustment to the provincial fee schedule in which preventive maintenance (recall) services were bundled at lower fees. DATA SOURCES/STUDY SETTING: Blue Cross dental insurance claims for claimants associated with four major Ontario employers using a common insurance plan over the period 1987-1990. STUDY DESIGN: This before-and-after design analyzes the dental claims experience over a four-year period for 4,455 individuals 18 years of age and older one year prior to the bundling of services, one year concurrent with the change, and two years after the introduction of bundling. The dependent variable is the annual adjusted payment per user. DATA COLLECTION/EXTRACTION METHODS: The analysis was based on all claims submitted by adult users for services received at recall visits and who reported at least one visit of this type between 1987 and 1990. In these data, 26,177 services were provided by 1,214 dentists and represent 41 percent of all adult service claims submitted over the four years of observation. PRINCIPAL FINDINGS: Real per capita payment for adult recall services decreased by 0.3 percent in the year bundling was implemented (1988), but by the end of the study period such payments had increased 4.8 percent relative to pre-bundling levels. Multiple regression analysis assessed the role of patient and provider variables in the upward trend of per capita payments. The following variables were significant in explaining 37 percent of the variation in utilization over the period of observation: subscriber employment location; ever having received periodontal scaling or ever having received restorative services; regular user; dentist's school of graduation; and interactions involving year, service type, and regular user status. CONCLUSIONS: The volume and intensity of services received by adult patients increased when fee constraints were imposed on dentists. Future efforts to contain dental expenditures through fee schedule design will need to take this into consideration. Issues for future dental services research include provider billing practices, utilization among frequent attenders, and outcomes evaluation particularly with regard to periodontal care and replacement of restorations. PMID:10536976

Preparing a cost analysis for the section of medical physics-guidelines and methods.

PubMed

Mills, M D; Spanos, W J; Jose, B O; Kelly, B A; Brill, J P

2000-01-01

Radiation oncology is a highly complex medical specialty, involving many varied routine and special procedures. To assure cost-effectiveness and maintain support for the medical physics program, managers are obligated to analyze and defend all aspects of an institutional billing and cost-reporting program. Present standards of practice require that each patient's radiation treatments be customized to fit his/her particular condition. Since the use of personnel time and other resources is highly variable among patients, graduated levels of charges have been established to allow for more precise billing. Some radiation oncology special procedures have no specific code descriptors; so existing codes are modified or additional information attached in order to avoid payment denial. Recent publications have explored the manpower needs, salaries, and other resources required to perform radiation oncology "physics" procedures. This information is used to construct a model cost-based resource use profile for a radiation oncology center. This profile can be used to help the financial officer prepare a cost report for the institution. Both civil and criminal penalties for Medicare fraud and abuse (intentional or unintentional) are included in the False Claims Act and other statutes. Compliance guidelines require managers to train all personnel in correct billing procedures and to review continually billing performance.

A method and knowledge base for automated inference of patient problems from structured data in an electronic medical record.

PubMed

Wright, Adam; Pang, Justine; Feblowitz, Joshua C; Maloney, Francine L; Wilcox, Allison R; Ramelson, Harley Z; Schneider, Louise I; Bates, David W

2011-01-01

Accurate knowledge of a patient's medical problems is critical for clinical decision making, quality measurement, research, billing and clinical decision support. Common structured sources of problem information include the patient problem list and billing data; however, these sources are often inaccurate or incomplete. To develop and validate methods of automatically inferring patient problems from clinical and billing data, and to provide a knowledge base for inferring problems. We identified 17 target conditions and designed and validated a set of rules for identifying patient problems based on medications, laboratory results, billing codes, and vital signs. A panel of physicians provided input on a preliminary set of rules. Based on this input, we tested candidate rules on a sample of 100,000 patient records to assess their performance compared to gold standard manual chart review. The physician panel selected a final rule for each condition, which was validated on an independent sample of 100,000 records to assess its accuracy. Seventeen rules were developed for inferring patient problems. Analysis using a validation set of 100,000 randomly selected patients showed high sensitivity (range: 62.8-100.0%) and positive predictive value (range: 79.8-99.6%) for most rules. Overall, the inference rules performed better than using either the problem list or billing data alone. We developed and validated a set of rules for inferring patient problems. These rules have a variety of applications, including clinical decision support, care improvement, augmentation of the problem list, and identification of patients for research cohorts.

Development of Next Generation Energy Audit Protocols for the Rapid and Advanced Analysis of Building Energy Use

NASA Astrophysics Data System (ADS)

Hartley, Christopher Ahlvin

Current building energy auditing techniques are outdated and lack targeted, actionable information. These analyses only use one year's worth of monthly electricity and gas bills to define energy conservation and efficiency measures. These limited data sets cannot provide robust, directed energy reduction recommendations. The need is apparent for an overhaul of existing energy audit protocols to utilize all data that is available from the building's utility provider, installed energy management system (EMS), and sub-metering devices. This thesis analyzed the current state-of-the-art in energy audits, generated a next generation energy audit protocol, and conducted both audits types on four case study buildings to find out what additional information can be obtained from additional data sources and increased data gathering resolutions. Energy data from each case study building were collected using a variety of means including utility meters, whole building energy meters, EMS systems, and sub-metering devices. In addition to conducting an energy analysis for each case study building using the current and next generation energy audit protocols, two building energy models were created using the programs eQuest and EnergyPlus. The current and next generation energy audit protocol results were compared to one another upon completion. The results show that using the current audit protocols, only variations in season are apparent. Results from the developed next generation energy audit protocols show that in addition to seasonal variations, building heating, ventilation and air conditioning (HVAC) schedules, occupancy schedules, baseline and peak energy demand levels, and malfunctioning equipment can be found. This new protocol may also be used to quickly generate accurate building models because of the increased resolution that yields scheduling information. The developed next generation energy auditing protocol is scalable and can work for many building types across the United States, and perhaps the world.

Effect on healthcare utilization and costs of spinal manual therapy for acute low back pain in routine care: A propensity score matched cohort study.

PubMed

Walker, Jochen; Mertens, Ulf Kai; Schmidt, Carsten Oliver; Chenot, Jean-François

2017-01-01

Spinal manual therapy (SMT) is a popular treatment option for low back pain (LBP). The aim of our analysis was to evaluate the effects of manual therapy delivered by general practitioners and ambulatory orthopedic surgeons in routine care on follow up consultations, sick leave, health service utilization and costs for acute LBP compared to matched patients not receiving manual therapy. This is a propensity score matched cohort study based on health claims data. We identified a total of 113.652 adult patients with acute LBP and no coded red flags of whom 21.021 (18%) received SMT by physicians. In the final analysis 17.965 patients in each group could be matched. Balance on patients' coded characteristics, comorbidity and prior health service utilization was achieved. The provision of SMT for acute LBP had no relevant impact on follow up visits and days of sick leave for LBP in the index billing period and the following year. SMT was associated with a higher proportion of imaging studies for LBP (30.6% vs. 23%, SMD: 0.164 [95% CI 0.143-0.185]). SMT did not lead to meaningful savings by replacing other health services for LBP. SMT for acute non-specific LBP in routine care was not clinically meaningful effective to reduce sick leave and reconsultation rates compared to no SMT and did not lead to meaningful savings by replacing other health services from the perspective of health insurance. This does not imply that SMT is ineffective but might reflect a problem with selection of suitable patients and the quality and quantity of SMT in routine care. National Manual Medicine societies should state clearly that imaging is not routinely needed prior to SMT in patients with low suspicion of presence of red flags and monitor the quality of provided services.

Changes in Saturday outpatient volume and billings after introducing the Saturday incentive programme to clinics in South Korea: a longitudinal cohort study using claims data from 2012 to 2014.

PubMed

Ha, Hyun Ji; Han, Kyu-Tae; Kim, Sun Jung; Sohn, Tae Yong; Jeon, Byungyool; Park, Eun-Cheol

2016-06-09

In October 2013, the South Korean government introduced an incentive programme to increase the availability of Saturday treatment at clinics, hoping to increase the role of primary care providers as gatekeepers to medical care. To the best of our knowledge, no one has yet investigated this programme's effect on overall outpatient care. Our study aims to analyse the change in Saturday outpatient volume and billings in clinics that adopted the Saturday incentive programme. Our study used 3 types of data from the period October 2012 to March 2014: National Health Insurance Service (NHIS) claims data, hospital evaluation data and medical institution data. These data consisted of 66 825 881 outpatient cases from 2837 clinics. Introducing the Saturday incentive programme. We performed a multilevel analysis that adjusted for clinic-level and outpatient-level variables to examine the difference in the percentage of Saturday outpatient volume and billings after introducing the Saturday incentive programme. The percentages of Saturday outpatient volume and billings were higher after introducing the programme (outpatient volume: β=2.065, p<0.001; outpatient billings: β=3.518, p<0.001). In addition, outpatient volume and billings on Friday and Saturday increased after introducing the programme, while those on weekdays, excluding Friday, decreased. Our findings suggest that the Saturday incentive programme has affected clinic outpatient care and is a worthwhile health policy in terms of promoting primary care. Thus, it may improve healthcare accessibility and quality of care, and prevent inappropriate usage such as emergency room visits by providing patients with weekend clinic hours. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Effects of prescription adaptation by pharmacists

PubMed Central

2010-01-01

Background Granting dispensing pharmacists the authority to prescribe has significant implications for pharmaceutical and health human resources policy, and quality of care. Despite the growing number of jurisdictions that have given pharmacists such privileges, there are few rigorous evaluations of these policy changes. This study will examine a January 2009 policy change in British Columbia (BC), Canada that allowed pharmacists to independently adapt and renew prescriptions. We hypothesize this policy increased drug utilization and drug costs, increased patient adherence to medication, and reduced total healthcare resource use. Methods/Design We will study a population-based cohort of approximately 4 million BC residents from 2004 through 2010. We will use data from BC PharmaNet on all of the prescriptions obtained by this cohort during the study period, and link it to administrative billings from physicians and hospital discharges. Using interrupted time series analysis, we will study longitudinal changes in drug utilization and costs, medication adherence, and short-term health care use. Further, using hierarchical modelling, we will examine the factors at the regional, pharmacy, patient, and prescription levels that are associated with prescription adaptations and renewals. Discussion In a recent survey of Canadian policymakers, many respondents ranked the issue of prescribing privileges as one of their most pressing policy questions. No matter the results of our study, they will be important for policymakers, as our data will make policy decisions surrounding pharmacist prescribing more evidence-based. PMID:21083922

Job Impact Analysis Act of 2010

THOMAS, 111th Congress

Sen. Snowe, Olympia J. [R-ME

2010-02-23

Senate - 02/23/2010 Read twice and referred to the Committee on Homeland Security and Governmental Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Greenhouse Gas Observation and Analysis System Act

THOMAS, 111th Congress

Sen. Rockefeller, John D., IV [D-WV

2009-07-29

Senate - 07/29/2009 Read twice and referred to the Committee on Commerce, Science, and Transportation. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Independent Agency Regulatory Analysis Act of 2012

THOMAS, 112th Congress

Sen. Portman, Rob [R-OH

2012-08-01

Senate - 08/01/2012 Read twice and referred to the Committee on Homeland Security and Governmental Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Independent Agency Regulatory Analysis Act of 2013

THOMAS, 113th Congress

Sen. Portman, Rob [R-OH

2013-06-18

Senate - 06/18/2013 Read twice and referred to the Committee on Homeland Security and Governmental Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

H2FIRST Reference Station Design Task: Project Deliverable 2-2

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

Pratt, Joseph; Terlip, Danny; Ainscough, Chris

2015-04-20

This report presents near-term station cost results and discusses cost trends of different station types. It compares various vehicle rollout scenarios and projects realistic near-term station utilization values using the station infrastructure rollout in California as an example. It describes near-term market demands and matches those to cost-effective station concepts. Finally, the report contains detailed designs for five selected stations, which include piping and instrumentation diagrams, bills of materials, and several site-specific layout studies that incorporate the setbacks required by NFPA 2, the National Fire Protection Association Hydrogen Technologies Code. This work identified those setbacks as a significant factor affectingmore » the ability to site a hydrogen station, particularly liquid stations at existing gasoline stations. For all station types, utilization has a large influence on the financial viability of the station.« less

Missed surgical intensive care unit billing: potential financial impact of 24/7 faculty presence.

PubMed

Hendershot, Kimberly M; Bollins, John P; Armen, Scott B; Thomas, Yalaunda M; Steinberg, Steven M; Cook, Charles H

2009-07-01

To efficiently capture evaluation and management (E&M) and procedural billing in our surgical intensive care unit (SICU), we have developed an electronic billing system that links to the electronic medical record (EMR). In this system, only notes electronically signed and coded by an attending generate billing charges. We hypothesized that capture of missed billing during nighttime and weekends might be sufficient to subsidize 24/7 in-house attending coverage. A retrospective chart EMR review was performed of the EMRs for all SICU patients during a 2-month period. Note type, date, time, attending signature, and coding were analyzed. Notes without attending signature, diagnosis, or current procedural terminology (CPT) code were considered incomplete and identified as "missed billing." Four hundred and forty-three patients had 465 admissions generating 2,896 notes. Overall, 76% of notes were signed and coded by an attending and billed. Incomplete (not billed) notes represented an overall missed billing opportunity of $159,138 for the 2-month time period (approximately $954,000 annually). Unbilled E&M encounters during weekdays totaled $54,758, whereas unbilled E&M and procedures from weeknights and weekends totaled $88,408 ($44,566 and $43,842, respectively). Missed billing after-hours thus represents approximately $530K annually, extrapolating to approximately $220K in collections from our payer mix. Surprisingly, missed E&M and procedural billing during weekdays totaled $70,730 (approximately $425K billing, approximately $170K collections annually), and typically represented patients seen, but transferred from the SICU before attending documentation was completed. Capture of nighttime and weekend ICU collections alone may be insufficient to add faculty or incentivize in-house coverage, but could certainly complement other in-house derived revenues to such ends. In addition, missed daytime billing in busy modern ICUs can be substantial, and use of an EMR to identify missed billing opportunities can help create solutions to recover these revenues.

Heat Loss May Explain Bill Size Differences between Birds Occupying Different Habitats

PubMed Central

Greenberg, Russell; Cadena, Viviana; Danner, Raymond M.; Tattersall, Glenn

2012-01-01

Background Research on variation in bill morphology has focused on the role of diet. Bills have other functions, however, including a role in heat and water balance. The role of the bill in heat loss may be particularly important in birds where water is limiting. Song sparrows localized in coastal dunes and salt marsh edge (Melospiza melodia atlantica) are similar in size to, but have bills with a 17% greater surface area than, those that live in mesic habitats (M. m. melodia), a pattern shared with other coastal sparrows. We tested the hypotheses that sparrows can use their bills to dissipate “dry” heat, and that heat loss from the bill is higher in M. m. atlantica than M. m. melodia, which would indicate a role of heat loss and water conservation in selection for bill size. Methodology/Principal Findings Bill, tarsus, and body surface temperatures were measured using thermal imaging of sparrows exposed to temperatures from 15–37°C and combined with surface area and physical modeling to estimate the contribution of each body part to total heat loss. Song sparrow bills averaged 5–10°C hotter than ambient. The bill of M. m atlantica dissipated up to 33% more heat and 38% greater proportion of total heat than that of M. m. melodia. This could potentially reduce water loss requirements by approximately 7.7%. Conclusions/Significance This >30% higher heat loss in the bill of M. m. atlantica is independent of evaporative water loss and thus could play an important role in the water balance of sparrows occupying the hot and exposed dune/salt marsh environments during the summer. Heat loss capacity and water conservation could play an important role in the selection for bill size differences between bird populations and should be considered along with trophic adaptations when studying variation in bill size. PMID:22848413

New York's Health Care Workforce Recruitment and Retention Act: an investigation of the effects of nonrecurring increases in health worker wage on health worker supply.

PubMed

Patel, Kavin

2014-01-01

This article analyzes New York's Health Care Workforce Recruitment and Retention Act of 2002. The analysis comes in 4 parts: part 1 provides a brief overview of New York's economy as it relates to health care, a feel for the political climate at the time, and a detailed presentation of the chain of events that connect this climate to the birth of the Health Care Workforce Recruitment and Retention Act of 2002; part 2 consists of a breakdown of the provisions contained within bill, including major and minor goals, intended effects, and the mechanics behind raising supporting funds; part 3 explores what actually happened by evaluating available data to determine whether the bill's 2 major goals of workforce recruitment and retention were fulfilled; and finally, part 4 will take all the aforementioned information to determine the overall success of the bill, the implications, and specific suggestions for future policy changes that time has revealed since its inception.

Dismantling reified African culture through localised homosexualities in Uganda.

PubMed

Nyanzi, Stella

2013-01-01

Uganda's Anti-Homosexuality Bill of 2009 aimed at protecting the cherished culture of the people against emergent threats to the traditional heterosexual family. The Bill's justification, however, lay in myopic imaginings of a homogenous African-ness and pedestrian oblivion to pluralities within African sexualities. This paper revisits the debate that homosexuality is 'un-African'. Rhetoric analysis of the Anti-Homosexuality Bill exposes how dominant discourses of law, medicine, religion, geography and culture reinforce the view that homosexuality is foreign to Africa. Based on ethnography in contemporary Uganda, I explore how self-identified same-sex-loving individuals simultaneously claim their African-ness and their homosexuality. Their strategies include ethnic belonging, membership to kinship structures, making connections with pre-colonial histories of homosexuality, civic participation in democratic processes, national identity, organising of lesbian, gay, bisexual, transgender, intersex and questioning support groups, language and nomenclature, visibility and voice in local communal activities, solidarity and adherence to cultural rituals. In present-day Uganda, same-sex-loving men, women and transgender people variously assert their African-ness.

[Sanitary control of alcohol advertisement in Brazil: a study of the law bills from 1988 to 2004].

PubMed

Falcão, Isa Cristina Lopes; Rangel-S, Maria Ligia

2010-11-01

This study analyses law bills towards the sanitary control of alcohol advertisement in the mass media presented to the Brazilian Congress from 1988 to 2004. The sanitary control of this advertising is a controversial issue bringing about an ethical-political debate in which the health-protecting interests conflict with commercial ones even after scientific evidence has established increasing alcohol intake as a health and social issue worldwide. The content analysis of 67 of such law bills was carried out, and these proposals were shown to consist mostly of strategies to both cope with alcohol advertising by dissociating from the product those values that might interfere with the children and teenagers' building of their social identity and limit advertisement contents in the mass media given the higher vulnerability of the subjects in that age range. This study reveals complexes challenges for the control of alcohol advertisement that in turn lead to rethinking the action of the State apparatus in dealing with this major public health issue.

Managing water and riparian habitats on the Bill Williams River with scientific benefit for other desert river systems

USGS Publications Warehouse

John Hickey,; Woodrow Fields,; Andrew Hautzinger,; Steven Sesnie,; Shafroth, Patrick B.; Dick Gilbert,

2016-01-01

This report details modeling to: 1) codify flow-ecology relationships for riparian species of the Bill Williams River as operational guidance for water managers, 2) test the guidance under different climate scenarios, and 3) revise the operational guidance as needed to address the effects of climate change. Model applications detailed herein include the River Analysis System  (HEC-RAS) and the Ecosystem Functions Model  (HEC-EFM), which was used to generate more than three million estimates of local seedling recruitment areas. Areas were aggregated and compared to determine which scenarios generated the most seedling area per unit volume of water. Scenarios that maximized seedling area were grouped into a family of curves that serve as guidance for water managers. This work has direct connections to water management decision-making and builds upon and adds to the rich history of science-based management for the Bill Williams River, Arizona, USA. 

Biopsychosocial law, health care reform, and the control of medical inflation in Colorado.

PubMed

Bruns, Daniel; Mueller, Kathryn; Warren, Pamela A

2012-05-01

A noteworthy attempt at health care reform was the 1992 Colorado workers' compensation reform bill, which led to the creation of what has been called "biopsychosocial laws." These laws mandated the use of treatment guidelines for patients with injury or chronic pain, which advocated a biopsychosocial model of rehabilitation, and aspired to use a "best practice" approach to controlling costs. The purpose of this study was to examine the financial impact of this health care reform process, and to test the hypothesis that this approach can be an effective strategy to contain costs while providing good care. This study utilized a dataset collected prospectively from 1992 to 2007 in 45 U.S. states for regulatory purposes. These data summarized the medical treatment and disability costs of 520,314 injured workers in Colorado, and an estimated 28.6 million injured workers nationally. As no other state passed a comparable bill, the Colorado worker compensation reform bill created a natural experiment, where a treatment group was created by legally enforceable medical treatment guidelines. In the 15 years following the implementation of the reform, the inflation of medical costs in Colorado workers' compensation was only one third that of the national average, saving an estimated $859 million on patients injured in 2007 alone. Although there were confounding variables, and causality could not be determined, these data are consistent with the hypothesis that Colorado's 1992 legislative efforts to reform workers compensation law using the biopsychosocial model worked as intended to provide good care while controlling costs. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Evaluating Outdoor Water Use Demand under Changing Climatic and Demographic Conditions: An Agent-based Modeling Approach

NASA Astrophysics Data System (ADS)

Kanta, L.

2016-12-01

Outdoor water use for landscape and irrigation constitutes a significant end use in residential water demand. In periods of water shortages, utilities may reduce garden demands by implementing irrigation system audits, rebate programs, local ordinances, and voluntary or mandatory water use restrictions. Because utilities do not typically record outdoor and indoor water uses separately, the effects of policies for reducing garden demands cannot be readily calculated. The volume of water required to meet garden demands depends on the housing density or lawn size, type of vegetation, climatic conditions, efficiency of garden irrigation systems, and consumer water-use behaviors. Many existing outdoor demand estimation methods are deterministic and do not include consumer responses to conservation campaigns. In addition, mandatory restrictions may have a substantial impact on reducing outdoor demands, but the effectiveness of mandatory restrictions depends on the timing and the frequency of restrictions, in addition to the distribution of housing density and consumer types within a community. This research investigates a garden end-use model by coupling an agent-based modeling approach and a mechanistic-stochastic water demand model to create a methodology for estimating garden demand and evaluating demand reduction policies. The garden demand model is developed for two water utilities, using a diverse data sets, including residential customer billing records, records of outdoor conservation programs, frequency and type of mandatory water use restrictions, lot size distribution, population growth, and climatic data. A set of garden irrigation parameter values, which are based on the efficiency of irrigation systems and irrigation habits of consumers, are determined for a set of conservation ordinances and restrictions. The model parameters are then validated using customer water usage data from the participating water utilities. A sensitivity analysis is conducted for garden irrigation parameters to determine the most significant factors that should be considered by water utilities to reduce outdoor demand. Data from multiple sources and the agent-based modeling methodology are integrated using a holistic approach to assist utilities in efficiently and sustainably managing outdoor demand.

Evaluating Outdoor Water Use Demand under Changing Climatic and Demographic Conditions: An Agent-based Modeling Approach

NASA Astrophysics Data System (ADS)

Kanta, L.; Berglund, E. Z.; Soh, M. H.

2017-12-01

Outdoor water-use for landscape and irrigation constitutes a significant end-use in total residential water demand. In periods of water shortages, utilities may reduce garden demands by implementing irrigation system audits, rebate programs, local ordinances, and voluntary or mandatory water-use restrictions. Because utilities do not typically record outdoor and indoor water-uses separately, the effects of policies for reducing garden demands cannot be readily calculated. The volume of water required to meet garden demands depends on the housing density, lawn size, type of vegetation, climatic conditions, efficiency of garden irrigation systems, and consumer water-use behaviors. Many existing outdoor demand estimation methods are deterministic and do not include consumer responses to conservation campaigns. In addition, mandatory restrictions may have a substantial impact on reducing outdoor demands, but the effectiveness of mandatory restrictions depends on the timing and the frequency of restrictions, in addition to the distribution of housing density and consumer types within a community. This research investigates a garden end-use model by coupling an agent-based modeling approach and a mechanistic-stochastic water demand model to create a methodology for estimating garden demand and evaluating demand reduction policies. The garden demand model is developed for two water utilities, using a diverse data sets, including residential customer billing records, outdoor conservation programs, frequency and type of mandatory water-use restrictions, lot size distribution, population growth, and climatic data. A set of garden irrigation parameter values, which are based on the efficiency of irrigation systems and irrigation habits of consumers, are determined for a set of conservation ordinances and restrictions. The model parameters are then validated using customer water usage data from the participating water utilities. A sensitivity analysis is conducted for garden irrigation parameters to determine the most significant factors that should be considered by water utilities to reduce outdoor demand. Data from multiple sources and the agent-based modeling methodology are integrated using a holistic approach to assist utilities in efficiently and sustainably managing outdoor demand.

Economic Well-Being Among Older-Adult Households: Variation by Veteran and Disability Status

PubMed Central

Wilmoth, Janet M.; London, Andrew S.; Heflin, Colleen M.

2015-01-01

This analysis uses data from the Survey of Income and Program Participation (SIPP) to examine whether veteran and disability statuses are jointly associated with household-level poverty and material hardship among older adults. Compared to households that do not include a person with a disability or veteran, disabled non-veteran households are more likely to be in poverty and to experience home hardship, medical hardship, and bill-paying hardship. Disabled veteran households are not significantly different in terms of poverty, but exhibit the highest odds of home hardship, medical hardship, bill-paying hardship, and food insufficiency. The implications for social work practice are discussed. PMID:25750998

Bills to Increase Employment Opportunities through the Youth Conservation Corps and Other Means, 95th Congress, 1st Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC.

This packet contains nine Senate bills and eight House bills from the 95th Congress, 1st session, all dealing with various means of increasing employment opportunities. Most of the bills deal with the creation of new jobs or with programs for job training, counseling, or placement. Seven of the bills constitute amendments to the Youth Conservation…

A Survey of Texas HIV, Sexually Transmitted Disease, Tuberculosis, and Viral Hepatitis Providers’ Billing and Reimbursement Capabilities

PubMed Central

Atwood, Robin; Greenberg, Jennifer B.; Ray, Tara; Harris, Karol Kaye

2015-01-01

The Affordable Care Act presents financial challenges and opportunities for publicly funded service providers. We assessed billing practices and anticipated barriers to third-party billing among organizations in Texas that provide publicly funded HIV, sexually transmitted diseases, tuberculosis, and viral hepatitis services. One third to one half of the organizations did not bill for medical services. The most common barrier to third-party billing was lack of staff knowledge about billing and coding. Future research must evaluate options for organizations and communities to maintain access to infectious disease services for vulnerable populations. PMID:26447911

Impact of tobacco industry and other corporations in the defeat of the 1994 Clinton health care plan.

PubMed

Givel, Michael

2017-06-21

The primary reason cited by many scholars for the defeat of the Clinton Administration's 1994 health care reform bill has long been identified as Health Insurance Association of America and National Federation of Independent Businesses opposition to the bill. Given this predominant consensus combined with sizeable proposed funding for the bill by a large tobacco product tax, this manuscript examined what the tobacco industry's role was in whole or part in defeating the Clinton health care bill. This research occurred through crosschecking internal tobacco industry documents and Clinton White House documents. Prior to the passage of the bill, the tobacco industry accepted a compromise of 45 cents per pack increase phased in over five years. Due to this compromise, the industry or third party allies had no role in the ultimate defeat in the bill. The primary reason for the bill's ultimate defeat was general business (but not tobacco industry and third party ally) opposition, the bill running out of time, and conflicting bills. Secondary reasons for the bill's defeat included issues with: employer mandates, high taxes on insurance plans, impacts on medical research and education, Congressional attention to other issues, election year politics, and possible future excise tax possibilities.

Analysis of Efficiency Standards for Air Conditioners, Heat Pumps, and Other Products

EIA Publications

2002-01-01

A series of analyses showing the impacts of each of the selected provisions of the bills on energy supply, demand, and prices, macroeconomic variables where feasible, import dependence, and emissions.

WE-AB-202-08: Feasibility of Single-Inhalation/Single-Energy Xenon CT for High-Resolution Imaging of Regional Lung Ventilation in Humans

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

Pinkham, D; Schueler, E; Diehn, M

Purpose: To demonstrate the efficacy of a novel functional lung imaging method that utilizes single-inhalation, single-energy xenon CT (Xe-CT) lung ventilation scans, and to compare it against the current clinical standard, ventilation single-photon emission CT (V-SPECT). Methods: In an IRB-approved clinical study, 14 patients undergoing thoracic radiotherapy received two successive single inhalation, single energy (80keV) CT images of the entire lung using 100% oxygen and a 70%/30% xenon-oxygen mixture. A subset of ten patients also received concurrent SPECT ventilation scans. Anatomic reproducibility between the two scans was achieved using a custom video biofeedback apparatus. The CT images were registered tomore » each other by deformable registration, and a calculated difference image served as surrogate xenon ventilation map. Both lungs were partitioned into twelve sectors, and a sector-wise correlation was performed between the xenon and V-SPECT scans. A linear regression model was developed with forced expiratory volume (FEV) as a predictor and the coefficient of variation (CoV) as the outcome. Results: The ventilation comparison for five of the patients had either moderate to strong Pearson correlation coefficients (0.47 to 0.69, p<0.05). Of these, four also had moderate to strong Spearman correlation coefficients (0.46 to 0.80, p<0.03). The patients with the strongest correlation had clear regional ventilation deficits. The patient comparisons with the weakest correlations had more homogeneous ventilation distributions, and those patients also had diminished lung function as assessed by spirometry. Analysis of the relationship between CoV and FEV yielded a non-significant trend toward negative correlation (Pearson coefficient −0.60, p<0.15). Conclusion: Significant correlations were found between the Xe-CT and V-SPECT ventilation imagery. The results from this small cohort of patients indicate that single inhalation, single energy Xe-CT has the potential to quantify regional lung ventilation volumetrically with high resolution using widely accessible radiologic equipment. Bill Loo and Peter Maxim are founders of TibaRay, Inc. Bill Loo is also a board member. Bill Loo and Peter Maxim have received research grants from Varian Medical Systems, Inc. and RaySearch Laboratory.« less

Directed educational training improves coding and billing skills for residents.

PubMed

Benke, James R; Lin, Sandra Y; Ishman, Stacey L

2013-03-01

To determine if coding and billing acumen improves after a single directed educational training session. Case-control series. Fourteen otolaryngology practitioners including trainees each completed two clinical scenarios before and after a directed educational session covering basic skills and common mistakes in otolaryngology billing and coding. Ten practitioners had never coded before; while, four regularly billed and coded in a clinical setting. Individuals with no previous billing experience had a mean score of 54% (median 55%) before the educational session which was significantly lower than that of the experienced billers who averaged 82% (median 83%, p=0.002). After the educational billing and coding session, the inexperienced billers mean score improved to 62% (median, 67%) which was still statistically lower than that of the experienced billers who averaged 76% (median 75%, p=0.039). The inexperienced billers demonstrated a significant improvement in their total score after the intervention (P=0.019); however, the change observed in experienced billers before and after the educational intervention was not significant (P=0.469). Billing and coding skill was improved after a single directed education session. Residents, who are not responsible for regular billing and coding, were found to have the greatest improvement in skill. However, providers who regularly bill and code had no significant improvement after this session. These data suggest that a single 90min billing and coding education session is effective in preparing those with limited experience to competently bill and code. Copyright © 2012. Published by Elsevier Ireland Ltd.

Seasonal dimorphism in the horny bills of sparrows

EPA Science Inventory

Bill shape and size are often viewed as species-specific adaptations for feeding, but they sometimes vary between sexes, suggesting that sexual selection or inter-sexual competition may also be important. Hypotheses to explain sexual bill size dimorphism in birds avian bill size...

Beyond Mirrors and Windows: A Critical Content Analysis of Latinx Children's Books

ERIC Educational Resources Information Center

Braden, Eliza G.; Rodriguez, Sanjuana C.

2016-01-01

This critical content analysis examines the representation of Latinx characters in 15 picture books published in 2013 and identified by Children's Cooperative Book Center (CCBC) as having significant Latinx content. The theoretical framework undergirding this study is Critical Race Theory (Ladson-Billings, 1998; Solórzano & Yosso, 2002;…

Counseling about firearms: proposed legislation is a threat to physicians and their patients.

PubMed

Vernick, Jon S; Teret, Stephen P; Smith, Gary A; Webster, Daniel W

2006-11-01

In early 2006, 2 separate but virtually identical bills were introduced in the Virginia and West Virginia legislatures that would have profoundly affected the relationship between a physician and his or her patients. Each bill would have prohibited a physician from asking a patient if he or she owned firearms for the purpose of counseling that patient about ways to reduce risks associated with firearms. Penalties for violation of the bills included revocation of a physician's license to practice. The Virginia bill was initially approved by its state House of Delegates by a vote of 88 to 11. It was ultimately defeated in a Virginia Senate committee. The West Virginia bill did not receive a vote during the 2006 legislative session. Although neither bill became law this year, this type of bill is likely to reappear in future legislative sessions. The Virginia and West Virginia bills were contrary to the best-practices recommendations of medical societies, including the American Academy of Pediatrics. Anticipatory guidance regarding firearms can indeed reduce risks to patients. Yet, the bills would have preferred the judgment of legislators over physicians regarding this aspect of the practice of medicine. In addition, the 2 bills raise legal issues regarding both medical malpractice and the First Amendment protection of the freedom of speech. The Virginia and West Virginia bills would have treated risks associated with firearms differently from other hazards and interfered with a physician's ability to protect his or her patients. The Virginia bill was defeated, in part, through the efforts of physicians to educate legislators. However, physicians must remain prepared to respond to similar state legislative initiatives in the future.

How important are autonomy and work setting to nurse practitioners' job satisfaction?

PubMed

Athey, Erin K; Leslie, Mayri Sagady; Briggs, Linda A; Park, Jeongyoung; Falk, Nancy L; Pericak, Arlene; El-Banna, Majeda M; Greene, Jessica

2016-06-01

Nurse practitioners (NPs) have reported aspects of their jobs that they are more and less satisfied with. However, few studies have examined the factors that predict overall job satisfaction. This study uses a large national sample to examine the extent to which autonomy and work setting predict job satisfaction. The 2012 National Sample Survey of Nurse Practitioners (n = 8311) was used to examine bivariate and multivariate relationships between work setting and three autonomy variables (independent billing practices, having one's NP skills fully utilized, and relationship with physician), and job satisfaction. NPs working in primary care reported the highest levels of autonomy across all three autonomy measures, while those working in hospital surgical settings reported the lowest levels. Autonomy, specifically feeling one's NP skills were fully utilized, was the factor most predictive of satisfaction. In multivariate analyses, those who strongly agreed their skills were being fully utilized had satisfaction scores almost one point higher than those who strongly disagreed. Work setting was only marginally related to job satisfaction. In order to attract and retain NPs in the future, healthcare organizations should ensure that NPs' skills are being fully utilized. ©2015 American Association of Nurse Practitioners.

Bill size variation in northern cardinals associated with anthropogenic drivers across North America.

PubMed

Miller, Colleen R; Latimer, Christopher E; Zuckerberg, Benjamin

2018-05-01

Allen's rule predicts that homeotherms inhabiting cooler climates will have smaller appendages, while those inhabiting warmer climates will have larger appendages relative to body size. Birds' bills tend to be larger at lower latitudes, but few studies have tested whether modern climate change and urbanization affect bill size. Our study explored whether bill size in a wide-ranging bird would be larger in warmer, drier regions and increase with rising temperatures. Furthermore, we predicted that bill size would be larger in densely populated areas, due to urban heat island effects and the higher concentration of supplementary foods. Using measurements from 605 museum specimens, we explored the effects of climate and housing density on northern cardinal bill size over an 85-year period across the Linnaean subspecies' range. We quantified the geographic relationships between bill surface area, housing density, and minimum temperature using linear mixed effect models and geographically weighted regression. We then tested whether bill surface area changed due to housing density and temperature in three subregions (Chicago, IL., Washington, D.C., and Ithaca, NY). Across North America, cardinals occupying drier regions had larger bills, a pattern strongest in males. This relationship was mediated by temperature such that birds in warm, dry areas had larger bills than those in cool, dry areas. Over time, female cardinals' bill size increased with warming temperatures in Washington, D.C., and Ithaca. Bill size was smaller in developed areas of Chicago, but larger in Washington, D.C., while there was no pattern in Ithaca, NY. We found that climate and urbanization were strongly associated with bill size for a wide-ranging bird. These biogeographic relationships were characterized by sex-specific differences, varying relationships with housing density, and geographic variability. It is likely that anthropogenic pressures will continue to influence species, potentially promoting microevolutionary changes over space and time.

48 CFR 42.704 - Billing rates.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Billing rates. 42.704... CONTRACT ADMINISTRATION AND AUDIT SERVICES Indirect Cost Rates 42.704 Billing rates. (a) The contracting... final indirect cost rates also shall be responsible for determining the billing rates. (b) The...

48 CFR 42.704 - Billing rates.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Billing rates. 42.704... CONTRACT ADMINISTRATION AND AUDIT SERVICES Indirect Cost Rates 42.704 Billing rates. (a) The contracting... final indirect cost rates also shall be responsible for determining the billing rates. (b) The...

48 CFR 42.704 - Billing rates.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Billing rates. 42.704... CONTRACT ADMINISTRATION AND AUDIT SERVICES Indirect Cost Rates 42.704 Billing rates. (a) The contracting... final indirect cost rates also shall be responsible for determining the billing rates. (b) The...

48 CFR 42.704 - Billing rates.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Billing rates. 42.704... CONTRACT ADMINISTRATION AND AUDIT SERVICES Indirect Cost Rates 42.704 Billing rates. (a) The contracting... final indirect cost rates also shall be responsible for determining the billing rates. (b) The...

Clinical Telemedicine Utilization in Ontario over the Ontario Telemedicine Network.

PubMed

O'Gorman, Laurel D; Hogenbirk, John C; Warry, Wayne

2016-06-01

Northern Ontario is a region in Canada with approximately 775,000 people in communities scattered across 803,000 km(2). The Ontario Telemedicine Network (OTN) facilitates access to medical care in areas that are often underserved. We assessed how OTN utilization differed throughout the province. We used OTN medical service utilization data collected through the Ontario Health Insurance Plan and provided by the Ministry of Health and Long Term Care. Using census subdivisions grouped by Northern and Southern Ontario as well as urban and rural areas, we calculated utilization rates per fiscal year and total from 2008/2009 to 2013/2014. We also used billing codes to calculate utilization by therapeutic area of care. There were 652,337 OTN patient visits in Ontario from 2008/2009 to 2013/2014. Median annual utilization rates per 1,000 people were higher in northern areas (rural, 52.0; urban, 32.1) than in southern areas (rural, 6.1; urban, 3.1). The majority of usage in Ontario was in mental health and addictions (61.8%). Utilization in other areas of care such as surgery, oncology, and internal medicine was highest in the rural north, whereas primary care use was highest in the urban south. Utilization was higher and therapeutic areas of care were more diverse in rural Northern Ontario than in other parts of the province. Utilization was also higher in urban Northern Ontario than in Southern Ontario. This suggests that telemedicine is being used to improve access to medical care services, especially in sparsely populated regions of the province.

Mapping "Trauma-Informed" Legislative Proposals in U.S. Congress.

PubMed

Purtle, Jonathan; Lewis, Michael

2017-11-01

Despite calls for translation of trauma-informed practice into public policy, no empirical research has investigated how the construct has been integrated into policy proposals. This policy mapping study identified and analyzed every bill introduced in US Congress that mentioned "trauma-informed" between 1973 and 2015. Forty-nine bills and 71 bill sections mentioned the construct. The number of trauma-informed bills introduced annually increased dramatically, from 0 in 2010 to 28 in 2015. Trauma-informed bill sections targeted a range of sectors, but disproportionally focused on youth (73.2%). Only three bills defined "trauma-informed." Implications within the context of a changing political environment are discussed.

A method and knowledge base for automated inference of patient problems from structured data in an electronic medical record

PubMed Central

Pang, Justine; Feblowitz, Joshua C; Maloney, Francine L; Wilcox, Allison R; Ramelson, Harley Z; Schneider, Louise I; Bates, David W

2011-01-01

Background Accurate knowledge of a patient's medical problems is critical for clinical decision making, quality measurement, research, billing and clinical decision support. Common structured sources of problem information include the patient problem list and billing data; however, these sources are often inaccurate or incomplete. Objective To develop and validate methods of automatically inferring patient problems from clinical and billing data, and to provide a knowledge base for inferring problems. Study design and methods We identified 17 target conditions and designed and validated a set of rules for identifying patient problems based on medications, laboratory results, billing codes, and vital signs. A panel of physicians provided input on a preliminary set of rules. Based on this input, we tested candidate rules on a sample of 100 000 patient records to assess their performance compared to gold standard manual chart review. The physician panel selected a final rule for each condition, which was validated on an independent sample of 100 000 records to assess its accuracy. Results Seventeen rules were developed for inferring patient problems. Analysis using a validation set of 100 000 randomly selected patients showed high sensitivity (range: 62.8–100.0%) and positive predictive value (range: 79.8–99.6%) for most rules. Overall, the inference rules performed better than using either the problem list or billing data alone. Conclusion We developed and validated a set of rules for inferring patient problems. These rules have a variety of applications, including clinical decision support, care improvement, augmentation of the problem list, and identification of patients for research cohorts. PMID:21613643

42 CFR 408.90 - Termination of group billing arrangement.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Termination of group billing arrangement. 408.90... SERVICES MEDICARE PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Direct Remittance: Group Payment § 408.90 Termination of group billing arrangement. (a) A group billing arrangement may be terminated...

42 CFR 408.90 - Termination of group billing arrangement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Termination of group billing arrangement. 408.90... SERVICES MEDICARE PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Direct Remittance: Group Payment § 408.90 Termination of group billing arrangement. (a) A group billing arrangement may be terminated...

42 CFR 408.90 - Termination of group billing arrangement.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Termination of group billing arrangement. 408.90... SERVICES MEDICARE PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Direct Remittance: Group Payment § 408.90 Termination of group billing arrangement. (a) A group billing arrangement may be terminated...

31 CFR 357.27 - Reinvestment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... AND BILLS HELD IN TREASURY/RESERVE AUTOMATED DEBT ENTRY SYSTEM (TRADES) AND LEGACY TREASURY DIRECT...) Treasury bills. A request by an owner for a single or successive reinvestment of a Treasury bill must be... the original bill, or by a subsequent transaction request received not less than ten (10) business...

31 CFR 357.27 - Reinvestment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... AND BILLS HELD IN TREASURY/RESERVE AUTOMATED DEBT ENTRY SYSTEM (TRADES) AND LEGACY TREASURY DIRECT...) Treasury bills. A request by an owner for a single or successive reinvestment of a Treasury bill must be... the original bill, or by a subsequent transaction request received not less than ten (10) business...

31 CFR 357.27 - Reinvestment.

Code of Federal Regulations, 2012 CFR

2012-07-01

... AND BILLS HELD IN TREASURY/RESERVE AUTOMATED DEBT ENTRY SYSTEM (TRADES) AND LEGACY TREASURY DIRECT...) Treasury bills. A request by an owner for a single or successive reinvestment of a Treasury bill must be... the original bill, or by a subsequent transaction request received not less than ten (10) business...

Report: EPA Should Bill Superfund Oversight Costs More Timely

EPA Pesticide Factsheets

Report #11-P-0697, September 22, 2011. Based on our audit of oversight billings for nine sites in Regions 1, 5, and 9, we found that Region 5 did not timely bill or did not bill approximately $8.6 million in oversight costs for two sites.

The evolution of the avian bill as a thermoregulatory organ.

PubMed

Tattersall, Glenn J; Arnaout, Bassel; Symonds, Matthew R E

2017-08-01

The avian bill is a textbook example of how evolution shapes morphology in response to changing environments. Bills of seed-specialist finches in particular have been the focus of intense study demonstrating how climatic fluctuations acting on food availability drive bill size and shape. The avian bill also plays an important but under-appreciated role in body temperature regulation, and therefore in energetics. Birds are endothermic and rely on numerous mechanisms for balancing internal heat production with biophysical constraints of the environment. The bill is highly vascularised and heat exchange with the environment can vary substantially, ranging from around 2% to as high as 400% of basal heat production in certain species. This heat exchange may impact how birds respond to heat stress, substitute for evaporative water loss at elevated temperatures or environments of altered water availability, or be an energetic liability at low environmental temperatures. As a result, in numerous taxa, there is evidence for a positive association between bill size and environmental temperatures, both within and among species. Therefore, bill size is both developmentally flexible and evolutionarily adaptive in response to temperature. Understanding the evolution of variation in bill size however, requires explanations of all potential mechanisms. The purpose of this review, therefore, is to promote a greater understanding of the role of temperature on shaping bill size over spatial gradients as well as developmental, seasonal, and evolutionary timescales. © 2016 Cambridge Philosophical Society.

Fatigue level estimation of monetary bills based on frequency band acoustic signals with feature selection by supervised SOM

NASA Astrophysics Data System (ADS)

Teranishi, Masaru; Omatu, Sigeru; Kosaka, Toshihisa

Fatigued monetary bills adversely affect the daily operation of automated teller machines (ATMs). In order to make the classification of fatigued bills more efficient, the development of an automatic fatigued monetary bill classification method is desirable. We propose a new method by which to estimate the fatigue level of monetary bills from the feature-selected frequency band acoustic energy pattern of banking machines. By using a supervised self-organizing map (SOM), we effectively estimate the fatigue level using only the feature-selected frequency band acoustic energy pattern. Furthermore, the feature-selected frequency band acoustic energy pattern improves the estimation accuracy of the fatigue level of monetary bills by adding frequency domain information to the acoustic energy pattern. The experimental results with real monetary bill samples reveal the effectiveness of the proposed method.

Developing a performance measurement approach to benefit/cost freight project prioritization.

DOT National Transportation Integrated Search

2014-10-01

Future reauthorizations of the federal transportation bill will require a comprehensive and quantitative analysis of the freight benefits : of proposed freight system projects. To prioritize public investments in freight systems and to insure conside...

Gulf of Mexico Economic Recovery and Job Impact Analysis Act of 2010

THOMAS, 111th Congress

Sen. Landrieu, Mary L. [D-LA

2010-06-29

Senate - 06/29/2010 Read twice and referred to the Committee on Small Business and Entrepreneurship. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Patients' success in negotiating out-of-network bills.

PubMed

Kyanko, Kelly A; Busch, Susan H

2016-10-01

Out-of-network (OON) care is one area where patients might be more likely to challenge their healthcare bills due to the high out-of-pocket costs and unexpected charges related to emergency care or hospital-affiliated providers. We aimed to determine whether, and under what circumstances, patients negotiate with either insurers or providers when services are billed OON and how often patients that do engage in negotiation are successful. Internet-based survey. We conducted a 2011 Internet survey on OON care on a nationally representative sample of privately insured adults (n = 721). We considered whether patients would be more likely to negotiate OON charges by demographic characteristics and under several scenarios: emergency visits, bills from hospital-affiliated OON providers at in-network hospitals, and balance bills. We found patients negotiated 19% of OON bills, were successful in lowering their costs 56% of the time, and were more likely to be successful negotiating with providers compared with insurers (63% vs 37%; P <.01). Men were more likely than women to be successful in lowering their costs (76% vs 50%; P <.05). OON bills for emergencies, providers at in-network hospitals, and with a balance bill were more likely to be negotiated, although bills from providers at in-network hospitals and with balance bills were less likely to be successfully negotiated. Patients had low rates of success in negotiating OON bills for emergency care and for OON providers at in-network hospitals. Policy makers aiming to protect patients under these scenarios should consider policies that allow for an easily accessible, formal, and unbiased mediation process.

Are anesthesia start and end times randomly distributed? The influence of electronic records.

PubMed

Deal, Litisha G; Nyland, Michael E; Gravenstein, Nikolaus; Tighe, Patrick

2014-06-01

To perform a frequency analysis of start minute digits (SMD) and end minute digits (EMD) taken from the electronic, computer-assisted, and manual anesthesia billing-record systems. Retrospective cross-sectional review. University medical center. This cross-sectional review was conducted on billing records from a single healthcare institution over a 15-month period. A total of 30,738 cases were analyzed. For each record, the start time and end time were recorded. Distributions of SMD and EMD were tested against the null hypothesis of a frequency distribution equivalently spread between zero and nine. SMD and EMD aggregate distributions each differed from equivalency (P < 0.0001). When stratified by type of anesthetic record, no differences were found between the recorded and expected equivalent distribution patterns for electronic anesthesia records for start minute (P < 0.98) or end minute (P < 0.55). Manual and computer-assisted records maintained nonequivalent distribution patterns for SMD and EMD (P < 0.0001 for each comparison). Comparison of cumulative distributions between SMD and EMD distributions suggested a significant difference between the two patterns (P < 0.0001). An electronic anesthesia record system, with automated time capture of events verified by the user, produces a more unified distribution of billing times than do more traditional methods of entering billing times. Copyright © 2014 Elsevier Inc. All rights reserved.

42 CFR 408.82 - Conditions for group billing.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Conditions for group billing. 408.82 Section 408.82... PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Direct Remittance: Group Payment § 408.82 Conditions for group billing. CMS agrees to a group billing arrangement only if the following conditions are met...

42 CFR 408.82 - Conditions for group billing.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Conditions for group billing. 408.82 Section 408.82... PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Direct Remittance: Group Payment § 408.82 Conditions for group billing. CMS agrees to a group billing arrangement only if the following conditions are met...

42 CFR 408.82 - Conditions for group billing.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Conditions for group billing. 408.82 Section 408.82... PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Direct Remittance: Group Payment § 408.82 Conditions for group billing. CMS agrees to a group billing arrangement only if the following conditions are met...

42 CFR 408.82 - Conditions for group billing.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Conditions for group billing. 408.82 Section 408.82... PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Direct Remittance: Group Payment § 408.82 Conditions for group billing. CMS agrees to a group billing arrangement only if the following conditions are met...

44 CFR 354.6 - Billing and payment of fees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... EMERGENCY PREPAREDNESS PROGRAM § 354.6 Billing and payment of fees. (a) Electronic billing and payment. We will deposit all funds collected under this part to the Radiological Emergency Preparedness Fund as... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Billing and payment of fees...

47 CFR 64.2401 - Truth-in-Billing Requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... relationships with the subscriber that will result in periodic charges on the subscriber's bill, unless the... content so that customers can accurately assess that the services for which they are billed correspond to... customer, and must clearly and conspicuously identify on the bill those charges for which non-payment will...

18 CFR 420.33 - Payment of bills.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Payment of bills. 420.33 Section 420.33 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL BASIN REGULATIONS-WATER SUPPLY CHARGES Entitlement; Measurement; Billing § 420.33 Payment of bills...

40 CFR 81.88 - Billings Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Quality Control Regions § 81.88 Billings Intrastate Air Quality Control Region. The Metropolitan Billings Intrastate Air Quality Control Region (Montana) has been renamed the Billings Intrastate Air Quality Control... to by Montana authorities as follows: Sec. 481.168Great Falls Intrastate Air Quality Control Region...

40 CFR 81.88 - Billings Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Quality Control Regions § 81.88 Billings Intrastate Air Quality Control Region. The Metropolitan Billings Intrastate Air Quality Control Region (Montana) has been renamed the Billings Intrastate Air Quality Control... to by Montana authorities as follows: Sec. 481.168Great Falls Intrastate Air Quality Control Region...

42 CFR 408.82 - Conditions for group billing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Conditions for group billing. 408.82 Section 408.82... PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Direct Remittance: Group Payment § 408.82 Conditions for group billing. CMS agrees to a group billing arrangement only if the following conditions are met...

48 CFR 942.704 - Billing rates.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Billing rates. 942.704... ADMINISTRATION AND AUDIT SERVICES Indirect Cost Rates 942.704 Billing rates. (b) When the contracting officer or auditor responsible for establishing billing rates, in accordance with 48 CFR 42.704, has not established...

48 CFR 942.704 - Billing rates.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Billing rates. 942.704... ADMINISTRATION AND AUDIT SERVICES Indirect Cost Rates 942.704 Billing rates. (b) When the contracting officer or auditor responsible for establishing billing rates, in accordance with 48 CFR 42.704, has not established...

48 CFR 942.704 - Billing rates.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Billing rates. 942.704... ADMINISTRATION AND AUDIT SERVICES Indirect Cost Rates 942.704 Billing rates. (b) When the contracting officer or auditor responsible for establishing billing rates, in accordance with 48 CFR 42.704, has not established...

46 CFR 169.813 - Station bills.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Station bills. 169.813 Section 169.813 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Operations § 169.813 Station bills. (a) A station bill (muster list) shall be prepared and signed by the master of...

46 CFR 169.813 - Station bills.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 7 2011-10-01 2011-10-01 false Station bills. 169.813 Section 169.813 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Operations § 169.813 Station bills. (a) A station bill (muster list) shall be prepared and signed by the master of...

41 CFR 109-40.5004 - Government bills of lading.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false Government bills of... Government bills of lading. In those instances where DOE cost-type contractors are authorized to use Government bills of lading, specific employees of cost-type contractors will be authorized by the contracting...

41 CFR 109-40.5004 - Government bills of lading.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Government bills of... Government bills of lading. In those instances where DOE cost-type contractors are authorized to use Government bills of lading, specific employees of cost-type contractors will be authorized by the contracting...

31 CFR 309.12 - Relief on account of loss, theft or destruction, etc.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., theft, destruction, mutilation or defacement of Treasury bills may be given only under the authority of... bills, immediate advice, with a full description of the bill or bills involved, should be sent to the... be given, instructions and necessary blank forms will be furnished. ...

31 CFR 309.12 - Relief on account of loss, theft or destruction, etc.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., theft, destruction, mutilation or defacement of Treasury bills may be given only under the authority of... bills, immediate advice, with a full description of the bill or bills involved, should be sent to the... be given, instructions and necessary blank forms will be furnished. ...

47 CFR 64.2401 - Truth-in-Billing Requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... for non-telecommunications services must place those charges in a distinct section of the bill... subtotaled. These separate subtotals for carrier and non-carrier charges also must be clearly and conspicuously displayed along with the bill total on the payment page of a paper bill or equivalent location on...

31 CFR 357.27 - Reinvestment.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., NOTES AND BILLS HELD IN TREASURY/RESERVE AUTOMATED DEBT ENTRY SYSTEM (TRADES) AND LEGACY TREASURY DIRECT...) Treasury bills. A request by an owner for a single or successive reinvestment of a Treasury bill must be... the original bill, or by a subsequent transaction request received not less than ten (10) business...

33 CFR 146.130 - Station bill.

Code of Federal Regulations, 2012 CFR

2012-07-01

... necessary for the proper handling of other emergencies. (c) The station bill shall contain the various... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Station bill. 146.130 Section 146... CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.130 Station bill. (a) The person in charge...

33 CFR 146.130 - Station bill.

Code of Federal Regulations, 2013 CFR

2013-07-01

... necessary for the proper handling of other emergencies. (c) The station bill shall contain the various... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Station bill. 146.130 Section 146... CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.130 Station bill. (a) The person in charge...

33 CFR 146.130 - Station bill.

Code of Federal Regulations, 2014 CFR

2014-07-01

... necessary for the proper handling of other emergencies. (c) The station bill shall contain the various... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Station bill. 146.130 Section 146... CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.130 Station bill. (a) The person in charge...

The Costs of Waiting: Implications of the Timing of Palliative Care Consultation among a Cohort of Decedents at a Comprehensive Cancer Center.

PubMed

Scibetta, Colin; Kerr, Kathleen; Mcguire, Joseph; Rabow, Michael W

2016-01-01

Palliative care is recommended along with oncologic care for patients with advanced cancer. However, there are limited data about how the timing of palliative care affects quality and costs. Comparison of health care utilization and care quality for patients with cancer who died having received early versus late palliative care. Analysis of cancer registry, administrative, and billing databases. Patients with cancer who died having received specialty palliative care consultation. Comparing early (more than 90 days prior to death) versus late (less than 90 days prior to death) palliative care, outcome measures included rates of health care utilization and health care costs. Among 922 decedents, 297 (32.2%) had palliative care referrals, with 93 (10.1%) receiving early referrals and 204 (22.1%) late referrals. Compared to patients receiving late palliative care, early palliative care patients had lower rates of inpatient (33% versus 66%, p < 0.01), ICU (5% versus 20%, p < 0.01), and ED utilization (34% versus 54%, p = 0.04) in the last month of life. Direct costs of inpatient care in the last 6 months of life for patients with early palliative care were lower compared to late palliative care ($19,067 versus $25,754, p < 0.01), while direct outpatient costs were similar ($13,040 versus $11,549, p = 0.85). Early palliative care was predominantly delivered in the outpatient setting (84%) while late palliative care was mostly delivered in the hospital (82%). Early palliative care is associated with less intensive medical care, improved quality outcomes, and cost savings at the end of life for patients with cancer. Despite recommendations that early palliative care be offered to all patients with metastatic cancer, palliative care services remain underutilized.

Cost-utility analysis of the inhaled steroids available in a developing country for the management of pediatric patients with persistent asthma.

PubMed

Rodríguez-Martínez, Carlos E; Sossa-Briceño, Mónica P; Castro-Rodriguez, Jose A

2013-05-01

The choice among the different treatments available can have a great impact on the costs of asthma, The objective of this study was to estimate the incremental cost-utility ratio of three inhaled corticosteroids (ICs): budesonide (BUD), fluticasone propionate (FP), and ciclesonide, compared to beclomethasone dipropionate (BDP) (the only IC included in the Compulsory Health Insurance Plan of Colombia), A Markov-type model was developed to estimate costs and health outcomes of a simulated cohort of patients less than 18 years of age with persistent asthma treated over a 12-month period. Effectiveness parameters were obtained from a systematic review of the literature. Cost data were obtained from a hospital´s bills and from the national manual of drug prices. The study assumed the perspective of the national healthcare in Colombia. The main outcome was the variable "quality-adjusted life years" (QALY), RESULTS: While treatment with BDP was associated with the lowest cost (£106.16 average cost per patient during 12 months), treatment with FP resulted in the greatest gain in QUALYs (0.9325 QALYs). FP was associated with a greater gain in QALYs compared to BUD and ciclesonide (0.9325 vs. 0.8999 and 0.9051 QALYs, respectively) at lower costs (£231.19 vs. £309.27 and £270.15, respectively), thus leading to dominance. The incremental cost-utility ratio of FP compared to BDP was £19,835.28 per QALY, CONCLUSIONS: BDP is the most cost-effective therapy for treating pediatric patients with persistent asthma when willingness to pay (WTP) is less than £21,129.22/QALY, otherwise, FP is the most cost-effective therapy.

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

PubMed Central

Fahs, M C

1992-01-01

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

Two Dimensional Viscoelastic Stress Analysis of a Prototypical JIMO Turbine Wheel

NASA Technical Reports Server (NTRS)

Gayda, John; Gabb, Timothy

2005-01-01

The designers of the Jupiter Icy Moons Orbiter (JIMO) are investigating the potential of nuclear powered-electric propulsion technology to provide deep space propulsion. In one design scenario a closed-Brayton-cycle power converter is used to convert thermal energy from a nuclear reactor to electrical power for the spacecraft utilizing an inert gas as the working fluid to run a turboalternator as described in L.S. Mason, "A Power Conversion for the Jupiter Icy Moons Orbiter," Journal of Propulsion and Power, vol. 20, no. 5, pp. 902-910. A key component in the turboalternator is the radial flow turbine wheel which may be fabricated from a cast superalloy. This turbine wheel is envisioned to run continuously over the life of the mission, which is anticipated to be about ten years. This scenario places unusual material requirements on the turbine wheel. Unlike the case of terrestrial turbine engines, fatigue, associated with start-up and shut-down of the engine, foreign-object damage, and corrosion issues are insignificant and thus creep issues become dominate. The purpose of this paper is to present estimates for creep growth of a prototypical JIMO turbine wheel over a ten year life. Since an actual design and bill of materials does not exist, the results presented in this paper are based on preliminary concepts which are likely to evolve over time. For this reason, as well as computational efficiency, a simplified 2-D, in lieu of a 3-D, viscoelastic, finite element model of a prototypical turbine wheel will be utilized employing material properties for the cast superalloy MAR-M247. The creep data employed in this analysis are based on preliminary data being generated at NASA Glenn Research Center.

US general aviation: The ingredients for a renaissance. A vision and technology strategy for US industry, NASA, FAA, universities

NASA Technical Reports Server (NTRS)

Holmes, Bruce

1993-01-01

General aviation today is a vital component in the nation's air transportation system. It is threatened for survival but has enormous potential for expansion in utility and use. This potential for expansion is fueled by new satellite navigation and communication systems, small computers, flat panel displays, and advanced aerodynamics, materials and manufacturing methods, and propulsion technologies which create opportunities for new levels of environmental and economic acceptability. Expanded general aviation utility and use could have a large impact on the nation's jobs, commerce, industry, airspace capacity, trade balance, and quality of life. This paper presents, in viewgraph form, a general overview of U.S. general aviation. Topics covered include general aviation shipment and billings; airport and general aviation infrastructure; cockpit, airplane, and airspace technologies; market demand; air traffic operations and aviation accidents; fuel efficiency comparisons; and general aviation goals and strategy.

Mobile phones and social structures: an exploration of a closed user group in rural Ghana

PubMed Central

2013-01-01

Background In the Millennium Villages Project site of Bonsaaso, Ghana, the Health Team is using a mobile phone closed user group to place calls amongst one another at no cost. Methods In order to determine the utilization and acceptability of the closed user group amongst users, social network analysis and qualitative methods were used. Key informants were identified and interviewed. The key informants also kept prospective call journals. Billing statements and de-identified call data from the closed user group were used to generate data for analyzing the social structure revealed by the network traffic. Results The majority of communication within the closed user group was personal and not for professional purposes. The members of the CUG felt that the group improved their efficiency at work. Conclusions The methods used present an interesting way to investigate the social structure surrounding communication via mobile phones. In addition, the benefits identified from the exploration of this closed user group make a case for supporting mobile phone closed user groups amongst professional groups. PMID:24007331

The big bang? An eventful year in workers' compensation.

PubMed

Guidotti, Tee L

2006-01-01

Workers' compensation in the past two years has been dominated by events in California, which have been so fundamental as to merit the term big bang. Passage of Senate Bill 899 has led to a comprehensive program of reform in access to medical care, access to rehabilitation services, temporary and permanent disability, evidence-based management, dispute resolution, and system innovation. Two noteworthy developments thus arose: a new requirement for apportionment by cause in causation analysis, and the adoption of evidence-based criteria for impairment assessment, treatment guidelines, and, soon, utilization review. Elsewhere in the United States, changes were modest, but extensive legislative activity in Texas suggests that Texas will be next to make major changes. In Canada, the Workers' Compensation Board of British Columbia has adopted an ambitious strategic initiative, and there is a Canadawide movement to establish presumption for certain diseases in firefighters. Suggestions for future directions include an increased emphasis on prevention, integration of programs, worker participation, enhancing the expertise of health care professionals, evidence-based management, process evaluation, and opportunities for innovation.

A study of drop-off recycling in Norman, Oklahoma: Behavior of recyclers and nonrecyclers

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

Sims, J.L.; Everett, J.W.

The reality of growing negative public opinion to new landfills prompted a newfound popularity for recycling programs as an alternative to traditional waste management in municipalities. The purpose of this research is to examine the behavioral and attitudinal differences between recyclers and nonrecyclers. These differences were tested statistically based on recycling behavior data gathered through two independent questionnaire surveys, one administered through utility bill statements, the other administered directly by the first author. Data were collected on: contact with the recycling organization, demographics, participation, convenience, incentives, ideological agreement, and assessment rationale. Seven hypotheses were tested, addressing most aspects of themore » Environmental Collective Action model (ECA), first proposed by the second author in 1994. The surveys were administered to City of Norman, Oklahoma residents. Norman operates several drop-off centers within the city limits. The results of the analysis indicate that individuals do make the decision to participate based on the principles outlined in the model of participation. All seven hypotheses are supported by the data in both surveys.« less

Clinical laboratory billing: superfluous requirements without justification?

PubMed

Stadler, Stephen

2004-01-01

Congress occasionally passes new laws that affect how clinical laboratories handle test orders from physicians and, subsequently, process the billing for tests. Once a bill is signed into law, it is forwarded to administrative agencies, which draft regulations and administrative procedures, under which the intentions of Congress are carried out. In the case of laboratory test ordering and billing, the Centers for Medicare and Medicaid Services (CMS) has the greatest influence over how these regulations and procedures are defined. Unfortunately, in many cases, billing rules have been promulgated in ways that create the need for hospitals and commercial laboratories to expend huge sums of money to bill within the confines of the administrative rules; cause clinical laboratories to suffer from omissions and mistakes of other parties who are part of the patient care process but are not accountable for the billing information they provide to laboratories; and, frankly, in some respects, simply defy common sense.

Clinical integration of billing for a pediatric nephrology and transplant program.

PubMed

Tietjen, Andrea L; Orsini, Jenoveva; Mulgaonkar, Shamkant; Morgan, Debbie

2003-09-01

To develop and implement a billing process that fully integrates all activities of a pediatric nephrology and transplant program, by facilitating and coordinating data from patients, physicians, hospitals, and third-party billing services to maximize revenues. Financial operations were analyzed via a randomized audit of patient charts that focused on office procedures and revenue collection. Results based on monthly reports documenting revenue received and outstanding, procedures billed, and patient registration accuracy. The combination of improvements in patient registration, chart documentation, new billing sheets with procedure and diagnosis codes, physician in-service education, upgraded charges, and the recredentialing of all practice physicians realized an increase in revenue collections from 18% in 2000 to 89% in 2001. The need to integrate and coordinate information is vital for both billing accuracy and revenue collections. Integration of clinical services and billing procedures has maximized performance, profitability, and accuracy while decreasing administrative time and costs.

20 CFR 30.701 - How are medical bills to be submitted?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false How are medical bills to be submitted? 30.701... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Information for Medical Providers Medical Records and Bills § 30.701 How are medical bills to be submitted? (a) All charges for...

20 CFR 30.701 - How are medical bills to be submitted?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true How are medical bills to be submitted? 30.701... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Information for Medical Providers Medical Records and Bills § 30.701 How are medical bills to be submitted? (a) All charges for...

20 CFR 30.701 - How are medical bills to be submitted?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false How are medical bills to be submitted? 30.701... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Information for Medical Providers Medical Records and Bills § 30.701 How are medical bills to be submitted? (a) All charges for...

20 CFR 30.701 - How are medical bills to be submitted?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true How are medical bills to be submitted? 30.701... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Information for Medical Providers Medical Records and Bills § 30.701 How are medical bills to be submitted? (a) All charges for...

Fixed-Rate Tuition Plans: A Survey in Response to Senate Bill 806

ERIC Educational Resources Information Center

State Council of Higher Education for Virginia, 2015

2015-01-01

Legislation introduced in 2015, including Senate Bill 806, sought to amend the "Code of Virginia" regarding fixed four-year tuition and other costs. Eventually, Senate Bill 1183 was incorporated into Senate Bill 806; the substitute amendment directed the board of visitors of each four-year public institution with an in-state…

76 FR 74017 - Empowering Consumers to Prevent and Detect Billing for Unauthorized Charges (“Cramming...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-30

... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 64 [CG Docket Nos. 11-116 and 09-158; CC Docket No. 98-170; FCC 11-106; DA 11-1860] Empowering Consumers to Prevent and Detect Billing for Unauthorized Charges (``Cramming''); Consumer Information and Disclosure; Truth-in-Billing and Billing Format AGENCY...

47 CFR 64.1201 - Restrictions on billing name and address disclosure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Carrier Validation and Billing Information for Joint Use Calling Cards, CC Docket No. 91-115, FCC 93-254... provider. (4) The term bulk basis means billing name and address information for all the local exchange... billing name and address information to any party other than a telecommunications service provider or an...

75 FR 15456 - Notice of Availability for the Signal Peak Energy, LLC, Federal Coal Lease Application...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-29

... James M. Sparks, Manager, Billings Field Office, 5001 Southgate Drive, Billings, Montana 59101-4669... CONTACT: Craig Drake, Assistant Manager, Billings Field Office, 5001 Southgate Drive, Billings, Montana... Application MTM 97988. DATES: The public hearing will be held in the BLM Montana State Office's main...

41 CFR 102-118.45 - How does a transportation service provider (TSP) bill my agency for transportation and...

Code of Federal Regulations, 2010 CFR

2010-07-01

... provider (TSP) bill my agency for transportation and transportation services? The manner in which your agency orders transportation and transportation services determines the manner in which a TSP bills for service. This is shown in the following table: Transportation Service Provider Billing (a) Ordering method...

19 CFR 24.3 - Bills and accounts; receipts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Bills and accounts; receipts. 24.3 Section 24.3... TREASURY CUSTOMS FINANCIAL AND ACCOUNTING PROCEDURE § 24.3 Bills and accounts; receipts. (a) Any bill or... document filed by the payer and the payer's cancelled check shall constitute evidence of payment. (c) A...

19 CFR 24.3 - Bills and accounts; receipts.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 1 2012-04-01 2012-04-01 false Bills and accounts; receipts. 24.3 Section 24.3... TREASURY CUSTOMS FINANCIAL AND ACCOUNTING PROCEDURE § 24.3 Bills and accounts; receipts. (a) Any bill or... document filed by the payer and the payer's cancelled check shall constitute evidence of payment. (c) A...

19 CFR 24.3 - Bills and accounts; receipts.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 1 2013-04-01 2013-04-01 false Bills and accounts; receipts. 24.3 Section 24.3... TREASURY CUSTOMS FINANCIAL AND ACCOUNTING PROCEDURE § 24.3 Bills and accounts; receipts. (a) Any bill or... document filed by the payer and the payer's cancelled check shall constitute evidence of payment. (c) A...

19 CFR 24.3 - Bills and accounts; receipts.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 1 2014-04-01 2014-04-01 false Bills and accounts; receipts. 24.3 Section 24.3... TREASURY CUSTOMS FINANCIAL AND ACCOUNTING PROCEDURE § 24.3 Bills and accounts; receipts. (a) Any bill or... document filed by the payer and the payer's cancelled check shall constitute evidence of payment. (c) A...

19 CFR 24.3 - Bills and accounts; receipts.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 1 2011-04-01 2011-04-01 false Bills and accounts; receipts. 24.3 Section 24.3... TREASURY CUSTOMS FINANCIAL AND ACCOUNTING PROCEDURE § 24.3 Bills and accounts; receipts. (a) Any bill or... document filed by the payer and the payer's cancelled check shall constitute evidence of payment. (c) A...

20 CFR 30.701 - How are medical bills to be submitted?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false How are medical bills to be submitted? 30.701... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Information for Medical Providers Medical Records and Bills § 30.701 How are medical bills to be submitted? (a) All charges for...

Minnesota State Colleges and Universities '99 Session: Mandates and Curiosities.

ERIC Educational Resources Information Center

Minnesota State Colleges and Universities System, St. Paul.

This publication highlights and explains relevant Minnesota legislative developments affecting higher education. For each bill, there is a summary provided in plain English, followed by copies of related portions of the legislation. The bills presented are: (1) Higher Education Omnibus Funding Bill (H.F. 2380); (2) Bonding Omnibus Bill (H.F.…

A cohort cost analysis of lumbar laminectomy--current trends in surgeon and hospital fees distribution.

PubMed

Molina, Camilo A; Zadnik, Patricia L; Gokaslan, Ziya L; Witham, Timothy F; Bydon, Ali; Wolinsky, Jean-Paul; Sciubba, Daniel M

2013-11-01

Spine-related health-care expenditures accounted for $86 billion dollars in 2005, a 65% increase from 1997. However, when adjusting for inflation, surgeons have seen decreased reimbursement rates over the last decade. To assess contribution of surgeon fees to overall procedure cost, we reviewed the charges and reimbursements for a noninstrumented lumbar laminectomy and compared the amounts reimbursed to the hospital and to the surgeon at a major academic institution. Retrospective review of costs associated with lumbar laminectomies. Seventy-seven patients undergoing lumbar laminectomy for spinal stenosis throughout an 18-month period at a single academic medical center were included in this study. Cost and number of laminectomy levels. The reimbursement schedule of six academic spine surgeons was collected over 18 months for performed noninstrumented lumbar laminectomy procedures. Bills and collections by the hospital and surgeon professional fees were comparatively analyzed and substratified by number of laminectomy levels and patient insurance status. Unpaired two-sample Student t test was used for analysis of significant differences. During an 18-month period, patients underwent a lumbar laminectomy involving on average three levels and stayed in the hospital on average 3.5 days. Complications were uncommon (13%). Average professional fee billing for the surgeon was $6,889±$2,882, and collection was $1,848±$1,433 (28% overall, 30% for private insurance, and 23% for Medicare/Medicaid insurance). Average hospital billing for the inpatient hospital stay minus professional fees from the surgeon was $14,766±$7,729, and average collection on such bills was $13,391±$7,256 (92% overall, 91% for private insurance, and 85% for Medicare/Medicaid insurance). Based on this analysis, the proportion of overall costs allocated to professional fees for a noninstrumented lumbar laminectomy is small, whereas those allocated to hospital costs are far greater. These findings suggest that the current focus on decreasing physician reimbursement as the principal cost saving strategy will lead to minimal reimbursement for surgeons without a substantial drop in the overall cost of procedures performed. Copyright © 2013 Elsevier Inc. All rights reserved.

Evolution of sexual dimorphism in bill size and shape of hermit hummingbirds (Phaethornithinae): a role for ecological causation

PubMed Central

Temeles, Ethan J.; Miller, Jill S.; Rifkin, Joanna L.

2010-01-01

Unambiguous examples of ecological causation of sexual dimorphism are rare, and the best evidence involves sexual differences in trophic morphology. We show that moderate female-biased sexual dimorphism in bill curvature is the ancestral condition in hermit hummingbirds (Phaethornithinae), and that it is greatly amplified in species such as Glaucis hirsutus and Phaethornis guy, where bills of females are 60 per cent more curved than bills of males. In contrast, bill curvature dimorphism is lost or reduced in a lineage of short-billed hermit species and in specialist Eutoxeres sicklebill hermits. In the hermits, males tend to be larger than females in the majority of species, although size dimorphism is typically small. Consistent with earlier studies of hummingbird feeding performance, both raw regressions of traits and phylogenetic independent contrasts supported the prediction that dimorphism in bill curvature of hermits is associated with longer bills. Some evidence indicates that differences between sexes of hermit hummingbirds are associated with differences in the use of food plants. We suggest that some hermit hummingbirds provide model organisms for studies of ecological causation of sexual dimorphism because their sexual dimorphism in bill curvature provides a diagnostic clue for the food plants that need to be monitored for studies of sexual differences in resource use. PMID:20194168

Community College Campus Carry Policy Analysis

ERIC Educational Resources Information Center

Alvarado, Joel; Toppin, Sheila

2017-01-01

This study provides a policy network analysis on the implications of HB 792 and HB 280 at urban two-year open campuses, with specific attention to Georgia Piedmont Technical College (GPTC), a unit of the Technical College System of Georgia (TCSG). Georgia state legislators passed House Bills 792 and 280, which authorized any person 18 years of age…

Social Studies and the Social Order: Telling Stories of Resistance

ERIC Educational Resources Information Center

McKnight, Douglas; Chandler, Prentice

2009-01-01

The social studies profession has always been at its weakest in dealing with the analysis of racism and class (Ladson-Billings, 2003; Marshall, 2001), and the new technocratic atmosphere and discourse generated by No Child Left Behind (NCLB) will serve to make such analysis completely absent, despite the rhetoric of the National Council of the…