The Relationship Between Hospital Value-Based Purchasing Program Scores and Hospital Bond Ratings.

PubMed

Rangnekar, Anooja; Johnson, Tricia; Garman, Andrew; O'Neil, Patricia

2015-01-01

Tax-exempt hospitals and health systems often borrow long-term debt to fund capital investments. Lenders use bond ratings as a standard metric to assess whether to lend funds to a hospital. Credit rating agencies have historically relied on financial performance measures and a hospital's ability to service debt obligations to determine bond ratings. With the growth in pay-for-performance-based reimbursement models, rating agencies are expanding their hospital bond rating criteria to include hospital utilization and value-based purchasing (VBP) measures. In this study, we evaluated the relationship between the Hospital VBP domains--Clinical Process of Care, Patient Experience of Care, Outcome, and Medicare Spending per Beneficiary (MSPB)--and hospital bond ratings. Given the historical focus on financial performance, we hypothesized that hospital bond ratings are not associated with any of the Hospital VBP domains. This was a retrospective, cross-sectional study of all hospitals that were rated by Moody's for fiscal year 2012 and participated in the Centers for Medicare & Medicaid Services' VBP program as of January 2014 (N = 285). Of the 285 hospitals in the study, 15% had been assigned a bond rating of Aa, and 46% had been assigned an A rating. Using a binary logistic regression model, we found an association between MSPB only and bond ratings, after controlling for other VBP and financial performance scores; however, MSPB did not improve the overall predictive accuracy of the model. Inclusion of VBP scores in the methodology used to determine hospital bond ratings is likely to affect hospital bond ratings in the near term.

Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities (SNFs) for FY 2016, SNF Value-Based Purchasing Program, SNF Quality Reporting Program, and Staffing Data Collection. Final Rule.

PubMed

2015-08-04

This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2016. In addition, it specifies a SNF all-cause all-condition hospital readmission measure, as well as adopts that measure for a new SNF Value-Based Purchasing (VBP) Program, and includes a discussion of SNF VBP Program policies we are considering for future rulemaking to promote higher quality and more efficient health care for Medicare beneficiaries. Additionally, this final rule will implement a new quality reporting program for SNFs as specified in the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). It also amends the requirements that a long-term care (LTC) facility must meet to qualify to participate as a skilled nursing facility (SNF) in the Medicare program, or a nursing facility (NF) in the Medicaid program, by establishing requirements that implement the provision in the Affordable Care Act regarding the submission of staffing information based on payroll data.

Value-based purchasing of medical devices.

PubMed

Obremskey, William T; Dail, Teresa; Jahangir, A Alex

2012-04-01

Health care in the United States is known for its continued innovation and production of new devices and techniques. While the intention of these devices is to improve the delivery and outcome of patient care, they do not always achieve this goal. As new technologies enter the market, hospitals and physicians must determine which of these new devices to incorporate into practice, and it is important these devices bring value to patient care. We provide a model of a physician-engaged process to decrease cost and increase review of physician preference items. We describe the challenges, implementation, and outcomes of cost reduction and product stabilization of a value-based process for purchasing medical devices at a major academic medical center. We implemented a physician-driven committee that standardized and utilized evidence-based, clinically sound, and financially responsible methods for introducing or consolidating new supplies, devices, and technology for patient care. This committee worked with institutional finance and administrative leaders to accomplish its goals. Utilizing this physician-driven committee, we provided access to new products, standardized some products, decreased costs of physician preference items 11% to 26% across service lines, and achieved savings of greater than $8 million per year. The implementation of a facility-based technology assessment committee that critically evaluates new technology can decrease hospital costs on implants and standardize some product lines.

Executive summary: value-based purchasing and technology assessment in orthopaedics.

PubMed

Ranawat, Anil S; Nunley, Ryan; Bozic, Kevin

2009-10-01

As US healthcare expenditures continue to rise, reform has shifted from spending controls to value-based purchasing. This paradigm shift is a drastic change on how health care is delivered and reimbursed. For the shift to work, policymakers and physicians must restructure the present system by using initiatives such as process reengineering, insurance and payment reforms, physician reeducation, data and quality measurements, and technology assessments. Value, as defined in economic terms, will be a critical concept in modern healthcare reform. We summarize the conclusions of this ABJS Carl T. Brighton Workshop on healthcare reform.

The current state of nursing performance measurement, public reporting, and value-based purchasing.

PubMed

Kurtzman, Ellen T; Dawson, Ellen M; Johnson, Jean E

2008-08-01

Over the last decade, there has been a substantial investment in holding health care providers accountable for the quality of care provided in hospitals and other settings of care. This investment has been realized through the proliferation of national policies that address performance measurement, public reporting, and value-based purchasing. Although nurses represent the largest segment of the health care workforce and despite their acknowledged role in patient safety and health care outcomes, they have been largely absent from policy setting in these areas. This article provides an analysis of current nursing performance measurement and public reporting initiatives and presents a summary of emerging trends in value-based purchasing, with an emphasis on activities in the United States. The article synthesizes issues of relevance to advancing the current climate for nursing quality and concludes with key issues for future policy setting.

An advanced look at surgical performance under Medicare's hospital-inpatient value-based purchasing program: who is winning and who is losing?

PubMed

Dupree, James M; Neimeyer, Jennifer; McHugh, Megan

2014-01-01

The Centers for Medicare and Medicaid Services (CMS) is beginning to shift from paying providers based on volume to more explicitly rewarding quality of care. The hospital value-based purchasing (VBP) program is the first in a series of mandatory programs to financially reward and penalize US hospitals based on quality measure performance. Our objective was to identify the characteristics of hospitals that perform well (and those that perform poorly) on the surgical measures in CMS' hospital VBP program. Using 2008 to 2010 performance data from CMS' Hospital Compare website and the 2009 American Hospital Association annual survey, we examined surgical measure performance for all acute care general hospitals in the US. Outcomes were determined by a composite surgical performance score indicating the percentage of eligible surgical performance points that a hospital received. There were 3,030 hospitals included in our study. Composite surgical performance scores were 15.6% lower at public hospitals than at for-profit hospitals (p < 0.01). Additionally, there were significant differences in the routes by which hospitals achieved points, with smaller hospitals, for-profit hospitals, Magnet hospitals, and NSQIP hospitals all more likely to obtain points via the achievement route. The results of our study indicate that public hospitals perform worse on the surgical measures in the hospital VBP program. This study raises important questions about the impact that this new, mandatory program will have on public hospitals, which serve an important safety-net role and appear to be disadvantaged in the hospital VBP program. This issue should continue to be investigated as these mandatory quality programs are updated in future years. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Impact of a Rewards-Based Incentive Program on Promoting Fruit and Vegetable Purchases

PubMed Central

Phipps, Etienne J.; Braitman, Leonard E.; Stites, Shana D.; Singletary, S. Brook; Wallace, Samantha L.; Hunt, Lacy; Axelrod, Saul; Glanz, Karen; Uplinger, Nadine

2015-01-01

Objectives. We assessed the impact of a rewards-based incentive program on fruit and vegetable purchases by low-income families. Methods. We conducted a 4-phase prospective cohort study with randomized intervention and wait-listed control groups in Philadelphia, Pennsylvania, in December 2010 through October 2011. The intervention provided a rebate of 50% of the dollar amount spent on fresh or frozen fruit and vegetables, reduced to 25% during a tapering phase, then eliminated. Primary outcome measures were number of servings of fruit and of vegetables purchased per week. Results. Households assigned to the intervention purchased an average of 8 (95% confidence interval [CI] = 1.5, 16.9) more servings of vegetables and 2.5 (95% CI = 0.3, 9.5) more servings of fruit per week than did control households. In longitudinal price-adjusted analyses, when the incentive was reduced and then discontinued, the amounts purchased were similar to baseline. Conclusions. Investigation of the financial costs and potential benefits of incentive programs to supermarkets, government agencies, and other stakeholders is needed to identify sustainable interventions. PMID:24625144

Hospitals Known for Nursing Excellence Perform Better on Value Based Purchasing Measures

PubMed Central

Lasater, Karen B.; Germack, Hayley D.; Small, Dylan S.; McHugh, Matthew D.

2018-01-01

It is well-established that hospitals recognized for good nursing care – Magnet hospitals – are associated with better patient outcomes. Less is known about how Magnet hospitals compare to non-Magnets on quality measures linked to Medicare reimbursement. The purpose of this study was to determine how Magnet hospitals perform compared to matched non-Magnet hospitals on Hospital Value Based Purchasing (VBP) measures. A cross-sectional analysis of three linked data sources was performed. The sample included 3,021 non-federal acute care hospitals participating in the VBP program (323 Magnets; 2,698 non-Magnets). Propensity score matching was used to match Magnet and non-Magnet hospitals with similar hospital characteristics. After matching, linear and logistic regression models were used to examine the relationship between Magnet status and VBP performance. After matching and adjusting for hospital characteristics, Magnet recognition predicted higher scores on Total Performance (Regression Coefficient [RC] = 1.66, p < 0.05), Clinical Processes (RC = 3.85; p < 0.01), and Patient Experience (RC = 6.33; p < 0.001). The relationships between Magnet recognition and the Outcome and Efficiency domains were not statistically significant. Magnet hospitals known for nursing excellence perform better on Hospital VBP measures. As healthcare systems adapt to evolving incentives that reward value, attention to nurses at the front lines may be central to ensuring high-value care for patients. PMID:28558604

Hospital Value-Based Purchasing: The Association Between Patient Experience and Clinical Outcome.

PubMed

Haley, D Rob; Hamadi, Hanadi; Zhao, Mei; Xu, Jing; Wang, Yi

The Affordable Care Act of 2010 introduced a Hospital Value-Based Purchasing Total Performance Score for payment purposes and to evaluate hospital quality of care. In fiscal year 2016, Total Performance Score was composed of (1) Clinical Processes of Care, (2) Patient Experience of Care, (3) Outcome, and (4) Efficiency domains. The objective of this study was to examine the association between the Patient Experience of Care and Outcome domains. The Donabedian model of structure, process, and outcome was used as a conceptual framework for this study. Data from the 2015-2016 Area Health Resource File, the 2016 American Hospital Association database, and the 2016 Hospital Value-Based Purchasing were used. Univariate, bivariate, and multivariate analyses were conducted to examine the impact of patient experience on outcome of care and hospitals. From a sample of 1866 hospitals across the United States, patient experience was significantly and positively associated with patient outcome. In addition, for-profit hospitals, hospitals with more beds, nonteaching hospitals, and hospitals located in less competitive markets were found to have a significant association with better outcomes. The study's findings are important as policy makers consider additional or alternative indicators that may better represent and encourage higher quality of care within acute care hospitals.

Safety-net hospitals more likely than other hospitals to fare poorly under Medicare's value-based purchasing.

PubMed

Gilman, Matlin; Adams, E Kathleen; Hockenberry, Jason M; Milstein, Arnold S; Wilson, Ira B; Becker, Edmund R

2015-03-01

Medicare's value-based purchasing (VBP) program potentially puts safety-net hospitals at a financial disadvantage compared to other hospitals. In 2014, the second year of the program, patient mortality measures were added to the VBP program's algorithm for assigning penalties and rewards. We examined whether the inclusion of mortality measures in the second year of the program had a disproportionate impact on safety-net hospitals nationally. We found that safety-net hospitals were more likely than other hospitals to be penalized under the VBP program as a result of their poorer performance on process and patient experience scores. In 2014, 63 percent of safety-net hospitals versus 51 percent of all other sample hospitals received payment rate reductions under the program. However, safety-net hospitals' performance on mortality measures was comparable to that of other hospitals, with an average VBP survival score of thirty-two versus thirty-one among other hospitals. Although safety-net hospitals are still more likely than other hospitals to fare poorly under the VBP program, increasing the weight given to mortality in the VBP payment algorithm would reduce this disadvantage. Project HOPE—The People-to-People Health Foundation, Inc.

Is There a Relationship Between Value-Based Purchasing and Hospital Profitability? An Exploratory Study of Missouri Hospitals.

PubMed

Turner, Jason S; Broom, Kevin D; Counte, Michael A

2015-01-01

Recent US legislation is attempting to transition inpatient Medicare payments to a value-based purchasing (VBP) program. The VBP program is a pay-for-performance (P4P) system that incentivizes hospitals to improve patient satisfaction, health outcomes, and adherence to clinical protocols while simultaneously holding down costs. Our study evaluates (1) the impact of financial performance on the VBP adjustments and (2) whether there is a correlation between the VBP adjustment and the financial performance of Missouri hospitals that opted into the program. While upward and downward adjustments to the inpatient base rate may be related to hospital financial performance, prior financial performance may also be related to the adjustments. Financial health may allow facilities to invest and position the hospital for favorable future P4P adjustments. The results of our analysis indicate the VBP adjustment to the inpatient base rate is very small (±0.18%), clustered around zero, and is not correlated with financial performance. We also find that financial performance and improvement in the years prior to the adjustment are not related to the VBP adjustment or its respective components. This suggests that CMS is avoiding penalizing less profitable facilities, but the adjustment is also so small and tightly clustered around zero that it is failing to provide an adequate incentive to hospitals. The costs of improving patient satisfaction, clinical process adherence, health care outcomes, and efficiency above that of peers coupled with the growing number of metrics being used to calculate the VBP adjustments call into question the financial incentives of the hospital VBP program.

Is There a Relationship Between Value-Based Purchasing and Hospital Profitability? An Exploratory Study of Missouri Hospitals

PubMed Central

Broom, Kevin D.; Counte, Michael A.

2015-01-01

Recent US legislation is attempting to transition inpatient Medicare payments to a value-based purchasing (VBP) program. The VBP program is a pay-for-performance (P4P) system that incentivizes hospitals to improve patient satisfaction, health outcomes, and adherence to clinical protocols while simultaneously holding down costs. Our study evaluates (1) the impact of financial performance on the VBP adjustments and (2) whether there is a correlation between the VBP adjustment and the financial performance of Missouri hospitals that opted into the program. While upward and downward adjustments to the inpatient base rate may be related to hospital financial performance, prior financial performance may also be related to the adjustments. Financial health may allow facilities to invest and position the hospital for favorable future P4P adjustments. The results of our analysis indicate the VBP adjustment to the inpatient base rate is very small (±0.18%), clustered around zero, and is not correlated with financial performance. We also find that financial performance and improvement in the years prior to the adjustment are not related to the VBP adjustment or its respective components. This suggests that CMS is avoiding penalizing less profitable facilities, but the adjustment is also so small and tightly clustered around zero that it is failing to provide an adequate incentive to hospitals. The costs of improving patient satisfaction, clinical process adherence, health care outcomes, and efficiency above that of peers coupled with the growing number of metrics being used to calculate the VBP adjustments call into question the financial incentives of the hospital VBP program. PMID:28462265

Teaching Grocery Store Purchasing Skills to Students with Intellectual Disabilities Using a Computer-Based Instruction Program

ERIC Educational Resources Information Center

Hansen, David L.; Morgan, Robert L.

2008-01-01

This research evaluated effects of a multi-media computer-based instruction (CBI) program designed to teach grocery store purchasing skills to three high-school students with intellectual disabilities. A multiple baseline design across participants used measures of computer performance mastery and grocery store probes to evaluate the CBI. All…

Mandatory bundled payment getting into formation for value-based care.

PubMed

Fink, John

2015-10-01

Succeeding under Medicare's enterprise Comprehensive Care for Joint Replacement Model will require collaboration among caregivers and financial arrangements to align incentives Priorities for most organization's transition to becoming a value-based hospitals will be care redesign, supply-purchasing strategy, and post-acute care provider partnering. Pursuing value for your joint replacement program will chart a path for other service lines and lead your organization's transition to becoming a value-based enterprise.

Medicare and Medicaid programs: hospital outpatient prospective payment; ambulatory surgical center payment; hospital value-based purchasing program; physician self-referral; and patient notification requirements in provider agreements. Final rule with comment period.

PubMed

2011-11-30

This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) for CY 2012 to implement applicable statutory requirements and changes arising from our continuing experience with this system. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the OPPS. In addition, this final rule with comment period updates the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system. In this final rule with comment period, we set forth the relative payment weights and payment amounts for services furnished in ASCs, specific HCPCS codes to which these changes apply, and other ratesetting information for the CY 2012 ASC payment system. We are revising the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, adding new requirements for ASC Quality Reporting System, and making additional changes to provisions of the Hospital Inpatient Value-Based Purchasing (VBP) Program. We also are allowing eligible hospitals and CAHs participating in the Medicare Electronic Health Record (EHR) Incentive Program to meet the clinical quality measure reporting requirement of the EHR Incentive Program for payment year 2012 by participating in the 2012 Medicare EHR Incentive Program Electronic Reporting Pilot. Finally, we are making changes to the rules governing the whole hospital and rural provider exceptions to the physician self-referral prohibition for expansion of facility capacity and changes to provider agreement regulations on patient notification requirements.

76 FR 2453 - Medicare Program; Hospital Inpatient Value-Based Purchasing Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-13

... requirements under the Hospital IQR program in the FY 2006 IPPS final rule (70 FR 47420). C. Hospital Inpatient... it was amended by section 3001(a)(2)(C) of the Affordable Care Act, required that the Secretary... discharge of 1%, as required by section 1886(o)(7). Section 1886(o)(1)(C) provides that the Hospital VBP...

40 CFR 312.29 - The relationship of the purchase price to the value of the property, if the property was not...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 27 2010-07-01 2010-07-01 false The relationship of the purchase price... COMMUNITY RIGHT-TO-KNOW PROGRAMS INNOCENT LANDOWNERS, STANDARDS FOR CONDUCTING ALL APPROPRIATE INQUIRIES Standards and Practices § 312.29 The relationship of the purchase price to the value of the property, if the...

Determining the value of disease management programs.

PubMed

Selby, Joe V; Scanlon, Dennis; Lafata, Jennifer Elston; Villagra, Victor; Beich, Jeff; Salber, Patricia R

2003-09-01

Increasing prevalence, rising costs, and persisting deficiencies in quality of care for chronic diseases pose economic and policy challenges to providers and purchasers. Disease management (DM) programs may address these challenges, but neither purchasers nor providers can assess their value. The potpourri of current quality indicators provides limited insight into the actual clinical benefit achieved. A conference sponsored by the Agency for Healthcare Research and Quality (AHRQ) and held in October 2002 explored new approaches to measuring and reporting the value of DM for diabetes mellitus. Quantifying the value of DM requires measuring clinical benefit and net impact on health care costs for the entire population with diabetes. If quality is measured with indicators that are clearly linked to outcomes, clinical benefit can be estimated. Natural history models combine the expected benefits of improvements in multiple indicators to yield a single, composite measure, the quality-adjusted life-year. Such metrics could fairly express, in terms of survival and complications prevention, relatively disparate DM programs' benefits. Measuring and comparing health care costs requires data validation and appropriate case-mix adjustment. Comparing value across programs may provide more accurate assessments of performance, enhance quality improvement efforts within systems, and contribute generalizable knowledge on the utility of DM approaches. Conference attendees recommended pilot projects to further explore use of natural history models for measuring and reporting the value of DM.

Statement of the Problem: Health Reform, Value-Based Purchasing, Alternative Payment Strategies, and Children and Youth With Special Health Care Needs.

PubMed

Bachman, Sara S; Comeau, Meg; Long, Thomas F

2017-05-01

There is increasing interest in maximizing health care purchasing value by emphasizing strategies that promote cost-effectiveness while achieving optimal health outcomes. These value-based purchasing (VBP) strategies have largely focused on adult health, and little is known about the impact of VBP program development and implementation on children, especially children and youth with special health care needs (CYSHCN). With the increasing emphasis on VBP, policymakers must critically analyze the potential impact of VBP for CYSCHN, because this group of children, by definition, uses more health care services than other children and inevitably incurs higher per person costs. We provide a history and definition of VBP and insurance design, noting its origin in employer-sponsored health insurance, and discuss various financing and payment strategies that may be pursued under a VBP framework. The relevance of these approaches for CYSHCN is discussed, and recommendations for next steps are provided. There is considerable work to be done if VBP strategies are to be applied to CYSHCN. Issues include the low prevalence of specific special health care need conditions, how to factor in a life course perspective, in which investments in children's health pay off over a long period of time, the marginal savings that may or may not accrue, the increased risk of family financial hardship, and the potential to exacerbate existing inequities across race, class, ethnicity, functional status, and other social determinants of health. Copyright © 2017 by the American Academy of Pediatrics.

Expected value based fuzzy programming approach to solve integrated supplier selection and inventory control problem with fuzzy demand

NASA Astrophysics Data System (ADS)

Sutrisno; Widowati; Sunarsih; Kartono

2018-01-01

In this paper, a mathematical model in quadratic programming with fuzzy parameter is proposed to determine the optimal strategy for integrated inventory control and supplier selection problem with fuzzy demand. To solve the corresponding optimization problem, we use the expected value based fuzzy programming. Numerical examples are performed to evaluate the model. From the results, the optimal amount of each product that have to be purchased from each supplier for each time period and the optimal amount of each product that have to be stored in the inventory for each time period were determined with minimum total cost and the inventory level was sufficiently closed to the reference level.

Episode-Based Payment and Direct Employer Purchasing of Healthcare Services: Recent Bundled Payment Innovations and the Geisinger Health System Experience.

PubMed

Slotkin, Jonathan R; Ross, Olivia A; Newman, Eric D; Comrey, Janet L; Watson, Victoria; Lee, Rachel V; Brosious, Megan M; Gerrity, Gloria; Davis, Scott M; Paul, Jacquelyn; Miller, E Lynn; Feinberg, David T; Toms, Steven A

2017-04-01

One significant driver of the disjointed healthcare often observed in the United States is the traditional fee-for-service payment model which financially incentivizes the volume of care delivered over the quality and coordination of care. This problem is compounded by the wide, often unwarranted variation in healthcare charges that purchasers of health services encounter for substantially similar episodes of care. The last 10 years have seen many stakeholder organizations begin to experiment with novel financial payment models that strive to obviate many of the challenges inherent in customary quantity-based cost paradigms. The Patient Protection and Affordable Care Act has allowed many care delivery systems to partner with Medicare in episode-based payment programs such as the Bundled Payments for Care Improvement (BPCI) initiative, and in patient-based models such as the Medicare Shared Savings Program. Several employer purchasers of healthcare services are experimenting with innovative payment models to include episode-based bundled rate destination centers of excellence programs and the direct purchasing of accountable care organization services. The Geisinger Health System has over 10 years of experience with episode-based payment bundling coupled with the care delivery reengineering which is integral to its ProvenCare® program. Recent experiences at Geisinger have included participation in BPCI and also partnership with employer-purchasers of healthcare through the Pacific Business Group on Health (representing Walmart, Lowe's, and JetBlue Airways). As the shift towards value-focused care delivery and patient experience progresses forward, bundled payment arrangements and direct purchasing of healthcare will be critical financial drivers in effecting change. Copyright © 2017 by the Congress of Neurological Surgeons.

Pawtucket Heart Health Program Point-of-Purchase Nutrition Education Program in Supermarkets.

ERIC Educational Resources Information Center

Hunt, Mary K.; And Others

1990-01-01

Evaluates a point-of-purchase nutrition education program in Pawtucket (Rhode Island). Uses consumer interviews to evaluate the effect of awareness of shelf labels on purchase behavior. Reports increases in shoppers' ability to identify correct shelf labels and in the number of shoppers who were encouraged to buy the identified foods. (FMW)

Who purchases nonprescription syringes? Characterizing customers of the Expanded Syringe Access Program (ESAP).

PubMed

Battles, Haven B; Rowe, Kirsten A; Ortega-Peluso, Christina; Klein, Susan J; Tesoriero, James M

2009-11-01

This study represents the first attempt in the USA to survey pharmacy nonprescription syringe customers at their point of purchase. We surveyed 62 individuals purchasing nonprescription syringes in seven pharmacies located in NYC and Albany, NY, USA. Three quarters of respondents purchased for illicit use, and 36% purchased for medical use, with differences found by race and gender. Half got their syringes from pharmacies "most of the time." Half had ever been refused a syringe purchase in a NYS pharmacy, with men, Blacks, and Hispanics reporting higher levels of refusals than women or whites. Two thirds reported syringe reuse but very few reported sharing. While approximately one quarter safely obtained and disposed of syringes "most of the time," two thirds used both safe and unsafe methods. Pharmacy-based syringe access programs are essential in areas not served by syringe exchanges.

Quality-based purchasing in health care.

PubMed

Waters, Hugh R; Morlock, Laura L; Hatt, Laurel

2004-01-01

Quality-based purchasing is a growing trend that seeks to improve healthcare quality through the purchaser-provider relationship. This article provides a unifying conceptual framework, presents examples of the purchaser-provider relationship in countries at different income levels, and identifies important supporting mechanisms for quality-based purchasing. As countries become wealthier, a higher proportion of healthcare spending is channeled through pooled arrangements, allowing for greater involvement of purchasers in promoting the quality of service provision. Global and line item budgets are the most common type of provider payment system in low and middle-income countries. In these countries, improving public hospital performance through contracting and incentives is a key issue. In middle and high-income countries, there are several documented examples of governments contracting to private or non-governmental health care providers, resulting in higher perceived quality of care and lower delivery costs. Encouraging quality through employer purchasing arrangements has been promoted in several countries, particularly the United States. Community-based financing schemes are an increasingly common form of health financing in parts of sub-Saharan Africa and Asia, but these schemes still cover less than 10% of national populations in countries in which they are active. To date, there is little evidence of their impact on healthcare quality. The availability of information--concerning healthcare service provision and outcomes--determines the options for establishing and monitoring contract provisions and promoting quality. Regardless of the context, quality-based purchasing depends critically on informa-tion--reporting, monitoring, and providing useful information to healthcare consumers. In many low and middle-income countries, the lack of availability of information is the principal constraint on measuring performance, a critical component of quality-based

Procurement Cards Pave the Way to Efficient Purchasing.

ERIC Educational Resources Information Center

Enos, Eileen D.

1999-01-01

As educators battle restricted budgets, inflation, and enrollment changes, strategic sourcing management is replacing traditional transaction-based procurement. Procurement-card programs, allowing organizations to use credit cards for small purchases or low-value items, save time and enhance controls over merchants, credit limits, issuance limits,…

Double Up Food Bucks program effects on SNAP recipients' fruit and vegetable purchases.

PubMed

Steele-Adjognon, Marie; Weatherspoon, Dave

2017-12-12

To encourage the consumption of more fresh fruits and vegetables, the 2014 United Sates Farm Bill allocated funds to the Double Up Food Bucks Program. This program provided Supplemental Nutrition Assistance Program beneficiaries who spent $10 on fresh fruits and vegetables, in one transaction, with a $10 gift card exclusively for Michigan grown fresh fruits and vegetables. This study analyzes how fruit and vegetable expenditures, expenditure shares, variety and purchase decisions were affected by the initiation and conclusion, as well as any persistent effects of the program. Changes in fruit and vegetable purchase behaviors due to Double Up Food Bucks in a supermarket serving a low-income, predominantly Hispanic community in Detroit, Michigan were evaluated using a difference in difference fixed effects estimation strategy. We find that the Double Up Food Bucks program increased vegetable expenditures, fruit and vegetable expenditure shares, and variety of fruits and vegetables purchased but the effects were modest and not sustainable without the financial incentive. Fruit expenditures and the fruit and vegetable purchase decision were unaffected by the program. This study provides valuable insight on how a nutrition program influences a low-income, urban, Hispanic community's fruit and vegetable purchase behavior. Policy recommendations include either removing or lowering the purchase hurdle for incentive eligibility and dropping the Michigan grown requirement to better align with the customers' preferences for fresh fruits and vegetables.

Web-based Factors Affecting Online Purchasing Behaviour

NASA Astrophysics Data System (ADS)

Ariff, Mohd Shoki Md; Sze Yan, Ng; Zakuan, Norhayati; Zaidi Bahari, Ahamad; Jusoh, Ahmad

2013-06-01

The growing use of internet and online purchasing among young consumers in Malaysia provides a huge prospect in e-commerce market, specifically for B2C segment. In this market, if E-marketers know the web-based factors affecting online buyers' behaviour, and the effect of these factors on behaviour of online consumers, then they can develop their marketing strategies to convert potential customers into active one, while retaining existing online customers. Review of previous studies related to the online purchasing behaviour in B2C market has point out that the conceptualization and empirical validation of the online purchasing behaviour of Information and Communication Technology (ICT) literate users, or ICT professional, in Malaysia has not been clearly addressed. This paper focuses on (i) web-based factors which online buyers (ICT professional) keep in mind while shopping online; and (ii) the effect of web-based factors on online purchasing behaviour. Based on the extensive literature review, a conceptual framework of 24 items of five factors was constructed to determine web-based factors affecting online purchasing behaviour of ICT professional. Analysis of data was performed based on the 310 questionnaires, which were collected using a stratified random sampling method, from ICT undergraduate students in a public university in Malaysia. The Exploratory factor analysis performed showed that five factors affecting online purchase behaviour are Information Quality, Fulfilment/Reliability/Customer Service, Website Design, Quick and Details, and Privacy/Security. The result of Multiple Regression Analysis indicated that Information Quality, Quick and Details, and Privacy/Security affect positively online purchase behaviour. The results provide a usable model for measuring web-based factors affecting buyers' online purchase behaviour in B2C market, as well as for online shopping companies to focus on the factors that will increase customers' online purchase.

The effect of proportional v. value pricing on fountain drink purchases: results from a field experiment.

PubMed

Gollust, Sarah E; Tang, Xuyang; Runge, Carlisle Ford; French, Simone A; Rothman, Alexander J

2018-05-15

Reducing sugar-sweetened beverage consumption is a public health priority, yet finding an effective and acceptable policy intervention is challenging. One strategy is to use proportional pricing (a consistent price per fluid ounce) instead of the typical value-priced approach where large beverages offer better value. The purpose of the present study was to evaluate whether proportional pricing affects the purchasing of fountain beverages at a university cinema concession stand. Four price strategies for beverages were evaluated over ten weekends of film screenings. We manipulated two factors: the price structure (value pricing v. proportional pricing) and the provision of information about the price per fluid ounce (labels v. no labels). The key outcomes were the number and size of beverages purchased. We analysed data using regression analyses, with standard errors clustered by film and controlling for the day and time of purchase. A university cinema concession stand in Minnesota, USA, in spring 2015. University students. Over the study period (360 beverages purchased) there were no significant effects of the proportional pricing treatment. Pairing a label with the standard value pricing increased the likelihood of purchasing large drinks but the label did not affect purchasing when paired with proportional pricing. Proportional prices did not significantly affect the size of beverages purchased by students at a university cinema, but adding a price-per-ounce label increased large drink purchases when drinks were value-priced. More work is needed to address whether pricing and labelling strategies might promote healthier beverage purchases.

The Financial Effect of Value-Based Purchasing and the Hospital Readmissions Reduction Program on Safety-Net Hospitals in 2014: A Cohort Study.

PubMed

Gilman, Matlin; Hockenberry, Jason M; Adams, E Kathleen; Milstein, Arnold S; Wilson, Ira B; Becker, Edmund R

2015-09-15

Medicare's value-based purchasing (VBP) and the Hospital Readmissions Reduction Program (HRRP) could disproportionately affect safety-net hospitals. To determine whether safety-net hospitals incur larger financial penalties than other hospitals under VBP and HRRP. Cross-sectional analysis. United States in 2014. 3022 acute care hospitals participating in VBP and the HRRP. Safety-net hospitals were defined as being in the top quartile of the Medicare disproportionate share hospital (DSH) patient percentage and Medicare uncompensated care (UCC) payments per bed. The differences in penalties in both total dollars and dollars per bed between safety-net hospitals and other hospitals were estimated with the use of bivariate and graphical regression methods. Safety-net hospitals in the top quartile of each measure were more likely to be penalized under VBP than other hospitals (62.9% vs. 51.0% under the DSH definition and 60.3% vs. 51.5% under the UCC per-bed definition). This was also the case under the HRRP (80.8% vs. 69.0% and 81.9% vs. 68.7%, respectively). Safety-net hospitals also had larger payment penalties ($115 900 vs. $66 600 and $150 100 vs. $54 900, respectively). On a per-bed basis, this translated to $436 versus $332 and $491 versus $314, respectively. Sensitivity analysis setting the cutoff at the top decile rather than the top quartile decile led to similar conclusions with somewhat larger differences between safety-net and other hospitals. The quadratic fit of the data indicated that the larger effect of these penalties is in the middle of the distribution of the DSH and UCC measures. Only 2 measures of safety-net status were included in the analyses. Safety-net hospitals were disproportionately likely to be affected under VBP and the HRRP, but most incurred relatively small payment penalties in 2014. Patient-Centered Outcomes Research Institute.

Disinvestment and Value-Based Purchasing Strategies for Pharmaceuticals: An International Review.

PubMed

Parkinson, Bonny; Sermet, Catherine; Clement, Fiona; Crausaz, Steffan; Godman, Brian; Garner, Sarah; Choudhury, Moni; Pearson, Sallie-Anne; Viney, Rosalie; Lopert, Ruth; Elshaug, Adam G

2015-09-01

Pharmaceutical expenditure has increased rapidly across many Organisation for Economic Cooperation and Development (OECD) countries over the past three decades. This growth is an increasing concern for governments and other third-party payers seeking to provide equitable and comprehensive healthcare within sustainable budgets. In order to create headroom for increasing utilisation, and to fund new high-cost therapies, there is an active push to 'disinvest' from low-value drugs. The aim of this article is to review how reimbursement policy decision makers have sought to partially or completely disinvest from drugs in a range of OECD countries (UK, France, Canada, Australia and New Zealand) where they are publicly funded or subsidised. We employed a systematic literature search strategy and the incorporation of grey literature known to the authorship team. We canvass key policy instruments from each country to outline key approaches to the identification of candidate drugs for disinvestment assessment (passive approaches vs. more active approaches); methods of disinvestment and value-based purchasing (de-listing, restricting treatment, price or reimbursement rate reductions, encouraging generic prescribing); lessons learnt from the various approaches; the potential role of coverage with evidence development; and the need for careful stakeholder management. Dedicated sections are provided with detailed coverage of policy approaches (with drug examples) from each country. Historically, countries have relied on 'passive disinvestment'; however, due to (1) the availability of new cost-effectiveness evidence, or (2) 'leakage' in drug utilisation, or (3) market failure in terms of price competition, there is an increasing focus towards 'active disinvestment'. Isolating low-value drugs that would create headroom for innovative new products to enter the market is also motivating disinvestment efforts by multiple parties, including industry. Historically, disinvestment has

[The price-based certainty of purchase influences consumer behavior for discount].

PubMed

Arihara, Katsuhiko; Ariga, Atsunori; Furuya, Takeshi

2016-04-01

Tversky & Kahneman (1981) reported that most participants decided to drive when they could save money on a low-price good as compared to when they could save on a high-price good, even though the discount prices were same. Although this irrational decision making has been interpreted as a rate-dependent estimation of value (prospect theory), this study newly proposes that it can be explained by the certainty of purchase based on the price of goods. Experiment 1 replicated the previously reported difference in decision making, and additionally demonstrated that participants' certainty of purchase was lower for a high- than a low-price good. When it was emphasized that participants' intention to purchase high- and low-price goods were equally sure, decision making did not significantly differ (Experiment 2). Furthermore, decision making differed based only on the certainty of purchase even,when prices of goods were-same (Experiment 3). Consumers' decision making may be rather rational, depending straightforwardly on the certainty of purchase that is susceptible to price.

[Panorama of purchasing food products from family farmers for the Brazilian School Nutrition Program].

PubMed

Saraiva, Elisa Braga; da Silva, Ana Paula Ferreira; de Sousa, Anete Araújo; Cerqueira, Gabrielle Fernandes; Chagas, Carolina Martins dos Santos; Toral, Natacha

2013-04-01

This article seeks to describe the viewpoint of purchasing food products from family farmers, analyzing their performance within the new guidelines of the Brazilian School Nutrition Program (PNAE). It is a critical assessment based on a review of the literature and the official data provided by the National Fund for the Development of Education/Ministry of Education relating to 2010. The program budget in 2010 was approximately R$2.5 billion and attended 45.6 million children, adolescents and adults. From the total amount, R$150,397,052.68 was allocated for the purchase of agricultural products from family farmers. In Brazil, 47.4% of the local councils acquired food products from family farmers for the Brazilian School Nutrition Program and the purchase percentage was, on average, 22.7%. Given the nature of recent legislation, other aspects should be explored in order to strengthen the compliance with the regulations in different Brazilian contexts and thus contribute both to local economic development and the provision of school meals which fulfill the principles of a healthy and adequate diet.

The Defense Logistics Agency Properly Awarded Power Purchase Agreements and the Army Obtained Fair Market Value for Leases Supporting Power Purchase Agreements

DTIC Science & Technology

2016-09-28

Fair Market Value for Leases Supporting Power Purchase Agreements I N T E G R I T Y  E F F I C I E N C Y  A C C O U N T A B I L I T Y  E X... Market Value for Leases Supporting Power Purchase Agreements Visit us at www.dodig.mil September 28, 2016 Objective We determined whether the...Department of the Army properly awarded and obtained fair market value for leases supporting energy production projects. We conducted this audit in

Financial incentives and purchase restrictions in a food benefit program affect the types of foods and beverages purchased: results from a randomized trial.

PubMed

French, Simone A; Rydell, Sarah A; Mitchell, Nathan R; Michael Oakes, J; Elbel, Brian; Harnack, Lisa

2017-09-16

This research evaluated the effects of financial incentives and purchase restrictions on food purchasing in a food benefit program for low income people. Participants (n=279) were randomized to groups: 1) Incentive- 30% financial incentive for fruits and vegetables purchased with food benefits; 2) Restriction- no purchase of sugar-sweetened beverages, sweet baked goods, or candies with food benefits; 3) Incentive plus Restriction; or 4) Control- no incentive or restrictions. Participants received a study-specific debit card where funds were added monthly for 12-weeks. Food purchase receipts were collected over 16 weeks. Total dollars spent on grocery purchases and by targeted food categories were computed from receipts. Group differences were examined using general linear models. Weekly purchases of fruit significantly increased in the Incentive plus Restriction ($4.8) compared to the Restriction ($1.7) and Control ($2.1) groups (p <.01). Sugar-sweetened beverage purchases significantly decreased in the Incentive plus Restriction (-$0.8 per week) and Restriction ($-1.4 per week) groups compared to the Control group (+$1.5; p< .0001). Sweet baked goods purchases significantly decreased in the Restriction (-$0.70 per week) compared to the Control group (+$0.82 per week; p < .01). Paired financial incentives and restrictions on foods and beverages purchased with food program funds may support more healthful food purchases compared to no incentives or restrictions. Clinicaltrials.gov Identifier: NCT02643576 .

Regional group purchasing of vaccines: review of the Pan American Health Organization EPI revolving fund and the Gulf Cooperation Council group purchasing program.

PubMed

DeRoeck, Denise; Bawazir, Saleh A; Carrasco, Peter; Kaddar, Miloud; Brooks, Alan; Fitzsimmons, John; Andrus, Jon

2006-01-01

This paper reviews the key design features, accomplishments of and lessons learned from two regional group procurement mechanisms dealing with vaccines that have been in operation for more than 25 years. The Pan American Health Organization (PAHO) EPI Revolving Fund purchases vaccines and immunization supplies on behalf of more than 35 countries in the Latin American and Caribbean region. Based on a 'central contracting' model, the program handles most aspects of procurement-from tendering to contracting with and paying producers--using a common fund to pay producers before being reimbursed by countries once goods are received in-country. The Gulf Cooperation Council (GCC) Group Purchasing Program among seven Persian Gulf States issues joint tenders for vaccines, as well as drugs and other medical goods. Through this 'group contracting' program, countries are responsible for contracting with and paying producers on their own, once the group has selected winning bids. Both programs have experienced substantial growth in the past two decades and are considered to have contributed to or accelerated achievements of immunization programs in both regions, including the introduction of new vaccines. The paper identifies several features of both programs--both those designed to attract country participation and those designed to ensure the programs' financial viability--which help explain their success and longevity.

Highly Insulating Windows Volume Purchase Program Final Report

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

None

2013-04-01

This report documents the development, execution outcomes and lessons learned of the Highly Insulating Windows Volume Purchase (WVP) Program carried out over a three-year period from 2009 through 2012. The primary goals of the program were met: 1) reduce the incremental cost of highly insulating windows compared to ENERGY STAR windows; and 2) raise the public and potential buyers’ awareness of highly insulating windows and their benefits. A key outcome of the program is that the 2013 ENERGY STAR Most Efficient criteria for primary residential windows were adopted from the technical specifications set forth in the WVP program.

Medicare and Medicaid Programs; CY 2017 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

PubMed

2016-11-03

This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP).

Medicare and Medicaid Programs; CY 2016 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

PubMed

2015-11-05

This final rule will update Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2016. As required by the Affordable Care Act, this rule implements the 3rd year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking and provides a clarification regarding the use of the "initial encounter'' seventh character applicable to certain ICD-10-CM code categories. This final rule will also finalize reductions to the national, standardized 60-day episode payment rate in CY 2016, CY 2017, and CY 2018 of 0.97 percent in each year to account for estimated case-mix growth unrelated to increases in patient acuity (nominal case-mix growth) between CY 2012 and CY 2014. In addition, this rule implements a HH value-based purchasing (HHVBP) model, beginning January 1, 2016, in which all Medicare-certified HHAs in selected states will be required to participate. Finally, this rule finalizes minor changes to the home health quality reporting program and minor technical regulations text changes.

Nutritional profile of Supplemental Nutrition Assistance Program household food and beverage purchases.

PubMed

Grummon, Anna H; Taillie, Lindsey Smith

2017-06-01

Background: The Supplemental Nutrition Assistance Program (SNAP), which is the largest federal nutrition assistance program in the United States, serves nearly 1 of 7 Americans. To date, few studies have examined food and beverage purchase behaviors in SNAP participants with the use of electronic purchase data. Objective: In this cross-sectional study, we examined household store purchases of key food, beverage, and nutrient groups in SNAP participants and nonparticipants. Design: Using a data set of US households' ( n = 98,256 household-by-quarter observations) packaged food and beverage purchases and SNAP status [current participant, income-eligible nonparticipant (income ≤130% of the Federal Poverty Level [FPL]), and higher-income nonparticipants (income >130% of the FPL)] from 3 quarters during 2012-2013, we estimated pooled ordinary least-squares models, clustered at the household level, to examine the association between SNAP status and purchases while controlling for sociodemographic characteristics. We examined purchases of health- and policy-relevant food and beverage groups [e.g., fruit and sugar-sweetened beverages (SSBs)] and nutrients (e.g., total calories and sodium). Results: Regardless of SNAP status, households had low mean purchases of fruit, vegetables, and fiber and high mean purchases of junk foods, saturated fat, and sodium. After adjustment for multiple comparisons and demographic characteristics, we found significant differences by SNAP status of purchases of fruit, processed meat, salty snacks, sweeteners and toppings, SSBs, and total calories, fiber, sugar, and sodium. Several of these differences were clinically important. For example, compared with income-eligible and higher-income nonparticipants, SNAP participants purchased an additional ∼15-20 kcal · person -1 · d -1 from SSBs ( P < 0.0001) and ∼174-195 mg total Na · person -1 · d -1 ( P <0.0001). Results were robust to corrections for sample-selection bias and to the

Proposal of a New SI Base Unit for Value. An Hedonic Estimation of the Physical Purchasing Power (PhPP) of Money.

NASA Astrophysics Data System (ADS)

Defilla, Steivan

2006-03-01

Hitherto, the purchasing power of money, i.e. its transaction value, has been measured in terms of inflation index numbers and consumer baskets. Consumer baskets are variable phenomena and their use as measurement units for value confuses the measuring with the measurand. We propose an invariant numeraire, or value unit, based on the market value of a Planck energy (1956 MJ). Planck units form a natural system of units independent of any civilization. The hedonic estimation of the PhPP of a currency differentiates energy by product as well as by thermodynamic quality (exergy). Following SI rules, we propose to name the value unit walras (Wal) in honour of the economist Leon Walras (1834 - 1910). One Wal can also be interpreted as the minimum cost of physiological life of a reference person during one year. The study uses official disaggregated Swiss Producer and Consumer Price Index data and estimates the PhPP of the Swiss franc in 2003.

Understanding Hospital Value-Based Purchasing.

PubMed

Brooks, Jo Ann

2016-05-01

This column is designed to provide a nursing perspective on new hospital quality measurements. Future articles will cover the various quality indicators hospitals face and the role of the nurse in meeting mandated benchmarks. Reader responses to this column are welcome and will help to make it more useful to nurses in meeting the challenges posed by health care reform and changing Medicare reimbursement programs.

A General Bayesian Network Approach to Analyzing Online Game Item Values and Its Influence on Consumer Satisfaction and Purchase Intention

NASA Astrophysics Data System (ADS)

Lee, Kun Chang; Park, Bong-Won

Many online game users purchase game items with which to play free-to-play games. Because of a lack of research into which there is no specified framework for categorizing the values of game items, this study proposes four types of online game item values based on an analysis of literature regarding online game characteristics. It then proposes to investigate how online game users perceive satisfaction and purchase intention from the proposed four types of online game item values. Though regression analysis has been used frequently to answer this kind of research question, we propose a new approach, a General Bayesian Network (GBN), which can be performed in an understandable way without sacrificing predictive accuracy. Conventional techniques, such as regression analysis, do not provide significant explanation for this kind of problem because they are fixed to a linear structure and are limited in explaining why customers are likely to purchase game items and if they are satisfied with their purchases. In contrast, the proposed GBN provides a flexible underlying structure based on questionnaire survey data and offers robust decision support on this kind of research question by identifying its causal relationships. To illustrate the validity of GBN in solving the research question in this study, 327 valid questionnaires were analyzed using GBN with what-if and goal-seeking approaches. The experimental results were promising and meaningful in comparison with regression analysis results.

24 CFR 906.15 - Requirements applicable to a family purchasing a property under a homeownership program.

Code of Federal Regulations, 2010 CFR

2010-04-01

... purchasing a property under a homeownership program. 906.15 Section 906.15 Housing and Urban Development... Purchaser Requirements § 906.15 Requirements applicable to a family purchasing a property under a... resident occupying the unit under § 906.13, a family purchasing a property under a PHA homeownership...

Demographic and psychographic associations of consumer intentions to purchase healthier food products.

PubMed

Burton, Melissa; Wang, Wei Chun; Worsley, Anthony

2015-01-01

This study investigated the associations of nutrition concerns, demographics, universalism (community oriented) values, perceived control over personal health and food buying, and perceived influence over the food system with intentions to purchase low fat, sugar and salt (LFSS) food products. A national online survey of 2204 Australian consumers administered in November 2011. Structural equation modeling was used to examine associations of LFSS purchasing intentions with demographic, values, perceived control, and influence factors. Nutrition concern, perceived influence over the food system, and universalism values were key predictors of LFSS purchasing intentions. Almost two thirds (64.6%) of the variance associated with LFSS purchasing was explained by the structural equation model. Communication programs which focus on universalism values, nutrition concern and perceived influence over the food system are likely to increase LFSS purchasing and perhaps reduce the demand for energy dense, nutrient poor foods.

Demographic and psychographic associations of consumer intentions to purchase healthier food products

PubMed Central

Burton, Melissa; Wang, Wei Chun; Worsley, Anthony

2014-01-01

Objective This study investigated the associations of nutrition concerns, demographics, universalism (community oriented) values, perceived control over personal health and food buying, and perceived influence over the food system with intentions to purchase low fat, sugar and salt (LFSS) food products. Methods A national online survey of 2204 Australian consumers administered in November 2011. Structural equation modeling was used to examine associations of LFSS purchasing intentions with demographic, values, perceived control, and influence factors. Results Nutrition concern, perceived influence over the food system, and universalism values were key predictors of LFSS purchasing intentions. Almost two thirds (64.6%) of the variance associated with LFSS purchasing was explained by the structural equation model. Conclusion Communication programs which focus on universalism values, nutrition concern and perceived influence over the food system are likely to increase LFSS purchasing and perhaps reduce the demand for energy dense, nutrient poor foods. PMID:26844047

Incentivizing fruit and vegetable purchases among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children.

PubMed

Andreyeva, Tatiana; Luedicke, Joerg

2015-01-01

In 2009, the US Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) began to provide participants with cash-value vouchers to purchase fruits and vegetables ($US 10 for women and $US 6 for children per month). The present paper assesses the potential effects of the new WIC incentives on fruit and vegetable purchases among WIC households in two New England states. A pre-post assessment of changes in fruit and vegetable purchases after the WIC revisions in generalized estimating equation models. Scanner data on grocery purchases from a regional supermarket chain in New England, USA. WIC-participating households (n 2137) that regularly shopped at the chain during January-September 2009 and January-September 2010. After the WIC revisions, purchases of fresh and frozen vegetables increased in volume by 17·5 % and 27·8 %, respectively. The biggest improvements were observed for fresh fruit, an increase of 28·6 %, adding almost a kilogram of fresh fruits per household per month. WIC households spent three times more of their WIC vouchers on purchasing fresh fruits than fresh vegetables. The magnitudes of substitution effects were relatively small: between 4 % (fresh fruit) and 13 % (canned vegetables) of the amounts purchased in 2009 with non-WIC funds were replaced by purchases made using WIC vouchers in 2010. The provision of fruit and vegetable benefits in the revised WIC food packages increased overall purchases of fruits and vegetables among WIC-participating households in New England. Efforts to encourage consumption of fruits and vegetables by people receiving federal food assistance are paying off.

Questionable validity of the catheter-associated urinary tract infection metric used for value-based purchasing.

PubMed

Calderon, Lindsay E; Kavanagh, Kevin T; Rice, Mara K

2015-10-01

Catheter-associated urinary tract infections (CAUTIs) occur in 290,000 US hospital patients annually, with an estimated cost of $290 million. Two different measurement systems are being used to track the US health care system's performance in lowering the rate of CAUTIs. Since 2010, the Agency for Healthcare Research and Quality (AHRQ) metric has shown a 28.2% decrease in CAUTI, whereas the Centers for Disease Control and Prevention metric has shown a 3%-6% increase in CAUTI since 2009. Differences in data acquisition and the definition of the denominator may explain this discrepancy. The AHRQ metric analyzes chart-audited data and reflects both catheter use and care. The Centers for Disease Control and Prevention metric analyzes self-reported data and primarily reflects catheter care. Because analysis of the AHRQ metric showed a progressive change in performance over time and the scientific literature supports the importance of catheter use in the prevention of CAUTI, it is suggested that risk-adjusted catheter-use data be incorporated into metrics that are used for determining facility performance and for value-based purchasing initiatives. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Development of a hospital-based program focused on improving healthcare value.

PubMed

Moriates, Christopher; Mourad, Michelle; Novelero, Maria; Wachter, Robert M

2014-10-01

Frontline physicians face increasing pressure to improve the quality of care they deliver while simultaneously decreasing healthcare costs. Although hospitals and physicians are beginning to implement initiatives targeting this new goal of healthcare value, few of them have a well-developed infrastructure to support this work. In March 2012, we launched a high-value care (HVC) program within the Division of Hospital Medicine at the University of California, San Francisco. The HVC program is co-led by a physician and the division's administrator, and includes other hospitalists, resident physicians, pharmacists, and administrators. The program aims to (1) use financial and clinical data to identify areas with clear evidence of waste in the hospital, (2) promote evidence-based interventions that improve both quality of care and value, and (3) pair interventions with evidence-based cost awareness education to drive culture change. We identified 6 ongoing projects during our first year. Preliminary data for our inaugural projects are encouraging. One initiative, which targeted decreasing nebulizer use on a high-acuity medical floor (often using metered-dose inhalers instead) led to a decrease in rates of more than 50%. The HVC program is proving to be a successful mechanism to promote improved healthcare value and clinician engagement. © 2014 Society of Hospital Medicine.

Report: EPA's Fiscal Year 2015 Purchase Card and Convenience Check Program Assessed as Low Risk

EPA Pesticide Factsheets

Report #16-P-0124, March 29, 2016. We determined the EPA's purchase card and convenience check program for FY 2015 to be at a low risk for illegal, improper or erroneous purchases and payments due to strengthened internal controls.

42 CFR § 484.330 - Process for determining and applying the value-based payment adjustment under the Home Health...

Code of Federal Regulations, 2010 CFR

2016-10-01

...-based payment adjustment under the Home Health Value-Based Purchasing (HHVBP) Model. § 484.330 Section... (HHVBP) Model Components for Competing Home Health Agencies Within State Boundaries § 484.330 Process for determining and applying the value-based payment adjustment under the Home Health Value-Based Purchasing...

42 CFR § 484.330 - Process for determining and applying the value-based payment adjustment under the Home Health...

Code of Federal Regulations, 2010 CFR

2017-10-01

...-based payment adjustment under the Home Health Value-Based Purchasing (HHVBP) Model. § 484.330 Section... (HHVBP) Model Components for Competing Home Health Agencies Within State Boundaries § 484.330 Process for determining and applying the value-based payment adjustment under the Home Health Value-Based Purchasing...

Medicare and Medicaid Programs; CY 2018 Home Health Prospective Payment System Rate Update and CY 2019 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

PubMed

2017-11-07

This final rule updates the home health prospective payment system (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor, effective for home health episodes of care ending on or after January 1, 2018. This rule also: Updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the third year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between calendar year (CY) 2012 and CY 2014; and discusses our efforts to monitor the potential impacts of the rebasing adjustments that were implemented in CY 2014 through CY 2017. In addition, this rule finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model and to the Home Health Quality Reporting Program (HH QRP). We are not finalizing the implementation of the Home Health Groupings Model (HHGM) in this final rule.

Identifying Procurement Fraud in Defense Agencies: An Analysis of the Government Purchase Card Program

DTIC Science & Technology

2011-04-30

fielding, contracting, interoperability, organizational behavior, risk management , cost estimating, and many others. Approaches range from... COSO ), (Whittington & Pany, 2012). In addition, the Federal Financial Management Improvement Act of 1996 identified internal control as an...fraud indicators within the DoD Government Purchase Card Programs and provides recommendations for improving the management of Government Purchase

24 CFR 291.515 - Purchaser qualifications.

Code of Federal Regulations, 2010 CFR

2010-04-01

... in § 291.530) at the time he/she submits a bid to purchase a home through the program and at the time of closing on the purchase of the home; (b) The person must certify to his/her good faith intention... Next Door Sales Program § 291.515 Purchaser qualifications. To qualify to purchase a home through the...

School Breakfast Program Participation and Rural Adolescents' Purchasing Behaviors in Food Stores and Restaurants

ERIC Educational Resources Information Center

Caspi, Caitlin Eicher; Wang, Qi; Shanafelt, Amy; Larson, Nicole; Wei, Susan; Hearst, Mary O.; Nanney, Marilyn S.

2017-01-01

Background: Little is known about adolescents' food purchasing behaviors in rural areas. This study examined whether purchasing food at stores/restaurants around schools was related to adolescents' participation in school breakfast programs and overall diet in rural Minnesota. Methods: Breakfast-skippers enrolled in a group-randomized intervention…

The imperative of culture: a quantitative analysis of the impact of culture on workforce engagement, patient experience, physician engagement, value-based purchasing, and turnover.

PubMed

Owens, Katie; Eggers, Jim; Keller, Stephanie; McDonald, Audrey

2017-01-01

Current uncertainty for the future of the health care landscape is placing an increasing amount of pressure on leadership teams to be prepared to steer their organization forward in a number of potential directions. It is commonly recognized among health care leaders that culture will either enable or disable organizational success. However, very few studies empirically link culture to health care-specific performance outcomes. Nearly every health care organization in the US specifies its cultural aspirations through mission and vision statements and values. Ambitions of patient-centeredness, care for the community, workplace of choice, and world-class quality are frequently cited; yet, little definitive research exists to quantify the importance of building high-performing cultures. Our study examined the impact of cultural attributes defined by a culture index (Cronbach's alpha = 0.88) on corresponding performance with key health care measures. We mapped results of the culture index across data sets, compared results, and evaluated variations in performance among key indicators for leaders. Organizations that perform in the top quartile for our culture index statistically significantly outperformed those in the bottom quartile on all but one key performance indicator tested. The culture top quartile organizations outperformed every domain for employee engagement, physician engagement, patient experience, and overall value-based purchasing performance with statistical significance. Culture index top quartile performers also had a 3.4% lower turnover rate than the bottom quartile performers. Finally, culture index top quartile performers earned an additional 1% on value-based purchasing. Our findings demonstrate a meaningful connection between performance in the culture index and organizational performance. To best impact these key performance outcomes, health care leaders should pay attention to culture and actively steer workforce engagement in attributes that

The imperative of culture: a quantitative analysis of the impact of culture on workforce engagement, patient experience, physician engagement, value-based purchasing, and turnover

PubMed Central

Owens, Katie; Eggers, Jim; Keller, Stephanie; McDonald, Audrey

2017-01-01

Current uncertainty for the future of the health care landscape is placing an increasing amount of pressure on leadership teams to be prepared to steer their organization forward in a number of potential directions. It is commonly recognized among health care leaders that culture will either enable or disable organizational success. However, very few studies empirically link culture to health care-specific performance outcomes. Nearly every health care organization in the US specifies its cultural aspirations through mission and vision statements and values. Ambitions of patient-centeredness, care for the community, workplace of choice, and world-class quality are frequently cited; yet, little definitive research exists to quantify the importance of building high-performing cultures. Our study examined the impact of cultural attributes defined by a culture index (Cronbach’s alpha = 0.88) on corresponding performance with key health care measures. We mapped results of the culture index across data sets, compared results, and evaluated variations in performance among key indicators for leaders. Organizations that perform in the top quartile for our culture index statistically significantly outperformed those in the bottom quartile on all but one key performance indicator tested. The culture top quartile organizations outperformed every domain for employee engagement, physician engagement, patient experience, and overall value-based purchasing performance with statistical significance. Culture index top quartile performers also had a 3.4% lower turnover rate than the bottom quartile performers. Finally, culture index top quartile performers earned an additional 1% on value-based purchasing. Our findings demonstrate a meaningful connection between performance in the culture index and organizational performance. To best impact these key performance outcomes, health care leaders should pay attention to culture and actively steer workforce engagement in attributes that

Value-Based Emergency Management.

PubMed

Corrigan, Zachary; Winslow, Walter; Miramonti, Charlie; Stephens, Tim

2016-02-01

This article touches on the complex and decentralized network that is the US health care system and how important it is to include emergency management in this network. By aligning the overarching incentives of opposing health care organizations, emergency management can become resilient to up-and-coming changes in reimbursement, staffing, and network ownership. Coalitions must grasp the opportunity created by changes in value-based purchasing and impending Centers for Medicare and Medicaid Services emergency management rules to engage payers, physicians, and executives. Hope and faith in doing good is no longer enough for preparedness and health care coalitions; understanding how physicians are employed and health care is delivered and paid for is now necessary. Incentivizing preparedness through value-based compensation systems will become the new standard for emergency management.

[Revelation of purchase system of developed nation to large medical equipment group purchase in our country].

PubMed

Tao, Lin; Guan, Bing; Liu, Shan

2011-01-01

There were some features of purchase system in developed nation, such as clear purchase objectives flexible methods, standard programming, emphasis on competition and open process. The measures suggested include playing the role of competition purchasing; establishing the e-business modern purchasing information system; establishing legislation system; and completing business purchasing.

The value of group purchasing organizations in the United States.

PubMed

Rooney, Curtis

2011-01-01

This article examines the valuable role of group purchasing organizations (GPOs) in hospital purchasing in the United States. For over 100 years old GPOs have helped hospitals and other health care providers realize savings and create contracting efficiencies by aggregating purchasing volume to negotiate discounts with manufacturers, distributors and other vendors. The US has recently enacted a series of healthcare reforms to correct some of the historical concerns regarding cost, quality and access. GPOs are expected to continue to play a critical role in the business of hospital purchasing and may potential export that other countries may wish to examine.

Purchasing Over-the-counter medicines from Australian pharmacy: What do the pharmacy customers value and expect?

PubMed

Chan, Vincent; Tran, Hung

2016-01-01

Over-the-counter medicines (OTC) are widely available and can be purchased without a prescription. Their availability means that a customer may choose to purchase them without the involvement of a pharmacy/pharmacist. It is important to understand customer OTC purchasing perceptions and behaviour from a pharmacy to better understand the needs and opportunities in this space. This study aimed to examine customers' key expectations and what they value when purchasing OTC and how the effect of health status/stress and perceived risks/benefits of purchasing OTCs from a pharmacy may influence their OTC shopping behaviour. Customers from two metropolitan pharmacies across two different suburbs in Brisbane, Queensland, Australia completed a self-administered questionnaire. Data collection was conducted over a six-week period. The questionnaire examined demographics, current level of health and stress, as well as a range of questions (seven-point Likert-scale) examining perceived benefits and risks, what they value, trust and expect when purchasing OTC. A total of 86 customers from a broad range of demographics were captured in this study. When asked about their current health state, 41% and 23% respectively indicated that they were stressed and tense when they arrived at the pharmacy but many were feeling well (38%). Most customers strongly agreed/agreed that trust in the advice from a pharmacy (96%), trust in the products (73%), and the altruistic approach of a pharmacy (95%) were critical to them. Further, 82% and 78% respectively disagreed that time pressures or costs were concerns, despite many feeling tense and stressed when they came in. When asked where they intend to buy their future OTC, 89% indicated pharmacy instead of a supermarket. High levels of trust, confidence and sense of altruism and care were key factors for customers buying OTC from a pharmacy, regardless of time pressures, costs or existing levels of stress and health.

University of Maryland MRSEC - For Members: Purchasing

Science.gov Websites

Educational Education Pre-College Programs Homeschool Programs Undergraduate & Graduate Programs Teacher next to each file. Purchasing Policies & Procedures Purchases of products and services require pre

Determinants of Private Long-Term Care Insurance Purchase in Response to the Partnership Program.

PubMed

Lin, Haizhen; Prince, Jeffrey T

2016-04-01

To assess three possible determinants of individuals' response in their private insurance purchases to the availability of the Partnership for Long-Term Care (PLTC) insurance program: bequest motives, financial literacy, and program awareness. The health and retirement study (HRS) merged with data on states' implementation of the PLTC program. Individual-level decision on private long-term care insurance is regressed on whether the PLTC program is being implemented for a given state-year, asset dummies, policy determinant variable, two-way and three-way interactions of these variables, and other controls, using fixed effects panel regression. Analysis used a sample between 50 and 69 years of age from 2002 to 2010, resulting in 12,695 unique individuals with a total of 39,151 observations. We find mild evidence that intent to bequest influences individual purchase of insurance. We also find that program awareness is necessary for response, while financial literacy notably increases responsiveness. Increasing response to the PLTC program among the middle class (the stated target group) requires increased efforts to create awareness of the program's existence and increased education about the program's benefits, and more generally, about long-term care risks and needs. © Health Research and Educational Trust.

A point-of-purchase intervention featuring in-person supermarket education affects healthful food purchases.

PubMed

Milliron, Brandy-Joe; Woolf, Kathleen; Appelhans, Bradley M

2012-01-01

This study tested the efficacy of a multicomponent supermarket point-of-purchase intervention featuring in-person nutrition education on the nutrient composition of food purchases. The design was a randomized trial comparing the intervention with usual care (no treatment). A supermarket in a socioeconomically diverse region of Phoenix, AZ. One hundred fifty-three adult shoppers were recruited onsite. The intervention consisted of brief shopping education by a nutrition educator and an explanation and promotion of a supermarket point-of-purchase healthful shopping program that included posted shelf signs identifying healthful foods, sample shopping lists, tips, and signage. Outcomes included purchases of total, saturated, and trans fat (grams/1,000 kcal), and fruits, vegetables, and dark-green/yellow vegetables (servings/1,000 kcal) derived through nutritional analysis of participant shopping baskets. Analysis of covariance compared the intervention and control groups on food purchasing patterns while adjusting for household income. The intervention resulted in greater purchasing of fruit and dark-green/yellow vegetables. No other group differences were observed. Long-term evaluations of supermarket interventions should be conducted to improve the evidence base and to determine the potential for influence on food choices associated with decreased chronic disease incidence. Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Outcomes of a randomized controlled trial of nutrition education to promote farmers' market fruit and vegetable purchases and consumption among women enrolled in the Special Supplemental Nutrition Program for Women, Infants,

USDA-ARS?s Scientific Manuscript database

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides participants seasonal Farmers' Market Nutrition Program (FMNP) vouchers to purchase fruits and vegetables (FV) at farmers' markets and monthly cash value vouchers (CVV) redeemable at farmers' markets. Despite ...

77 FR 34326 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-11

... Purchasing (VBP) Program, we inadvertently omitted data from the table entitled ``Proposed Performance..., Proposed Hospital Inpatient Value- Based Purchasing (VBP) Program Adjustment Factors for FY 2013, as a... partial paragraph-- (1) Lines 2 and 3, the phrase ``all hospitals are expected to experience a decrease...

Rolling capital: managing investments in a value-based care world.

PubMed

Jasuta, Lynette

2016-06-01

The importance of capital planning is increasing as the healthcare industry moves toward value-based care. Replacing unwieldy and inflexible traditional capital planning processes with a rolling capital planning approach can result in: Greater standardization, facilitating better strategic planning across the whole system. Reduced labor intensity in the planning and budgeting process. Reduced costs through being able to plan better for replacement purchases and take advantage of group purchasing and bundling opportunities. Increased transparency in the decision-making process.

The Impact of a Sport-Based Life Skill Program on Adolescent Prosocial Values

ERIC Educational Resources Information Center

Brunelle, John; Danish, Steven J.; Forneris, Tanya

2007-01-01

This article describes the implementation and evaluation of a sport-based life skills and community service program. The purpose of this investigation was to determine the impact of a combined life skills and community service program on adolescents' prosocial values. The program was part of a national golf and life skills enrichment academy for…

48 CFR 213.7002 - Purchase orders.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Purchase orders. 213.7002... Acquisition Procedures Under the 8(a) Program 213.7002 Purchase orders. The contracting officer need not obtain a contractor's written acceptance of a purchase order or modification of a purchase order for an...

Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Procurement Organization Reporting and Communication; Transplant Outcome Measures and Documentation Requirements; Electronic Health Record (EHR) Incentive Programs; Payment to Nonexcepted Off-Campus Provider-Based Department of a Hospital; Hospital Value-Based Purchasing (VBP) Program; Establishment of Payment Rates Under the Medicare Physician Fee Schedule for Nonexcepted Items and Services Furnished by an Off-Campus Provider-Based Department of a Hospital. Final rule with comment period and interim final rule with comment period.

PubMed

2016-11-14

This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2017 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program. Further, in this final rule with comment period, we are making changes to tolerance thresholds for clinical outcomes for solid organ transplant programs; to Organ Procurement Organizations (OPOs) definitions, outcome measures, and organ transport documentation; and to the Medicare and Medicaid Electronic Health Record Incentive Programs. We also are removing the HCAHPS Pain Management dimension from the Hospital Value-Based Purchasing (VBP) Program. In addition, we are implementing section 603 of the Bipartisan Budget Act of 2015 relating to payment for certain items and services furnished by certain off-campus provider-based departments of a provider. In this document, we also are issuing an interim final rule with comment period to establish the Medicare Physician Fee Schedule payment rates for the nonexcepted items and services billed by a nonexcepted off-campus provider-based department of a hospital in accordance with the provisions of section 603.

16 CFR 233.4 - Bargain offers based upon the purchase of other merchandise.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Bargain offers based upon the purchase of... PRACTICE RULES GUIDES AGAINST DECEPTIVE PRICING § 233.4 Bargain offers based upon the purchase of other... given a customer on the condition that he purchase a particular article at the price usually offered by...

Purchasing Over-the-counter medicines from Australian pharmacy: What do the pharmacy customers value and expect?

PubMed Central

2016-01-01

Background: Over-the-counter medicines (OTC) are widely available and can be purchased without a prescription. Their availability means that a customer may choose to purchase them without the involvement of a pharmacy/pharmacist. It is important to understand customer OTC purchasing perceptions and behaviour from a pharmacy to better understand the needs and opportunities in this space. Objective: This study aimed to examine customers’ key expectations and what they value when purchasing OTC and how the effect of health status/stress and perceived risks/benefits of purchasing OTCs from a pharmacy may influence their OTC shopping behaviour. Methods: Customers from two metropolitan pharmacies across two different suburbs in Brisbane, Queensland, Australia completed a self-administered questionnaire. Data collection was conducted over a six-week period. The questionnaire examined demographics, current level of health and stress, as well as a range of questions (seven-point Likert-scale) examining perceived benefits and risks, what they value, trust and expect when purchasing OTC. Results: A total of 86 customers from a broad range of demographics were captured in this study. When asked about their current health state, 41% and 23% respectively indicated that they were stressed and tense when they arrived at the pharmacy but many were feeling well (38%). Most customers strongly agreed/agreed that trust in the advice from a pharmacy (96%), trust in the products (73%), and the altruistic approach of a pharmacy (95%) were critical to them. Further, 82% and 78% respectively disagreed that time pressures or costs were concerns, despite many feeling tense and stressed when they came in. When asked where they intend to buy their future OTC, 89% indicated pharmacy instead of a supermarket. Conclusions: High levels of trust, confidence and sense of altruism and care were key factors for customers buying OTC from a pharmacy, regardless of time pressures, costs or existing

California safety-net hospitals likely to be penalized by ACA value, readmission, and meaningful-use programs.

PubMed

Gilman, Matlin; Adams, E Kathleen; Hockenberry, Jason M; Wilson, Ira B; Milstein, Arnold S; Becker, Edmund R

2014-08-01

The Affordable Care Act includes provisions to increase the value obtained from health care spending. A growing concern among health policy experts is that new Medicare policies designed to improve the quality and efficiency of hospital care, such as value-based purchasing (VBP), the Hospital Readmissions Reduction Program (HRRP), and electronic health record (EHR) meaningful-use criteria, will disproportionately affect safety-net hospitals, which are already facing reduced disproportionate-share hospital (DSH) payments under both Medicare and Medicaid. We examined hospitals in California to determine whether safety-net institutions were more likely than others to incur penalties under these programs. To assess quality, we also examined whether mortality outcomes were different at these hospitals. Our study found that compared to non-safety-net hospitals, safety-net institutions had lower thirty-day risk-adjusted mortality rates in the period 2009-11 for acute myocardial infarction, heart failure, and pneumonia and marginally lower adjusted Medicare costs. Nonetheless, safety-net hospitals were more likely than others to be penalized under the VBP program and the HRRP and more likely not to meet EHR meaningful-use criteria. The combined effects of Medicare value-based payment policies on the financial viability of safety-net hospitals need to be considered along with DSH payment cuts as national policy makers further incorporate performance measures into the overall payment system. Project HOPE—The People-to-People Health Foundation, Inc.

A point-of-purchase intervention featuring in-person supermarket education impacts healthy food purchases

PubMed Central

Woolf, Kathleen; Appelhans, Bradley M.

2011-01-01

Objective This study tested the efficacy of a multicomponent supermarket point-of-purchase (POP) intervention featuring in-person nutrition education on the nutrient composition of food purchases. Design The design was a randomized trial comparing the intervention to usual care (no treatment). Setting A supermarket in a socioeconomically diverse region of Phoenix, Arizona. Participants One-hundred fifty-three adult shoppers were recruited on-site. Intervention The intervention consisted of brief shopping education by a nutrition educator and an explanation and promotion of a supermarket POP healthy shopping program that included posted shelf signs identifying healthy foods, sample shopping lists, tips, and signage. Main Outcome Measures Outcomes included purchases of total, saturated, and trans fat (g/1000 kcals), and fruits, vegetables, and dark green and bright yellow vegetables (servings/1000 kcals) derived through nutritional analysis of participant shopping baskets. Analysis Analysis of covariance compared the intervention and control groups on food purchasing patterns while adjusting for household income. Results The intervention resulted in greater purchasing of fruit and green and yellow vegetables. No other group differences were observed. Conclusions and Implications Long-term evaluations of supermarket interventions should be conducted to improve the evidence base, and to determine the potential for impact on food choices associated with decreased chronic disease. PMID:22104016

School Breakfast Program Participation and Rural Adolescents' Purchasing Behaviors in Food Stores and Restaurants.

PubMed

Caspi, Caitlin Eicher; Wang, Qi; Shanafelt, Amy; Larson, Nicole; Wei, Susan; Hearst, Mary O; Nanney, Marilyn S

2017-10-01

Little is known about adolescents' food purchasing behaviors in rural areas. This study examined whether purchasing food at stores/restaurants around schools was related to adolescents' participation in school breakfast programs and overall diet in rural Minnesota. Breakfast-skippers enrolled in a group-randomized intervention in 2014 to 2015 (N = 404 from 8 schools) completed 24-hour dietary recalls and pre/post surveys assessing food establishment purchase frequency. Healthy Eating Index Scores (HEI-2010) were calculated for each student. Student-level school breakfast participation (SBP) was obtained from school food service records. Mixed-effects regression models estimated: (1) whether SBP was associated with store/restaurant use at baseline, (2) whether an increase in SBP was associated with a decrease in store/restaurant use, and (3) whether stores/restaurant use was associated with HEI-2010 scores at baseline. Students with increased SBP were more likely to decrease fast-food restaurant purchases on the way home from school (OR 1.017, 95% CI 1.005, 1.029), but were less likely to decrease purchases at food stores for breakfast (OR 0.979, 95% CI 0.959, 0.999). Food establishment use was associated with lower HEI-2010 dairy component scores (p = .017). Increasing participation in school breakfast may result in modest changes in purchases at food establishments. © 2017, American School Health Association.

Priority setting and evidence based purchasing.

PubMed

Frith, L

1999-01-01

The purpose of this paper is to consider the role that values play in priority setting through the use of EBP. It is important to be clear about the role of values at all levels of the decision making process. At one level, society as a whole has to make decisions about the kind of health provision that it wants. As is generally accepted, these priority setting questions cannot be answered by medical science alone but involve important judgements of value. However, as I hope to show values come into priority setting questions at another level, one not often explicitly recognised in much of the literature: that of the very definition of the effectiveness of treatments. This has important consequences for patient care. If we do not recognise that the effectiveness of a treatment involve subjective elements--a patient's own assessment of the value of the treatment--then this could lead to the belief that we can purchase one treatment that is the most effective for all patients. This might result in a detrimental reduction in the range of options that a patient is given with some patients not receiving the treatment that is most effective for them.

24 CFR 291.565 - Continuing obligations after purchase.

Code of Federal Regulations, 2010 CFR

2010-04-01

... purchase. 291.565 Section 291.565 Housing and Urban Development Regulations Relating to Housing and Urban... Neighbor Next Door Sales Program § 291.565 Continuing obligations after purchase. To remain in compliance.../her sole residence, the home purchased through the GNND Sales Program; and (b) Certify initially and...

Notification: Fiscal Year 2015 Risk Assessment of EPA's Purchase Card and Convenience Check Programs

EPA Pesticide Factsheets

Project #OA-FY15-0064, August 26, 2015. The U.S. Environmental Protection Agency (EPA) Office oflnspector General (OIG) plans to begin the preliminary research phase ofauditing the agency's purchase card and convenience check programs.

24 CFR 291.545 - Financing purchase of the home.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Financing purchase of the home. 291... Neighbor Next Door Sales Program § 291.545 Financing purchase of the home. (a) Purchase using conventional... conventional financing to purchase a home under the GNND Sales Program, the amount of the mortgage may not...

24 CFR 291.545 - Financing purchase of the home.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Financing purchase of the home. 291... Neighbor Next Door Sales Program § 291.545 Financing purchase of the home. (a) Purchase using conventional... conventional financing to purchase a home under the GNND Sales Program, the amount of the mortgage may not...

24 CFR 291.545 - Financing purchase of the home.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Financing purchase of the home. 291... Neighbor Next Door Sales Program § 291.545 Financing purchase of the home. (a) Purchase using conventional... conventional financing to purchase a home under the GNND Sales Program, the amount of the mortgage may not...

24 CFR 291.545 - Financing purchase of the home.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Financing purchase of the home. 291... Neighbor Next Door Sales Program § 291.545 Financing purchase of the home. (a) Purchase using conventional... conventional financing to purchase a home under the GNND Sales Program, the amount of the mortgage may not...

24 CFR 291.545 - Financing purchase of the home.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Financing purchase of the home. 291... Neighbor Next Door Sales Program § 291.545 Financing purchase of the home. (a) Purchase using conventional... conventional financing to purchase a home under the GNND Sales Program, the amount of the mortgage may not...

An approach to value-based simulator selection: The creation and evaluation of the simulator value index tool.

PubMed

Rooney, Deborah M; Hananel, David M; Covington, Benjamin J; Dionise, Patrick L; Nykamp, Michael T; Pederson, Melvin; Sahloul, Jamal M; Vasquez, Rachael; Seagull, F Jacob; Pinsky, Harold M; Sweier, Domenica G; Cooke, James M

2018-04-01

Currently there is no reliable, standardized mechanism to support health care professionals during the evaluation of and procurement processes for simulators. A tool founded on best practices could facilitate simulator purchase processes. In a 3-phase process, we identified top factors considered during the simulator purchase process through expert consensus (n = 127), created the Simulator Value Index (SVI) tool, evaluated targeted validity evidence, and evaluated the practical value of this SVI. A web-based survey was sent to simulation professionals. Participants (n = 79) used the SVI and provided feedback. We evaluated the practical value of 4 tool variations by calculating their sensitivity to predict a preferred simulator. Seventeen top factors were identified and ranked. The top 2 were technical stability/reliability of the simulator and customer service, with no practical differences in rank across institution or stakeholder role. Full SVI variations predicted successfully the preferred simulator with good (87%) sensitivity, whereas the sensitivity of variations in cost and customer service and cost and technical stability decreased (≤54%). The majority (73%) of participants agreed that the SVI was helpful at guiding simulator purchase decisions, and 88% agreed the SVI tool would help facilitate discussion with peers and leadership. Our findings indicate the SVI supports the process of simulator purchase using a standardized framework. Sensitivity of the tool improved when factors extend beyond traditionally targeted factors. We propose the tool will facilitate discussion amongst simulation professionals dealing with simulation, provide essential information for finance and procurement professionals, and improve the long-term value of simulation solutions. Limitations and application of the tool are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

42 CFR 441.482 - Permissible purchases.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Permissible purchases. 441.482 Section 441.482... Optional Self-Directed Personal Assistance Services Program § 441.482 Permissible purchases. (a... assistance. (b) The services, supports and items that are purchased with a service budget must be linked to...

Making Wise Buys: Five Values to Consider when Evaluating a Library Purchase

ERIC Educational Resources Information Center

Durr, Chris

2011-01-01

Library staff members should ultimately base their purchasing choices on the mission statements of their employing institutions. Fortunately, library mission statements have much in common. Undoubtedly, for example, all libraries have a goal that includes "serve the information needs of the community," because on some level, all libraries are…

Purchases Made with a Fruit and Vegetable Voucher in a Rural Mexican-Heritage Community.

PubMed

Hanbury, Meagan M; Gomez-Camacho, Rosa; Kaiser, Lucia; Sadeghi, Banafsheh; de la Torre, Adela

2017-10-01

Recent recommendations for US food assistance programs are intended to ensure foods provided through these programs help households consume a varied, healthful diet. From a policy viewpoint, it is important to examine the impact of economic incentives to purchase healthy foods across subpopulations, particularly low-income Latinos, who comprise 40% of the WIC program nationwide. Our aim was to determine how rural, Mexican-heritage households (N = 227) residing in California's Central Valley distributed fruit and vegetable (F/V) voucher spending among F/V subgroups and specific items over a 1-year period. Households contained at least one child who was between 3 and 8 years old at baseline and had a parent of Mexican-heritage. F/V voucher purchase data were collected via grocery store scanners. Expenditure and frequency shares of subgroups and individual items were analyzed to determine purchasing habits. Fruits were the most commonly purchased subgroup, representing 55% of spending and 45% of frequency. Households allocated low percentages of their voucher to dark green and red/orange vegetables-7 and 9% respectively. Approximately 20% of purchases were good potassium sources and 30% of purchases were good fiber sources. Many of the most frequently purchased items were of cultural significance (tomatillo, chayote, chili/jalapeño pepper, and Mexican squash). This study suggests that economic incentives can contribute important nutrients to participants' diets and targeted vouchers provided by food assistance programs should continue to include culturally important foods and be aware of the cultural values of their participants.

Evaluating group purchasing organizations.

PubMed

Kaldor, Dennis C; Kowalski, Jamie C; Tankersley, Mark A

2003-01-01

A formal evaluation process can help healthcare organizations assess the current and/or potential value of a group purchasing organization (GPO). Healthcare organizations should approach a GPO evaluation as if they were entering into a new relationship. The evaluation should include purchasing and financial services, value-added services, and corporate relations/business practices. Healthcare organizations should consider the potential economies of scale and other services offered by a GPO. Healthcare organizations should consider using acceptable substitutes for products currently used or seeking products through alternative sources if doing so achieves greater value.

The effect of new purchase criteria on food procurement for the Brazilian school feeding program.

PubMed

Soares, Panmela; Davó-Blanes, M Carmen; Martinelli, Suellen Secchi; Melgarejo, Leonardo; Cavalli, Suzi Barletto

2017-01-01

To explore the effect of the school feeding program purchase criteria on the quantity, variety and origin of food products acquired for school meals in a municipality in Brazil. Analysis of purchase lists for two years prior and two years after implementation of the purchase criteria (2010). The origin (family farms (FF)/other providers (OP)) and nutritional characteristics (recommended/controlled) of food products were studied, registering annual varieties (n) and daily quantities (kg/day); contrast of proportions was applied. The acquisition of recommended products increased, and the quantity of controlled products decreased (p = 0.005). Purchase of legumes and vegetables (p < 0.05) increased and high sugar foods decreased (p = 0.02). The majority of food products in 2010 and 2011 were acquired from OP (64% and 61%), although FF provided the greatest proportion of legumes and vegetables. Ten new varieties of recommended products were incorporated, 9 of which were acquired from FF. The criteria of direct purchase from family farms resulted in an increase in the variety and quantity of healthy foods in the schools in the municipality. Copyright © 2016 Elsevier Ltd. All rights reserved.

Subprimal purchasing and merchandising decisions for pork: relationship to retail value.

PubMed

Lorenzen, C L; Walter, J P; Dockerty, T R; Griffin, D B; Johnson, H K; Savell, J W

1996-01-01

To assess retail value and profitability, cutting test data were obtained in a simulated retail cutting room for boxed pork subprimals, bone-in loins (n = 180), boneless loins (n = 94), Boston butts (n = 148), fresh hams (n = 28), and boneless hams (n = 23). Processing times (seconds) and retail weights (kilograms) were used to determine relative value. Cutting style affected (P < .05) value differential (US$/subprimal) for bone-in and boneless loins. When cutting styles within subprimals were pooled, value differential was affected (P < .05) by purchasing specification for bone-in loins, boneless loins, Boston butts, and inside fresh hams. Processing bone-in loins to a boneless end point produced a greater (P < .05) value differential and percentage of gross margin than a bone-in retail end point. Bone-in loins fabricated to a boneless retail end point produced a greater (P < .05) value differential and percentage of gross margin than boneless loins fabricated to the same end point. The increase in retail value can be attributed to the increased number and weight of retail cuts produced from bone-in loins. The thick, boneless loin cutting style produced a greater (P < .05) value differential and percentage of gross margin as a result of a lower (P < .05) cost of fabrication and increased value of retail cuts than the thin, boneless cutting style. In general, boneless pork cutting methods were more profitable than bone-in cutting methods regardless of subprimal.

78 FR 36508 - Notice of Sugar Purchase and Exchange for Re-Export Program Credits; and Notice of Re-Export...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-18

... DEPARTMENT OF AGRICULTURE Commodity Credit Corporation Office of the Secretary Notice of Sugar... to purchase sugar to be offered in exchange for Refined Sugar Re-export Program credits. CCC will purchase sugar from domestic sugarcane processors or beet processors under the Cost Reduction Options of...

Should general practitioners purchase health care for their patients? The total purchasing experiment in Britain.

PubMed

Wyke, Sally; Mays, Nicholas; Street, Andrew; Bevan, Gwyn; McLeod, Hugh; Goodwin, Nick

2003-09-01

Until relatively recently, general practitioners (GPs) have been allowed to work independently, with no requirement to consider the resource implications of their referral and prescribing decisions. In order to align the interests of GPs with the overall objectives of health systems a number of countries have introduced primary care based capitation, funds pooling and budget holding either as experiments or as an overall policy. Are these experiments and policies likely to work? This paper presents evidence from the UK total purchasing experiment, which was the first major quasi-market development in the NHS to be independently evaluated from the outset. Total purchasing gave volunteer groups of practices freedom to purchase all hospital and community health services for their patients. The evidence suggests that whilst GPs have great potential as purchasers, they also have considerable limitations. The expectation that they will be able to improve the quality of patient experience of care, or to alter the use of resources, may not be generally realised. GP-based purchasing may be more appropriate where the task is to alter the balance or location of care between hospital and extramural settings. However, budgetary incentives are not 'magic potions' which have similar effects on behaviour wherever they are introduced. Holding budgets and having independent contracts, while important pre-requisites for being taken seriously in a quasi-market, were not sufficient for effective total purchasing. The paper concludes that health systems should not only value innovation and experimentation and encourage learning from evaluative research; they should also recognise the importance of supportive circumstances for any innovation to effect real and sustained change.

Purchases of ready-to-eat cereals vary across US household sociodemographic categories according to nutritional value and advertising targets.

PubMed

Castetbon, Katia; Harris, Jennifer L; Schwartz, Marlene B

2012-08-01

To describe ready-to-eat (RTE) cereal purchases in 2008 in the USA according to cereal nutritional quality and marketing strategy and household sociodemographic characteristics. Cross-sectional study of purchases in one year. Each type of cereal was assigned to one of four nutrition quality categories (based on Nutrient Profile Index, NPI) and one of four advertising categories based on television exposure and analysis of packaging (child-targeted, family-targeted, adult-targeted and no television advertising). Medians and distributions of purchase indicators were calculated for the cereal categories and the distributions were compared across sociodemographic groups. RTE cereals (n 249) with complete label and nutritional content. RTE cereal purchases according to household sociodemographic characteristics obtained from Nielsen Homescan, a nationally representative panel of households. Purchases of RTE cereals were highest in households with one or more child and lowest in African-American and Asian households, as well as those earning <$US 30 000 per annum. The lowest-quality products were purchased by four times as many households as the highest-quality cereals, but loyalty to these products was lower. Purchases of cereals by households with children and in African-American and Hispanic households increased as cereal nutritional quality declined. Compared with non-advertised products, advertised child-targeted cereals were purchased thirteen times more frequently; family-targeted brand purchases were ten times higher; and adult-targeted cereals were purchased four times more frequently. Our findings suggest that improving the nutritional quality of RTE cereals with advertising targeted to children could also lead to increased consumption of healthier products by young people.

48 CFR 2913.301 - Governmentwide commercial purchase card.

Code of Federal Regulations, 2013 CFR

2013-10-01

... other methods of purchasing. However, the same legal restrictions apply to credit card purchases that.../Agency Purchase/Credit Card Program procedures. A number of the more common restrictions which... purchase card. 2913.301 Section 2913.301 Federal Acquisition Regulations System DEPARTMENT OF LABOR...

48 CFR 2913.301 - Governmentwide commercial purchase card.

Code of Federal Regulations, 2014 CFR

2014-10-01

... other methods of purchasing. However, the same legal restrictions apply to credit card purchases that.../Agency Purchase/Credit Card Program procedures. A number of the more common restrictions which... purchase card. 2913.301 Section 2913.301 Federal Acquisition Regulations System DEPARTMENT OF LABOR...

48 CFR 2913.301 - Governmentwide commercial purchase card.

Code of Federal Regulations, 2011 CFR

2011-10-01

... other methods of purchasing. However, the same legal restrictions apply to credit card purchases that.../Agency Purchase/Credit Card Program procedures. A number of the more common restrictions which... purchase card. 2913.301 Section 2913.301 Federal Acquisition Regulations System DEPARTMENT OF LABOR...

Informed Purchasing Can Stretch Short Dollars.

ERIC Educational Resources Information Center

Miller, John B.; Miller, Kathryn Madera

1979-01-01

Provides purchasing tips for programs on a tight budget. Topics include writing specifications for the merchandise needed, finding and developing sources (vendors), receiving and analyzing bids, writing purchase orders, and receiving merchandise. (CM)

Notification: Review of the U.S. Environmental Protection Agency's Purchase Card and Convenience Check Program

EPA Pesticide Factsheets

Project #OA-FY13-0116, December 20, 2012. The U.S. Environmental Protection Agency, Office of Inspector General, plans to begin preliminary research for an audit of the agency’s purchase card and convenience check programs.

U.S. Residential Photovoltaic (PV) System Prices, Q4 2013 Benchmarks: Cash Purchase, Fair Market Value, and Prepaid Lease Transaction Prices

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

Davidson, C.; James, T. L.; Margolis, R.

The price of photovoltaic (PV) systems in the United States (i.e., the cost to the system owner) has dropped precipitously in recent years, led by substantial reductions in global PV module prices. This report provides a Q4 2013 update for residential PV systems, based on an objective methodology that closely approximates the book value of a PV system. Several cases are benchmarked to represent common variation in business models, labor rates, and module choice. We estimate a weighted-average cash purchase price of $3.29/W for modeled standard-efficiency, polycrystalline-silicon residential PV systems installed in the United States. This is a 46% declinemore » from the 2013-dollar-adjusted price reported in the Q4 2010 benchmark report. In addition, this report frames the cash purchase price in the context of key price metrics relevant to the continually evolving landscape of third-party-owned PV systems by benchmarking the minimum sustainable lease price and the fair market value of residential PV systems.« less

Determining the Use and Perceived Effectiveness of a Point-of-Purchase Cafeteria Nutrition Education Program.

PubMed

Ruzansky, ANITA S.; Whiting, Susan; Dobson, JOANNE DESMARAIS

1998-01-01

The Eat Smart Heart Beat Cafeteria Program (ESCP) is a point-of-purchase nutrition education program (PPNEP), which was developed by the Ottawa-Carleton Health Department (OCHD). The intent of this program was to increase the awareness and availability of lower-fat, higher-fibre foods in cafeterias. The purpose of this study was to evaluate the ESCP using a Feedback Questionnaire. The questionnaire was developed primarily to determine the use of the ESCP manual and to evaluate the users' perceived effectiveness of this program. Purchasers of the ESCP were asked to complete the questionnaire one year after they received the program resources. Forty of the 88 program recipients (45%) returned the questionnaire. Most responses were from nutritionists or dietitians, health service managers and occupational health workers. Most respondents represented large workplaces (more than 250 employees) such as hospitals, government, health units and educational institutions. Of the 40 respondents, 10 implemented the program and indicated that they were moderately to very satisfied with all of the resources and that they would continue using the program. The 30 respondents who reported not using the program indicated that this was mainly due to time constraints. The ESCP has the potential to increase the awareness and availability of lower-fat, higher-fibre foods. Therefore, it is recommended that the program be continued in a ready-to-use format to increase its usability. Further research is needed to clarify the effects of the ESCP on behaviour change.

48 CFR 313.301 - Government-wide commercial purchase card.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., Appendix B, “Improving the Management of Government Charge Card Programs;” GSA's SmartPay Program guidance; and HHS Purchase Card program standards. (2) The OPDIVs, through their designated Agency/Organization... training requirements to ensure effective implementation of the HHS purchase card program. (3) OPDIVs shall...

Computer-Based Instruction for Purchasing Skills

ERIC Educational Resources Information Center

Ayres, Kevin M.; Langone, John; Boon, Richard T.; Norman, Audrey

2006-01-01

The purpose of this study was to investigate use of computers and video technologies to teach students to correctly make purchases in a community grocery store using the dollar plus purchasing strategy. Four middle school students diagnosed with intellectual disabilities participated in this study. A multiple probe across participants research…

Comparison of Cooperative and Noncooperative Purchasing in School Nutrition Programs

ERIC Educational Resources Information Center

Rice, Beth W.; Strohbehn, Catherine; Shelly, Mark C.; Arendt, Susan; Gregoire, Mary

2010-01-01

Purpose/Objectives: The purpose of this study was to compare food cost and public school foodservice directors' satisfaction between districts participating in school foodservice cooperatives or group purchasing arrangements and districts purchasing independently. It also assessed the prevalence of purchasing cooperatives in school foodservice and…

The influence of ethical values and food choice motivations on intentions to purchase sustainably sourced foods.

PubMed

Dowd, Kylie; Burke, Karena J

2013-10-01

This study examined a three-step adaptation of the Theory of Planned Behaviour (TPB) applied to the intention of consumers to purchase sustainably sourced food. The sample consisted of 137 participants, of which 109 were female, who were recruited through a farmers market and an organic produce outlet in an Australian capital city. Participants completed an online questionnaire containing the TPB scales of attitude, subjective norms, perceived behavioural control and intention; measures of positive moral attitude and ethical self identity; and food choice motives. Hierarchical multiple regression was used to examine the predictive utility of the TPB in isolation (step 1) and the TPB expanded to include the constructs of moral attitude and ethical self-identity (step 2). The results indicated the expansion of the TPB to include these constructs added significantly to the predictive model measuring intention to purchase sustainably sourced food. The third step in the adaptation utilised this expanded TPB model and added a measure of retail channel (where consumers reported buying fresh produce) and 9 food choice motives, in order to assess the predictive utility of the inclusion of choice motivations in this context. Of the 8 food choice motives examined, only health and ethical values significantly predicted intention to purchase sustainably sourced food. However, with the addition of food choice motives, ethical self-identity was no longer a significant predictor of intention to purchase sustainably sourced food. Overall the adapted TPB model explained 76% of the variance in intention to purchase sustainably sourced food. Copyright © 2013 Elsevier Ltd. All rights reserved.

Prevalence of Malaria Parasitemia and Purchase of Artemisinin-Based Combination Therapies (ACTs) among Drug Shop Clients in Two Regions in Tanzania with ACT Subsidies

PubMed Central

Briggs, Melissa A.; Kalolella, Admirabilis; Bruxvoort, Katia; Wiegand, Ryan; Lopez, Gerard; Festo, Charles; Lyaruu, Pierre; Kenani, Mitya; Abdulla, Salim; Goodman, Catherine; Kachur, S. Patrick

2014-01-01

Background Throughout Africa, many people seek care for malaria in private-sector drug shops where diagnostic testing is often unavailable. Recently, subsidized artemisinin-based combination therapies (ACTs), a first-line medication for uncomplicated malaria, were made available in these drug shops in Tanzania. This study assessed the prevalence of malaria among and purchase of ACTs by drug shop clients in the setting of a national ACT subsidy program and sub-national drug shop accreditation program. Method and Findings A cross-sectional survey of drug shop clients was performed in two regions in Tanzania, one with a government drug shop accreditation program and one without, from March-May, 2012. Drug shops were randomly sampled from non-urban districts. Shop attendants were interviewed about their education, training, and accreditation status. Clients were interviewed about their symptoms and medication purchases, then underwent a limited physical examination and laboratory testing for malaria. Malaria prevalence and predictors of ACT purchase were assessed using univariate analysis and multiple logistic regression. Amongst 777 clients from 73 drug shops, the prevalence of laboratory-confirmed malaria was 12% (95% CI: 6–18%). Less than a third of clients with malaria had purchased ACTs, and less than a quarter of clients who purchased ACTs tested positive for malaria. Clients were more likely to have purchased ACTs if the participant was <5 years old (aOR: 6.6; 95% CI: 3.9–11.0) or the shop attendant had >5 years, experience (aOR: 2.8; 95% CI: 1.2–6.3). Having malaria was only a predictor of ACT purchase in the region with a drug shop accreditation program (aOR: 3.4; 95% CI: 1.5–7.4). Conclusion Malaria is common amongst persons presenting to drug shops with a complaint of fever. The low proportion of persons with malaria purchasing ACTs, and the high proportion of ACTs going to persons without malaria demonstrates a need to better target who receives

Prevalence of malaria parasitemia and purchase of artemisinin-based combination therapies (ACTs) among drug shop clients in two regions in Tanzania with ACT subsidies.

PubMed

Briggs, Melissa A; Kalolella, Admirabilis; Bruxvoort, Katia; Wiegand, Ryan; Lopez, Gerard; Festo, Charles; Lyaruu, Pierre; Kenani, Mitya; Abdulla, Salim; Goodman, Catherine; Kachur, S Patrick

2014-01-01

Throughout Africa, many people seek care for malaria in private-sector drug shops where diagnostic testing is often unavailable. Recently, subsidized artemisinin-based combination therapies (ACTs), a first-line medication for uncomplicated malaria, were made available in these drug shops in Tanzania. This study assessed the prevalence of malaria among and purchase of ACTs by drug shop clients in the setting of a national ACT subsidy program and sub-national drug shop accreditation program. A cross-sectional survey of drug shop clients was performed in two regions in Tanzania, one with a government drug shop accreditation program and one without, from March-May, 2012. Drug shops were randomly sampled from non-urban districts. Shop attendants were interviewed about their education, training, and accreditation status. Clients were interviewed about their symptoms and medication purchases, then underwent a limited physical examination and laboratory testing for malaria. Malaria prevalence and predictors of ACT purchase were assessed using univariate analysis and multiple logistic regression. Amongst 777 clients from 73 drug shops, the prevalence of laboratory-confirmed malaria was 12% (95% CI: 6-18%). Less than a third of clients with malaria had purchased ACTs, and less than a quarter of clients who purchased ACTs tested positive for malaria. Clients were more likely to have purchased ACTs if the participant was <5 years old (aOR: 6.6; 95% CI: 3.9-11.0) or the shop attendant had >5 years, experience (aOR: 2.8; 95% CI: 1.2-6.3). Having malaria was only a predictor of ACT purchase in the region with a drug shop accreditation program (aOR: 3.4; 95% CI: 1.5-7.4). Malaria is common amongst persons presenting to drug shops with a complaint of fever. The low proportion of persons with malaria purchasing ACTs, and the high proportion of ACTs going to persons without malaria demonstrates a need to better target who receives ACTs in these drug shops.

7 CFR 1435.602 - Eligible sugar to be purchased by CCC.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 10 2014-01-01 2014-01-01 false Eligible sugar to be purchased by CCC. 1435.602... CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS SUGAR PROGRAM Feedstock Flexibility Program § 1435.602 Eligible sugar to be purchased by CCC. (a) CCC will only purchase raw sugar...

Quality improvement and cost reduction realized by a purchaser through diabetes disease management.

PubMed

Snyder, James W; Malaskovitz, Joyce; Griego, Janet; Persson, Jeffrey; Flatt, Kristy

2003-01-01

This report documents the clinical improvements and costs experienced by a purchaser after introduction of a diabetes disease management program. A purchaser contracted with American Healthways, a disease management organization, to initiate a diabetes disease management program called Diabetes Decisions. Started in 1998, the program grew to include 662 participants. The results reported are based on the continuously participating population (12 months of participation in the program for the reporting year). Participants were entered into American Healthways' clinical information system and risk-stratified, and an individualized treatment plan was devised. Outbound telephone calls by specially trained nurses were a key intervention. Data were collected on key process measures, financial parameters, and participant satisfaction. By year 3, there were 422 continuously participating participants. From baseline to the third year of the program, significant increases in frequency of A1C testing (21.3% to 82.2%), dilated retinal exams (17.2% to 70.7%), and performance of foot exams (2.0% to 75.6%) were noted. For 166 participants with five A1C determinations, A1C values dropped from 8.89% to 7.88%. Participants experienced a 36% drop in inpatient costs. Without adjustment for medical inflation, total medical costs decreased by 26.8% from the baseline period, dropping to $268.63 per diabetes participant per month (PDPPM) by year 3, a gross savings of $98.49 PDPPM. After subtracting the fees paid to Diabetes Decisions, a net savings of $986,538 was realized. This yielded a return on investment of 3.37. By investing in a diabetes disease management program, a purchaser was able to realize significant improvements in clinical care, substantial cost savings, and a favorable return on investment.

Increase the Government Purchase Card Limit

DTIC Science & Technology

2014-06-01

Acquisition BPA blanket purchase agreement CCPMD Consolidated Card Program Management Division COTS commercial, off-the-shelf CPI consumer price index...purchase agreements ( BPA ) or indefinite delivery/indefinite quantity (ID/IQ) contracts for repetitive orders. This authority is discussed further in...where they can purchase up to $150,000 in supplies from established mandatory sources and BPAs , for example. (3) Fewer commands have “ordering 2

Measuring Value in Internal Medicine Residency Training Hospitals Using Publicly Reported Measures.

PubMed

Schickedanz, Adam; Gupta, Reshma; Arora, Vineet M; Braddock, Clarence H

2018-03-01

Graduate medical education (GME) lacks measures of resident preparation for high-quality, cost-conscious practice. The authors used publicly reported teaching hospital value measures to compare internal medicine residency programs on high-value care training and to validate these measures against program director perceptions of value. Program-level value training scores were constructed using Centers for Medicare & Medicaid Services Value-Based Purchasing (VBP) Program hospital quality and cost-efficiency data. Correlations with Association of Program Directors in Internal Medicine Annual Survey high-value care training measures were examined using logistic regression. For every point increase in program-level VBP score, residency directors were more likely to agree that GME programs have a responsibility to contain health care costs (adjusted odds ratio [aOR] 1.18, P = .04), their faculty model high-value care (aOR 1.07, P = .03), and residents are prepared to make high-value medical decisions (aOR 1.07, P = .09). Publicly reported clinical data offer valid measures of GME value training.

77 FR 217 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment; Ambulatory Surgical...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-04

... Donald Howard, (410) 786-6764, Hospital Value-Based Purchasing (VBP) Program Issues. SUPPLEMENTARY... analyses performed by Brandeis University and Mathematica Policy Research together despite their slightly...

Notification: Fiscal Year 2016 Risk Assessment of EPA’s Purchase Card and Convenience Check Program

EPA Pesticide Factsheets

Project #OA-FY16-0229, July 14, 2016. The EPA OIG plans to begin a risk assessment of the EPA’s purchase card and convenience check program with the Office of Acquisition Management (OAM) within the Office of Administration and Resources Management (OARM).

The Impact of Nursing Home Pay-for-Performance on Quality and Medicare Spending: Results from the Nursing Home Value-Based Purchasing Demonstration.

PubMed

Grabowski, David C; Stevenson, David G; Caudry, Daryl J; O'Malley, A James; Green, Lisa H; Doherty, Julia A; Frank, Richard G

2017-08-01

To evaluate the impact of the Nursing Home Value-Based Purchasing demonstration on quality of care and Medicare spending. Administrative and qualitative data from Arizona, New York, and Wisconsin nursing homes over the base-year (2008-2009) and 3-year (2009-2012) demonstration period. Nursing homes were randomized to the intervention in New York, while the comparison facilities were constructed via propensity score matching in Arizona and Wisconsin. We used a difference-in-difference analysis to compare outcomes across the base-year relative to outcomes in each of the three demonstration years. To provide context and assist with interpretation of results, we also interviewed staff members at participating facilities. Medicare savings were observed in Arizona in the first year only and Wisconsin for the first 2 years; no savings were observed in New York. The demonstration did not systematically impact any of the quality measures. Discussions with nursing home administrators suggested that facilities made few, if any, changes in response to the demonstration, leading us to conclude that the observed savings likely reflected regression to the mean rather than true savings. The Federal nursing home pay-for-performance demonstration had little impact on quality or Medicare spending. © Health Research and Educational Trust.

24 CFR 982.317 - Lease-purchase agreements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Lease-purchase agreements. 982.317...-purchase agreements. (a) A family leasing a unit with assistance under the program may enter into an agreement with an owner to purchase the unit. So long as the family is receiving such rental assistance, all...

Corner Store Purchases in a Low-Income Urban Community in NYC.

PubMed

Kiszko, Kamila; Cantor, Jonathan; Abrams, Courtney; Ruddock, Charmaine; Moltzen, Kelly; Devia, Carlos; McFarline, Bernice; Singh, Hardeep; Elbel, Brian

2015-12-01

We assessed purchases made, motivations for shopping, and frequency of shopping at four New York City corner stores (bodegas). Surveys and purchase inventories (n = 779) were collected from consumers at four bodegas in Bronx, NY. We use Chi square tests to compare types of consumers, items purchased and characteristics of purchases based on how frequently the consumer shops at the specific store and the time of day the purchase was made. Most consumers shopped at the bodega because it was close to their home (52 %). The majority (68 %) reported shopping at the bodega at least once per day. The five most commonly purchased items were sugary beverages, (29.27 %), sugary snacks (22.34 %), coffee, (13.99 %), sandwiches, (13.09 %) and non-baked potato chips (12.2 %). Nearly 60 % of bodega customers reported their purchase to be healthy. Most of the participants shopped at the bodega frequently, valued its convenient location, and purchased unhealthy items. Work is needed to discover ways to encourage healthier choices at these stores.

Validation of the Consumer Values versus Perceived Product Attributes Model Measuring the Purchase of Athletic Team Merchandise

ERIC Educational Resources Information Center

Lee, Donghun; Byon, Kevin K.; Schoenstedt, Linda; Johns, Gary; Bussell, Leigh Ann; Choi, Hwansuk

2012-01-01

Various consumer values and perceived product attributes trigger consumptive behaviors of athletic team merchandise (Lee, Trail, Kwon, & Anderson, 2011). Likewise, using a principal component analysis technique on a student sample, a measurement scale was proposed that consisted of nine factors affecting the purchase of athletic team…

76 FR 39006 - Medicare Program; Hospital Inpatient Value-Based Purchasing Program; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-05

... Pneumonia (PN) 30-Day .8818 Mortality Rate. 7. On page 26516, Table 7 is corrected to read as follows... Day Mortality Rate. MORT-30 PN Pneumonia (PN) 30-Day .9021 Mortality Rate. 8. On page 26527, in the...

Orthopedic Implant Value Drivers: A Qualitative Survey Study of Hospital Purchasing Administrators.

PubMed

Li, Chuan Silvia; Vannabouathong, Christopher; Sprague, Sheila; Bhandari, Mohit

2015-01-01

Osteoarthritis (OA) is a chronic, degenerative disease that is highly prevalent in the population, yet the factors that affect purchasing decisions related to this condition are poorly understood. A questionnaire was developed and administered to hospital executives across North America to determine the factors that affect purchasing decisions related to OA. Thirty-four individuals participated in the survey. Clinical evidence and cost effectiveness were deemed to be the most important factors in the process of making purchasing decisions. The most important considerations for adopting new technology were whether there was sufficient evidence in the literature, followed by thoughts of key opinion leaders, and cost of intervention/device. Ongoing research is still needed, but the current study allowed us to identify some trends in the data, providing new insight on how hospital purchasing decisions are made, which could have an immediate impact on those currently involved with making these decisions.

Value management program: performance, quantification, and presentation of imaging value-added actions.

PubMed

Patel, Samir

2015-03-01

Health care is in a state of transition, shifting from volume-based success to value-based success. Hospital executives and referring physicians often do not understand the total value a radiology group provides. A template for easy, cost-effective implementation in clinical practice for most radiology groups to demonstrate the value they provide to their clients (patients, physicians, health care executives) has not been well described. A value management program was developed to document all of the value-added activities performed by on-site radiologists, quantify them in terms of time spent on each activity (investment), and present the benefits to internal and external stakeholders (outcomes). The radiology value-added matrix is the platform from which value-added activities are categorized and synthesized into a template for defining investments and outcomes. The value management program was first implemented systemwide in 2013. Across all serviced locations, 9,931.75 hours were invested. An annual executive summary report template demonstrating outcomes is given to clients. The mean and median individual value-added hours per radiologist were 134.52 and 113.33, respectively. If this program were extrapolated to the entire field of radiology, approximately 30,000 radiologists, this would have resulted in 10,641,161 uncompensated value-added hours documented in 2013, with an estimated economic value of $2.21 billion. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Consumer peach preferences and purchasing behavior: a mixed methods study.

PubMed

Kelley, Kathleen M; Primrose, Rachel; Crassweller, Robert; Hayes, John E; Marini, Richard

2016-05-01

Peaches (Prunus persica (L.) Stokes) are grown in several regions throughout the USA, are eaten fresh, and used as ingredients in value-added processed products. An Internet survey was conducted to investigate Mid-Atlantic consumers' fresh and processed peach purchasing behaviors, and whether packaging certain numbers of peaches together, providing information about nutritional content, and other factors would increase purchases. Additionally, laboratory-based sensory testing was used to better understand peel color, texture, sweetness, sourness, and flavor preferences for cultivars commonly grown in the Mid-Atlantic region. Irrespective of fresh peach consumption frequency, certain value-added products were of interest. For some products, interest in purchasing was higher than reported purchasing behavior. Preference for certain fresh peach characteristics, such as peel color, differed between less frequent fresh peach consumers and those who consumed fresh peaches more often. Of the four peach cultivars included in the sensory test, most were liked; however, there were some cultivar differences pertaining to color, texture, sweetness, tartness, and flavor liking. Potential marketing strategies can be developed based on frequency of fresh peach consumption and household demographics. Data can be used to select peaches that best appeal to consumers. © 2015 Society of Chemical Industry. © 2015 Society of Chemical Industry.

Buying best value health care: Evolution of purchasing among Australian private health insurers

PubMed Central

Willcox, Sharon

2005-01-01

Since 1995 Australian health insurers have been able to purchase health services pro-actively through negotiating contracts with hospitals, but little is known about their experience of purchasing. This paper examines the current status of purchasing through interviews with senior managers representing all Australian private health insurers. Many of the traditional tools used to generate competition and enhance efficiency (such as selective contracting and co-payments) have had limited use due to public and political opposition. Adoption of bundled case payment models using diagnosis related groups (DRGs) has been slow. Insurers cite multiple reasons including poor understanding of private hospital costs, unfamiliarity with DRGs, resistance from the medical profession and concerns about premature discharge. Innovation in payment models has been limited, although some insurers are considering introduction of volume-outcome purchasing and pay for performance incentives. Private health insurers also face a complex web of regulation, some of which appears to impede moves towards more efficient purchasing. PMID:15801982

Impact of Provider Incentives on Quality and Value of Health Care.

PubMed

Doran, Tim; Maurer, Kristin A; Ryan, Andrew M

2017-03-20

The use of financial incentives to improve quality in health care has become widespread. Yet evidence on the effectiveness of incentives suggests that they have generally had limited impact on the value of care and have not led to better patient outcomes. Lessons from social psychology and behavioral economics indicate that incentive programs in health care have not been effectively designed to achieve their intended impact. In the United States, Medicare's Hospital Readmission Reduction Program and Hospital Value-Based Purchasing Program, created under the Affordable Care Act (ACA), provide evidence on how variations in the design of incentive programs correspond with differences in effect. As financial incentives continue to be used as a tool to increase the value and quality of health care, improving the design of programs will be crucial to ensure their success.

Cooperative Purchasing Guidelines. Background and Research, Pros and Cons, Examples of Exemplary Programs, Sample Forms, and Organization Procedures.

ERIC Educational Resources Information Center

Association of School Business Officials, Chicago, IL.

Cooperative purchasing programs among school districts have grown rapidly in the past decade, but significant questions remain about the benefits and drawbacks of such programs. This document presents the results of a project sponsored by the Association of School Business Officials for the purpose of addressing these questions. Comprising…

Harem: Hardwood lumber remanufacturing program for maxmizing value based on size, grade and current market prices

Treesearch

C.J. Schwehm; P. Klinkhachorn; Charles W. McMillin; Henry A. Huber

1990-01-01

This paper describes an expert system computer program which will determine the optimum way to edge and trim a hardwood board so as to yield the highest dollar value based on the grade, size of each board, and current market prices. The program uses the Automated Hardwood Lumber Grading Program written by Klinkhachorn, et al. for determining the grade of each board...

Purchasing and Accounting. MAS-116. Waste Isolation Division (WID). Management and Supervisor Training (MAST) Program.

ERIC Educational Resources Information Center

Westinghouse Electric Corp., Carlsbad, NM.

This learning module, which is part of a management and supervisor training program for managers and supervisors employed at the Department of Energy's Waste Isolation Division, is designed to prepare trainees to perform purchasing and accounting tasks efficiently and effectively. The first section is an introduction to the module. The next three…

Encouraging use of coupons to stimulate condom purchase.

PubMed Central

Dahl, D W; Gorn, G J; Weinberg, C B

1999-01-01

OBJECTIVES: This study examined the feasibility of using high-value coupons to induce condom purchase and evaluated execution factors that can influence the effectiveness of this form of promotion. METHODS: Two levels of coupon discount value (10% off and 75% off) were used to promote condom purchase among young adults. Coupons were distributed according to a widespread strategy or a more focused in-store disbursement method. RESULTS: Redemption of coupons distributed through the widespread disbursement strategy was negligible. In contrast, coupons from the in-store distribution method, particularly the higher value coupon, resulted in a high redemption rate. CONCLUSIONS: This research provides strong evidence that discount coupons, particularly high-value ones distributed at the purchase location, can be used successfully as a condom promotional incentive. PMID:10589320

Program Support and Value of Training in Mentors' Satisfaction and Anticipated Continuation of School-Based Mentoring Relationships

ERIC Educational Resources Information Center

McQuillin, Samuel D.; Straight, Gerald G.; Saeki, Elina

2015-01-01

In this study, we tested a theoretical model of training practices in school-based mentoring by comparing the differences between two mentoring programs on mentor-reported program support, value of training, relationship satisfaction, and plans to continue mentoring. The two mentoring programs that we compared were conducted at the same school and…

Exploring risk profiles and emergency frequency of purchasers and non-purchasers of personal emergency alarms: a prospective cohort study.

PubMed

De San Miguel, Kristen; Lewin, Gill; Burton, Elissa; Toye, Christine; Boldy, Duncan; Howat, Peter

2015-10-27

Personal alarms support independent living and have the potential to reduce serious consequences after a fall or during a medical emergency. While some Australian states have government funded personal alarm programs, others do not; but user-pays services are available. Although several studies have examined the profiles of alarm users, little is known about the risk profile of non-users. Specifically, whether there are "at risk" individuals who are unable, or choose not to purchase a service, who experience a home-based emergency in which an alarm could have mitigated an adverse outcome. This study aimed to describe the 'risk profile' of purchasers and non-purchasers of alarms; explore the reasons behind the decision to purchase or not to purchase and identify how often emergency assistance was needed and why. Purchasers and non-purchasers were followed for one year in this prospective cohort study. Demographic, decision-making and risk factor data were collected at an initial face-to-face interview, while information about emergencies was collected by monthly calls. One hundred and fifty-seven purchasers and sixty-five non-purchasers completed the study. The risk profiles between the groups were similar in terms of gender, living arrangements, fall history and medical conditions. Purchasers (Mean = 82.6 years) were significantly older than non-purchasers (Mean = 79.3 years), (t(220) = -3.38, p = 0.000) and more functionally dependent on the IADL (z = -2.57, p = 0.010) and ADL (z = -2.45 p = 0.014) function scores. Non-purchasers (Mean = 8.04, SD = 3.57) were more socially isolated with significantly fewer family networks than purchasers (Mean = 9.46, SD = 3.25) (t(220) = -2.86, p = 0.005). Both groups experienced similarly high numbers of emergencies, 38.2 % of purchasers and 41.5 % of non-purchasers had at least one emergency where an alarm could have assisted. Main reasons for non-purchase were: cost (77 %), limited alarm range (51 %), no need (39 %) and lack

33 CFR 137.75 - The relationship of the purchase price to the value of the facility and the real property on...

Code of Federal Regulations, 2011 CFR

2011-07-01

... COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND...-OWNER DEFENSE Standards and Practices § 137.75 The relationship of the purchase price to the value of...

33 CFR 137.75 - The relationship of the purchase price to the value of the facility and the real property on...

Code of Federal Regulations, 2014 CFR

2014-07-01

... COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND...-OWNER DEFENSE Standards and Practices § 137.75 The relationship of the purchase price to the value of...

33 CFR 137.75 - The relationship of the purchase price to the value of the facility and the real property on...

Code of Federal Regulations, 2012 CFR

2012-07-01

... COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND...-OWNER DEFENSE Standards and Practices § 137.75 The relationship of the purchase price to the value of...

33 CFR 137.75 - The relationship of the purchase price to the value of the facility and the real property on...

Code of Federal Regulations, 2010 CFR

2010-07-01

... COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND...-OWNER DEFENSE Standards and Practices § 137.75 The relationship of the purchase price to the value of...

33 CFR 137.75 - The relationship of the purchase price to the value of the facility and the real property on...

Code of Federal Regulations, 2013 CFR

2013-07-01

... COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND...-OWNER DEFENSE Standards and Practices § 137.75 The relationship of the purchase price to the value of...

Examination of universal purchase programs as a driver of vaccine uptake among US States, 1995-2014.

PubMed

Mulligan, Karen; Snider, Julia Thornton; Arthur, Phyllis; Frank, Gregory; Tebeka, Mahlet; Walker, Amy; Abrevaya, Jason

2018-06-01

Immunization against numerous potentially life-threatening illnesses has been a great public health achievement. In the United States, the Vaccines for Children (VFC) program has provided vaccines to uninsured and underinsured children since the early 1990s, increasing vaccination rates. In recent years, some states have adopted Universal Purchase (UP) programs with the stated aim of further increasing vaccination rates. Under UP programs, states also purchase vaccines for privately-insured children at federally-contracted VFC prices and bill private health insurers for the vaccines through assessments. In this study, we estimated the effect of UP adoption in a state on children's vaccination rates using state-level and individual-level data from the 1995-2014 National Immunization Survey. For the state-level analysis, we performed ordinary least squares regression to estimate the state's vaccination rate as a function of whether the state had UP in the given year, state demographic characteristics, other vaccination policies, state fixed effects, and a time trend. For the individual analysis, we performed logistic regression to estimate a child's likelihood of being vaccinated as a function of whether the state had UP in the given year, the child's demographic characteristics, state characteristics and vaccine policies, state fixed effects, and a time trend. We performed separate regressions for each of nine recommended vaccines, as well as composite measures on whether a child was up-to-date on all required vaccines. In the both the state-level and individual-level analyses, we found UP had no significant (p < 0.10) effect on any of the vaccines or composite measures in our base case specifications. Results were similar in alternative specifications. We hypothesize that UP was ineffective in increasing vaccination rates. Policymakers seeking to increase vaccination rates would do well to consider other policies such as addressing provider practice issues and

A cash-back rebate program for healthy food purchases in South Africa: results from scanner data.

PubMed

Sturm, Roland; An, Ruopeng; Segal, Darren; Patel, Deepak

2013-06-01

Improving diet quality is a key health promotion strategy. There is much interest in the role of prices and financial incentives to encourage healthy diet, but no data from large population interventions. This study examines the effect of a price reduction for healthy food items on household grocery shopping behavior among members of South Africa's largest health plan. The HealthyFood program provides a cash-back rebate of up to 25% for healthy food purchases in over 400 designated supermarkets across all provinces in South Africa. Monthly household supermarket food purchase scanner data between 2009 and 2012 are linked to 170,000 households (60% eligible for the rebate) with Visa credit cards. Two approaches were used to control for selective participation using these panel data: a household fixed-effect model and a case-control differences-in-differences model. Rebates of 10% and 25% for healthy foods are associated with an increase in the ratio of healthy to total food expenditure by 6.0% (95% CI=5.3, 6.8) and 9.3% (95% CI=8.5, 10.0); an increase in the ratio of fruit and vegetables to total food expenditure by 5.7% (95% CI=4.5, 6.9) and 8.5% (95% CI=7.3, 9.7); and a decrease in the ratio of less desirable to total food expenditure by 5.6% (95% CI=4.7, 6.5) and 7.2% (95% CI=6.3, 8.1). Participation in a rebate program for healthy foods led to increases in purchases of healthy foods and to decreases in purchases of less-desirable foods, with magnitudes similar to estimates from U.S. time-series data. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

A Community-Based Marketing Campaign at Farmers Markets to Encourage Fruit and Vegetable Purchases in Rural Counties With High Rates of Obesity, Kentucky, 2015-2016.

PubMed

DeWitt, Emily; McGladrey, Margaret; Liu, Emily; Peritore, Nicole; Webber, Kelly; Butterworth, Brooke; Vail, Ann; Gustafson, Alison

2017-08-31

Availability of farmers markets may increase fruit and vegetable consumption among rural residents of the United States. We conducted a community-based marketing campaign, Plate it Up Kentucky Proud (PIUKP), in 6 rural communities over 2 years to determine the association between exposure to the campaign and fruit and vegetable purchases, adjusted for Supplemental Nutrition Assistance Program recipient status. Logistic regression was used to examine the odds of the PIUKP campaign influencing purchases. Awareness of the PIUKP marketing campaign was significantly associated with a willingness to prepare fruits and vegetables at home. Using marketing strategies at farmers markets may be an effective way to improve fruit and vegetable purchases in rural communities.

Does the benefits schedule of cash assistance programs affect the purchase of temptation goods? Evidence from Peru.

PubMed

White, Justin S; Basu, Sanjay

2016-03-01

A critique of cash assistance programs is that beneficiaries may spend the money on "temptation goods" such as alcohol and tobacco. We exploit a change in the payment schedule of Peru's conditional cash transfer program to identify the impact of benefit receipt frequency on the purchase of temptation goods. We use annual household data among cross-sectional and panel samples to analyze the effect of the policy change on the share of the household budget devoted to four categories of temptation goods. Using a difference-in-differences estimation approach, we find that larger, less frequent payments increased the expenditure share of alcohol by 55-80% and sweets by 10-40%, although the absolute magnitudes of these effects are small. Our study suggests that less frequent benefits scheduling may lead cash recipients to make certain types of temptation purchases. Copyright © 2016 Elsevier B.V. All rights reserved.

41 CFR 101-26.501 - Purchase of new motor vehicles.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Purchase of new motor... SOURCES AND PROGRAM 26.5-GSA Procurement Programs § 101-26.501 Purchase of new motor vehicles. (a) It shall be the policy to procure commercially available motor vehicles, unless other vehicles are...

Alternative to the traditional discount method of wholesaler purchasing.

PubMed

Lee, G F; Bair, J N; Piz, J W

1982-07-01

A program of purchasing drugs from wholesalers at the wholesaler's exact invoice cost plus a percentage is described and compared with the traditional method of average wholesale price (AWP) less a discount. The comparison was conducted by the pharmacy department of a 310-bed, teaching hospital that awarded a one-year contract to a wholesaler offering its items at the exact cost plus a pre-established percentage. Data collected from monthly wholesaler computer printouts gave the following information on each product: (1) list price per item, (2) actual cost to pharmacy per item, (3) percentage discount from AWP, and (4) quantity ordered. The net percentage discount from AWP for 12 months was calculated and compared to the former (traditional) discount rate. The net discount from AWP was 15.6% for purchases made by the hospital during the first 12 months of the program. When compared with the smaller discount the hospital traditionally received, the new program saved the hospital $5758 on annual purchases of $136,419. The actual dollar savings to an institution that changes from a traditional discount program to a cost-plus-percentage program depends on: (1) the negotiated percentage added to wholesaler cost, (2) the discount from AWP that the institution was previously receiving, and (3) the volume of wholesale purchases.

Waiting for Merlot: anticipatory consumption of experiential and material purchases.

PubMed

Kumar, Amit; Killingsworth, Matthew A; Gilovich, Thomas

2014-10-01

Experiential purchases (money spent on doing) tend to provide more enduring happiness than material purchases (money spent on having). Although most research comparing these two types of purchases has focused on their downstream hedonic consequences, the present research investigated hedonic differences that occur before consumption. We argue that waiting for experiences tends to be more positive than waiting for possessions. Four studies demonstrate that people derive more happiness from the anticipation of experiential purchases and that waiting for an experience tends to be more pleasurable and exciting than waiting to receive a material good. We found these effects in studies using questionnaires involving a variety of actual planned purchases, in a large-scale experience-sampling study, and in an archival analysis of news stories about people waiting in line to make a purchase. Consumers derive value from anticipation, and that value tends to be greater for experiential than for material purchases. © The Author(s) 2014.

Reaffirming Some Basic Principles in Purchasing and Maintenance.

ERIC Educational Resources Information Center

Throop, Harold L., Jr.

1985-01-01

Reaffirms necessary elements for the successful operation of college purchasing and maintenance programs (e.g., purchasing calendar, bidding procedures, vendor selection, contracting services, budgeting for maintenance, and workforce analysis). Discusses ways some colleges are saving on operating costs (e.g., solar energy, energy management,…

7 CFR 760.104 - Risk management purchase requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 7 2011-01-01 2011-01-01 false Risk management purchase requirements. 760.104 Section... Agricultural Disaster Assistance Programs § 760.104 Risk management purchase requirements. (a) To be eligible... available from the USDA Risk Management Agency (RMA)) obtained catastrophic coverage or better under a...

48 CFR 2413.301 - Governmentwide commercial purchase card.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Commercial Credit Card Program. [60 FR 46155, Sept. 5, 1995. Redesignated at 64 FR 46095, Aug. 23, 1999] ... purchase card. 2413.301 Section 2413.301 Federal Acquisition Regulations System DEPARTMENT OF HOUSING AND... Acquisition Methods 2413.301 Governmentwide commercial purchase card. (c) HUD's procedures concerning the use...

48 CFR 2413.301 - Governmentwide commercial purchase card.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Commercial Credit Card Program. [60 FR 46155, Sept. 5, 1995. Redesignated at 64 FR 46095, Aug. 23, 1999] ... purchase card. 2413.301 Section 2413.301 Federal Acquisition Regulations System DEPARTMENT OF HOUSING AND... Acquisition Methods 2413.301 Governmentwide commercial purchase card. (c) HUD's procedures concerning the use...

48 CFR 2413.301 - Governmentwide commercial purchase card.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Commercial Credit Card Program. [60 FR 46155, Sept. 5, 1995. Redesignated at 64 FR 46095, Aug. 23, 1999] ... purchase card. 2413.301 Section 2413.301 Federal Acquisition Regulations System DEPARTMENT OF HOUSING AND... Acquisition Methods 2413.301 Governmentwide commercial purchase card. (c) HUD's procedures concerning the use...

48 CFR 2413.301 - Governmentwide commercial purchase card.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Commercial Credit Card Program. [60 FR 46155, Sept. 5, 1995. Redesignated at 64 FR 46095, Aug. 23, 1999] ... purchase card. 2413.301 Section 2413.301 Federal Acquisition Regulations System DEPARTMENT OF HOUSING AND... Acquisition Methods 2413.301 Governmentwide commercial purchase card. (c) HUD's procedures concerning the use...

48 CFR 2413.301 - Governmentwide commercial purchase card.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Commercial Credit Card Program. [60 FR 46155, Sept. 5, 1995. Redesignated at 64 FR 46095, Aug. 23, 1999] ... purchase card. 2413.301 Section 2413.301 Federal Acquisition Regulations System DEPARTMENT OF HOUSING AND... Acquisition Methods 2413.301 Governmentwide commercial purchase card. (c) HUD's procedures concerning the use...

7 CFR 760.104 - Risk management purchase requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Risk management purchase requirements. 760.104 Section... Agricultural Disaster Assistance Programs § 760.104 Risk management purchase requirements. (a) To be eligible... available from the USDA Risk Management Agency (RMA)) obtained catastrophic coverage or better under a...

Where do people purchase food? A novel approach to investigating food purchasing locations.

PubMed

Thornton, Lukar E; Crawford, David A; Lamb, Karen E; Ball, Kylie

2017-03-07

Studies exploring associations between food environments and food purchasing behaviours have been limited by the absence of data on where food purchases occur. Determining where food purchases occur relative to home and how these locations differ by individual, neighbourhood and trip characteristics is an important step to better understanding the association between food environments and food behaviours. Conducted in Melbourne, Australia, this study recruited participants within sixteen neighbourhoods that were selected based on their socioeconomic characteristics and proximity to supermarkets. The survey material contained a short questionnaire on individual and household characteristics and a food purchasing diary. Participants were asked to record details related to all food purchases made over a 2-week period including food store address. Fifty-six participants recorded a total of 952 food purchases of which 893 were considered valid for analysis. Households and food purchase locations were geocoded and the network distance between these calculated. Linear mixed models were used to determine associations between individual, neighbourhood, and trip characteristics and distance to each food purchase location from home. Additional analysis was conducted limiting the outcome to: (a) purchase made when home was the prior origin (n. 484); and (b) purchases made within supermarkets (n. 317). Food purchases occurred a median distance of 3.6 km (IQR 1.8, 7.2) from participants' homes. This distance was similar when home was reported as the origin (median 3.4 km; IQR 1.6, 6.4) whilst it was shorter for purchases made within supermarkets (median 2.8 km; IQR 1.6, 5.6). For all purchases, the reported food purchase location was further from home amongst the youngest age group (compared to the oldest age group), when workplace was the origin of the food purchase trip (compared to home), and on weekends (compared to weekdays). Differences were also observed by

The attentional drift-diffusion model extends to simple purchasing decisions.

PubMed

Krajbich, Ian; Lu, Dingchao; Camerer, Colin; Rangel, Antonio

2012-01-01

How do we make simple purchasing decisions (e.g., whether or not to buy a product at a given price)? Previous work has shown that the attentional drift-diffusion model (aDDM) can provide accurate quantitative descriptions of the psychometric data for binary and trinary value-based choices, and of how the choice process is guided by visual attention. Here we extend the aDDM to the case of purchasing decisions, and test it using an eye-tracking experiment. We find that the model also provides a reasonably accurate quantitative description of the relationship between choice, reaction time, and visual fixations using parameters that are very similar to those that best fit the previous data. The only critical difference is that the choice biases induced by the fixations are about half as big in purchasing decisions as in binary choices. This suggests that a similar computational process is used to make binary choices, trinary choices, and simple purchasing decisions.

The Attentional Drift-Diffusion Model Extends to Simple Purchasing Decisions

PubMed Central

Krajbich, Ian; Lu, Dingchao; Camerer, Colin; Rangel, Antonio

2012-01-01

How do we make simple purchasing decisions (e.g., whether or not to buy a product at a given price)? Previous work has shown that the attentional drift-diffusion model (aDDM) can provide accurate quantitative descriptions of the psychometric data for binary and trinary value-based choices, and of how the choice process is guided by visual attention. Here we extend the aDDM to the case of purchasing decisions, and test it using an eye-tracking experiment. We find that the model also provides a reasonably accurate quantitative description of the relationship between choice, reaction time, and visual fixations using parameters that are very similar to those that best fit the previous data. The only critical difference is that the choice biases induced by the fixations are about half as big in purchasing decisions as in binary choices. This suggests that a similar computational process is used to make binary choices, trinary choices, and simple purchasing decisions. PMID:22707945

A dynamic programming-based particle swarm optimization algorithm for an inventory management problem under uncertainty

NASA Astrophysics Data System (ADS)

Xu, Jiuping; Zeng, Ziqiang; Han, Bernard; Lei, Xiao

2013-07-01

This article presents a dynamic programming-based particle swarm optimization (DP-based PSO) algorithm for solving an inventory management problem for large-scale construction projects under a fuzzy random environment. By taking into account the purchasing behaviour and strategy under rules of international bidding, a multi-objective fuzzy random dynamic programming model is constructed. To deal with the uncertainties, a hybrid crisp approach is used to transform fuzzy random parameters into fuzzy variables that are subsequently defuzzified by using an expected value operator with optimistic-pessimistic index. The iterative nature of the authors' model motivates them to develop a DP-based PSO algorithm. More specifically, their approach treats the state variables as hidden parameters. This in turn eliminates many redundant feasibility checks during initialization and particle updates at each iteration. Results and sensitivity analysis are presented to highlight the performance of the authors' optimization method, which is very effective as compared to the standard PSO algorithm.

School District Purchasing.

ERIC Educational Resources Information Center

Natale, Joseph L.

This chapter of "Principles of School Business Management" discusses the effective management of purchasing processes in a school district. These processes include obtaining materials, supplies, and equipment of maximum value for the least expense, and receiving, storing, and distributing the items obtained. The chapter opens with an overview of…

From intelligence to evidence-based healthcare: a purchasing odyssey.

PubMed

Booth, A; Hey, S

1995-12-01

Since the appearance of the NHS Executive's guidance document, Purchasing Intelligence (1991), efforts have been concentrated on the development of 'purchasing intelligence facilities' staffed, in the main, by health librarians. However, the concept of 'intelligence' has a wider dimension that impacts upon the whole culture of an organization. The authors examine purchasing organizations against popular theories of organizational development. The characteristics of Handy's Task culture, with Athena as its patron, may be observed in many authorities. Using the results of two surveys, conducted in March 1995, they identify some key information management issues involving structure, tasks, technology and people. Skills in information 'transformation' must be acquired by all staff in purchasing authorities. The intelligence officer must become a modern-day Odysseus if the intelligence facility is to 'survive and thrive'.

Value-based formulas for purchasing. Does managed care offer value to society?

PubMed

Priester, R

1997-01-01

To assess whether managed care is, all things considered, a good investment for our society, we can measure its performance relative to five essential health care goals: promote efficiency; expand access; improve quality; preserve freedom of choice; and protect patient advocacy. These goals, which have shaped and continue to shape health care policy, define what is important to us in our health care system. Concerns about managed care's ability to advance these goals and thus to offer value are heightened if recently observed trends continue.

The neural bases underlying social risk perception in purchase decisions.

PubMed

Yokoyama, Ryoichi; Nozawa, Takayuki; Sugiura, Motoaki; Yomogida, Yukihito; Takeuchi, Hikaru; Akimoto, Yoritaka; Shibuya, Satoru; Kawashima, Ryuta

2014-05-01

Social considerations significantly influence daily purchase decisions, and the perception of social risk (i.e., the anticipated disapproval of others) is crucial in dissuading consumers from making purchases. However, the neural basis for consumers' perception of social risk remains undiscovered, and this novel study clarifies the relevant neural processes. A total of 26 volunteers were scanned while they evaluated purchase intention of products (purchase intention task) and their anticipation of others' disapproval for possessing a product (social risk task), using functional magnetic resonance imaging (fMRI). The fMRI data from the purchase intention task was used to identify the brain region associated with perception of social risk during purchase decision making by using subjective social risk ratings for a parametric modulation analysis. Furthermore, we aimed to explore if there was a difference between participants' purchase decisions and their explicit evaluations of social risk, with reference to the neural activity associated with social risk perception. For this, subjective social risk ratings were used for a parametric modulation analysis on fMRI data from the social risk task. Analysis of the purchase intention task revealed a significant positive correlation between ratings of social risk and activity in the anterior insula, an area of the brain that is known as part of the emotion-related network. Analysis of the social risk task revealed a significant positive correlation between ratings of social risk and activity in the temporal parietal junction and the medial prefrontal cortex, which are known as theory-of-mind regions. Our results suggest that the anterior insula processes consumers' social risk implicitly to prompt consumers not to buy socially unacceptable products, whereas ToM-related regions process such risk explicitly in considering the anticipated disapproval of others. These findings may prove helpful in understanding the mental

21 CFR 820.50 - Purchasing controls.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Purchasing controls. 820.50 Section 820.50 Food... DEVICES QUALITY SYSTEM REGULATION Purchasing Controls § 820.50 Purchasing controls. Each manufacturer... control to be exercised over the product, services, suppliers, contractors, and consultants, based on the...

21 CFR 820.50 - Purchasing controls.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Purchasing controls. 820.50 Section 820.50 Food... DEVICES QUALITY SYSTEM REGULATION Purchasing Controls § 820.50 Purchasing controls. Each manufacturer... control to be exercised over the product, services, suppliers, contractors, and consultants, based on the...

21 CFR 820.50 - Purchasing controls.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Purchasing controls. 820.50 Section 820.50 Food... DEVICES QUALITY SYSTEM REGULATION Purchasing Controls § 820.50 Purchasing controls. Each manufacturer... control to be exercised over the product, services, suppliers, contractors, and consultants, based on the...

21 CFR 820.50 - Purchasing controls.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Purchasing controls. 820.50 Section 820.50 Food... DEVICES QUALITY SYSTEM REGULATION Purchasing Controls § 820.50 Purchasing controls. Each manufacturer... control to be exercised over the product, services, suppliers, contractors, and consultants, based on the...

21 CFR 820.50 - Purchasing controls.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Purchasing controls. 820.50 Section 820.50 Food... DEVICES QUALITY SYSTEM REGULATION Purchasing Controls § 820.50 Purchasing controls. Each manufacturer... control to be exercised over the product, services, suppliers, contractors, and consultants, based on the...

United Nations Environment Program - Sustainable Purchasing Guidance Profile

EPA Pesticide Factsheets

To help you find the resource that is right for your organization, EPA conducted a scan of the landscape and developed summary profiles of some of the leading sources of sustainable purchasing guidance around the globe.

Advertising, marketing and purchase behavior for energy-related products

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

Tiedemann, K.; Nelson, D.

Energy conservation programs have relied heavily on incentives and regulatory standards to reduce residential energy consumption. However, in the changing market environment characterized by competitive pressures, alternative mechanisms such as marketing and promotions may increase substantially in importance compared to the demand-side management programs which have been the focus of most research. This paper describes the role of marketing and promotions in encouraging energy efficiency at the household level in British Columbia. The paper examines three related issues: first, the purchase process for energy-related products; second, the criteria used by customers in making purchase decisions; and third, the impact andmore » effectiveness of alternative marketing tools. A key finding is the energy-related purchases do not fall into the impulse purchase category. There are two reasons for this: first, most of these products require installation and this requires a high level of commitment on the part of the purchaser; second, many energy-related products require a significant outlay of funds and this reduces impulse buying.« less

Evaluation of purchase intention of customers in two wheeler automobile segment: AHP and TOPSIS

NASA Astrophysics Data System (ADS)

Sri Yogi, Kottala

2018-03-01

Winning heart of customers is preeminent main design of any business organization in global business environment. This paper explored customer’s priorities while purchasing a two wheeler automobile segment using Analytical Hierarchy Process (AHP) and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) as a multi criteria decision making tools to accomplish the research objectives. Study has been done to analyze different criteria to be considered during purchasing of two wheeler automobiles among respondents using structured questionnaire based on SAATY scale. Based on our previous work on empirical & fuzzy logic approach to product quality and purchase intention of customers in two wheeler- operational, performance, economic, brand value and maintenance aspects are considered as decision criteria of customers while purchasing a two wheeler. The study suggests high pick up during overtaking, petrol saving, reasonable spare parts price, unique in design and identity and easy to change gear as main criterion in purchasing process. We also found some leading two wheeler automobiles models available in Indian market using some objective function criterion in choosing some important characteristics like price, cylinder capacity, brake horse power and weight during purchasing process of two wheeler automobile in Indian market based on respondents perception.

FRAMEWORK FOR ENVIRONMENTAL DECISION-MAKING, FRED: A TOOL FOR ENVIRONMENTALLY-PREFERABLE PURCHASING

EPA Science Inventory

In support of the Environmentally Preferable Purchasing Program of the US EPA, the Systems Analysis Branch has developed a decision-making tool based on life cycle assessment. This tool, the Framework for Responsible Environmental Decision-making or FRED streamlines LCA by choosi...

42 CFR § 484.325 - Payments for home health services under Home Health Value-Based Purchasing (HHVBP) Model.

Code of Federal Regulations, 2010 CFR

2017-10-01

... Purchasing (HHVBP) Model. CMS will determine a payment adjustment up to the maximum applicable percentage... Total Performance Score using a linear exchange function. Payment adjustments made under the HHVBP Model... 42 Public Health 5 2017-10-01 2017-10-01 false Payments for home health services under Home Health...

42 CFR § 484.325 - Payments for home health services under Home Health Value-Based Purchasing (HHVBP) Model.

Code of Federal Regulations, 2010 CFR

2016-10-01

... Purchasing (HHVBP) Model. CMS will determine a payment adjustment up to the maximum applicable percentage... Total Performance Score using a linear exchange function. Payment adjustments made under the HHVBP Model... 42 Public Health 5 2016-10-01 2016-10-01 false Payments for home health services under Home Health...

31 CFR 50.13 - Offer, purchase, and renewal.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Section 50.13 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM Disclosures as Conditions for Federal Payment § 50.13 Offer, purchase, and renewal. An insurer is deemed to be in compliance with the requirement of providing disclosure “at the time of offer, purchase...

The Path to Savings: Understanding the Federal Purchase of Energy-Consuming Products

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

Taylor, Margaret; Fujita, K. Sydny

Energy efficiency has been a federal procurement policy objective since at least 1992, with the origin of the Energy Efficient Product Procurement (EEPP) program within the larger Federal Energy Management Program (FEMP). Today, the EEPP program’s mandate is based on requirements that 95% of new contract actions, task orders, and delivery orders for products and services be energy and water efficient, as laid out in Executive Order 13514 in 2009. Facilitating full compliance with EO 13514 presents a significant strategic planning challenge to the FEMP EEPP program, given the size of the federal government, the range of missions of itsmore » many agencies, the mix of management approaches for its buildings, and the diverse set of roughly 80 energy efficient products which has been established through preceding legislation and executive orders. The goal of this report is to aid the program in prioritizing its resources by providing an overview of how the purchase of energy-consuming products occurs in today’s evolving federal procurement system, as well as identify likely intervention points and compliance review mechanisms. Through a synthesis of the literature on U.S. federal sector procurement and two dozen primary interviews, the report particularly focuses on the importance of price in determining the actor(s) responsible for any given purchase of an energy-consuming product. This identification is important, as the relevant actors are trained and reviewed in different ways that the FEMP EEPP program can prioritize for targeting, based on the decision criteria such as the potential energy savings associated with the actor’s purchases or the administrative ease of the intervention.« less

Adding Value through Program Integration: A Kayaking Model (Rental, Retail, Repair, Clinics and Outings).

ERIC Educational Resources Information Center

Poff, Raymond

Outdoor programs can offset initial investment costs in services and products by developing integrated program areas. The experience of Outdoors Unlimited, a recently created kayaking program at Brigham Young University (Utah), is provided as a model. The purchase of 11 kayaks for rental was followed by the introduction of retail sales, repair…

Effects of a food advertising literacy intervention on Taiwanese children's food purchasing behaviors.

PubMed

Liao, Li-Ling; Lai, I-Ju; Chang, Li-Chun; Lee, Chia-Kuei

2016-08-01

Unhealthy food advertising is an important contributor to childhood obesity. The purpose of this pilot study was to evaluate the impact of a food advertising literacy program that incorporated components of health-promoting media literacy education on fifth-grade children. Participants were 140 fifth-graders (10 and 11 years old) from one school who were randomly divided into three groups. Experimental Group A received a food advertising literacy program, experimental Group B received a comparable knowledge-based nutrition education program and the control group did not receive any nutrition education. Repeated measures analysis of variance and multivariate analysis of covariance were used to test mean changes between pretest, posttest and follow-up on participants' nutritional knowledge, food advertising literacy and food purchasing behavior. Results showed that, as compared with Group B and the control groups, Group A showed higher nutritional knowledge, food advertising literacy and food purchasing behavior at post-intervention, but had no significant improvements in nutritional knowledge and food purchasing behavior at the 1-month follow-up. Although some improvements were observed, future studies should consider a long-term, settings-based approach that is closely connected with children's daily lives, as this might be helpful to solidify children's skills in recognizing, evaluating and understanding unhealthy food advertising. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Women, infants, and children cash value voucher (CVV) use in Arizona: a qualitative exploration of barriers and strategies related to fruit and vegetable purchases.

PubMed

Bertmann, Farryl M W; Barroso, Cristina; Ohri-Vachaspati, Punam; Hampl, Jeffrey S; Sell, Karen; Wharton, Christopher M

2014-01-01

Women, Infants, and Children (WIC) cash value vouchers (CVV) have been inconsistently redeemed in Arizona. The objective of this study was to explore perceived barriers to use of CVV as well as strategies participants use to overcome them. Eight focus groups were conducted to explore attitudes and behaviors related to CVV use. Focus groups were conducted at 2 WIC clinics in metro-Phoenix, AZ. Participants in WIC who were at least 18 years of age and primarily responsible for buying and preparing food for their households. Perceived barriers to CVV use and strategies used to maximize their purchasing value. Transcripts were analyzed using a general inductive approach to identify emergent themes. Among 41 participants, multiple perceived barriers emerged, such as negative interactions in stores or confusion over WIC rules. Among experienced shoppers, WIC strategies also emerged to deal with barriers and maximize CVV value, including strategic choice of times and locations at which to shop and use of price-matching, rewards points, and other ways to increase purchasing power. Arizona WIC participants perceived barriers that limit easy redemption of CVV. Useful strategies were also identified that could be important to explore further to improve WIC CVV purchasing experiences. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Factors Influencing the Food Purchases of Early Care and Education Providers.

PubMed

Otten, Jennifer J; Hirsch, Tad; Lim, Catherine

2017-05-01

With the majority of US children enrolled in some form of early care and education, the settings for early care and education represent a valuable opportunity to positively impact young children's diets and their interactions with food. Little evidence exists on how early care and education providers make food purchasing and service decisions for this population of young children. Our aim was to explore the factors that influence early care and education providers' food purchasing and service decisions. A qualitative design consisting of individual, in-person, and semi-structured interviews with providers and on-site observations was used. Sixteen early care and education providers-selected across a variety of characteristics that might affect food selection (eg, size of site, participation in reimbursement programs, presence of staff assigned to foodservice) using maximum variation purposive sampling-based in the Puget Sound region, Washington, were interviewed from June to September 2014. Provider perspectives on food purchasing and service decisions. Inductive analysis of transcribed interviews using TAMS Analyzer software (GPL version 2, 2012) to identify themes. Ten main influencers emerged from the data. These were grouped into four categories based on an ecological framework: macro-level environments (ie, regulations; suppliers and vendors, including stores); physical environment and settings (ie, organizational mission, budget, and structure; the facility itself); social environments (ie, professional networks; peers; the site-specific parent and child community); and individual factors at both a provider and child-level (ie, providers' skills, behaviors, motivations, attitudes, knowledge, and values; child food preferences; and, child allergies). A model was then developed to identify potential pathways of intervention and underscore the need for a comprehensive approach to improve early care and education nutrition. This study suggests that a more

Fuzzy Constraint Based Model for Efficient Management of Dynamic Purchasing Environments

NASA Astrophysics Data System (ADS)

Sakas, D. P.; Vlachos, D. S.; Simos, T. E.

2007-12-01

This paper considers the application of a fuzzy constraint based model for handling dynamic environments where only one of possibly many bundles of items must be purchased and quotes for items open and close over time. Simulation results are presented and compared with the optimal solution.

A randomized controlled trial of nutrition education to promote farmers' market fruit and vegetable purchases and consumption among women enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children

USDA-ARS?s Scientific Manuscript database

This report describes the protocol guiding the design and evaluation of a theory-driven, web-based lesson to promote farmers' market fruit and vegetable (FV) purchases and consumption among women enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). Designed t...

Altering shoppers' supermarket purchases to fit nutritional guidelines: An interactive information system

PubMed Central

Winett, Richard A.; Geller, E. Scott; Mundy, Laurie L.; Moore, John F.; Wagner, Jana L.; Hite, Lee A.; Leahy, Michael; Neubauer, Tamara E.; Walberg, Janet L.; Walker, W. Bruce; Lombard, David

1991-01-01

This study reports the results of one effort to help supermarket shoppers alter food purchases to make purchases (and meals) that are lower in fat and higher in fiber. A prototype interactive information system using instructional video programs, feedback on purchases with specific goals for change, weekly programs, and the ability to track user interactions and intended purchases was evaluated. The major dependent measure was users' actual food purchases as derived from participants' highly detailed supermarket receipts. After a 5- to 7-week baseline phase, participants were randomly assigned to an experimental or control condition for the 7- to 8-week intervention phase. A follow-up phase began 5 to 8 weeks after participants completed the intervention and discontinued use of the system. The results indicated that experimental participants, when compared to control participants, decreased high fat purchases and increased high fiber purchases during intervention, with evidence for some maintenance of effect in follow-up. Plans for increasing the use and impact of the system are discussed. ImagesFigure 1 PMID:1647387

41 CFR 101-26.501-3 - Consolidated purchase program.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 26-PROCUREMENT..., purchased in the aggregate by group to the extent practical. These procurements are designed to obtain the...

Perceived Value of University-Based Continuing Education Leadership Development Programs for Administrators

ERIC Educational Resources Information Center

Stone, Geri L.; Major, Claire H.

2014-01-01

This quantitative study, which involved development of a Value Creation Survey, examined the perceived value of leadership development programs (LDPs) provided by continuing higher education for administrators in colleges and universities. Participants were administrators at Association for Continuing Higher Education (ACHE) member institutions.…

Eating Better for Less: A National Discount Program for Healthy Food Purchases in South Africa

PubMed Central

An, Ruopeng; Patel, Deepak; Segal, Darren; Sturm, Roland

2012-01-01

Background Improving diet quality is a key health promotion strategy. The HealthyFood program provides up to a 25% discount on selected food items to about 260,000 households across South Africa. Objectives Examine whether reducing prices for healthy food purchases leads to changes in self-reported measures of food consumption and weight status. Methods Repeated surveys of about 350,000 HealthyFood participants and nonparticipants. Results Program participation is associated with more consumption of fruits/vegetables and wholegrain foods, and less consumption of high sugar/salt foods, fried foods, processed meats, and fast-food. There is no strong evidence that participation reduces obesity. Conclusions A substantial price intervention might be effective in improving diets. PMID:22943101

Demographics and beef preferences affect consumer motivation for purchasing fresh beef steaks and roasts.

PubMed

Reicks, A L; Brooks, J C; Garmyn, A J; Thompson, L D; Lyford, C L; Miller, M F

2011-04-01

Surveys completed by 1370 consumers determined the motivational factors affecting consumer purchasing decisions for fresh beef steaks and roasts in three regions in the United States. Females placed greater importance on tenderness, ease of preparation, and nutritional value of steaks and roasts when compared to males. Age influenced tenderness, product consistency, and nutritional value of steaks, but influenced flavor, product consistency, and nutritional value of roasts. Consumers felt juiciness, nutritional value, and natural products were less important in determining their purchasing choices of steaks and roasts as their level of education increased. The preferred degree of doneness of steaks influenced the value placed on six of the nine purchasing motivators. Beef preferences and demographics influenced consumer purchasing decisions for fresh beef steaks and roasts. Results from this study can be used to help identify factors to positively influence purchasing decisions within targeted market segments. © 2010 The American Meat Science Association. Published by Elsevier Ltd. All rights reserved.

Eating better for less: a national discount program for healthy food purchases in South Africa.

PubMed

An, Ruopeng; Patel, Deepak; Segal, Darren; Sturm, Roland

2013-01-01

To examine whether reducing prices for healthy food purchases leads to changes in self-reported measures of food consumption and weight status. Repeated surveys of about 350,000 HealthyFood participants and nonparticipants. Program participation is associated with more consumption of fruits/vegetables and whole-grain foods and less consumption of high sugar/salt foods, fried foods, processed meats, and fast food. There is no strong evidence that participation reduces obesity. A substantial price intervention might be effective in improving diets.

Value-Based Payment Reform and the Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015: A Primer for Plastic Surgeons.

PubMed

Squitieri, Lee; Chung, Kevin C

2017-07-01

In 2015, the U.S. Congress passed the Medicare Access and Children's Health Insurance Program Reauthorization Act, which effectively repealed the Centers for Medicare and Medicaid Services sustainable growth rate formula and established the Centers for Medicare and Medicaid Services Quality Payment Program. The Medicare Access and Children's Health Insurance Program Reauthorization Act represents an unparalleled acceleration toward value-based payment models and a departure from traditional volume-driven fee-for-service reimbursement. The Quality Payment Program includes two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. The Merit-Based Incentive Payment System pathway replaces existing quality reporting programs and adds several new measures to create a composite performance score for each provider (or provider group) that will be used to adjust reimbursed payment. The advanced alternative payment model pathway is available to providers who participate in qualifying Advanced Alternative Payment Models and is associated with an initial 5 percent payment incentive. The first performance period for the Merit-Based Incentive Payment System opens January 1, 2017, and closes on December 31, 2017, and is associated with payment adjustments in January of 2019. The Centers for Medicare and Medicaid Services estimates that the majority of providers will begin participation in 2017 through the Merit-Based Incentive Payment System pathway, but aims to have 50 percent of payments tied to quality or value through Advanced Alternative Payment Models by 2018. In this article, the authors describe key components of the Medicare Access and Children's Health Insurance Program Reauthorization Act to providers navigating through the Quality Payment Program and discuss how plastic surgeons may optimize their performance in this new value-based payment program.

Does school size affect interest for purchasing local foods in the midwest?

PubMed

Smith, Sylvia; Wleklinski, Danielle; Roth, Sara Long; Tragoudas, Ulrike

2013-04-01

Due to the recent surge in environmental consciousness and the need to address childhood obesity, Farm to School programs have gained momentum. Even though Farm to School programs have increased in popularity, many schools still fail to take advantage of the benefits from such programs. School food service employees' lack of familiarity with the benefits of Farm to School programs or the means to overcome obstacles to implement such programs, along with school size, may represent key variables that serve to explain why more schools do not purchase more local foods for their schools. This study used a convenience sampling methodology to gather information regarding food service employees' perceptions of the benefits and obstacles and their attitudes to purchasing and serving local foods in their schools. A self-administered questionnaire was used to collect data from school food service employees in southern Illinois. Data (n=151) were collected from 60 schools, representing 16 counties during the month of December, 2009. Purchasers from large- and medium-size schools perceived the "ability to know product sources" as a greater benefit to purchasing local food and perceived "cost of food," "adequate volume," "reliable supply of food quantity," "payment arrangement," and "packing material" as greater obstacles (p<0.05) compared to small schools. In addition, results indicated that food service employees were interested in receiving training to prepare and serve more local foods. Findings from this study indicate a need for continued education, development, and training to better prepare school food service purchasers in southern Illinois for how to buy more local foods to meet the 2020 legislation requiring schools to purchase at least 10% locally.

7 CFR 3560.505 - Agency loans to finance purchases of REO properties.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Agency loans to finance purchases of REO properties... Disposition of Real Estate Owned (REO) Properties § 3560.505 Agency loans to finance purchases of REO properties. (a) Agency loans to finance the purchase of REO property designated to be sold as program...

7 CFR 3560.505 - Agency loans to finance purchases of REO properties.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 15 2011-01-01 2011-01-01 false Agency loans to finance purchases of REO properties... Disposition of Real Estate Owned (REO) Properties § 3560.505 Agency loans to finance purchases of REO properties. (a) Agency loans to finance the purchase of REO property designated to be sold as program...

7 CFR 3560.505 - Agency loans to finance purchases of REO properties.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Agency loans to finance purchases of REO properties... Disposition of Real Estate Owned (REO) Properties § 3560.505 Agency loans to finance purchases of REO properties. (a) Agency loans to finance the purchase of REO property designated to be sold as program...

7 CFR 3560.505 - Agency loans to finance purchases of REO properties.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Agency loans to finance purchases of REO properties... Disposition of Real Estate Owned (REO) Properties § 3560.505 Agency loans to finance purchases of REO properties. (a) Agency loans to finance the purchase of REO property designated to be sold as program...

36 CFR 223.62 - Timber purchaser road construction credit.

Code of Federal Regulations, 2010 CFR

2010-07-01

... deposits for slash disposal and road maintenance. As used in this section estimated construction costs... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Timber purchaser road... § 223.62 Timber purchaser road construction credit. Appraisal may also establish stumpage value as if...

How Can Adult Children Influence Parents’ Long-Term Care Insurance Purchase Decisions?

PubMed Central

Voils, Corrine I.; Coe, Norma B.; Konetzka, R. Tamara; Boles, Jillian; Van Houtven, Courtney Harold

2017-01-01

Abstract Purpose of the Study: Long-term care (LTC) poses a significant strain on public health insurance financing. In response, there is policy interest in bolstering the private long-term care insurance (LTCI) market. Although families are central to LTC provision, their role in LTCI demand remains unclear. The purpose of this study was to obtain in-depth information concerning: (a) How do older parents evaluate the need for LTCI, (b) what role do adult children play? and (c) How do families communicate about parents’ LTC preferences and plans, including LTCI purchase? Design and Methods: We conducted focus groups with older parents and adult children in diverse markets. Two groups were conducted with older parents who had purchased LTCI and two with parents who had not purchased LTCI. Four groups were conducted with adult children, mixed as to whether their parents had purchased LTCI. Probes were informed by published reasons for purchasing or not purchasing LTCI. We analyzed transcriptions using directed content analysis and constant comparative method. Results: Older parents valued autonomy for themselves and their children. Older parent purchasers regarded LTCI as supporting this value while nonpurchasers perceived limitations. Adult children described unstated expectations that they would care for their parents. Though discussions between parents and children about LTCI were rare, successful influence occurred when children appealed to shared values, specifically avoiding burden and remaining home. Implications: Messages that emphasize autonomy over LTC decisions and interventions that start the LTC conversation among families, with attention to shared values, could increase private LTCI uptake. PMID:25209446

48 CFR 313.303-5 - Purchases under blanket purchase agreements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Purchases under blanket purchase agreements. 313.303-5 Section 313.303-5 Federal Acquisition Regulations System HEALTH AND HUMAN... Methods 313.303-5 Purchases under blanket purchase agreements. (e)(5) HHS personnel that sign delivery...

Convenience-based food purchase patterns: identification and associations with dietary quality, sociodemographic factors and attitudes.

PubMed

Peltner, Jonas; Thiele, Silke

2018-02-01

The present study aimed to derive food purchase patterns considering the convenience level of foods. Associations between identified patterns and dietary quality were analysed, as well as household characteristics associated with the dietary patterns. A Convenience Food Classification Scheme (CFCS) was developed. After classifying basic food groups into the CFCS, the formed groups were used to apply a factor analysis to identify convenience-based food purchase patterns. For these patterns nutrient and energy densities were examined. Using regression analysis, associations between the adherence to the patterns and household characteristic and attitude variables were analysed. The study used representative German food purchase data from 2011. Approximately 12 million purchases of 13 131 households were recorded in these data. Three convenience-based patterns were identified: a low-convenience, a semi-convenience and a ready-to-eat food pattern. Tighter adherence to the semi-convenience pattern was shown to result in the lowest nutrient and highest energy densities. Important factors influencing adherence to the patterns were household size, presence of children and attitudes. Working full-time was negatively associated with adherence to the low-convenience pattern and positively with the ready-to-eat pattern. Convenience foods were an important part of households' food baskets which in some cases led to lower nutritional quality. Therefore, it is important to offer convenience foods higher in nutrient density and lower in energy density. Interventions targeted on enhancing cooking skills could be an effective strategy to increase purchases of unprocessed foods, which, in turn, could also contribute to an improved diet quality.

Continuous quality improvement programs provide new opportunities to drive value innovation initiatives in hospital-based radiology practices.

PubMed

Steele, Joseph R; Schomer, Don F

2009-07-01

Imaging services constitute a huge portion of the of the total dollar investment within the health care enterprise. Accordingly, this generates competition among medical specialties organized along service lines for their pieces of the pie and increased scrutiny from third-party payers and government regulators. These market and political forces create challenge and opportunity for a hospital-based radiology practice. Clearly, change that creates or builds greater value for patients also creates sustainable competitive advantage for a radiology practice. The somewhat amorphous concept of quality constitutes a significant value driver for innovation in this scenario. Quality initiatives and programs seek to define and manage this amorphous concept and provide tools for a radiology practice to create or build more value. Leadership and the early adoption of these inevitable programs by a radiology practice strengthens relationships with hospital partners and slows the attrition of imaging service lines to competitors.

Authorities and Mechanisms for Purchased Care at the Department of Veterans Affairs

PubMed Central

Greenberg, Michael D.; Batka, Caroline; Buttorff, Christine; Dunigan, Molly; Lovejoy, Susan L.; McGovern, Geoffrey; Pace, Nicholas M.; Pillemer, Francesca; Williams, Kayla M.; Apaydin, Eric; Aranibar, Clara; Buenaventura, Maya; Carter, Phillip; Cherney, Samantha; Davis, Lynn E.; Donohue, Amy Grace; Geyer, Lily; Hemler, Joslyn; Roshan, Parisa; Skrabala, Lauren; Simmons, Stephen; Thompson, Joseph; Welch, Jonathan; Hosek, Susan D.; Farmer, Carrie M.

2016-01-01

Abstract The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the authorities and mechanisms by which the Department of Veterans Affairs (VA) pays for health care services from non-VA providers. Purchased care accounted for 10 percent, or around $5.6 billion, of VA's health care budget in fiscal year 2014, and the amount of care purchased from outside VA is growing rapidly. VA purchases non-VA care through an array of programs, each with different payment processes and eligibility requirements for veterans and outside providers. A review and analysis of statutes, regulations, legislation, and literature on VA purchased care, along with interviews with expert stakeholders, a survey of VA medical facilities, and an evaluation of local-level policy documents revealed that VA's purchased care system is complex and decentralized. Inconsistencies in procedures, unclear goals, and a lack of cohesive strategy for purchased care could have ramifications for veterans' access to care. Adding to the complexity of VA's purchased care system is a lack of systematic data collection on access to and quality of care provided through VA's purchased care programs. The analysis also explored concepts of “episodes of care” and their implications for purchased care by VA. PMID:28083425

49 CFR Appendix D to Part 599 - CARS Purchaser Survey

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false CARS Purchaser Survey D Appendix D to Part 599 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY... RECYCLE AND SAVE ACT PROGRAM Pt. 599, App. D Appendix D to Part 599—CARS Purchaser Survey ER29JY09.008 ...

49 CFR Appendix D to Part 599 - CARS Purchaser Survey

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false CARS Purchaser Survey D Appendix D to Part 599 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY... RECYCLE AND SAVE ACT PROGRAM Pt. 599, App. D Appendix D to Part 599—CARS Purchaser Survey ER29JY09.008 ...

49 CFR Appendix D to Part 599 - CARS Purchaser Survey

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 7 2012-10-01 2012-10-01 false CARS Purchaser Survey D Appendix D to Part 599 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY... RECYCLE AND SAVE ACT PROGRAM Pt. 599, App. D Appendix D to Part 599—CARS Purchaser Survey ER29JY09.008 ...

49 CFR Appendix D to Part 599 - CARS Purchaser Survey

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false CARS Purchaser Survey D Appendix D to Part 599 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY... RECYCLE AND SAVE ACT PROGRAM Pt. 599, App. D Appendix D to Part 599—CARS Purchaser Survey ER29JY09.008 ...

49 CFR Appendix D to Part 599 - CARS Purchaser Survey

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false CARS Purchaser Survey D Appendix D to Part 599 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY... RECYCLE AND SAVE ACT PROGRAM Pt. 599, App. D Appendix D to Part 599—CARS Purchaser Survey ER29JY09.008 ...

7 CFR 1430.2 - Price support levels and purchase conditions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Program for Milk § 1430.2 Price support levels and purchase conditions. (a)(1) The level of price support provided to farmers marketing milk containing 3.67 percent milkfat from dairy cows is $9.90 per... for milk will be made available through CCC purchases of butter, nonfat dry milk, and Cheddar cheese...

How Can Adult Children Influence Parents' Long-Term Care Insurance Purchase Decisions?

PubMed

Sperber, Nina R; Voils, Corrine I; Coe, Norma B; Konetzka, R Tamara; Boles, Jillian; Van Houtven, Courtney Harold

2017-04-01

Long-term care (LTC) poses a significant strain on public health insurance financing. In response, there is policy interest in bolstering the private long-term care insurance (LTCI) market. Although families are central to LTC provision, their role in LTCI demand remains unclear. The purpose of this study was to obtain in-depth information concerning: (a) How do older parents evaluate the need for LTCI, (b) what role do adult children play? and (c) How do families communicate about parents' LTC preferences and plans, including LTCI purchase? We conducted focus groups with older parents and adult children in diverse markets. Two groups were conducted with older parents who had purchased LTCI and two with parents who had not purchased LTCI. Four groups were conducted with adult children, mixed as to whether their parents had purchased LTCI. Probes were informed by published reasons for purchasing or not purchasing LTCI. We analyzed transcriptions using directed content analysis and constant comparative method. Older parents valued autonomy for themselves and their children. Older parent purchasers regarded LTCI as supporting this value while nonpurchasers perceived limitations. Adult children described unstated expectations that they would care for their parents. Though discussions between parents and children about LTCI were rare, successful influence occurred when children appealed to shared values, specifically avoiding burden and remaining home. Messages that emphasize autonomy over LTC decisions and interventions that start the LTC conversation among families, with attention to shared values, could increase private LTCI uptake. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Questionable Economic Case for Value-Based Drug Pricing in Market Health Systems.

PubMed

Pauly, Mark V

2017-02-01

This article investigates the economic theory and interpretation of the concept of "value-based pricing" for new breakthrough drugs with no close substitutes in a context (such as the United States) in which a drug firm with market power sells its product to various buyers. The interpretation is different from that in a country that evaluates medicines for a single public health insurance plan or a set of heavily regulated plans. It is shown that there will not ordinarily be a single value-based price but rather a schedule of prices with different volumes of buyers at each price. Hence, it is incorrect to term a particular price the value-based price, or to argue that the profit-maximizing monopoly price is too high relative to some hypothesized value-based price. When effectiveness of treatment or value of health is heterogeneous, the profit-maximizing price can be higher than that associated with assumed values of quality-adjusted life-years. If the firm sets a price higher than the value-based price for a set of potential buyers, the optimal strategy of the buyers is to decline to purchase that drug. The profit-maximizing price will come closer to a unique value-based price if demand is less heterogeneous. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The impact of financial incentives on participants' food purchasing patterns in a supermarket-based randomized controlled trial.

PubMed

Olstad, Dana Lee; Crawford, David A; Abbott, Gavin; McNaughton, Sarah A; Le, Ha Nd; Ni Mhurchu, Cliona; Pollard, Christina; Ball, Kylie

2017-08-25

The impacts of supermarket-based nutrition promotion interventions might be overestimated if participants shift their proportionate food purchasing away from their usual stores. This study quantified whether participants who received price discounts on fruits and vegetables (FV) in the Supermarket Healthy Eating for Life (SHELf) randomized controlled trial (RCT) shifted their FV purchasing into study supermarkets during the intervention period. Participants were 642 females randomly assigned to a 1) skill-building (n = 160), 2) price reduction (n = 161), 3) combined skill-building and price reduction (n = 160), or 4) control (n = 161) group. Participants self-reported the proportion of FV purchased in study supermarkets at baseline, 3- and 6-months post-intervention. Fisher's exact and χ 2 tests assessed differences among groups in the proportion of FV purchased in study supermarkets at each time point. Multinomial logistic regression assessed differences among groups in the change in proportionate FV purchasing over time. Post-intervention, 49% of participants purchased ≥50% of their FV in study supermarkets. Compared to all other groups, the price reduction group was approximately twice as likely (RRR: 1.8-2.2) to have increased proportionate purchasing of FV in study supermarkets from baseline to post-intervention (p< 0.05). Participants who received price reductions on FV were approximately twice as likely to shift their FV purchasing from other stores into study supermarkets during the intervention period. Unless food purchasing data are available for all sources, differential changes in purchasing patterns can make it difficult to discern the true impacts of nutrition interventions. The SHELf trial is registered with Current Controlled Trials Registration ISRCTN39432901, Registered 30 June 2010, Retrospectively registered ( http://www.isrctn.com/ISRCTN39432901 ).

Notes from the field: the economic value chain in disease management organizations.

PubMed

Fetterolf, Donald

2006-12-01

The disease management (DM) "value chain" is composed of a linear series of steps that include operational milestones in the development of knowledge, each stage evolving from the preceding one. As an adaptation of Michael Porter's "value chain" model, the process flow in DM moves along the following path: (1) data/information technology, (2) information generation, (3) analysis, (4) assessment/recommendations, (5) actionable customer plan, and (6) program assessment/reassessment. Each of these stages is managed as a major line of product operations within a DM company or health plan. Metrics around each of the key production variables create benchmark milestones, ongoing management insight into program effectiveness, and potential drivers for activity-based cost accounting pricing models. The value chain process must remain robust from early entry of data and information into the system, through the final presentation and recommendations for our clients if the program is to be effective. For individuals involved in the evaluation or review of DM programs, this framework is an excellent method to visualize the key components and sequence in the process. The value chain model is an excellent way to establish the value of a formal DM program and to create a consultancy relationship with a client involved in purchasing these complex services.

Evaluating Federal Information Technology Program Success Based on Earned Value Management

ERIC Educational Resources Information Center

Moy, Mae N.

2016-01-01

Despite the use of earned value management (EVM) techniques to track development progress, federal information (IT) software programs continue to fail by not meeting identified business requirements. The purpose of this logistic regression study was to examine, using IT software data from federal agencies from 2011 to 2014, whether a relationship…

Notification: Purchase Card and Convenience Check Audit

EPA Pesticide Factsheets

Project #OA-FY13-0116, April 11, 2013. The U.S. Environmental Protection Agency, Office of Inspector General, is beginning the fieldwork phase of its audit of the agency’s purchase card and convenience check programs.

The Perceived Value of University-Based, Continuing Education Leadership Development Programs for Administrators in Higher Education: An Intangibles Model of Value Creation

ERIC Educational Resources Information Center

Stone, Geraldine Louise

2012-01-01

This study examined the perceived value of leadership development programs (LDPs) provided by continuing education for administrators in colleges and universities. Included in this study were questions about the perceived value of non-credit, credit, and blended (credit and non-credit) programs at the individual, institutional, and higher…

Habitual and value-guided purchase behavior.

PubMed

Biel, Anders; Dahlstrand, Ulf; Grankvist, Gunne

2005-06-01

Society increasingly requests that individuals adopt environmentally benign behavior. Information campaigns purported to change people's attitudes are often regarded as prerequisites to installing such changes. While such information may be a necessary step, it is not sufficient by itself. We argue that many everyday behaviors with environmental consequences are habitual, and that little attention is given to information directed toward changing these habitual behaviors. In other instances, behavior is guided by values in a more reflective process. However, other information besides environmental consequences may draw a person's attention and affect behavioral choice. Using surveys and experimental studies targeting consumer behavior, we studied under what conditions different kinds of information is likely to influence people with varying levels of environmental concern. Based on results from these studies, implications for behavioral change are discussed.

Collective purchase behavior toward retail price changes

NASA Astrophysics Data System (ADS)

Ueno, Hiromichi; Watanabe, Tsutomu; Takayasu, Hideki; Takayasu, Misako

2011-02-01

By analyzing a huge amount of point-of-sale data collected from Japanese supermarkets, we find power law relationships between price and sales numbers. The estimated values of the exponents of these power laws depend on the category of products; however, they are independent of the stores, thereby implying the existence of universal human purchase behavior. The rate of sales numbers around these power laws are generally approximated by log-normal distributions implying that there are hidden random parameters, which might proportionally affect the purchase activity.

A Cash-back Rebate Program for Healthy Food Purchases in South Africa: Selection and Program Effects in Self-reported Diet Patterns.

PubMed

An, Ruopeng; Sturm, Roland

2017-03-01

A South African insurer launched a rebate program for healthy food purchases for its members, but only available in program-designated supermarkets. To eliminate selection bias in program enrollment, we estimated the impact of subsidies in nudging the population towards a healthier diet using an instrumental variable approach. Data came from a health behavior questionnaire administered among members in the health promotion program. Individual and supermarket addresses were geocoded and differential distances from home to program-designated supermarkets versus competing supermarkets were calculated. Bivariate probit and linear instrumental variable models were performed to control for likely unobserved selection biases, employing differential distances as a predictor of program enrollment. For regular fast-food, processed meat, and salty food consumption, approximately two-thirds of the difference between participants and nonparticipants was attributable to the intervention and one-third to selection effects. For fruit/ vegetable and fried food consumption, merely one-eighth of the difference was selection. The rebate reduced regular consumption of fast food by 15% and foods high in salt/sugar and fried foods by 22%- 26%, and increased fruit/vegetable consumption by 21% (0.66 serving/day). Large population interventions are an essential complement to laboratory experiments, but selection biases require explicit attention in evaluation studies conducted in naturalistic settings.

Food concerns and support for environmental food policies and purchasing.

PubMed

Worsley, Anthony; Wang, Wei C; Burton, Melissa

2015-08-01

Consumer support for pro environmental food policies and food purchasing are important for the adoption of successful environmental policies. This paper examines consumers' views of food policy options as their predisposition to purchase pro environmental foods along with their likely demographic, educational and cognitive antecedents including food and environmental concerns and universalism values (relating to care for others and the environment). An online survey to assess these constructs was conducted among 2204 Australian adults in November 2011. The findings showed strong levels of support for both environmental food policies (50%-78% support) and pro environmental food purchasing (51%-69% intending to purchase pro environmental foods). Confirmatory factor analysis and structural equation modelling showed that different cognitive mediators exist along pathways between demographics and the two outcome variables. Support for food policy was positively related to food and environment concerns (std. Beta = 0.25), universalism (0.41), perceived control (0.07), and regulatory issues (0.64 but negatively with food security issues (-0.37). Environment purchasing intentions were positively linked to food and nutrition concerns (0.13), food and environment concerns (0.24), food safety concerns (0.19), food and animal welfare concerns (0.16), universalism (0.25), female gender (0.05), education (0.04), and perceived influence over the food system (0.17). In addition, health study in years 11 and 12 was positively related to the beginning of both of these pathways (0.07 for each). The results are discussed in relation to the opportunities that communications based on the mediating variables offer for the promotion of environmental food policies and purchasing. Copyright © 2015 Elsevier Ltd. All rights reserved.

Incentivizing Fruit and Vegetable Purchasers at Fresh Markets in Lower 9th Ward, New Orleans.

PubMed

Ferdinand, Rashida; Torres, Rosamar; Scott, Jennifer; Saeed, Imran; Scribner, Richard

2017-01-01

Disparities in fruit and vegetable consumption have been observed across income and race-ethnicity and shown to be associated with both access to fresh food venues and price. This study assesses the feasibility of increasing produce consumption by incentivizing fruit and vegetable purchases at local markets. We conducted analyses of a cross-sectional survey of program participants and point-of-sale reports on fruit and vegetable purchases at the fresh food markets. Five fresh food markets in the Lower Ninth Ward (LNW) of New Orleans, Louisiana. A total of 176 participants were enrolled in the "Veggie Dollars" program (VDP). From January to July 2016, Sankofa, our community partner, recruited patrons at its markets into the VDP, a fresh food incentive program. Participants received coupons worth $4 per week for fruit and vegetables over a six-week period. Total monthly gross, VDP, and SNAP benefit sales at the markets measured program participation. A survey (N=96) assessed the demographics and fruit and vegetable purchasing practices of participants. Participants were predominantly women (81%), African American (94%) and raising children at home (53%). Point-of-sales data indicated that VDP sales nearly doubled over the intervention period. Total market sales and SNAP benefit purchases also increased. The majority (63%) of VDP participants reported their produce purchases increased and 89% reported increasing their consumption of fruit and vegetables since entering the program. Monetary incentives were associated with increased fruit and vegetable purchases at local fresh food markets in a low-income minority community.

Recognition of Values-Based Constructs in a Summer Physical Activity Program.

ERIC Educational Resources Information Center

Watson, Doris L.; Newton, Maria; Kim, Mi-Sook

2003-01-01

Examined the extent to which participants in a summer sports camp embraced values-based constructs, noting the relationship between perceptions of values-based constructs and affect and attitude. Data on ethnically diverse 10-13-year-olds indicated that care for others/goal setting, self-responsibility, and self-control/respect positively related…

Who Purchases Low-Cost Alcohol in Australia?

PubMed

Callinan, Sarah; Room, Robin; Livingston, Michael; Jiang, Heng

2015-11-01

Debates surrounding potential price-based polices aimed at reducing alcohol-related harms tend to focus on the debate concerning who would be most affected-harmful or low-income drinkers. This study will investigate the characteristics of people who purchase low-cost alcohol using data from the Australian arm of the International Alcohol Control study. 1681 Australians aged 16 and over who had consumed alcohol and purchased it in off-licence premises were asked detailed questions about both practices. Low-cost alcohol was defined using cut-points of 80¢, $1.00 or $1.25 per Australian standard drink. With a $1.00 cut-off low income (OR = 2.1) and heavy drinkers (OR = 1.7) were more likely to purchase any low-cost alcohol. Harmful drinkers purchased more, and low-income drinkers less, alcohol priced at less than $1.00 per drink than high income and moderate drinkers respectively. The relationship between the proportion of units purchased at low cost and both drinker category and income is less clear, with hazardous, but not harmful, drinkers purchasing a lower proportion of units at low cost than moderate drinkers. The impact of minimum pricing on low income and harmful drinkers will depend on whether the proportion or total quantity of all alcohol purchased at low cost is considered. Based on absolute units of alcohol, minimum unit pricing could be differentially effective for heavier drinkers compared to other drinkers, particularly for young males. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

A home-based individualized information communication technology training program for older adults: a demonstration of effectiveness and value.

PubMed

Arthanat, Sajay; Vroman, Kerryellen G; Lysack, Catherine

2016-01-01

To demonstrate the effectiveness and value of a home-based information communication technology (ICT) training program for older adults. Thirteen older adults were provided in-home ICT training by graduate occupational therapy students using an iPad. The breadth and frequency of ICT use, perspectives on technology, and perceived independence were recorded at baseline, during the 3-month training and at follow-up, along with an end-of-study questionnaire. Non-parametric Friedman analysis was conducted to verify trends in the outcome measures. The qualitative data were examined by content analysis. Participants' breadth of ICT activities showed a significant trend across 6 months. Leisure accounted for the significant increase, while health management and social connections activities increased modestly. A positive trend in participants' perspectives on technology was evident along with a marginal increase in perceived independence. Participants' perspectives were thematically categorized as technology experiences, interactions with coach, training approach, and specific activities. As reflection of the training program's value, 12 of the 13 participants took ownership of the iPad at the end of the study. Building capacity of older adults to utilize the multifaceted potential of ICT is critical in addressing declines in health, impending disabilities, and social isolation. Implications for Rehabilitation A one-on-one home-based individualized information communication technology (ICT) training program for older adults could result in a progressive increase in the breadth of online activities carried out by them. Specifically, the increase in their usage of ICT could be expected in leisure-based online activities. Individualized training programs designed based on needs, priorities, and learning style of older adults could have a positive impact on their technological perspectives and intrinsic motivation to adopt ICT.

Managing Medicaid managed care: are states becoming prudent purchasers?

PubMed

Fossett, J W; Goggin, M; Hall, J S; Johnston, J; Plein, L C; Roper, R; Weissert, C

2000-01-01

This paper examines the extent to which five states are becoming "prudent purchasers" in their oversight of Medicaid managed care. Our conclusions are mixed. These states are making more sustained efforts along these lines than most private purchasers are and have improved the amount and quality of the data they collect on the experiences of Medicaid clients when compared with the traditional fee-for-service program. They have been less successful in ensuring data quality that is adequate to support contracting decisions and in developing the analytical or political capacity to use data to "manage" the managed care system. Becoming a prudent purchaser appears to be a complex task for states that may prove difficult to achieve.

Purchasing habits of senior farmers' market shoppers: utilizing the theory of planned behavior.

PubMed

Middleton, Crystal; Smith, Sylvia

2011-01-01

The purpose of this study was to understand fresh fruit and vegetable purchasing habits among senior farmers' market shoppers using the theory of planned behavior. A survey instrument was developed to collect information on seniors' fruit and vegetable purchasing habits. A convenience sample of seniors shopping at farmers' markets was employed. A total of 184 surveys were collected. Respondents were divided into two groups based on response to a question of whether they received Senior Farmers' Market Nutritional Program (SFMNP) checks: 35 were on the SFMNP and 149 were not. Results indicated attitudes, subjective norms (SN), and perceived behavioral control (PBC) were all significantly correlated with intentions at the p < 0.01 level. Attitude had the strongest association with intentions (0.730), followed by PBC (0.666) and SN (0.587). Regression analysis was significant and explained 66% of the variance (F = 86.151, p < 0.001, adjusted R square = 0.656). Results indicated attitude to be the strongest predictor of seniors' intentions to purchase more fresh fruits and vegetables at farmers' markets. Senior programs may find this information useful when promoting fresh fruits and vegetables for senior citizens. These findings may also benefit farmers' markets while promoting fresh fruits and vegetables.

Opinion survey: materials management and purchasing habits.

PubMed

1988-01-01

This opinion survey was undertaken to gauge the current status of materials management and purchasing departments at hospitals throughout the southern and southeastern United States. The survey was based on lengthy telephone interviews (from 30 to 60 minutes) and followup discussions with materials managers, purchasing agents and administrators. Interviews covered a variety of topics, including: cost-containment strategies; group purchasing and consignment purchasing; and current and anticipated trends in materials management. Many questions were left open-ended, so the survey could gauge attitudes, as well as determine contemporary practices and procedures. (In some cases, respondents were also given the opportunity to comment on the statements of their peers, in order to corroborate and substantiate data.)

Impact of Standardized New Medication Education Program on Postdischarge Patients' Knowledge and Satisfaction.

PubMed

Jones, Tammie R; Coke, Lola

2016-10-01

This study, implemented on 2 medical-surgical units, evaluated the impact of a standardized, evidence-based new medication education program. Outcomes evaluated included patient postdischarge knowledge of new medication purpose and side effects, patient satisfaction with new medication, and Medicare reimbursement earn-back potential. As a result, knowledge scores for new medication purpose and side effects were high post intervention. Patient satisfaction with new medication education increased. Value-based purchasing reimbursement earn-back potential improved.

Factors important in the purchase of partnership long-term care insurance.

PubMed

McCall, N; Mangle, S; Bauer, E; Knickman, J

1998-06-01

To understand the factors important in the purchase of long-term care insurance through the Robert Wood Johnson Foundation Partnership for Long-Term Care. Information on the Partnership programs, telephone surveys, data on Partnership purchasers, and random sample frames. Logistic regression analysis is used to examine characteristics associated with the purchase of a Partnership insurance policy. Independent variables are health status, demographic and financial characteristics, knowledge, and attitudes. A telephone survey of Partnership purchasers and a random sample of the population in each Partnership state were conducted. Survey questions included health status, opinions about long-term care and long-term care insurance, financial planning, demographic characteristics, and income and assets. Important in the purchase of a Partnership policy were variables associated with education and knowledge about long-term care. Other important factors include attitudes and health status. Partnership purchase is associated with higher income and asset levels up to a point, with the effect plateauing and decreasing at the highest income and asset levels. Improved education and knowledge are important in increasing long-term care insurance purchase. Attitudes about having a caregiver, and about the government's role in paying for long-term care as well as the potential purchaser's willingness to consider nursing home care affect policy purchase. Also associated with Partnership policy purchase are better health and middle income and asset levels.

Bid purchasing of pharmaceuticals.

PubMed

Swift, R G; Ryan, M R

1978-11-01

The effects of bid purchasing of drug products by hospitals and the factors to consider in bid purchasing of pharmaceuticals are reviewed; further, the prices available with bid purchasing to a specific hospital in 1974 and 1977 are presented. Factors important for a successful bid purchasing system of pharmaceuticals are: (1) use of a formulary policy, (2) an effective procedure for handling bid purchasing and (3) criteria for evaluation of drug products. Significant differences were found between prices available with and without bid purchasing for 50 nonproprietary drug products in 1974 and for 19 products in 1977. Although monetary savings to hospitals do exist with bid purchasing of pharmaceuticals, the degree of savings is dependent upon the drug usage for that hospital.

Purchasing oncology services. Kerr L. White Institute/American Cancer Society Task Force on Purchasing Oncology Services.

PubMed

Cangialose, C B; Blair, A E; Borchardt, J S; Ades, T B; Bennett, C L; Dickersin, K; Gesme, D H; Henderson, I C; McGinnis, L S; Mooney, K; Mortenson, L E; Sperduto, P; Winkenwerder, W; Ballard, D J

2000-06-15

A multidisciplinary panel representing various stakeholders in the health care delivery and oncology services marketplace was convened to develop specific criteria for healthcare purchasers to consider when evaluating the structures and processes of health plans. These rank ordered criteria also can be used by oncologic service providers and health plan designers as a yardstick for the services they offer. A multidisciplinary 31-member Task Force was assembled by the Kerr L. White Institute and the American Cancer Society in March 1997. Task Force members were selected for their ability to offer expert insight as purchasers, suppliers, policymakers, consumers, or stakeholders in the health care marketplace. A preference-weighted majority voting rule was used to identify the three most important recommendations of the 10 that were generated through a modified Delphi technique. To test the practicality of the top three recommendations, leaders of large managed care organizations (MCOs) were surveyed; the results of this survey then were compared with the results of the Task Force survey. The three most important recommendations from the Task Force were that health plans provide access to: 1) comprehensive cancer care, 2) preventive and screening services, and 3) second opinions and treatment options supported by scientific evidence. The difference between the responses of the Task Force and the MCOs was that MCOs placed the highest importance on evidence-based decision-making, with their next three rankings coinciding with those identified by the Task Force. The value of these summary recommendations will be realized through their use by both purchasers and suppliers to influence the structure and content of the delivery of oncologic services.

48 CFR 1553.213 - Small purchases and other simplified purchase procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Small purchases and other simplified purchase procedures. 1553.213 Section 1553.213 Federal Acquisition Regulations System ENVIRONMENTAL PROTECTION AGENCY CLAUSES AND FORMS FORMS Prescription of Forms 1553.213 Small purchases and other...

The Boston Middle School-Corner Store Initiative: Development, Implementation, and Initial Evaluation of a Program Designed to Improve Adolescents' Beverage-Purchasing Behaviors

ERIC Educational Resources Information Center

Hoffman, Jessica A.; Morris, Vivien; Cook, John

2009-01-01

The Boston Middle School Corner Store Initiative (CSI) brought together schools, businesses, and community partners to develop, implement, and evaluate a multicomponent pilot program designed to promote healthier beverage purchasing at corner stores among 3,500 middle school students living in Boston, Massachusetts. Healthy drinks were defined for…

45 CFR 400.148 - Purchase of services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Purchase of services. 400.148 Section 400.148 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.148 - Purchase of services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 2 2012-10-01 2012-10-01 false Purchase of services. 400.148 Section 400.148 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.148 - Purchase of services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true Purchase of services. 400.148 Section 400.148 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.148 - Purchase of services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true Purchase of services. 400.148 Section 400.148 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.148 - Purchase of services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 2 2011-10-01 2011-10-01 false Purchase of services. 400.148 Section 400.148 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

Values underpinning poverty programs for children.

PubMed

Heclo, H H

1997-01-01

Values create a framework through which the American public gives meaning to particular concepts and events. To better understand the values underlying public support for poverty programs for children, this article examines public attitudes toward children, poverty, and government. Although Americans continue to view helping children as a top policy priority, there is ambivalence with regard to poor children because of their inevitable connection to poor adults and the public's expectation that adults be self-sufficient. Rather than choosing between extreme ideological views of the causes of poverty and the ideal role of government in curbing poverty, the American public takes an integrative perspective that both values individual initiative and supports opportunities for all Americans. Favored are government programs fitted to the practical needs of everyday life. Such programs should support personal efforts but not assume responsibility for individual or particular group outcomes.

Achieving Consumer Purchase Payoffs: A Used Car Purchase.

ERIC Educational Resources Information Center

Maynes, E. Scott; Maynes, Blanche R.

1997-01-01

This case study of a used car purchase illuminates the concepts and principles that should guide purchase decisions. It suggests that consumers should be aware there is little correlation between price and quality; competent shopping yields better quality; and consumers must decide their preferred trade-off between price and quality. (SK)

Purchase habits, use of paracetamol, and information sources on a reregulated Swedish pharmacy market: A population-based study.

PubMed

Hedenrud, T; Håkonsen, H

2017-01-01

Considering the general lack of knowledge on how over-the-counter paracetamol is used combined with the reported increase in paracetamol poisonings after the reregulation of the Swedish pharmacy market in 2009, we aimed to analyze purchase habits and use of paracetamol in Sweden. A further aim was to investigate sources of information about paracetamol. Data were collected in October 2015 through the Citizen Panel, a Web-based panel encompassing over 50,000 Swedes. A stratified sample of 6000 (aged 18 years and older) was emailed a survey invitation. Questions concerned paracetamol use, purchase habits and information sources. The participation rate was 58%. A majority (70.5%) reported use of paracetamol during the last three months. Purchasing paracetamol solely over-the-counter was most common (81.1%). Close to two-thirds usually purchased paracetamol at a pharmacy. However, it was more common to purchase OTC paracetamol at non-pharmacy outlets among younger compared to older respondents. The results of this study did not reveal any harmful paracetamol use. The most common information source overall was patient information leaflets, and it was significantly more common among the youngest compared to older subjects. Based on our results combined with previous research, we suggest more studies, both qualitative and quantitative, among young adults, both on the use of paracetamol and on the understanding of information in patient information leaflets and on the Internet. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Identifying acceptability and price points for purchasing micronutrient powders for children 2 to 5 years old in Nepal.

PubMed

Gunnala, Rajni; Perrine, Cria G; Subedi, Giriraj; Mebrahtu, Saba; Dahal, Pradiumna; Jefferds, Maria Elena

2017-01-01

Little is known about purchasing micronutrient powders (MNP) for children 2-5 years. We describe acceptability for purchasing and price points for MNP for children 2-5 years among caregivers living in districts where free MNP are distributed for children 6-23 months. Crosssectional surveys conducted 3 months after MNP program implementation in 2 districts; 15 months after implementation in 2 different districts. Chi square tests and logistic regression describe associations among sociodemographics and program exposure factors and acceptability of purchasing MNP among 1,261 mothers of children 6-23 months who had heard of MNP. Overall, 77.5% and 86.1% of mothers reported acceptability for purchasing MNP in the 3 and 15 month surveys, respectively. Positive pricing attitude (PPA) about paying 150 Nepali rupees for 60 sachets of MNP was reported by 66.3% and 73.4% of mothers. Acceptability for purchasing MNP in both time periods increased with higher wealth quintile and higher maternal education; PPA increased with higher maternal education. Controlling for socio-demographics, program exposure factors associated with acceptability for purchasing MNP included: lack of perceived barriers to MNP intake and health worker counselling (3 month surveys); knowledge of benefits of MNP intake and lack of perceived barriers to MNP intake (15 month surveys). Mothers reported acceptability for purchasing MNP and PPA for older children in Nepal. Differences in acceptability were found across socio-demographics and program exposures. Use of these results and further exploration into actual purchasing behaviour can inform future MNP distribution methods in Nepal.

The Theory of Value-Based Payment Incentives and Their Application to Health Care.

PubMed

Conrad, Douglas A

2015-12-01

To present the implications of agency theory in microeconomics, augmented by behavioral economics, for different methods of value-based payment in health care; and to derive a set of future research questions and policy recommendations based on that conceptual analysis. Original literature of agency theory, and secondarily behavioral economics, combined with applied research and empirical evidence on the application of those principles to value-based payment. Conceptual analysis and targeted review of theoretical research and empirical literature relevant to value-based payment in health care. Agency theory and secondarily behavioral economics have powerful implications for design of value-based payment in health care. To achieve improved value-better patient experience, clinical quality, health outcomes, and lower costs of care-high-powered incentives should directly target improved care processes, enhanced patient experience, and create achievable benchmarks for improved outcomes. Differing forms of value-based payment (e.g., shared savings and risk, reference pricing, capitation, and bundled payment), coupled with adjunct incentives for quality and efficiency, can be tailored to different market conditions and organizational settings. Payment contracts that are "incentive compatible"-which directly encourage better care and reduced cost, mitigate gaming, and selectively induce clinically efficient providers to participate-will focus differentially on evidence-based care processes, will right-size and structure incentives to avoid crowd-out of providers' intrinsic motivation, and will align patient incentives with value. Future research should address the details of putting these and related principles into practice; further, by deploying these insights in payment design, policy makers will improve health care value for patients and purchasers. © Health Research and Educational Trust.

Shopping for health: purchasing health services through contracts.

PubMed

Howden-Chapman, P; Ashton, T

1994-01-01

The 1993 New Zealand health service reforms were based on the purported efficiencies of the purchaser/provider split. Purchasers are required to contract for services that will maintain, improve and restore the health of the populations they serve. The purchasing role, which requires the development of contracting skills as well as the setting of strategic directions and priorities, is new and as yet poorly developed. This paper describes the role of purchasing agents in setting priorities, the different approaches that are being taken to contracting for services and some of the problems that have arisen in the first year of contracting. It explores the trade-off that is evident between the potential for improving efficiency through contestable contracting and the need to minimise transaction costs associated with the contracting process. The purchasers' accountability to the public and the Minister is analysed in the broader political context of the purchasers' role in shaping a public health service and improving the health of the population.

Microbiological Testing Results of Boneless and Ground Beef Purchased for the National School Lunch Program, 2011 to 2014.

PubMed

Doerscher, Darin R; Lutz, Terry L; Whisenant, Stephen J; Smith, Kerry R; Morris, Craig A; Schroeder, Carl M

2015-09-01

The Agricultural Marketing Service (AMS) purchases boneless and ground beef for distribution to recipients through federal nutrition assistance programs, including the National School Lunch Program, which represents 93% of the overall volume. Approximately every 2,000 lb (ca. 907 kg) of boneless beef and 10,000 lb (ca. 4,535 kg) of ground beef are designated a "lot" and tested for Escherichia coli O157:H7, Salmonella, standard plate count organisms (SPCs), E. coli, and coliforms. Any lot of beef positive for E. coli O157:H7 or for Salmonella, or any beef with concentrations of organisms exceeding critical limits for SPCs (100,000 CFU g(-1)), E. coli (500 CFU g(-1)), or coliforms (1,000 CFU g(-1)) is rejected for purchase by AMS and must be diverted from federal nutrition assistance programs. From July 2011 through June 2014, 537,478,212 lb (ca. 243,795,996 kg) of boneless beef and 428,130,984 lb (ca. 194,196,932 kg) of ground beef were produced for federal nutrition assistance programs. Of the 230,359 boneless beef samples collected over this period, 82 (0.04%) were positive for E. coli O157:H7, 924 (0.40%) were positive for Salmonella, 222 (0.10%) exceeded the critical limit for SPCs, 69 (0.03%) exceeded the critical limit for E. coli, and 123 (0.05%) exceeded the critical limit for coliforms. Of the 46,527 ground beef samples collected over this period, 30 (0.06%) were positive for E. coli O157:H7, 360 (0.77%) were positive for Salmonella, 20 (0.04%) exceeded the critical limit for SPCs, 22 (0.05%) exceeded the critical limit for E. coli, and 17 (0.04%) exceeded the critical limit for coliforms. Cumulatively, these data suggest beef produced for the AMS National School Lunch Program is done so under an adequate food safety system, as indicated by the low percentage of lots that were pathogen positive or exceeded critical limits for indicator organisms.

Sugar and total energy content of household food purchases in Brazil.

PubMed

Levy, Renata Bertazzi; Claro, Rafael Moreira; Monteiro, Carlos Augusto

2009-11-01

To study the role of energy derived from sugar (both table sugar and sugar added to processed foods) in the total energy content of food purchases in Brazil. Food purchase data were collected during a national household budget survey carried out between June 2002 and July 2003 on a probabilistic sample representative of all households in the country. The amount of food purchased in this 12-month period was transformed into energy and energy from sugar using food composition tables. Multiple linear regression models were used to study the association between amount of energy from sugar and total energy content of food purchases, controlling for sociodemographic variables and potential interactions between these variables and sugar purchases. There was a positive and significant association between energy from sugar and total household energy purchases. A 1 kJ increase in sugar purchase corresponded to a 3.637 kJ increase in total energy. In the absence of expenditure on meals outside the home, i.e. when household food purchases tend to approximate actual food consumption by household members, sugar purchase of 1926.35 kJ/d (the 90th percentile of the distribution of sugar purchases in Brazil) was associated, depending on income strata, with total energy purchase over 40-60 % of the recommended daily value for energy intake in Brazil. The present results corroborate the recommendations of the WHO and the Brazilian Ministry of Health regarding limiting the consumption of sugar.

The effects of purchasing alcohol and marijuana among adolescents at-risk for future substance use.

PubMed

Osilla, Karen Chan; Pedersen, Eric R; Ewing, Brett A; Miles, Jeremy N V; Ramchand, Rajeev; D'Amico, Elizabeth J

2014-09-18

Among high-risk youth, those who may be at increased risk for adverse alcohol and other drug (AOD) use outcomes may benefit from targeted prevention efforts; how youth acquire AOD may provide an objective means of identifying youth at elevated risk. We assessed how youth acquired alcohol and marijuana (purchasing vs. other means), demographics, AOD behaviors/consequences, and environment among adolescents referred to a diversion program called Teen Court (N = 180) at two time points (prior to the program and 180 days from baseline). Participants were predominantly White and Hispanic/Latino(a). In cross-sectional analyses among alcohol and marijuana users, purchasing marijuana was associated with more frequent marijuana use and consequences, time spent around teens who use marijuana, higher likelihood of substance use disorders, and lower resistance self-efficacy compared to non-purchasers. Teens who purchased both alcohol and marijuana experienced similar outcomes to those who purchased only marijuana, and also reported more frequent and higher quantity of drinking, greater alcohol-related consequences, time spent around teens who use other drugs, and prescription drug misuse. Longitudinally, purchasing alcohol and marijuana at baseline was associated with more frequent and higher quantity of drinking compared to non-purchasers at follow-up. Marijuana only purchasers had a greater likelihood of substance use disorders at follow-up compared to non-purchasers. In an era where drinking is commonplace and attitudes towards marijuana use are becoming more tolerant, it is essential to evaluate how accessibility to AOD and subsequent purchasing behaviors affect youth consumption and intervene accordingly to prevent future consequences.

Weight loss strategies: association with consumption of sugary beverages, snacks and values about food purchases.

PubMed

Bleich, Sara N; Wolfson, Julia A

2014-07-01

To examine whether weight loss strategies are associated with consumption of sugar-sweetened beverages (SSBs), snacks or food values. Cross-sectional analysis of 24-h dietary recall data obtained from the National Health and Nutrition Examination Survey 2007-2010 (N=9440). Adults trying to lose weight consumed roughly 2000 total calories, 250 calories from SSBs, 225 calories from salty snacks, and 350 calories from sweet snacks. Adults not trying to lose weight consumed roughly 2300 total calories, 300 calories from SSBs, 250 calories from salty snacks, and 380 calories from sweet snacks. While overweight and obese adults trying to lose weight consumed fewer calories than those who were not, heavier adults trying to lose weight using dietary strategies or a combination of diet and physical activity consumed more calories than healthy weight adults using that same weight loss strategy (p<0.05). Price (>70%) and nutrition (>50%) were most when making food choices (p<0.05) for all groups. Consumption of discretionary calories is high regardless of body weight or weight loss intention. Promoting reduced SSB and snack consumption in the clinical setting may be important for weight loss, particularly among heavier individuals. Clinicians should consider values related to food purchasing to identify concrete behavioral targets. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

A singular value decomposition linear programming (SVDLP) optimization technique for circular cone based robotic radiotherapy.

PubMed

Liang, Bin; Li, Yongbao; Wei, Ran; Guo, Bin; Xu, Xuang; Liu, Bo; Li, Jiafeng; Wu, Qiuwen; Zhou, Fugen

2018-01-05

With robot-controlled linac positioning, robotic radiotherapy systems such as CyberKnife significantly increase freedom of radiation beam placement, but also impose more challenges on treatment plan optimization. The resampling mechanism in the vendor-supplied treatment planning system (MultiPlan) cannot fully explore the increased beam direction search space. Besides, a sparse treatment plan (using fewer beams) is desired to improve treatment efficiency. This study proposes a singular value decomposition linear programming (SVDLP) optimization technique for circular collimator based robotic radiotherapy. The SVDLP approach initializes the input beams by simulating the process of covering the entire target volume with equivalent beam tapers. The requirements on dosimetry distribution are modeled as hard and soft constraints, and the sparsity of the treatment plan is achieved by compressive sensing. The proposed linear programming (LP) model optimizes beam weights by minimizing the deviation of soft constraints subject to hard constraints, with a constraint on the l 1 norm of the beam weight. A singular value decomposition (SVD) based acceleration technique was developed for the LP model. Based on the degeneracy of the influence matrix, the model is first compressed into lower dimension for optimization, and then back-projected to reconstruct the beam weight. After beam weight optimization, the number of beams is reduced by removing the beams with low weight, and optimizing the weights of the remaining beams using the same model. This beam reduction technique is further validated by a mixed integer programming (MIP) model. The SVDLP approach was tested on a lung case. The results demonstrate that the SVD acceleration technique speeds up the optimization by a factor of 4.8. Furthermore, the beam reduction achieves a similar plan quality to the globally optimal plan obtained by the MIP model, but is one to two orders of magnitude faster. Furthermore, the SVDLP

A singular value decomposition linear programming (SVDLP) optimization technique for circular cone based robotic radiotherapy

NASA Astrophysics Data System (ADS)

Liang, Bin; Li, Yongbao; Wei, Ran; Guo, Bin; Xu, Xuang; Liu, Bo; Li, Jiafeng; Wu, Qiuwen; Zhou, Fugen

2018-01-01

With robot-controlled linac positioning, robotic radiotherapy systems such as CyberKnife significantly increase freedom of radiation beam placement, but also impose more challenges on treatment plan optimization. The resampling mechanism in the vendor-supplied treatment planning system (MultiPlan) cannot fully explore the increased beam direction search space. Besides, a sparse treatment plan (using fewer beams) is desired to improve treatment efficiency. This study proposes a singular value decomposition linear programming (SVDLP) optimization technique for circular collimator based robotic radiotherapy. The SVDLP approach initializes the input beams by simulating the process of covering the entire target volume with equivalent beam tapers. The requirements on dosimetry distribution are modeled as hard and soft constraints, and the sparsity of the treatment plan is achieved by compressive sensing. The proposed linear programming (LP) model optimizes beam weights by minimizing the deviation of soft constraints subject to hard constraints, with a constraint on the l 1 norm of the beam weight. A singular value decomposition (SVD) based acceleration technique was developed for the LP model. Based on the degeneracy of the influence matrix, the model is first compressed into lower dimension for optimization, and then back-projected to reconstruct the beam weight. After beam weight optimization, the number of beams is reduced by removing the beams with low weight, and optimizing the weights of the remaining beams using the same model. This beam reduction technique is further validated by a mixed integer programming (MIP) model. The SVDLP approach was tested on a lung case. The results demonstrate that the SVD acceleration technique speeds up the optimization by a factor of 4.8. Furthermore, the beam reduction achieves a similar plan quality to the globally optimal plan obtained by the MIP model, but is one to two orders of magnitude faster. Furthermore, the SVDLP

43 CFR 30.175 - When does a purchased interest vest in the purchaser?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false When does a purchased interest vest in the purchaser? 30.175 Section 30.175 Public Lands: Interior Office of the Secretary of the Interior INDIAN PROBATE HEARINGS PROCEDURES Purchase at Probate § 30.175 When does a purchased interest vest in the...

43 CFR 30.175 - When does a purchased interest vest in the purchaser?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false When does a purchased interest vest in the purchaser? 30.175 Section 30.175 Public Lands: Interior Office of the Secretary of the Interior INDIAN PROBATE HEARINGS PROCEDURES Purchase at Probate § 30.175 When does a purchased interest vest in the...

43 CFR 30.175 - When does a purchased interest vest in the purchaser?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false When does a purchased interest vest in the purchaser? 30.175 Section 30.175 Public Lands: Interior Office of the Secretary of the Interior INDIAN PROBATE HEARINGS PROCEDURES Purchase at Probate § 30.175 When does a purchased interest vest in the...

43 CFR 30.175 - When does a purchased interest vest in the purchaser?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false When does a purchased interest vest in the purchaser? 30.175 Section 30.175 Public Lands: Interior Office of the Secretary of the Interior INDIAN PROBATE HEARINGS PROCEDURES Purchase at Probate § 30.175 When does a purchased interest vest in the...

43 CFR 30.175 - When does a purchased interest vest in the purchaser?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true When does a purchased interest vest in the purchaser? 30.175 Section 30.175 Public Lands: Interior Office of the Secretary of the Interior INDIAN PROBATE HEARINGS PROCEDURES Purchase at Probate § 30.175 When does a purchased interest vest in the...

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

PubMed

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

2013-12-01

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

Wise Purchasing.

ERIC Educational Resources Information Center

Bridgman, Anne

1990-01-01

Recent events in Florida, California, and other states suggest that school equipment purchasing is fraught with scandal and risk. This article recommends putting district policies in writing, carefully selecting bidders, timing bids to avoid peak periods, and resisting personalized incentives. Sidebars detail model purchasing guidelines and…

Purchaser strategies to influence quality of care: from rhetoric to global applications.

PubMed

McNamara, P

2006-06-01

The potential of purchasers to influence the quality and safety of care has captured the attention of health sector leaders worldwide. Quality based purchasing explicitly seeks to hold providers accountable for the quality and safety of care. Three strategies are available to purchasers: (1) selective contracting based on quality; (2) payment differentials based on quality; and (3) sponsorship of comparative provider report cards. Examples are given to illustrate each of the three strategies. Governments, employers, social insurance funds, community based insurance organizations, health plans, donors, and other buyers of health services are encouraged to explore and debate these purchaser strategies within the context of an overarching national or local quality framework. Public and private funders of operations research are encouraged to support and disseminate evaluations of purchaser efforts to improve quality. This paper is designed to highlight and frame purchasers' strategies explicitly crafted to enhance the quality and safety of care. The ultimate aim is to encourage thoughtful discussion about whether or not one or more purchaser strategy might support a particular country's goals to improve care. Experiences from both developed and developing countries are included to facilitate the exchange of ideas and provide the broadest of perspectives.

24 CFR 906.25 - Ownership interests that may be conveyed to a purchaser.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Ownership interests that may be... § 906.25 Ownership interests that may be conveyed to a purchaser. A homeownership program may provide for sale to the purchasing family of any ownership interest that the PHA considers appropriate under...

13 CFR 108.825 - Purchasing securities from an underwriter or other third party.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM Financing of Small Businesses by NMVC Companies Structuring Nmvc Company's Financing of Eligible Small Businesses § 108.825 Purchasing securities from an... within 90 days of the date the public offering is first made; (2) Your purchase price is no more than the...

Energy-efficient Public Procurement: Best Practice in Program Delivery

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

Payne, Christopher; Weber, Andrew; Semple, Abby

2013-02-15

This document illustrates the key issues and considerations involved in implementing energy-efficient public procurement. Our primary sources of information have been our partners in the Super Efficient Equipment and Appliance Deployment (SEAD) Initiative Procurement Working Group. Where applicable, we have highlighted specific ways in which working group participants have successfully overcome barriers to delivering effective programs. The following key points emerge from this analysis of programs for energy-efficient public procurement. Lessons for both developed and developing programs are highlighted throughout the guide. 1. Policy: Policy provides the initiative to begin a transition from first cost to life-cycle cost based purchasingmore » methods and culture. Effective policy is well-communicated, establishes accountability from top to bottom of organizations and simplifies the processes necessary to comply. Flexibility and responsiveness are essential in policy development and implementation. Mandatory and voluntary policies may complement one another. 2. Procurement Criteria: Procurement staff must be confident that energy-efficient procurement criteria offer the best long-term value for their organization’s money and represent real environmental gains. Involving multiple stakeholders at the early stages of the criteria creation process can result in greater levels of cooperation from private industry. Criteria should make comparison of products easy for purchasers and require minimal additional calculations. Criteria will need to be regularly updated to reflect market developments. 3. Training: Resources for the creation of training programs are usually very limited, but well-targeted training is necessary in order for a program to be effective. Training must emphasize a process that is efficient for purchasers and simplifies compliance. Purchaser resources and policy must be well designed for training to be effective. Training program development is

Evaluation of a Secure Laptop-Based Testing Program in an Undergraduate Nursing Program: Students' Perspective.

PubMed

Tao, Jinyuan; Gunter, Glenda; Tsai, Ming-Hsiu; Lim, Dan

2016-01-01

Recently, the many robust learning management systems, and the availability of affordable laptops, have made secure laptop-based testing a reality on many campuses. The undergraduate nursing program at the authors' university began to implement a secure laptop-based testing program in 2009, which allowed students to use their newly purchased laptops to take quizzes and tests securely in classrooms. After nearly 5 years' secure laptop-based testing program implementation, a formative evaluation, using a mixed method that has both descriptive and correlational data elements, was conducted to seek constructive feedback from students to improve the program. Evaluation data show that, overall, students (n = 166) believed the secure laptop-based testing program helps them get hands-on experience of taking examinations on the computer and gets them prepared for their computerized NCLEX-RN. Students, however, had a lot of concerns about laptop glitches and campus wireless network glitches they experienced during testing. At the same time, NCLEX-RN first-time passing rate data were analyzed using the χ2 test, and revealed no significant association between the two testing methods (paper-and-pencil testing and the secure laptop-based testing) and students' first-time NCLEX-RN passing rate. Based on the odds ratio, however, the odds of students passing NCLEX-RN the first time was 1.37 times higher if they were taught with the secure laptop-based testing method than if taught with the traditional paper-and-pencil testing method in nursing school. It was recommended to the institution that better quality of laptops needs to be provided to future students, measures needed to be taken to further stabilize the campus wireless Internet network, and there was a need to reevaluate the Laptop Initiative Program.

A Supermarket Double-Dollar Incentive Program Increases Purchases of Fresh Fruits and Vegetables Among Low-Income Families With Children: The Healthy Double Study.

PubMed

Polacsek, Michele; Moran, Alyssa; Thorndike, Anne N; Boulos, Rebecca; Franckle, Rebecca L; Greene, Julie C; Blue, Dan J; Block, Jason P; Rimm, Eric B

2018-03-01

To carry out a pilot study to determine whether a supermarket double-dollar fruit and vegetable (F&V) incentive increases F&V purchases among low-income families. Randomized controlled design. Purchases were tracked using a loyalty card that provided participants with a 5% discount on all purchases during a 3-month baseline period followed by the 4-month intervention. A supermarket in a low-income rural Maine community. A total of 401 low-income and Supplemental Nutrition Assistance Program (SNAP) supermarket customers. Same-day coupon at checkout for half-off eligible fresh, frozen, or canned F&V over 4 months. Weekly spending in dollars on eligible F&V. A linear model with random intercepts accounted for repeated transactions by individuals to estimate change in F&V spending per week from baseline to intervention. Secondary analyses examined changes among SNAP-eligible participants. Coupons were redeemed among 53% of eligible baskets. Total weekly F&V spending increased in the intervention arm compared with control ($1.83; 95% confidence interval [CI], $0.29 to $3.88). The largest increase was for fresh F&V ($1.97; 95% CI, $0.49 to $3.44). Secondary analyses revealed greater increases in F&V spending among SNAP-eligible participants who redeemed coupons ($5.14; 95% CI, $1.93 to $8.34) than among non-SNAP eligible participants who redeemed coupons ($3.88; 95% CI, $1.67 to $6.08). A double-dollar pricing incentive increased F&V spending in a low-income community despite the moderate uptake of the coupon redemption. Customers who were eligible for SNAP saw the greatest F&V spending increases. Financial incentives for F&V are an effective strategy for food assistance programs to increase healthy purchases and improve dietary intake in low-income families. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Identifying acceptability and price points for purchasing micronutrient powders for children 2 to 5 years old in Nepal

PubMed Central

Gunnala, Rajni; Perrine, Cria G; Subedi, Giriraj; Mebrahtu, Saba; Dahal, Pradiumna; Jefferds, Maria Elena

2017-01-01

Background and Objective Little is known about purchasing micronutrient powders (MNP) for children 2–5 years. We describe acceptability for purchasing and price points for MNP for children 2–5 years among caregivers living in districts where free MNP are distributed for children 6–23 months. Methods and Study Design Cross-sectional surveys conducted 3 months after MNP program implementation in 2 districts; 15 months after implementation in 2 different districts. Chi square tests and logistic regression describe associations among socio-demographics and program exposure factors and acceptability of purchasing MNP among 1,261 mothers of children 6–23 months who had heard of MNP. Results Overall, 77.5% and 86.1% of mothers reported acceptability for purchasing MNP in the 3 and 15 month surveys, respectively. Positive pricing attitude (PPA) about paying 150 Nepali rupees for 60 sachets of MNP was reported by 66.3% and 73.4% of mothers. Acceptability for purchasing MNP in both time periods increased with higher wealth quintile and higher maternal education; PPA increased with higher maternal education. Controlling for socio-demographics, program exposure factors associated with acceptability for purchasing MNP included: lack of perceived barriers to MNP intake and health worker counselling (3 month surveys); knowledge of benefits of MNP intake and lack of perceived barriers to MNP intake (15 month surveys). Conclusions Mothers reported acceptability for purchasing MNP and PPA for older children in Nepal. Differences in acceptability were found across socio-demographics and program exposures. Use of these results and further exploration into actual purchasing behaviour can inform future MNP distribution methods in Nepal. PMID:28049270

Residency Program Directors' View on the Value of Teaching.

PubMed

Korte, Catherine; Smith, Andrew; Pace, Heather

2016-08-01

There is no standardization for teaching activities or a requirement for residency programs to offer specific teaching programs to pharmacy residents. This study will determine the perceived value of providing teaching opportunities to postgraduate year 1 (PGY-1) pharmacy residents in the perspective of the residency program director. The study will also identify the features, depth, and breadth of the teaching experiences afforded to PGY-1 pharmacy residents. A 20-question survey was distributed electronically to 868 American Society of Health-System Pharmacists-accredited PGY-1 residency program directors. The survey was completed by 322 program directors. Developing pharmacy educators was found to be highly valued by 57% of the program directors. Advertisement of teaching opportunities was found to be statistically significant when comparing program directors with a high perceived value for providing teaching opportunities to program demographics. Statistically significant differences were identified associating development of a teaching portfolio, evaluation of Advanced Pharmacy Practice Experiences students, and delivery of didactic lectures with program directors who highly value developing pharmacy educators. Future residency candidates interested in teaching or a career in academia may utilize these findings to identify programs that are more likely to value developing pharmacy educators. The implementation of a standardized teaching experience among all programs may be difficult. © The Author(s) 2015.

Effects of nutrient profiling and price changes based on NuVal® scores on food purchasing in an online experimental supermarket.

PubMed

Epstein, Leonard H; Finkelstein, Eric A; Katz, David L; Jankowiak, Noelle; Pudlewski, Corrin; Paluch, Rocco A

2016-08-01

The goal of the present study was to apply experimental economic methods in an online supermarket to examine the effects of nutrient profiling, and differential pricing based on the nutrient profile, on the overall diet quality, energy and macronutrients of the foods purchased, and diet cost. Participants were provided nutrient profiling scores or price adjustments based on nutrient profile scores while completing a hypothetical grocery shopping task. Prices of foods in the top 20 % of nutrient profiling scores were reduced (subsidized) by 25 % while those in the bottom 20 % of scores were increased (taxed) by 25 %. We evaluated the independent and interactive effects of nutrient profiling or price adjustments on overall diet quality of foods purchased as assessed by the NuVal® score, energy and macronutrients purchased and diet cost in a 2×2 factorial design. A large (>10 000 food items) online experimental supermarket in the USA. Seven hundred and eighty-one women. Providing nutrient profiling scores improved overall diet quality of foods purchased. Price changes were associated with an increase in protein purchased, an increase in energy cost, and reduced carbohydrate and protein costs. Price changes and nutrient profiling combined were associated with no unique benefits beyond price changes or nutrient profiling alone. Providing nutrient profile score increased overall NuVal® score without a reduction in energy purchased. Combining nutrient profiling and price changes did not show an overall benefit to diet quality and may be less useful than nutrient profiling alone to consumers who want to increase overall diet quality of foods purchased.

Linking Quality and Spending to Measure Value for People with Serious Illness.

PubMed

Ryan, Andrew M; Rodgers, Phillip E

2018-03-01

Healthcare payment is rapidly evolving to reward value by measuring and paying for quality and spending performance. Rewarding value for the care of seriously ill patients presents unique challenges. To evaluate the state of current efforts to measure and reward value for the care of seriously ill patients. We performed a PubMed search of articles related to (1) measures of spending for people with serious illness and (2) linking spending and quality measures and rewarding performance for the care of people with serious illness. We limited our search to U.S.-based studies published in English between January 1, 1960, and March 31, 2017. We supplemented this search by identifying public programs and other known initiatives that linked quality and spending for the seriously ill and extracted key program elements. Our search related to linking spending and quality measures and rewarding performance for the care of people with serious illness yielded 277 articles. We identified three current public programs that currently link measures of quality and spending-or are likely to within the next few years-the Oncology Care Model; the Comprehensive End-Stage Renal Disease Model; and Home Health Value-Based Purchasing. Models that link quality and spending consist of four core components: (1) measuring quality, (2) measuring spending, (3) the payment adjustment model, and (4) the linking/incentive model. We found that current efforts to reward value for seriously ill patients are targeted for specific patient populations, do not broadly encourage the use of palliative care, and have not closely aligned quality and spending measures related to palliative care. We develop recommendations for policymakers and stakeholders about how measures of spending and quality can be balanced in value-based payment programs.

Linking Quality and Spending to Measure Value for People with Serious Illness

PubMed Central

Rodgers, Phillip E.

2018-01-01

Abstract Background: Healthcare payment is rapidly evolving to reward value by measuring and paying for quality and spending performance. Rewarding value for the care of seriously ill patients presents unique challenges. Objective: To evaluate the state of current efforts to measure and reward value for the care of seriously ill patients. Design: We performed a PubMed search of articles related to (1) measures of spending for people with serious illness and (2) linking spending and quality measures and rewarding performance for the care of people with serious illness. We limited our search to U.S.-based studies published in English between January 1, 1960, and March 31, 2017. We supplemented this search by identifying public programs and other known initiatives that linked quality and spending for the seriously ill and extracted key program elements. Results: Our search related to linking spending and quality measures and rewarding performance for the care of people with serious illness yielded 277 articles. We identified three current public programs that currently link measures of quality and spending—or are likely to within the next few years—the Oncology Care Model; the Comprehensive End-Stage Renal Disease Model; and Home Health Value-Based Purchasing. Models that link quality and spending consist of four core components: (1) measuring quality, (2) measuring spending, (3) the payment adjustment model, and (4) the linking/incentive model. We found that current efforts to reward value for seriously ill patients are targeted for specific patient populations, do not broadly encourage the use of palliative care, and have not closely aligned quality and spending measures related to palliative care. Conclusions: We develop recommendations for policymakers and stakeholders about how measures of spending and quality can be balanced in value-based payment programs. PMID:29091529

Applying Resource Based Relative Value Scales (RBRVS) to the Champus Program

DTIC Science & Technology

1990-12-01

fee for the related service .[Ref. 6:p. 7] F. EFFECTS OF RBRVS When a Medicare fee schedule is fully implemented, several Important...reimbursement rates increase would be attracted to CHAMPUS. In analyzing the impact of a resource based fee schedule on the Medicare program, the PPRC...procedures performed by physicians into components of work, training costs, and practice costs. The Medicare program is planning to implement a fee

Neural predictors of purchases

PubMed Central

Knutson, Brian; Rick, Scott; Wimmer, G. Elliott; Prelec, Drazen; Loewenstein, George

2007-01-01

Microeconomic theory maintains that purchases are driven by a combination of consumer preference and price. Using event-related FMRI, we investigated how people weigh these factors to make purchasing decisions. Consistent with neuroimaging evidence suggesting that distinct circuits anticipate gain and loss, product preference activated the nucleus accumbens (NAcc), while excessive prices activated the insula and deactivated the mesial prefrontal cortex (MPFC) prior to the purchase decision. Activity from each of these regions independently predicted immediately subsequent purchases above and beyond self-report variables. These findings suggest that activation of distinct neural circuits related to anticipatory affect precedes and supports consumers’ purchasing decisions. PMID:17196537

31 CFR 360.10 - Amounts which may be purchased.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Amounts which may be purchased. 360.10 Section 360.10 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL... follows: (a) General annual limitation, $5,000 (par value). (b) Special limitation, $4,000 (par value...

31 CFR 360.10 - Amounts which may be purchased.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 2 2012-07-01 2012-07-01 false Amounts which may be purchased. 360.10 Section 360.10 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL... follows: (a) General annual limitation, $5,000 (par value). (b) Special limitation, $4,000 (par value...

77 FR 43723 - Energy Efficiency and Conservation Loan Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-26

... communities by investing in energy efficiency, and (5) encouraging the use of renewable energy fuels for both... contracts. Impacts The new Subpart H. for the Energy Efficiency and Conservation Loan Program can have several economic impacts. The benefits include: (1) The value of purchased energy saved; (2) the value of...

Experiential or Material Purchases? Social Class Determines Purchase Happiness.

PubMed

Lee, Jacob C; Hall, Deborah L; Wood, Wendy

2018-05-01

Which should people buy to make themselves happy: experiences or material goods? The answer depends in part on the level of resources already available in their lives. Across multiple studies using a range of methodologies, we found that individuals of higher social class, whose abundant resources make it possible to focus on self-development and self-expression, were made happier by experiential over material purchases. No such experiential advantage emerged for individuals of lower social class, whose lesser resources engender concern with resource management and wise use of limited finances. Instead, lower-class individuals were made happier from material purchases or were equally happy from experiential and material purchases.

Promise and problems with supply chain management approaches to health care purchasing.

PubMed

Ford, Eric W; Scanlon, Dennis P

2007-01-01

Double-digit health care inflation, coupled with widespread reports of poor care quality and deadly medical errors, has caused private sector employers to reevaluate their health benefits purchasing strategies, with a focus on supply chain management approaches. In other industries, this strategy has proven to be an effective method for simultaneously reducing costs and increasing quality. This article describes four current applications of supply chain management network methodologies to health care systems and identifies potential ways to improve purchasers' return on investment. In particular, information exchanges, purchase decision, and payment agreement components of integrated supply chains are described. First, visual depictions of the health care supply chain are developed from a purchaser's perspective. Next, five nationwide programs designed to realign incentives and rewards across the health care supply chain are described. Although several nationwide efforts are gaining traction in the marketplace, at this time, no cost reduction and quality improvement program initiative appears to systematically align the entire health care supply chain from providers to purchasers, raising doubt about the ability of supply chain management network techniques to significantly impact the health care marketplace in the short run. Current individual efforts to coordinate the health care supply chain do not act on all of the actors necessary to improve outcomes, promote safety, and control costs. Nevertheless, there are indications that several of the individual efforts are coming together. If national efforts touching on all critical elements can coordinate with purchasers, then the health care supply chain's performance may improve significantly.

41 CFR 102-73.130 - When may Federal agencies consider acquiring leases with purchase options?

Code of Federal Regulations, 2010 CFR

2010-07-01

... consider leasing with a purchase option at or below fair market value, consistent with the lease-purchase... and other advantages to the Government and is consistent with the Government's goals. (b) The...

BOOKS PURCHASED FOR GIFTED CENTERS, GRADE SIX.

ERIC Educational Resources Information Center

Oakland Unified School District, CA.

THE LISTED REFERENCE BOOKS HAVE BEEN PURCHASED FROM FUNDS ALLOTTED TO THE GIFTED PROGRAM. THEY ARE LOANS TO THE SCHOOL AND ARE TO BE KEPT IN THE SIXTH-GRADE CLASSROOM. THIRTY BOOKS ARE INCLUDED IN ALPHABETICAL ORDER ACCORDING TO AUTHOR. SCIENCE TOPICS INCLUDE ASTRONOMY, WEIGHTS AND MEASURES, PLANTS, PHYSICS, THE SEA, CHEMISTRY, BIOLOGY,…

Accounting issues: should the merger be treated as purchase or pooling?

PubMed

Finkler, S A

1985-05-01

Under accounting rules, a merger or consolidation can be treated as either a purchase or pooling. A purchase causes an adjustment in the selling hospital's asset basis to fair market value with goodwill often resulting. Such an adjustment is usually favorable for a taxable acquisition but not a tax-free reorganization. A pooling, on the other hand, results in the assets of the two organizations being merged together with no adjustment in asset values or increase in goodwill. The requirements for pooling are strict but the result is the carryover of assets at historical cost, usually favorable for reporting EPS.

Brownfields initiatives offer few incentives for prospective developers, purchasers

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

Wesolowski, T.; Antol, S.M.

There has been much discussion and analysis in recent years among government agencies and state legislators regarding redevelopment of contaminated industrial sites, or brownfields. The goal of brownfields program is to encourage developers and purchasers to redevelop existing industrial sites, rather than choosing greenfield suburban sites. These programs create initiatives for redevelopment, such as reducing the potential liability of innocent purchasers or developers, streamlining administrative process relating to cleanups, and issuing guidance on cleanup methods and standards. Although such attempts are admirable and important, brownfields initiatives have failed because they address only one component of what is necessary to achievemore » redevelopment. The initiatives attempt to minimize disincentives to brownfields redevelopment; however, what is necessary for progress in this area is to create real economic and other incentives to make such redevelopment more attractive.« less

Weight loss strategies: Association with consumption of sugary beverages, snacks and values about food purchases

PubMed Central

Bleich, Sara N.; Wolfson, Julia A.

2014-01-01

Objective To examine whether weight loss strategies are associated with consumption of sugar-sweetened beverages (SSBs), snacks or food values. Design and Methods Cross-sectional analysis of 24-hour dietary recall data obtained from the National Health and Nutrition Examination Survey 2007–2010 (N=9,440). Results Adults trying to lose weight consumed roughly 2000 total calories, 250 calories from SSBs, 225 calories from salty snacks, and 350 calories from sweet snacks. Adults not trying to lose weight consumed roughly 2300 total calories, 300 calories from SSBs, 250 calories from salty snacks, and 380 calories from sweet snacks. While overweight and obese adults trying to lose weight consumed fewer calories than those who were not, heavier adults trying to lose weight using dietary strategies or a combination of diet and physical activity consumed more calories than healthy weight adults using that same weight loss strategy (p < 0.05). Price (>70%) and nutrition (>50%) were most when making food choices (p < 0.05) for all groups. Conclusions Consumption of discretionary calories is high regardless of body weight or weight loss intention. Practice Implications Promoting reduced SSB and snack consumption in the clinical setting may be important for weight loss, particularly among heavier individuals. Clinicians should consider values related to food purchasing to identify concrete behavioral targets. PMID:24801411

Further Validation of a Marijuana Purchase Task

PubMed Central

Aston, Elizabeth R.; Metrik, Jane; MacKillop, James

2015-01-01

Background A valid measure of the relative economic value of marijuana is needed to characterize individual variation in the drug’s reinforcing value and inform evolving national marijuana policy. Relative drug value (demand) can be measured via purchase tasks, and demand for alcohol and cigarettes has been associated with craving, dependence, and treatment response. This study examined marijuana demand with a marijuana purchase task (MPT). Methods The 22-item self-report MPT was administered to 99 frequent marijuana users (37.4% female, 71.5% marijuana use days, 15.2% cannabis dependent). Results Pearson correlations indicated a negative relationship between intensity (free consumption) and age of initiation of regular use (r=−0.34, p<0.001), and positive associations with use days (r=0.26, p<0.05) and subjective craving (r=0.43, p<0.001). Omax (maximum expenditure) was positively associated with use days (r=0.29, p<0.01) and subjective craving (r=0.27, p<0.01). Income was not associated with demand. An exponential demand model provided an excellent fit to the data across users (R2=0.99). Group comparisons based on presence or absence of DSM-IV cannabis dependence symptoms revealed that users with any dependence symptoms showed significantly higher intensity of demand and more inelastic demand, reflecting greater insensitivity to price increases. Conclusions These results provide support for construct validity of the MPT, indicating its sensitivity to marijuana demand as a function of increasing cost, and its ability to differentiate between users with and without dependence symptoms. The MPT may denote abuse liability and is a valuable addition to the behavioral economic literature. Potential applications to marijuana pricing and tax policy are discussed. PMID:26002377

12 CFR 167.12 - Purchased credit card relationships, servicing assets, intangible assets (other than purchased...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 1 2014-01-01 2014-01-01 false Purchased credit card relationships, servicing assets, intangible assets (other than purchased credit card relationships and servicing assets), credit... Purchased credit card relationships, servicing assets, intangible assets (other than purchased credit card...

12 CFR 167.12 - Purchased credit card relationships, servicing assets, intangible assets (other than purchased...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 1 2013-01-01 2013-01-01 false Purchased credit card relationships, servicing assets, intangible assets (other than purchased credit card relationships and servicing assets), credit... Purchased credit card relationships, servicing assets, intangible assets (other than purchased credit card...

12 CFR 167.12 - Purchased credit card relationships, servicing assets, intangible assets (other than purchased...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 1 2012-01-01 2012-01-01 false Purchased credit card relationships, servicing assets, intangible assets (other than purchased credit card relationships and servicing assets), credit... Purchased credit card relationships, servicing assets, intangible assets (other than purchased credit card...

A Curriculum for Purchasing.

ERIC Educational Resources Information Center

Pinkerton, Richard LaDoyt

The objective of this research was to identify the necessary educational organization required to form a curriculum plan for the field of purchasing and to investigate the nature of the industrial purchasing function. The dissertation delineates the critical areas of business operation: industrial purchasing, procurement, and material management.…

Seven PC Purchasing Pitfalls.

ERIC Educational Resources Information Center

Wodarz, Nan

1997-01-01

Explores how to avoid common pitfalls when schools purchase computer equipment. Purchasing tips are provided in the areas of choosing multiple platforms, buying the cheapest model available, choosing a proprietary design, falling for untested technology, purchasing systems that are not upgradable, ignoring extended warranties, and failing to plan…

Off-premise alcohol purchasing in Australia: Variations by age group, income level and annual amount purchased.

PubMed

Jiang, Heng; Callinan, Sarah; Livingston, Michael; Room, Robin

2017-03-01

To delineate what type and how much alcohol is purchased from different types of off-licence premises and how this varies across demographic sub-groups, as a basis for public debate and decisions on pricing and planning policies to reduce alcohol-related harm in Australia. The data on alcohol purchasing from off-licence premises are taken from the Australian Alcohol Consumption and Purchasing survey-a nationally representative landline and mobile telephone survey in 2013 on the experiences with alcohol consumption and purchasing of 2020 Australians aged 16+. The present analysis uses data from 1730 respondents who purchased alcohol from off-licence premises in the previous 6 months. The majority (54%) of alcohol purchased from off-licence premises was sold from liquor barns (large warehouse-style alcohol stores), with bottle shops (31%) the second most common outlet. Cask wine was the cheapest alcohol available at off-licence premises in Australia. Respondents in higher alcohol purchasing quintiles and with those with lower income purchased a higher percentage of cheaper alcohol in their total volume of purchasing than lower purchasing quintiles and those with middle and higher income, and younger respondents purchased more expensive alcohol than older age groups. A minimum unit price or increasing alcohol taxes may effectively reduce alcohol purchasing for lower income heavy alcohol purchasers and older age groups from off-licence premise sources, and may be less effective on younger age groups. [Jiang H, Callinan S, Livingston M, Room R. Off-premise alcohol purchasing in Australia: Variations by age group, income level and annual amount purchased. Drug Alcohol Rev 2017;36:210-219]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

Barriers to Pharmacy-Based Syringe Purchase Among Injection Drug Users in Tijuana, Mexico: A Mixed Methods Study

PubMed Central

Lozada, Remedios; Gallardo, Manuel; Rosen, Perth; Vera, Alicia; Macias, Armando; Palinkas, Lawrence A.; Strathdee, Steffanie A.

2010-01-01

Injection drug users (IDUs) may be denied purchase of sterile syringes even where purchase without a prescription is legal. This study examined barriers to over-the-counter (OTC) syringe purchase among IDUs in Tijuana, Mexico. A quantitative survey and subsequent focus groups were used to quantify barriers to purchase, identify their correlates and provide in-depth exploration of syringe purchase experiences. Of 627 IDUs, 81% purchased a syringe in the past 6 months and 16% were refused or overcharged. Factors independently associated with refusal/overcharging were homelessness, receptive syringe sharing, >5 uses per syringe, and number of lifetime abscesses. Few pharmacies sold syringes to IDUs, who adapted by limiting purchase attempts to pharmacies known to sell syringes consistently. Failed purchases occurred when drug withdrawal required purchase at unusual times or locations, often following release from jail. IDUs reported syringe sharing, syringe reuse, and searching through unsecured medical waste for syringes in response to failed purchase attempts. Interventions to expand OTC syringe sales to IDUs, particularly near detention facilities, will facilitate safer injection practices. PMID:20300820

Price and maternal obesity influence purchasing of low- and high-energy-dense foods.

PubMed

Epstein, Leonard H; Dearing, Kelly K; Paluch, Rocco A; Roemmich, James N; Cho, David

2007-10-01

Price can influence food purchases, which can influence consumption. Limited laboratory research has assessed the effect of price changes on food purchases, and no research on individual differences that may interact with price to influence purchases exists. We aimed to assess the influence of price changes of low-energy-density (LED) and high-energy-density (HED) foods on mother's food purchases in a laboratory food-purchasing analogue. Mothers were randomly assigned to price conditions in which the price of either LED or HED foods was manipulated from 75% to 125% of the reference purchase price, whereas the price of the alternative foods was kept at the reference value. Mothers completed purchases for 2 income levels ($15 or $30 per family member). Purchases were reduced when prices of LED (P < 0.01) and HED (P < 0.001) foods were increased. Maternal BMI interacted with price to influence purchases of HED foods when the price of HED foods increased (P = 0.016) and interacted with price to influence purchases of LED foods when the price of HED foods increased (P = 0.008). These results show the relevance of considering price change as a way to influence food purchases of LED compared with HED foods and the possibility that individual differences may influence the own-price elasticity of HED foods and substitution of LED for HED foods.

Surgical lights. Making a purchase decision.

PubMed

Gregory, M M

1987-11-01

Based on the preceding factors, a profile can be made for each light. The profile should include the following information: product literature with detailed information about the light, the average score from each of the six categories on the questionnaire, a summary of positive and negative comments from the questionnaire (recurring comments can identify significant factors), recommendations from other hospitals using the light, warranty and service information and any pertinent information about the vendor and manufacturer, information or comments from the clinical engineer, the purchasing agent, and the architect/engineer, and information about possible purchase agreements. Once the profiles of the lights are finished, present them to the OR committee or group charged with making the final decision. The information will enable the group to compare the lights and will serve as a basis for either the final purchase or a detailed bid specification. If cost is a major factor in the decision, the evaluation results can be used to justify purchasing lights that are more expensive but that the users believe are clearly superior. This constitutes the "professional justification" that some government institutions require to circumvent regulations that require buying the low-bid product. Although the result of this selection process is clearly a subjective decision, it is an informed subjective decision. Once the lights are installed, the staff members' satisfaction with the lights will not be based on objective criteria but on the same subjective opinions that were used to justify the selection.

22 CFR 132.1 - Purchase.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Purchase. 132.1 Section 132.1 Foreign Relations DEPARTMENT OF STATE MISCELLANEOUS BOOKS, MAPS, NEWSPAPERS, ETC. § 132.1 Purchase. The purchase by the... determination has been made by the Secretary, as permitted by the provisions of the act, that such purchase is...

Predictability in Pathological Gambling? Applying the Duplication of Purchase Law to the Understanding of Cross-Purchases Between Regular and Pathological Gamblers.

PubMed

Lam, Desmond; Mizerski, Richard

2017-06-01

The objective of this study is to explore the gambling participations and game purchase duplication of light regular, heavy regular and pathological gamblers by applying the Duplication of Purchase Law. Current study uses data collected by the Australian Productivity Commission for eight different types of games. Key behavioral statistics on light regular, heavy regular, and pathological gamblers were computed and compared. The key finding is that pathological gambling, just like regular gambling, follows the Duplication of Purchase Law, which states that the dominant factor of purchase duplication between two brands is their market shares. This means that gambling between any two games at pathological level, like any regular consumer purchases, exhibits "law-like" regularity based on the pathological gamblers' participation rate of each game. Additionally, pathological gamblers tend to gamble more frequently across all games except lotteries and instant as well as make greater cross-purchases compared to heavy regular gamblers. A better understanding of the behavioral traits between regular (particularly heavy regular) and pathological gamblers can be useful to public policy makers and social marketers in order to more accurately identify such gamblers and better manage the negative impacts of gambling.

Value-based insurance plus disease management increased medication use and produced savings.

PubMed

Gibson, Teresa B; Mahoney, John; Ranghell, Karlene; Cherney, Becky J; McElwee, Newell

2011-01-01

We evaluated the effects of implementing a value-based insurance design program for patients with diabetes in two groups within a single firm. One group participated in disease management; the other did not. We matched members of the two groups to similar enrollees within the company that did not offer the value-based program. We found that participation in both value-based insurance design and disease management resulted in sustained improvement over time. Use of diabetes medications increased 6.5 percent over three years. Adherence to diabetes medical guidelines also increased, producing a return on investment of $1.33 saved for every dollar spent during a three-year follow-up period.

The transition to value-based care.

PubMed

Ray, Jordan C; Kusumoto, Fred

2016-10-01

Delivery of medical care is evolving rapidly worldwide. Over the past several years in the USA, there has been a rapid shift in reimbursement from a simple fee-for-service model to more complex models that attempt to link payment to quality and value. Change in any large system can be difficult, but with medicine, the transition to a value-based system has been particularly hard to implement because both quality and cost are difficult to quantify. Professional societies and other medical groups are developing different programs in an attempt to define high value care. However, applying a national standard of value for any treatment is challenging, since value varies from person to person, and the individual benefit must remain the central tenet for delivering best patient-centered medical care. Regardless of the specific operational features of the rapidly changing healthcare environment, physicians must first and foremost always remain patient advocates.

Case management's value is finally recognized. What happens now? .

PubMed

2015-10-01

In recent years, case management has been recognized as a key in improving healthcare quality and reducing costs, but while hospitals are giving case managers more responsibilities, many administrators are not approving an increase in staff to handle the extra work. Case managers can help their hospital succeed with the Centers for Medicare & Medicaid Services' Value-based Purchasing program, the readmission reduction program, and bundled payments. Case management directors should make sure the hospital's senior leadership understands the roles and responsibilities of case managers and how their interventions can affect outcomes and the bottom line. The number of caseloads depends on the case management model, the responsibilities of case managers, and whether they have assistants or case management extenders who can take over some tasks and allow the licensed staff to work at the top of their licenses. Don't let technology replace communication and patient-centered interactions.

Analyzing Value Content in Television Programs.

ERIC Educational Resources Information Center

Jensen, Larry; Zelig, Mark

Four prime time television programs--"Charlie's Angels,""Little House on the Prairie,""Grizzly Adams," and "Lou Grant" --were rated by university students for their portrayal of moral reasoning and values. Data were obtained from three episodes of each program by randomly assigning raters to one of two viewing groups, both of which used an…

Value-based payment in implementing evidence-based care: the Mental Health Integration Program in Washington state.

PubMed

Bao, Yuhua; McGuire, Thomas G; Chan, Ya-Fen; Eggman, Ashley A; Ryan, Andrew M; Bruce, Martha L; Pincus, Harold Alan; Hafer, Erin; Unützer, Jürgen

2017-01-01

To assess the role of value-based payment (VBP) in improving fidelity and patient outcomes in community implementation of an evidence-based mental health intervention, the Collaborative Care Model (CCM). Retrospective study based on a natural experiment. We used the clinical tracking data of 1806 adult patients enrolled in a large implementation of the CCM in community health clinics in Washington state. VBP was initiated in year 2 of the program, creating a natural experiment. We compared implementation fidelity (measured by 3 process-of-care elements of the CCM) between patient-months exposed to VBP and patient-months not exposed to VBP. A series of regressions were estimated to check robustness of findings. We estimated a Cox proportional hazard model to assess the effect of VBP on time to achieving clinically significant improvement in depression (measured based on changes in depression symptom scores over time). Estimated marginal effects of VBP on fidelity ranged from 9% to 30% of the level of fidelity had there been no exposure to VBP (P <.05 for every fidelity measure). Improvement in fidelity in response to VBP was greater among providers with a larger patient panel and among providers with a lower level of fidelity at baseline. Exposure to VBP was associated with an adjusted hazard ratio of 1.45 (95% confidence interval, 1.04-2.03) for achieving clinically significant improvement in depression. VBP improved fidelity to key elements of the CCM, both directly incentivized and not explicitly incentivized by the VBP, and improved patient depression outcomes.

Ethical issues in purchasing: a field study of Midwest hospitals.

PubMed

Tomaszewski, K; Motwani, J

1995-01-01

A large sum of money is spent annually by salespeople on gifts and favors for purchasing executives. The provision of gifts and favors to buyers remains a common practice despite the fact that it often leads to ethical conflicts for purchasing executives, sales managers, and salespeople. This paper investigates the perceptions of 51 purchasing executives of midwest hospitals regarding their behavior towards certain buying practices, the favors offered by vendors, favors actually accepted, as well as purchasers' discomfort and repayment levels regarding indebtedness. Based on the data analysis, this paper provides conclusions and directions for future research.

Emerging lessons from regional and state innovation in value-based payment reform: balancing collaboration and disruptive innovation.

PubMed

Conrad, Douglas A; Grembowski, David; Hernandez, Susan E; Lau, Bernard; Marcus-Smith, Miriam

2014-09-01

In recent decades, practitioners and policymakers have turned to value-based payment initiatives to help contain spending on health care and to improve the quality of care. The Robert Wood Johnson Foundation funded 7 grantees across the country to design and implement value-based, multistakeholder payment reform projects in 6 states and 3 regions of the United States. As the external evaluator of these projects, we reviewed documents, conducted Internet searches, interviewed key stakeholders, cross-validated factual and narrative interpretation, and performed qualitative analyses to derive cross-site themes and implications for policy and practice. The nature of payment reform and its momentum closely reflects the environmental context of each project. Federal legislation such as the Patient Protection and Affordable Care Act and federal and state support for the development of the patient-centered medical home and accountable care organizations encourage value-based payment innovation, as do local market conditions for payers and providers that combine a history of collaboration with independent innovation and experimentation by individual organizations. Multistakeholder coalitions offer a useful facilitating structure for galvanizing payment reform. But to achieve the objectives of reduced cost and improved quality, multistakeholder payment innovation must overcome such barriers as incompatible information systems, the technical difficulties and transaction costs of altering existing billing and payment systems, competing stakeholder priorities, insufficient scale to bear population health risk, providers' limited experience with risk-bearing payment models, and the failure to align care delivery models with the form of payment. From the evidence adduced in this article, multistakeholder, value-based payment reform requires a trusted, widely respected "honest broker" that can convene and maintain the ongoing commitment of health plans, providers, and purchasers

Your loyalty program is betraying you.

PubMed

Nunes, Joseph C; Drèze, Xavier

2006-04-01

Even as loyalty programs are launched left and right, many are being scuttled. How can that be? These days, everyone knows that an old customer retained is worth more than a new customer won. What is so hard about making a simple loyalty program work? Quite a lot, the authors say. The biggest challenges include clarifying business goals, engineering the reward structure, and creating incentives powerful enough to change buying behavior but not so generous that they erode margins. Additionally, companies have to sort out the puzzles of consumer psychology, which can result, for example, in two rewards of equal economic value inspiring very different levels of purchasing. In their research, the authors have discovered patterns in what the successful loyalty programs get right and in how the others fail. Together, their findings constitute a tool kit for designing something rare indeed: a program that won't do you wrong. To begin with, it's important to know exactly what a loyalty program can do. It can keep customers from defecting, induce them to consolidate certain purchases with one seller (in other words, win a greater share of wallet), prompt customers to make additional purchases, yield insight into their behavior and preferences, and turn a profit. A program can meet these objectives in several ways--for instance, by offering rewards (points, say, or frequent-flier miles) divisible enough to provide many redemption opportunities but not so divisible that they fail to lock in customers. Companies striving to generate customer loyalty should avoid five common mistakes: Don't create a new commodity, which can result in price wars and other tit-for-tat competitive moves; don't cater to the disloyal by making rewards easy for just anyone to reap; don't reward purchasing volume over profitability; don't give away the store; and, finally, don't promise what can't be delivered.

Promoting fruit and vegetable consumption in different lifestyle groups: recommendations for program development based on behavioral research and consumer media data.

PubMed

Della, Lindsay J; DeJoy, David M; Lance, Charles E

2008-01-01

Fruit and vegetable consumption affects the etiology of cardiovascular disease as well as many different types of cancers. Still, Americans' consumption of fruit and vegetables is low. This article builds on initial research that assessed the validity of using a consumer-based psychographic audience segmentation in tandem with the theory of planned behavior to explain differences among individuals' consumption of fruit and vegetables. In this article, we integrate the findings from our initial analyses with media and purchase data from each audience segment. We then propose distinct, tailored program suggestions for reinventing social marketing programs focused on increasing fruit and vegetable consumption in each segment. Finally, we discuss the implications of utilizing a consumer-based psychographic audience segmentation versus a more traditional readiness-to-change social marketing segmentation. Differences between these two segmentation strategies, such as the ability to access media usage and purchase data, are highlighted and discussed.

Promoting fruit and vegetable consumption in different lifestyle groups: Recommendations for program development based on behavioral research and consumer media data

PubMed Central

DeJoy, David M.; Lance, Charles E.

2014-01-01

Fruit and vegetable consumption impacts the etiology of cardiovascular disease as well as many different types of cancers. Still, Americans' consumption of fruit and vegetables is low. This article builds on initial research that assessed the validity of using a consumer-based psychographic audience segmentation in tandem with the theory of planned behavior to explain differences among individuals' consumption of fruit and vegetables. In this article, we integrate the findings from our initial analyses with media and purchase data from each audience segment. We then propose distinct, tailored program suggestions for reinventing social marketing programs focused on increasing fruit and vegetable consumption in each segment. Finally, we discuss the implications of utilizing a consumer-based psychographic audience segmentation versus more traditional readiness-to-change social marketing segmentation. Differences between these two segmentation strategies, such as the ability to access media usage and purchase data, are highlighted and discussed. PMID:18935880

12 CFR 925.20 - Stock purchase.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Stock purchase. 925.20 Section 925.20 Banks and... BANKS Stock Requirements § 925.20 Stock purchase. (a) Minimum stock purchase. Each member shall purchase... outstanding advances. (b) Timing of minimum stock purchase. (1) Within 60 calendar days after an institution...

Professional Values Competency Evaluation for Students Enrolled in a Concept-Based Curriculum.

PubMed

Elliott, Annette M

2017-01-01

Although many nursing programs have transitioned toward the use of concept-based curricula, the evaluation of student learning associated with the curricular approach has been limited. An evaluation of student learning related to professional values for programs offering concept-based curricula was not evident in the literature. The purpose was to determine how a course competency related to professional values was addressed by nursing students studying in a concept-based nursing curriculum. The qualitative methodology of framework analysis was used to evaluate written assignments (N = 75). The core concept appreciation for professional values and the core concept disillusionment with unprofessional behaviors were identified in students' written reflections. The core concept of appreciation for professional values contributes to an evidence base of contemporary professional values identified in nursing. The core concept of disillusionment with unprofessional behaviors can inform curricular planning and research on how to advocate for professional behaviors. [J Nurs Educ. 2017;56(1):12-21.]. Copyright 2017, SLACK Incorporated.

Assessment of perception and intention in pesticide purchase in Taiwan.

PubMed

Yeh, Jong Chao; Liao, Chih-Hsiang

2016-05-01

Environmental chemical agents such as pesticides can be purchased easily at a relatively low price, and this has resulted in high concern of environmental toxicity to human health, due to their persistence in various environmental bodies. Hence, this study aims to propose important factors influencing pesticide purchase intentions, including consumers' perceptions of the brand image and the ecological health risk. Since consumers are primary users, the seller knows the product's features but not the psychology of those who purchase it. Therefore, we attempted to clarify purchase intentions and perceptions using structural equation modeling techniques to empirically analyze survey data from 324 pesticide consumers in Taiwan. Our results demonstrate that perceived brand image positively affects perceived quality of a product, whereas perceived risk negatively affects perceived quality and purchase intentions. Furthermore, this study provides evidence that perceived quality positively affects purchase intentions. These relationships suggest that perceived quality mediates both the positive association between brand image and purchase intentions and the negative association between perceived risk and purchase intentions. Based on such outcomes, we propose that consumers need to be informed of pesticides related to costs and environmental benefits.

Western hardwoods : value-added research and demonstration program

Treesearch

D. W. Green; W. W. Von Segen; S. A. Willits

1995-01-01

Research results from the value-added research and demonstration program for western hardwoods are summarized in this report. The intent of the program was to enhance the economy of the Pacific Northwest by helping local communities and forest industries produce wood products more efficiently. Emphasis was given to value-added products and barriers to increased...

78 FR 40953 - Loan Participations; Purchase, Sale and Pledge of Eligible Obligations; Purchase of Assets and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-09

...; Purchase, Sale and Pledge of Eligible Obligations; Purchase of Assets and Assumption of Liabilities...- day effective date, a final rule titled Loan Participations; Purchase, Sale and Pledge of Eligible Obligations; Purchase of Assets and Assumption of Liabilities, effective July 25, 2013. The Board extends the...

Using rewards-based incentives to increase purchase of fruit and vegetables in lower-income households: design and start-up of a randomized trial.

PubMed

Phipps, Etienne J; Wallace, Samantha L; Stites, Shana D; Uplinger, Nadine; Brook Singletary, S; Hunt, Lacy; Axelrod, Saul; Glanz, Karen; Braitman, Leonard E

2013-05-01

To report the design and baseline results of a rewards-based incentive to promote purchase of fruit and vegetables by lower-income households. A four-phase randomized trial with wait-listed controls. In a pilot study, despite inadequate study coupon use, purchases of fresh fruit (but not vegetables) increased, but with little maintenance. In the present study, credits on the study store gift card replace paper coupons and a tapering phase is added. The primary outcome is the number of servings of fresh and frozen fruit and vegetables purchased per week. A large full-service supermarket located in a predominantly minority community in Philadelphia, Pennsylvania, USA. Fifty-eight households, with at least one child living in the home. During the baseline period, households purchased an average of 3·7 servings of fresh vegetables and an average of less than 1 serving of frozen vegetables per week. Households purchased an average of 1·9 servings of fresh fruit per week, with little to no frozen fruit purchases. Overall, the range of fresh and frozen produce purchased during this pre-intervention period was limited. At baseline, produce purchases were small and of limited variety. The study will contribute to understanding the impact of financial incentives on increasing the purchases of healthier foods by lower-income populations.

The Viability of Lease Purchases as a Means for Funding School Facilities.

ERIC Educational Resources Information Center

Bunch, Beverly S.; Smith, Tina

2002-01-01

Examines the use of the lease purchase of school facilities in Texas; provides background on the use of lease purchases by Texas school districts; describes factors influencing the use of lease purchases and superintendents' experiences based on survey responses from 50 school districts; recommends careful evaluation of advantages and…

Development of a sustainable community-based dental education program.

PubMed

Piskorowski, Wilhelm A; Fitzgerald, Mark; Mastey, Jerry; Krell, Rachel E

2011-08-01

Increasing the use of community-based programs is an important trend in improving dental education to meet the needs of students and the public. To support this trend, understanding the history of programs that have established successful models for community-based education is valuable for the creation and development of new programs. The community-based education model of the University of Michigan School of Dentistry (UMSOD) offers a useful guide for understanding the essential steps and challenges involved in developing a successful program. Initial steps in program development were as follows: raising funds, selecting an outreach clinical model, and recruiting clinics to become partners. As the program developed, the challenges of creating a sustainable financial model with the highest educational value required the inclusion of new clinical settings and the creation of a unique revenue-sharing model. Since the beginning of the community-based program at UMSOD in 2000, the number of community partners has increased to twenty-seven clinics, and students have treated thousands of patients in need. Fourth-year students now spend a minimum of ten weeks in community-based clinical education. The community-based program at UMSOD demonstrates the value of service-based education and offers a sustainable model for the development of future programs.

Economic evaluation of price discounts and skill-building strategies on purchase and consumption of healthy food and beverages: The SHELf randomized controlled trial.

PubMed

Le, Ha N D; Gold, Lisa; Abbott, Gavin; Crawford, David; McNaughton, Sarah A; Mhurchu, Cliona Ni; Pollard, Christina; Ball, Kylie

2016-06-01

Pricing strategies are a promising approach for promoting healthier dietary choices. However, robust evidence of the cost-effectiveness of pricing manipulations on dietary behaviour is limited. We aimed to assess the cost-effectiveness of a 20% price reduction on fruits and vegetables and a combined skills-based behaviour change and price reduction intervention. Cost-effectiveness analysis from a societal perspective was undertaken for the randomized controlled trial Supermarket Healthy Eating for Life (SHELf). Female shoppers in Melbourne, Australia were randomized to: (1) skill-building (n = 160); (2) price reductions (n = 161); (3) combined skill-building and price reduction (n = 161); or (4) control group (n = 161). The intervention was implemented for three months followed by a six month follow-up. Costs were measured in 2012 Australian dollars. Fruit and vegetable purchasing and consumption were measured in grams/week. At three months, compared to control participants, price reduction participants increased vegetable purchases by 233 g/week (95% CI 4 to 462, p = 0.046) and fruit purchases by 364 g/week (95% CI 95 to 633, p = 0.008). Participants in the combined group purchased 280 g/week more fruits (95% CI 27 to 533, p = 0.03) than participants in the control group. Increases were not maintained six-month post intervention. No effect was noticed in the skill-building group. Compared to the control group, the price reduction intervention cost an additional A$2.3 per increased serving of vegetables purchased per week or an additional A$3 per increased serving of fruit purchased per week. The combined intervention cost an additional A$12 per increased serving of fruit purchased per week compared to the control group. A 20% discount on fruits and vegetables was effective in promoting overall fruit and vegetable purchases during the period the discount was active and may be cost-effective. The price discount program gave better value for money

40 CFR 86.411-78 - Maintenance instructions, vehicle purchaser.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 19 2013-07-01 2013-07-01 false Maintenance instructions, vehicle...) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES... instructions, vehicle purchaser. (a) The manufacturer shall furnish or cause to be furnished to the ultimate...

Sweetened food purchases and indulgent feeding are associated with increased toddler anthropometry.

PubMed

Chaidez, Virginia; McNiven, Scott; Vosti, Stephen A; Kaiser, Lucia L

2014-01-01

To explore the role of feeding practices and food purchases in toddler dietary intake and anthropometry. A convenience sample of Latino mother and toddler pairs were interviewed at baseline and at 6-month follow-up. Data on feeding practices, toddler dietary intake, anthropometry, and food purchases were collected using the Toddler-Feeding Questionnaire; 24-hour recalls; measurements of weight, height, and/or length; and food purchase receipts. Indulgent feeding scores and high intake of sweetened beverage were associated with a 0.52 increase (P = .03) and 0.46 increase in toddler weight-for-height z-score (P = .05), respectively. Households with 10 percentage points of more sweetened food and beverage expenditures were associated with increases in weight indicator z-scores. Indulgent feeding, high intake, and purchase of sweetened beverage are associated with weight gain in Latino toddlers. Programs should target food purchasing decisions and provide concrete guidance for the division of responsibility around feeding. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Influence of neighbourhood purchasing power on breastfeeding at four months of age: a Swedish population-based cohort study.

PubMed

Almquist-Tangen, Gerd; Strömberg, Ulf; Holmén, Anders; Alm, Bernt; Roswall, Josefine; Bergman, Stefan; Dahlgren, Jovanna

2013-11-15

Parental socioeconomic status (SES) is an important determinant in child health, influencing beneficial factors such as breastfeeding. A better understanding of the influence of neighbourhood-level SES measures, relating to spatial determinants, might lead to targeted actions to promote breastfeeding during infancy. A cross-sectional study analysis the association between breastfeeding at four months of age and neighbourhood purchasing power, taking account of individual-level variables including maternal age, smoking and parental level of education. Data were obtained from a prospective population- based cohort study recruited from birth in 2007-2008 in the Halland region, southwestern Sweden. Questionnaire data on the individual-level variables and the outcome variable of breastfeeding at four months (yes/no) were used (n=2,407). Each mother was geo-coded with respect to her residential parish (there are 61 parishes in the region) and then stratified by parish-level household purchasing power. It emerged that four neighbourhood characteristics were reasonable to use, viz. <10%, 10-19%, 20-29% and ≥ 30% of the resident families with low purchasing power. The proportion of mothers not breastfeeding at four months of age showed a highly significant trend across the neighbourhood strata (p=0.00004): from 16.3% (< 10% with low purchasing power) to 29.4% (≥ 30% with low purchasing power), yielding an OR of 2.24 (95% confidence interval: 1.45-3.16). After adjusting for the individual-level variables, the corresponding OR=1.63 (1.07-2.56) was significant and the trend across the strata was still evident (p=0.05). A multi-level analysis estimated that, in the neighbourhoods with ≥ 30% of the families with low purchasing power, 20% more mothers than expected, taking account of the individual-level factors, reported no breastfeeding at four months of age (≥ 95% posterior probability of an elevated observed-to-expected ratio). The neighbourhood purchasing power

Influence of neighbourhood purchasing power on breastfeeding at four months of age: a Swedish population-based cohort study

PubMed Central

2013-01-01

Background Parental socioeconomic status (SES) is an important determinant in child health, influencing beneficial factors such as breastfeeding. A better understanding of the influence of neighbourhood-level SES measures, relating to spatial determinants, might lead to targeted actions to promote breastfeeding during infancy. Methods A cross-sectional study analysis the association between breastfeeding at four months of age and neighbourhood purchasing power, taking account of individual-level variables including maternal age, smoking and parental level of education. Data were obtained from a prospective population- based cohort study recruited from birth in 2007–2008 in the Halland region, southwestern Sweden. Questionnaire data on the individual-level variables and the outcome variable of breastfeeding at four months (yes/no) were used (n = 2 407). Each mother was geo-coded with respect to her residential parish (there are 61 parishes in the region) and then stratified by parish-level household purchasing power. It emerged that four neighbourhood characteristics were reasonable to use, viz. <10%, 10-19%, 20-29% and ≥ 30% of the resident families with low purchasing power. Results The proportion of mothers not breastfeeding at four months of age showed a highly significant trend across the neighbourhood strata (p = 0.00004): from 16.3% (< 10% with low purchasing power) to 29.4% (≥ 30% with low purchasing power), yielding an OR of 2.24 (95% confidence interval: 1.45-3.16). After adjusting for the individual-level variables, the corresponding OR = 1.63 (1.07-2.56) was significant and the trend across the strata was still evident (p = 0.05). A multi-level analysis estimated that, in the neighbourhoods with ≥ 30% of the families with low purchasing power, 20% more mothers than expected, taking account of the individual-level factors, reported no breastfeeding at four months of age (≥ 95% posterior probability of an elevated observed

Qualitative Measurement of Environmentally Preferable Purchasing Among Federal Employees in 2000

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency’s (EPA’s) Environmentally Preferable Purchasing (EPP) program is mandated by Executive Order 13101 to green the federal government. This was a study to determine federal attitudes.

Nutrition education at the point of purchase: the foods for health project evaluated.

PubMed

Ernst, N D; Wu, M; Frommer, P; Katz, E; Matthews, O; Moskowitz, J; Pinsky, J L; Pohl, S; Schreiber, G B; Sondik, E

1986-01-01

Foods for Health, a nutrition education and research program sponsored by the National Heart, Lung, and Blood Institute and Giant Food, Inc., was designed to demonstrate the feasibility of cardiovascular nutrition education at the point of purchase, specifically, in the supermarket. To evaluate the program's effectiveness, measures of consumer awareness, knowledge, and food purchases were determined before, during, and after the campaign. The program was conducted in the Washington, D.C., area, with Baltimore, Maryland, area stores serving as controls. At the conclusion of the campaign, Washington shoppers showed a significant increase in knowledge scores, while these scores decreased in the Baltimore area. The gain in correct knowledge scores for Washington shoppers compared with Baltimore shoppers was 9% for food fat and cholesterol content and 11% for the relationship between dietary fat and blood cholesterols levels. The food sales data indicate no apparent differences attributable to the intervention. Issues that might account for the lack of a significant change in food purchases, such as cost and the markets' individual sales promotion campaigns, are discussed, and recommendations for the design of future projects are made.

Scaling-up strategic purchasing: analysis of health system governance imperatives for strategic purchasing in a free maternal and child healthcare programme in Enugu State, Nigeria.

PubMed

Ogbuabor, Daniel Chukwuemeka; Onwujekwe, Obinna Emmanuel

2018-04-05

Significant knowledge gaps exist in the functioning of institutional designs and organisational practices in purchasing within free healthcare schemes in low resource countries. The study provides evidence of the governance requirements to scale up strategic purchasing in free healthcare policies in Nigeria and other low-resource settings facing similar approaches. The study was conducted at the Ministry of Health and in two health districts in Enugu State, Nigeria, using a qualitative case study design. Semi-structured interviews were conducted with 44 key health system actors (16 policymakers, 16 providers and 12 health facility committee leaders) purposively selected from the Ministry of Health and the two health districts. Data collection and analysis were guided by Siddiqi and colleagues' health system governance framework. Data were analysed using a framework approach. The key findings show that supportive governance practices in purchasing included systems to verify questionable provider claims, pay providers directly for services, compel providers to procure drugs centrally and track transfer of funds to providers. However, strategic vision was undermined by institutional conflicts, absence of purchaser-provider split and lack of selective contracting of providers. Benefit design was not based on stakeholder involvement. Rule of law was limited by delays in provider payment. Benefits and obligations to users were not transparent. The criteria and procedure for resource allocation were unclear. Some target beneficiaries seemed excluded from the scheme. Effectiveness and efficiency was constrained by poor adherence to purchasing rules. Accountability of purchasers and providers to users was weak. Intelligence and information is constrained by paper-based system. Rationing of free services by providers and users' non-adherence to primary gate-keeping role hindered ethics. Weak governance of purchasing function limits potential of FMCHP to contribute towards

Activity space-based measures of the food environment and their relationships to food purchasing behaviours for young urban adults in Canada.

PubMed

Widener, Michael J; Minaker, Leia M; Reid, Jessica L; Patterson, Zachary; Ahmadi, Tara Kamal; Hammond, David

2018-03-16

To examine the potential links between activity spaces, the food retail environment and food shopping behaviours for the population of young, urban adults. Participants took part in the Canada Food Study, which collected information on demographics, food behaviour, diet and health, as well as an additional smartphone study that included a seven-day period of logging GPS (global positioning system) location and food purchases. Using a time-weighted, continuous representation of participant activity spaces generated from GPS trajectory data, the locations of food purchases and a geocoded food retail data set, negative binomial regression models were used to explore what types of food retailers participants were exposed to and where food purchases were made. Toronto, Montreal, Vancouver, Edmonton and Halifax, Canada. Young adults aged 16-30 years (n 496). These participants were a subset of the larger Canada Food Study. Demographics, household food shopper status and city of residence were significantly associated with different levels of exposure to various types of food retailers. Food shopping behaviours were also statistically significantly associated with demographics, the activity space-based food environment, self-reported health and city of residence. The study confirms that food behaviours are related to activity space-based food environment measures, which provide a more comprehensive accounting of food retail exposure than home-based measures. In addition, exposure to food retail and food purchasing behaviours of an understudied population are described.

30 CFR 1206.301 - Value basis for royalty computation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... royalty computation. (a) The gross value for royalty purposes shall be the sale or contract unit price...) That a contract of sale or other business arrangement between the lessee and a purchaser of some or all... because it is based in whole or in part upon considerations other than the value of the commodities, or (2...

Effects of a price increase on purchases of sugar sweetened beverages. Results from a randomized controlled trial.

PubMed

Waterlander, Wilma Elzeline; Ni Mhurchu, Cliona; Steenhuis, Ingrid H M

2014-07-01

Sugar sweetened beverage (SSB) taxes are receiving increased political interest. However, there have been no experimental studies of the effects of price increases on SSBs or the effects on close substitutes such as diet drinks, alcohol or sugary snacks. Therefore, the aim of this study was to examine the effects of a price increase on SSBs on beverage and snack purchases using a randomized controlled design within a three-dimensional web-based supermarket. The trial contained two conditions: experimental condition with a 19% tax on SSBs (to reflect an increase in Dutch value added tax from 6% to 19%); and a control condition with regular prices. N = 102 participants were randomized and purchased groceries on a single occasion at a three-dimensional Virtual Supermarket. Data were analysed using independent t-tests and regression analysis. Results showed that participants in the price increase condition purchased significantly less SSBs than the control group (B = -.90; 95% CI = -1.70 to -.10 L per household per week). There were no significant effects on purchases in other beverage or snack food categories. This means that the higher VAT rate was effective in reducing SSB purchases and had no negative side-effects. Copyright © 2014. Published by Elsevier Ltd.

The Value of Timber Inventory Information.

Treesearch

B.E. Borders; W.M. Harrison; M.L. Clutter; B.D. Shiver; R.A. Souter

2008-01-01

Timber inventory data is the basis for many monetary transactions related to timber and timberland sale and (or) purchase as well as for development of timber management plans. The value of such data is well known and much appreciated for sale and (or) purchase of standing merchantable timber.  Unfortunatley, the value of timber inventory data for planning...

A Competency-Based Program for Electronic Gaming Equipment Repair.

ERIC Educational Resources Information Center

Hardman, James R.

This program is designed to provide entry-level training to individuals (especially workers displaced from industry) who desire employment as "slot technicians" in the casino industry. The 96-hour course includes both classroom instruction and hands-on experience. Sources for direct purchase of required manuals are provided. The 13…

10 CFR 603.700 - Standards for purchasing systems of for-profit firms.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Purchasing § 603.700 Standards for purchasing systems of for-profit firms. (a) If the TIA is an expenditure... instruments subject to the purchasing standards in 10 CFR 600.331 to use the same requirements for the TIA... documented in the award file). (b) Other for-profit participants under an expenditure-based TIA should be...

Point-of-purchase nutrition information influences food-purchasing behaviors of college students: a pilot study.

PubMed

Freedman, Marjorie R; Connors, Rachel

2011-05-01

The goal of point-of-purchase (POP) nutrition information is to help consumers make informed, healthful choices. Despite limited evaluation, these population-based approaches are being advocated to replace traditional, more expensive, individual behavior-change strategies. Few studies have examined the effect of POP information on buying patterns of college students, a group with high obesity rates and poor eating habits. This quasi-experimental pilot project sought to determine whether the "Eat Smart" POP program affected food-purchasing habits of multiethnic college students shopping at an on-campus convenience store. Baseline sales data of foods in the cereal, soup, cracker, and bread categories were collected for 6 weeks during Fall 2008. After Winter break, a few food items within each of these food categories were labeled as healthful using a "Fuel Your Life" shelf tag, and sales data were then collected for 5 weeks. In each of the four food categories, nontagged foods were available at the identical price as tagged items. Following intervention, there were increased sales of tagged items (measured as a percentage of total sales) in the cereal, soup, and cracker categories, while sales of bread decreased. Although none of these changes were statistically significant, the intervention resulted in a 3.6%±1.6% (P=0.082) increase in the percentage of sales from tagged items. Thus, providing POP nutrition information in a college campus convenience store may promote healthful food choices. A longer study examining the effect of POP on sales of items in other food categories is warranted. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Point-of-purchase nutrition information influences food-purchasing behaviors of college students: a pilot study.

PubMed

Freedman, Marjorie R; Connors, Rachel

2010-08-01

The goal of point-of-purchase (POP) nutrition information is to help consumers make informed, healthful choices. Despite limited evaluation, these population-based approaches are being advocated to replace traditional, more expensive, individual behavior-change strategies. Few studies have examined the effect of POP information on buying patterns of college students, a group with high obesity rates and poor eating habits. This quasi-experimental pilot project sought to determine whether the "Eat Smart" POP program affected food-purchasing habits of multiethnic college students shopping at an on-campus convenience store. Baseline sales data of foods in the cereal, soup, cracker, and bread categories were collected for 6 weeks during Fall 2008. After Winter break, a few food items within each of these food categories were labeled as healthful using a "Fuel Your Life" shelf tag, and sales data were then collected for 5 weeks. In each of the four food categories, nontagged foods were available at the identical price as tagged items. Following intervention, there were increased sales of tagged items (measured as a percentage of total sales) in the cereal, soup, and cracker categories, while sales of bread decreased. Although none of these changes were statistically significant, the intervention resulted in a 3.6%+/-1.6% (P=0.082) increase in the percentage of sales from tagged items. Thus, providing POP nutrition information in a college campus convenience store may promote healthful food choices. A longer study examining the effect of POP on sales of items in other food categories is warranted. 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

12 CFR 567.12 - Purchased credit card relationships, servicing assets, intangible assets (other than purchased...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 6 2013-01-01 2012-01-01 true Purchased credit card relationships, servicing assets, intangible assets (other than purchased credit card relationships and servicing assets), credit... credit card relationships, servicing assets, intangible assets (other than purchased credit card...

12 CFR 567.12 - Purchased credit card relationships, servicing assets, intangible assets (other than purchased...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 6 2012-01-01 2012-01-01 false Purchased credit card relationships, servicing assets, intangible assets (other than purchased credit card relationships and servicing assets), credit... credit card relationships, servicing assets, intangible assets (other than purchased credit card...

12 CFR 567.12 - Purchased credit card relationships, servicing assets, intangible assets (other than purchased...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 6 2014-01-01 2012-01-01 true Purchased credit card relationships, servicing assets, intangible assets (other than purchased credit card relationships and servicing assets), credit... credit card relationships, servicing assets, intangible assets (other than purchased credit card...

Monitoring changes in the nutritional content of ready-to-eat grain-based dessert products manufactured and purchased between 2005 and 2012.

PubMed

Mathias, Kevin C; Ng, Shu Wen; Popkin, Barry

2015-03-01

Monitoring changes in the nutritional content of food/beverage products and shifts in consumer purchasing behaviors is needed to measure the effectiveness of efforts by both food manufacturers and policy makers to improve dietary quality in the United States. To examine changes in the nutritional content (eg, energy, saturated fat, and sugar density) of ready-to-eat (RTE) grain-based dessert (GBD) products manufactured and purchased between 2005 and 2012. Nutrition Facts panel information from commercial databases was linked to RTE GBD products purchased by households (N=134,128) in the Nielsen Homescan longitudinal dataset 2005-2012. Linear regression models were used to examine changes in the energy, saturated fat, and sugar density of RTE GBD products manufactured in each year between 2005 and 2012. Random effects models controlling for demographics, household composition/size, and geographic location were used to examine changes in household purchases of RTE GBD products (in grams) and the average energy, saturated fat, and sugar density of RTE GBD products purchased. The saturated fat density (grams/100 g) of RTE GBD products increased significantly from 6.5±0.2 in 2005 to 7.3±0.2 and 7.9±0.2 for pre-existing and newly introduced products in 2012, respectively. Between 2005 and 2012, the energy density (kilocalories/100 g) of RTE GBD products purchased decreased significantly from 433±0.2 to 422±0.2, the saturated fat density (grams/100 g) of products purchased increased significantly from 6.3±0.01 to 6.6±0.01, the sugar density (grams/100 g) of products purchased decreased significantly from 32.4±0.03 to 31.3±0.02, and household purchases of RTE GBD products (in grams) decreased by 24.1%±0.4%. These results highlight an opportunity for both food manufacturers and public health officials to develop new strategies to shift consumer purchases toward products with lower energy, saturated fat, and sugar densities in addition to decreasing overall

Monitoring Changes in the Nutritional Content of Ready-To-Eat Grain-Based Dessert Products Manufactured and Purchased Between 2005 and 2012

PubMed Central

Mathias, Kevin C.; Wen, Shu; Popkin, Barry; Kenan, W.R.

2014-01-01

Background Monitoring changes in the nutritional content of food/beverage products and shifts in consumer purchasing behaviors is needed to measure the effectiveness of efforts by both food manufacturers and policy makers to improve dietary quality in the United States. Objective Examine changes in the nutritional content (e.g., energy, saturated fat, and sugar density) of Ready-To-Eat (RTE) Grain-Based Dessert (GBD) products manufactured and purchased between 2005 and 2012. Design Nutrition facts panel information from commercial databases was linked to RTE GBD products purchased by households (n=134,128) in the Nielsen Homescan longitudinal dataset 2005–2012. Statistical Analysis Linear regression models were utilized to examine changes in the energy, saturated fat, and sugar density of RTE GBD products manufactured in each year between 2005 and 2012. Random effects models controlling for demographics, household composition/size, and geographic location were utilized to examine changes in household purchases of RTE GBD products (grams) and the average energy, saturated fat, and sugar density of RTE GBD products purchased. Results The saturated fat density (g/100 g) of RTE GBD products increased significantly from 6.5 ± 0.2 in 2005 to 7.3 ± 0.2 and 7.9 ± 0.2 for pre-existing and newly introduced products in 2012, respectively. Between 2005 and 2012, the energy density (kcal/100 g) of RTE GBD products purchased decreased significantly from 433 ± 0.2 to 422 ± 0.2, the saturated fat density (g/100 g) of products purchased increased significantly from 6.3 ± 0.01 to 6.6 ± 0.01, the sugar density (g/100 g) of products purchased decreased significantly from 32.4 ± 0.03 to 31.3 ± 0.02, and household purchases of RTE GBD products (grams) decreased by 24.1 ± 0.4%. Conclusions These results highlight an opportunity for both food manufacturers and public health officials to develop new strategies to shift consumer purchases towards products with lower energy

Price and maternal obesity influence purchasing of low- and high-energy-dense foods2

PubMed Central

Epstein, Leonard H; Dearing, Kelly K; Paluch, Rocco A; Roemmich, James N; Cho, David

2007-01-01

Background Price can influence food purchases, which can influence consumption. Limited laboratory research has assessed the effect of price changes on food purchases, and no research on individual differences that may interact with price to influence purchases exists. Objective We aimed to assess the influence of price changes of low-energy-density (LED) and high-energy-density (HED) foods on mother’s food purchases in a laboratory food-purchasing analogue. Design Mothers were randomly assigned to price conditions in which the price of either LED or HED foods was manipulated from 75% to 125% of the reference purchase price, whereas the price of the alternative foods was kept at the reference value. Mothers completed purchases for 2 income levels ($15 or $30 per family member). Results Purchases were reduced when prices of LED (P < 0.01) and HED (P < 0.001) foods were increased. Maternal BMI interacted with price to influence purchases of HED foods when the price of HED foods increased (P = 0.016) and interacted with price to influence purchases of LED foods when the price of HED foods increased (P = 0.008). Conclusion These results show the relevance of considering price change as a way to influence food purchases of LED compared with HED foods and the possibility that individual differences may influence the own-price elasticity of HED foods and substitution of LED for HED foods. PMID:17921365

12 CFR 390.471 - Purchased credit card relationships, servicing assets, intangible assets (other than purchased...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Purchased credit card relationships, servicing assets, intangible assets (other than purchased credit card relationships and servicing assets), credit... THE OFFICE OF THRIFT SUPERVISION Capital § 390.471 Purchased credit card relationships, servicing...

12 CFR 390.471 - Purchased credit card relationships, servicing assets, intangible assets (other than purchased...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Purchased credit card relationships, servicing assets, intangible assets (other than purchased credit card relationships and servicing assets), credit... THE OFFICE OF THRIFT SUPERVISION Capital § 390.471 Purchased credit card relationships, servicing...

12 CFR 390.471 - Purchased credit card relationships, servicing assets, intangible assets (other than purchased...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Purchased credit card relationships, servicing assets, intangible assets (other than purchased credit card relationships and servicing assets), credit... THE OFFICE OF THRIFT SUPERVISION Capital § 390.471 Purchased credit card relationships, servicing...

Stakeholder challenges in purchasing medical devices for patient safety.

PubMed

Hinrichs, Saba; Dickerson, Terry; Clarkson, John

2013-03-01

This study identifies the stakeholders who have a role in medical device purchasing within the wider system of health-care delivery and reports on their particular challenges to promote patient safety during purchasing decisions. Data was collected through observational work, participatory workshops, and semi-structured qualitative interviews, which were analyzed and coded. The study takes a systems-based and engineering design approach to the study. Five hospitals took part in this study, and the participants included maintenance, training, clinical end-users, finance, and risk departments. The main stakeholders for purchasing were identified to be staff from clinical engineering (Maintenance), device users (Clinical), device trainers (Training), and clinical governance for analyzing incidents involving devices (Risk). These stakeholders display varied characteristics in terms of interpretation of their own roles, competencies for selecting devices, awareness and use of resources for purchasing devices, and attitudes toward the purchasing process. The role of "clinical engineering" is seen by these stakeholders to be critical in mediating between training, technical, and financial stakeholders but not always recognized in practice. The findings show that many device purchasing decisions are tackled in isolation, which is not optimal for decisions requiring knowledge that is currently distributed among different people within different departments. The challenges expressed relate to the wider system of care and equipment management, calling for a more systemic view of purchasing for medical devices.

State and Local Government Purchasing.

ERIC Educational Resources Information Center

Council of State Governments, Lexington, KY.

This report concerns public purchasing at all levels of government and brings into focus the role of the purchasing official in government management. Covered in the report are essential elements of the purchasing process, including the assessment of needs; written specifications; advertising, evaluating, and awarding bids; and inspection and…

The Importance of Teaching Management's Role in Capital Equipment Purchases.

ERIC Educational Resources Information Center

Silbergleid, Michael Ian

This essay discusses broadcasting and telecommunication management curricula and makes an argument for including instruction in capital equipment purchases. The argument is based on recent changes in the role of the television station department managers who in economically competitive times are involved in decisions about equipment purchasing. In…

Planning for Program Design and Assessment Using Value Creation Frameworks

ERIC Educational Resources Information Center

Whisler, Laurel; Anderson, Rachel; Brown, Jenai

2017-01-01

This article explains a program design and planning process using the Value Creation Framework (VCF) developed by Wenger, Trayner, and de Laat (2011). The framework involves identifying types of value or benefit for those involved in the program, conditions and activities that support creation of that value, data that measure whether the value was…

43 CFR 30.271 - How must the tribe pay for the interests it purchases?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false How must the tribe pay for the interests it purchases? 30.271 Section 30.271 Public Lands: Interior Office of the Secretary of the Interior... the tribe pay for the interests it purchases? (a) A tribe must pay the full fair market value of the...

43 CFR 30.271 - How must the tribe pay for the interests it purchases?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false How must the tribe pay for the interests it purchases? 30.271 Section 30.271 Public Lands: Interior Office of the Secretary of the Interior... the tribe pay for the interests it purchases? (a) A tribe must pay the full fair market value of the...

Some "Thing" to Talk About? Differential Story Utility From Experiential and Material Purchases.

PubMed

Kumar, Amit; Gilovich, Thomas

2015-10-01

Psychological research has shown that experiential purchases (a hike in the woods, a trip to Rome) bring more happiness than material purchases (a designer shirt, a flat-screen television). The research presented in this article investigates one cause and consequence of this difference: People talk more about their experiences than their possessions and derive more value from doing so. A series of eight studies demonstrate that taking away the ability to talk about experiences (but not material goods) would diminish the enjoyment they bring; that people believe they derive more happiness from talking about experiential purchases; that when given a choice about which of their purchases to talk about, people are more likely to talk about experiential rather than material consumption; and that people report being more inclined to talk about their experiences than their material purchases and derive more hedonic benefits as a result--both in prospect and in retrospect. © 2015 by the Society for Personality and Social Psychology, Inc.

A modeling framework for optimal long-term care insurance purchase decisions in retirement planning.

PubMed

Gupta, Aparna; Li, Lepeng

2004-05-01

The level of need and costs of obtaining long-term care (LTC) during retired life require that planning for it is an integral part of retirement planning. In this paper, we divide retirement planning into two phases, pre-retirement and post-retirement. On the basis of four interrelated models for health evolution, wealth evolution, LTC insurance premium and coverage, and LTC cost structure, a framework for optimal LTC insurance purchase decisions in the pre-retirement phase is developed. Optimal decisions are obtained by developing a trade-off between post-retirement LTC costs and LTC insurance premiums and coverage. Two-way branching models are used to model stochastic health events and asset returns. The resulting optimization problem is formulated as a dynamic programming problem. We compare the optimal decision under two insurance purchase scenarios: one assumes that insurance is purchased for good and other assumes it may be purchased, relinquished and re-purchased. Sensitivity analysis is performed for the retirement age.

[Consumer's psychological processes of hoarding and avoidant purchasing after the Tohoku earthquake].

PubMed

Ohtomo, Shoji; Hirose, Yukio

2014-02-01

This study examined psychological processes of consumers that had determined hoarding and avoidant purchasing behaviors after the Tohoku earthquake within a dual-process model. The model hypothesized that both intentional motivation based on reflective decision and reactive motivation based on non-reflective decision predicted the behaviors. This study assumed that attitude, subjective norm and descriptive norm in relation to hoarding and avoidant purchasing were determinants of motivations. Residents in the Tokyo metropolitan area (n = 667) completed internet longitudinal surveys at three times (April, June, and November, 2011). The results indicated that intentional and reactive motivation determined avoidant purchasing behaviors in June; only intentional motivation determined the behaviors in November. Attitude was a main determinant of the motivations each time. Moreover, previous behaviors predicted future behaviors. In conclusion, purchasing behaviors were intentional rather than reactive behaviors. Furthermore, attitude and previous behaviors were important determinants in the dual-process model. Attitude and behaviors formed in April continued to strengthen the subsequent decisions of purchasing behavior.

Analysis of Cigarette Purchase Task Instrument Data with a Left-Censored Mixed Effects Model

PubMed Central

Liao, Wenjie; Luo, Xianghua; Le, Chap; Chu, Haitao; Epstein, Leonard H.; Yu, Jihnhee; Ahluwalia, Jasjit S.; Thomas, Janet L.

2015-01-01

The drug purchase task is a frequently used instrument for measuring the relative reinforcing efficacy (RRE) of a substance, a central concept in psychopharmacological research. While a purchase task instrument, such as the cigarette purchase task (CPT), provides a comprehensive and inexpensive way to assess various aspects of a drug’s RRE, the application of conventional statistical methods to data generated from such an instrument may not be adequate by simply ignoring or replacing the extra zeros or missing values in the data with arbitrary small consumption values, e.g. 0.001. We applied the left-censored mixed effects model to CPT data from a smoking cessation study of college students and demonstrated its superiority over the existing methods with simulation studies. Theoretical implications of the findings, limitations of the proposed method and future directions of research are also discussed. PMID:23356731

Analysis of cigarette purchase task instrument data with a left-censored mixed effects model.

PubMed

Liao, Wenjie; Luo, Xianghua; Le, Chap T; Chu, Haitao; Epstein, Leonard H; Yu, Jihnhee; Ahluwalia, Jasjit S; Thomas, Janet L

2013-04-01

The drug purchase task is a frequently used instrument for measuring the relative reinforcing efficacy (RRE) of a substance, a central concept in psychopharmacological research. Although a purchase task instrument, such as the cigarette purchase task (CPT), provides a comprehensive and inexpensive way to assess various aspects of a drug's RRE, the application of conventional statistical methods to data generated from such an instrument may not be adequate by simply ignoring or replacing the extra zeros or missing values in the data with arbitrary small consumption values, for example, 0.001. We applied the left-censored mixed effects model to CPT data from a smoking cessation study of college students and demonstrated its superiority over the existing methods with simulation studies. Theoretical implications of the findings, limitations of the proposed method, and future directions of research are also discussed.

Grocery store beverage choices by participants in federal food assistance and nutrition programs.

PubMed

Andreyeva, Tatiana; Luedicke, Joerg; Henderson, Kathryn E; Tripp, Amanda S

2012-10-01

Sugar-sweetened beverages are a target for reduction in the 2010 Dietary Guidelines for Americans. Concerns have been raised about sugar-sweetened beverages purchased with Supplemental Nutrition Assistance Program (SNAP) benefits. This paper describes purchases of non-alcoholic refreshment beverages among participants in the U.S. Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and SNAP. Grocery store scanner data from a regional supermarket chain were used to assess refreshment beverage purchases of 39,172 households in January-June 2011. The sample consisted of families with a history of WIC participation in 2009-2011; about half also participated in SNAP. Beverage spending and volume purchased were compared for WIC sampled households either using SNAP benefits (SNAP) or not (WIC-only). Analyses were completed in 2012. Refreshment beverages were a significant contributor to expenditure on groceries by SNAP and WIC households. Sugar-sweetened beverages accounted for 58% of refreshment beverage purchases made by SNAP households and 48% of purchases by WIC-only households. Soft drinks were purchased most by all households. Fruit-based beverages were mainly 100% juice for WIC-only households and sugary fruit drinks for SNAP households. SNAP benefits paid for 72% of the sugar-sweetened beverage purchases made by SNAP households. Nationwide, SNAP was estimated to pay at least $1.7 to $2.1 billion annually for sugar-sweetened beverages purchased in grocery stores. Considerable amounts of sugar-sweetened beverages are purchased by households participating in WIC and SNAP. The SNAP program pays for most of the sugar-sweetened beverage purchases among SNAP households. The upcoming SNAP reauthorization could be a good time to reconsider the program priorities to align public funds with public health. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

31 CFR 315.11 - Excess purchases.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Excess purchases. 315.11 Section 315..., D, E, F, G, H, J, AND K, AND U.S. SAVINGS NOTES Limitations on Annual Purchases § 315.11 Excess purchases. The Commissioner of the Public Debt may permit excess purchases to stand in any particular case...

Maslow and Values Education

ERIC Educational Resources Information Center

Farmer, Rodney

1978-01-01

Identifies major value bases which have been used to teach values in the classroom and outlines a values education program which stresses teaching about values without indoctrination. Based upon the hierarchy of human needs developed by psychologist Abraham Maslow, the program is based upon universal values, basic human needs, and recognition of…

Place over traits? Purchasing edibles from medical marijuana dispensaries in Los Angeles, CA.

PubMed

Kepple, Nancy Jo; Freisthler, Bridget

2017-10-01

To examine discrete purchasing behaviors of marijuana-infused edibles from medical marijuana dispensaries with the aim to identify potential venue- and individual-level targets for prevention. Two-stage, venue-based sampling approach was used to randomly select patrons exiting 16 medical marijuana dispensaries in Los Angeles, California during Spring 2013. Hierarchical generalized linear modeling was used to examine the likelihood of purchasing edibles among 524 patrons reporting a discrete purchase regressed on characteristics of the sampled dispensaries and their patrons. At a venue level, patrons were more likely to purchase edibles from dispensaries located within Census tracts with higher median incomes or in close proximity to a higher number of dispensaries. At an individual level, patrons who identified as Black or Hispanic were associated with a lower likelihood of purchasing edibles when compared to patrons who identified as other non-White, non-Hispanic race/ethnicity. Place-based policies focused on regulating edible sales through dispensaries may be fruitful in influencing access to edibles. Additionally, social marketing campaigns may benefit from targeting both locations where edible purchases are more likely and populations who are more likely to purchase edibles. Copyright © 2017 Elsevier Ltd. All rights reserved.

Army Needs to Identify Government Purchase Card High-Risk Transactions

DTIC Science & Technology

2012-01-20

Purchase Card Program Data Mining Process Needs Improvement 11...Mining Process Needs Improvement The 17 transactions that were noncompliant occurred because cardholders ignored the GPC business rules so the...Scope and Methodology 16 Use of Computer- Processed Data 16 Use of Technical Assistance 17 Prior Coverage

Beyond cost: 'responsible purchasing' of managed care by employers.

PubMed

Lo Sasso, A T; Perloff, L; Schield, J; Murphy, J J; Mortimer, J D; Budetti, P P

1999-01-01

We explore the extent of "responsible purchasing" by employers--the degree to which employers collect and use nonfinancial information in selecting and managing employee health plans. Most firms believe that they have some responsibility for assessing the quality of the health plans they offer. Some pay attention to plan characteristics such as the ability to provide adequate access to providers and services and scores on enrollee satisfaction surveys. A more limited but still notable number of firms take specific actions based on responsible purchasing information. Because of countervailing pressures, however, it is not clear whether or not the firms most involved in responsible purchasing are signaling a developing trend.

U.S.-Russian Cooperation in Science and Technology: A Case Study of the TOPAZ Space-Based Nuclear Reactor International Program

NASA Astrophysics Data System (ADS)

Dabrowski, Richard S.

2014-08-01

The TOPAZ International Program (TIP) was the final name given to a series of projects to purchase and test the TOPAZ-II, a space-based nuclear reactor of a type that had been further developed in the Soviet Union than in the United States. In the changing political situation associated with the break-up of the Soviet Union it became possible for the United States to not just purchase the system, but also to employ Russian scientists, engineers and testing facilities to verify its reliability. The lessons learned from the TIP illuminate some of the institutional and cultural challenges to U.S. - Russian cooperation in technology research which remain true today.

The effects of price and perceived quality on the behavioural economics of alcohol, amphetamine, cannabis, cocaine, and ecstasy purchases.

PubMed

Goudie, Andrew J; Sumnall, Harry R; Field, Matt; Clayton, Hannah; Cole, Jon C

2007-07-10

Behavioural economic models of substance use describe the relationship between changes in unit price and consumption. However, these models rarely take account of the perceived quality (i.e. potency) of controlled drugs. Therefore we investigated the effects of both price and quality on the decision to purchase controlled drugs by polysubstance misusers. Forty current polysubstance misusers (29 males, 11 females; mean age 23.8) were recruited into the study. Participants were asked to hypothetically purchase drugs from a price list of alcohol, amphetamine, cannabis, cocaine and ecstasy at different levels of quality and price (i.e. better quality drugs cost more money). The disposable income available for those purchases was systematically varied in order to determine the impact of income on the decision to purchase drugs. Demand for both normal and strong alcohol was income inelastic. Demand for both poor and average quality cannabis and ecstasy was income inelastic, but demand for good quality cannabis and ecstasy was income elastic. The demand for poor quality cocaine was income inelastic, with the demand for both average and good quality cocaine being income elastic. Participants reported too few purchases of amphetamine, which precluded behavioural economic analysis. These results suggest that, like other goods, controlled drugs are purchased based upon the consumer's interpretations of their relative value. Therefore, it is probable that the purchase and subsequent use of controlled drugs by polysubstance misusers will be heavily influenced by the economic environment.

A dynamic programming approach to estimate the capacity value of energy storage

DOE PAGES

Sioshansi, Ramteen; Madaeni, Seyed Hossein; Denholm, Paul

2013-09-17

Here, we present a method to estimate the capacity value of storage. Our method uses a dynamic program to model the effect of power system outages on the operation and state of charge of storage in subsequent periods. We combine the optimized dispatch from the dynamic program with estimated system loss of load probabilities to compute a probability distribution for the state of charge of storage in each period. This probability distribution can be used as a forced outage rate for storage in standard reliability-based capacity value estimation methods. Our proposed method has the advantage over existing approximations that itmore » explicitly captures the effect of system shortage events on the state of charge of storage in subsequent periods. We also use a numerical case study, based on five utility systems in the U.S., to demonstrate our technique and compare it to existing approximation methods.« less

From State-controlled to Polycentric Governance in Forest Landscape Restoration: The Case of the Ecological Forest Purchase Program in Yong'an Municipality of China.

PubMed

Long, Hexing; Liu, Jinlong; Tu, Chengyue; Fu, Yimin

2018-07-01

Forest landscape restoration is emerging as an effective approach to restore degraded forests for the provision of ecosystem services and to minimize trade-offs between conservation and rural livelihoods. Policy and institutional innovations in China illustrate the governance transformation of forest landscape restoration from state-controlled to polycentric governance. Based on a case study of the Ecological Forest Purchase Program in Yong'an municipality, China's Fujian Province, this paper explores how such forest governance transformation has evolved and how it has shaped the outcomes of forest landscape restoration in terms of multi-dimensionality and actor configurations. Our analysis indicates that accommodating the participation of multiple actors and market-based instruments facilitate a smoother transition from state-centered to polycentric governance in forest landscape restoration. Governance transitions for forest landscape restoration must overcome a number of challenges including ensurance of a formal participation forum, fair participation, and a sustainable legislative and financial system to enhance long-term effectiveness.

7 CFR 1955.114 - Sales steps for program property (housing).

Code of Federal Regulations, 2010 CFR

2010-01-01

... property. (1) The following provisions apply to all offers to purchase SFH inventory property: (i) Program property will be available for purchase only by program applicants for the first 45 days from the date of... 45-day exclusive period for program applicants, program property may be purchased by offerors...

Value pricing pilot program : lessons learned

DOT National Transportation Integrated Search

2008-08-01

This "Lessons Learned Report" provides a summary of projects sponsored by the Federal Highway Administration's (FHWA's) Congestion and Value Pricing Pilot Programs from 1991 through 2006 and draws lessons from a sample of projects with the richest an...

A framework for understanding grocery purchasing in a low-income urban environment.

PubMed

Zachary, Drew A; Palmer, Anne M; Beckham, Sarah W; Surkan, Pamela J

2013-05-01

Research demonstrates that food desert environments limit low-income shoppers' ability to purchase healthy foods, thereby increasing their likelihood of diet-related illnesses. We sought to understand how individuals in an urban American food desert make grocery-purchasing decisions, and specifically why unhealthy purchases arise. Analysis is based on ethnographic data from participant observation, 37 in-depth interviews, and three focus groups with low-income, primarily African American shoppers with children. We found participants had detailed knowledge of and preference for healthy foods, but the obligation to consistently provide food for their families required them to apply specific decision criteria which, combined with structural qualities of the supermarket environment, increased unhealthy purchases and decreased healthy purchases. Applying situated cognition theory, we constructed an emic model explaining this widely shared grocery-purchasing decision process and its implications. This context-specific understanding of behavior suggests that multifaceted, system-level approaches to intervention are needed to increase healthy purchasing in food deserts.

78 FR 38286 - Notice of Change to the CCC Sugar Purchase and Exchange To Include Certificates of Quota...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

... DEPARTMENT OF AGRICULTURE Commodity Credit Corporation Notice of Change to the CCC Sugar Purchase... TPA) in the sugar purchase and exchange announced on June 18, 2013. DATES: Effective date: June 26... (voice and TDD). SUPPLEMENTARY INFORMATION: USDA's Sugar Program and the Domestic Sugar Market Conditions...

"Whether something cool is good enough": The role of evidence, sales representatives and nurses' expertise in hospital purchasing decisions.

PubMed

Grundy, Quinn

2016-09-01

The emphasis on "value" within healthcare institutions has achieved unprecedented priority, particularly around the purchase of medical products and equipment. Health systems and institutions are implementing formal decision-making processes involving clinicians and supply chain professionals to rationalize purchasing and promote cost-effective investment. One particular form of this process is the "Value Analysis" process. Drawing from fieldwork (100 h), interviews (n = 51) and focus groups (n = 4) conducted from January 2012 to October 2014 at 4 acute care hospitals in the western United States, I analyze the ways that committee members constructed and evaluated a case for a product's value. Participants (n = 72) were a purposive sample including nurses, administrators, supply chain and industry professionals. Interpretive phenomenology served as the analytic approach to generating iterative themes. While trying to be evidence-based, Value Analysis committees lacked data related to a product's price or efficacy and relied heavily on local knowledge and expertise. Sales representatives were an integral part of the process, creating interest in the product and providing product information. As vehicles for cost-savings and quality improvement, purchasing committees need unique support that emphasizes local contexts and expertise, while maintaining rigor and minimizing bias. Drawing from participants' experiences, and principles of health technology assessment and economic evaluation, a guiding framework is proposed to support this decision-making. Copyright © 2016 Elsevier Ltd. All rights reserved.

Markets for individual health insurance: can we make them work with incentives to purchase insurance?

PubMed

Swartz, K

2001-01-01

Simple income-based incentives to purchase health insurance (tax credits or deductions, or subsidies) are unlikely to succeed in significantly reducing the number of uninsured because income is not a good predictor of the extent to which individuals use medical service. Proposals to provide incentives to low-income people so they will purchase individual health insurance need to address the inherent tension between the interests of low-risk and high-risk people who rely on individual coverage. If carriers are forced to cover all applicants and to community rate premiums, low-risk people will drop coverage or not apply for it because premiums will exceed their expected need for insurance. Concern for people who currently have access to individual coverage calls for careful examination of options to permit incentive programs to succeed with the individual insurance markets. In particular, attention should focus on using alternatives to simple income-based subsidies to spread the burden of high-risk people's costs broadly, rather than impose the costs on low-risk people who purchase individual coverage. This paper describes three such alternatives. One uses risk adjustments and two rely on reinsurance so that carriers are compensated for the higher costs of covering high-risk people who use incentives to buy insurance. One alternative also permits risk selection by insurance carriers.

Acceptance and purchase intent of US consumers for nonwheat rice butter cakes.

PubMed

Sae-Eaw, A; Chompreeda, P; Prinyawiwatkul, W; Haruthaithanasan, V; Suwonsichon, T; Saidu, J E; Xu, Z

2007-03-01

This study evaluated consumer acceptance and purchase intent of nonwheat butter cake formulations prepared with Thai jasmine rice flour. Three nonwheat rice butter cakes were prepared with varying amounts of powdered emulsifier (propylene glycol ester:diacetyl tartaric acid ester of monoglyceride, 8:2) at 0% (product A), 7.5% (product B), and 15% (product C) of the margarine content (15%) in the cake formulation. A commercial wheat-based butter cake served as the control. Consumers (n= 400) evaluated acceptability of 9 sensory attributes using a 9-point hedonic scale. Overall acceptance and purchase intent were determined with a binomial (yes/no) scale. At least 81% of consumers accepted products B and C, of which 42.1% and 47%, respectively, would purchase the products if commercially available. Product A was neither liked nor disliked with an overall liking score of 5.39. The butter cake products were differentiated by textural acceptability (overall texture, softness, and moistness) with a canonical correlation of 0.71 to 0.79. Overall liking and taste influenced overall acceptance and purchase intent. Odor influenced purchase intent (P= 0.0014), but not overall acceptance. The odds ratio of overall liking was 3.462 for purchase intent, indicating the probability of the product being purchased is 3.462 times higher (than not being purchased, P < 0.0001) with every 1-unit increase of the overall liking score. Based on the logit model, overall acceptance and purchase intent could be predicted with 89.3% and 83.3% accuracy, respectively. The study demonstrated feasibility of completely substituting wheat flour with Thai jasmine rice flour for production of butter cake products acceptable to American consumers.

7 CFR 4290.825 - Purchasing securities from an underwriter or other third party.

Code of Federal Regulations, 2010 CFR

2010-01-01

... BUSINESS INVESTMENT COMPANY (âRBICâ) PROGRAM Financing of Enterprises by RBICs Structuring Rbic Financing of Eligible Enterprises-Types of Financings § 4290.825 Purchasing securities from an underwriter or...

Indigenous health: designing a clinical orientation program valued by learners.

PubMed

Huria, Tania; Palmer, Suetonia; Beckert, Lutz; Lacey, Cameron; Pitama, Suzanne

2017-10-05

Indigenous health programs are seen as a curriculum response to addressing health disparities and social accountability. Several interrelated teaching approaches to cultural competency curricula have been recommended, however evidence of the impact of these on learner outcomes including engagement and self-reported competencies is limited. We aimed to explore undergraduate medical student perspectives of an indigenous health orientation program to inform curriculum strategies that promote learning and development of clinical skills. We analyzed quantitative and qualitative student evaluations (n = 602) of a three-day immersed indigenous health orientation program between 2006 and 2014 based on Likert-scale responses and open-text comments. We conducted a thematic analysis of narrative student experiences (n = 426). Overall, 509 of 551 respondents (92%) rated the indigenous health orientation program as extremely or highly valuable and most (87%) reported that the course strongly increased their interest in indigenous health. The features of the clinical course that enhanced value for learners included situated learning (learning environment; learning context); teaching qualities (enthusiasm and passion for Māori health; role-modelling); curriculum content (re-presenting Māori history; exploring Māori beliefs, values and practices; using a Māori health framework in clinical practice); teaching methodologies (multiple teaching methods; simulated patient interview); and building relationships with peers (getting to know the student cohort; developing professional working relationships). Undergraduate medical students valued an indigenous health program delivered in an authentic indigenous environment and that explicitly reframed historical notions of indigenous health to contextualize learning. Content relevant to clinical practice, faculty knowledge, and strengthened peer interactions combined to build learner confidence and self-reported indigenous health

A Community-Based Social Marketing Campaign at Pacific University Oregon: Recycling, Paper Reduction, and Environmentally Preferable Purchasing

ERIC Educational Resources Information Center

Cole, Elaine J.; Fieselman, Laura

2013-01-01

Purpose: The purpose of this paper is to design a community-based social marketing (CBSM) campaign to foster sustainable behavior change in paper reduction, commingled recycling, and purchasing environmentally preferred products (EPP) with faculty and staff at Pacific University Oregon. Design/methodology/approach: A CBSM campaign was developed…

Are users' most recent drug purchases representative?

PubMed

Bond, Brittany; Caulkins, Jonathan P; Scott, Nick; Kilmer, Beau; Dietze, Paul

2014-09-01

Various surveys now ask respondents to describe their most recent purchase of illicit drugs, as one mechanism through which market size can be estimated. This raises the question of whether issues surrounding the timing of survey administration might make a sample of most recent purchases differ from a random sample of all purchases. We investigate these issues through a series of questions which ask about the three most recent purchases, and about drug use. Data were drawn from 688 respondents in the Melbourne Injecting Drug User Cohort Study across the period 2008-2013 and 2782 respondents to the Washington Cannabis Consumption Study in 2013. Responses to questions about the most recent purchases were compared to larger subsets of all recent purchases. For heroin, methamphetamine and cannabis no differences were found between the amount spent by participants on their most recent purchase and the average amount spent on three or more recent purchases. There were also no differences concerning the locations and types of deals, and the duration between consecutive cannabis purchases was the same for first and second most recent, and second and third most recent. Asking about the most recent purchase appears to be an economical way to learn about purchases more generally, with little evidence of substantial variation between the most recent purchase and other recent purchases reported by participants. In spite of consistent findings across our two surveys, further replication of the work reported in this paper involving other populations of users is warranted. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Food and beverage purchases in corner stores, gas-marts, pharmacies and dollar stores.

PubMed

Caspi, Caitlin E; Lenk, Kathleen; Pelletier, Jennifer E; Barnes, Timothy L; Harnack, Lisa; Erickson, Darin J; Laska, Melissa N

2017-10-01

Little is known about customer purchases of foods and beverages from small and non-traditional food retailers (i.e. corner stores, gas-marts, dollar stores and pharmacies). The present study aimed to: (i) describe customer characteristics, shopping frequency and reasons for shopping at small and non-traditional food retailers; and (ii) describe food/beverage purchases and their nutritional quality, including differences across store type. Data were collected through customer intercept interviews. Nutritional quality of food/beverage purchases was analysed; a Healthy Eating Index-2010 (HEI-2010) score for purchases was created by aggregating participant purchases at each store. Small and non-traditional food stores that were not WIC-authorized in Minneapolis and St. Paul, MN, USA. Customers (n 661) from 105 food retailers. Among participants, 29 % shopped at the store at least once daily; an additional 44 % shopped there at least once weekly. Most participants (74 %) cited convenient location as the primary draw to the store. Customers purchased a median of 2262 kJ (540 kcal), which varied by store type (P=0·04). The amount of added sugar far surpassed national dietary recommendations. At dollar stores, participants purchased a median of 5302 kJ (1266 kcal) for a median value of $US 2·89. Sugar-sweetened beverages were the most common purchase. The mean HEI-2010 score across all stores was 36·4. Small and non-traditional food stores contribute to the urban food environment. Given the poor nutritional quality of purchases, findings support the need for interventions that address customer decision making in these stores.

20 CFR 638.506 - Purchase of vocational supplies and equipment.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... 638.506 Section 638.506 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR JOB CORPS PROGRAM UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.506 Purchase of vocational supplies and equipment. The Job Corps Director shall develop procedures for the low...

Parental Characteristics and Reasons Associated With Purchasing Kids' Meals for Their Children.

PubMed

Lee-Kwan, Seung Hee; Park, Sohyun; Maynard, Leah M; Blanck, Heidi M; McGuire, Lisa C; Collins, Janet L

2018-02-01

Characteristics of parents who purchased kids' meals, reasons for the purchase, and desire for healthy options were examined. Quantitative, cross-sectional study. National. The SummerStyles survey data of 1147 parents (≥18 years). Self-reported outcome variables were purchase of kids' meals (yes/no), reasons for the purchase (13 choices), and desire for healthy options (yes/no). We used multivariable logistic regression to estimate odds ratios (ORs) for purchasing kids' meals based on parental sociodemographic and behavioral characteristics. Over half (51%) of parents reported purchasing kids' meals in the past month. The adjusted OR of purchasing kids' meals were significantly higher among younger parents (OR = 3.44 vs ≥50 years) and among parents who consumed sugar-sweetened beverages (SSBs) daily (OR = 2.70 vs none). No differences were found for race/ethnicity, income, and education. Parents who purchased kids' meals reported that the top 3 reasons for purchase were (1) because their children asked for kids' meals, (2) habit, and (3) offering of healthier sides such as fruits or fruit cups. Thirty-seven percent of parents who did not purchase kids' meals expressed willingness to purchase kids' meals if healthy options were available; this willingness was highest among younger parents (47%; P < .05). Kids' meal purchases were somewhat common. Our findings on characteristics of parents who frequently bought kids' meals (ie, younger parents and SSB consumers), common reasons for purchasing kids' meals, and willingness to buy healthier kids' meal can be used to inform intervention efforts to improve quality of kids' meals.

Employers flex their muscles as health care purchasers.

PubMed

Delbanco, Suzanne

2007-08-01

Engaged health care purchasers--both individual and group--can stimulate some good, healthy competition in the health care system, and competition needs to be based on results. To determine results, we need accepted measures of quality and efficiency that make sense. Then, performance on those measures must be disclosed publicly. Only when this information is available to consumers and other purchasers of health care will they be able to make informed choices and reward effective and efficient health care providers.

Direct purchase contracts carry risks, benefits.

PubMed

Fine, A

1991-05-01

To better control their purchasing of healthcare services, some employers are seeking direct managed care contracts with healthcare facilities. Along with evaluating potential markets introduced by a proposed contract, a provider should develop a pricing strategy, a monitoring system, and a process for internal audit before entering into a direct purchase contract. With the proper checks in place, direct purchase contracts can be mutually beneficial to providers and purchasers.

Consortium Purchases: Case Study for a Cost-Benefit Analysis.

ERIC Educational Resources Information Center

Scigliano, Marisa

2002-01-01

Discusses library cooperation and academic library consortia and presents a case study of a Canadian consortia that conducted a cost-benefit analysis for purchasing an electronic resource. Reports on member library subscription costs, external economic factors, value of patron time saved, costs and benefits for patrons, and net savings. (LRW)

Parents' level of support for adults' purchase and consumption of alcohol at primary school events when children are present.

PubMed

Ward, Bernadette; Kippen, Rebecca; Buykx, Penny; Gilligan, Conor; Chapman, Kathy

2015-03-01

Environmental and societal factors are significant determinants of children's initiation to and use of alcohol. Schools are important settings for promoting well-being and substantial resources have been devoted to curriculum-based alcohol programs, but the effects of these in reducing the misuse of alcohol have been modest. Adults can and do consume alcohol at school events when students are present, but there is a dearth of evidence about parents' level of support for the practice. The aim of this study was to examine parents' level of support for the purchase and consumption of alcohol at primary school fundraising events when children are present. Four hundred seventy-nine Australian parents of children aged 0-12 years participated in an online survey. Logistic regression was used to assess the impact of parent characteristics on the level of agreement with parental purchase and consumption of alcohol at school fundraising events when children are present. The majority of parents (60%) disagreed/strongly disagreed with the practice of adults being able to purchase and consume alcohol at school fundraising events when children were present. The 21% of parents who supported the practice were more likely to be daily smokers and/or have higher (>6) Alcohol Use Disorders Identification Test-alcohol consumption scores. Despite the fact that the majority of parents disagree with this practice, published reports suggest that adults' use of alcohol at primary school events is an emerging issue. It is important that school decision-makers are mindful of the financial and educational value of fundraising activities. © 2014 Australasian Professional Society on Alcohol and other Drugs.

Responsible Purchasing Network - Sustainable Purchasing Guidance Profile

EPA Pesticide Factsheets

To help you find the resource that is right for your organization, EPA conducted a scan of the landscape and developed summary profiles of some of the leading sources of sustainable purchasing guidance around the globe.

International Green Purchasing Network - Sustainable Purchasing Profile

EPA Pesticide Factsheets

To help you find the resource that is right for your organization, EPA conducted a scan of the landscape and developed summary profiles of some of the leading sources of sustainable purchasing guidance around the globe.

Social capital, political trust and purchase of illegal liquor: a population-based study in southern Sweden.

PubMed

Lindström, Martin

2008-05-01

To investigate the association between political trust in the Riksdag (the national parliament in Sweden) and having purchased illegal liquor during the past 12 months. The 2004 public health survey in Skåne is a cross-sectional postal questionnaire study answered by 27,757 respondents aged 18-80 with a 59% response rate. A logistic regression model was used to investigate the associations between political trust and having purchased illegal liquor during the past 12 months. Multivariate analyses of political trust and having purchased illegal liquor were performed in order to investigate the importance of possible confounders (including generalized/horizontal trust in other people). A 21.2% fraction of the men and 9.6% of the women had purchased illegal alcohol during the past 12 months. A total of 17.3% and 11.6% of the male and female respondents, respectively, reported that they had no trust at all in the national parliament, and another 38.2% and 36.2%, respectively, reported that their political trust was not particularly high. Respondents in younger age groups, with medium/low education, economic stress, low horizontal trust and not particularly high and no political trust at all and no opinion had significantly higher levels of having purchased illegal liquor. The significant odds ratios of having purchased illegal liquor in the not particularly high political trust and no political trust at all categories were somewhat reduced although still significant after multiple adjustments. The results suggest that political trust may have an independent effect on the propensity to purchase illegal liquor in Sweden.

[Factors related to purchasing over-the-counter medications online].

PubMed

Kishimoto, Keiko; Yoshida, Takeshi; Fukushima, Noriko

2009-09-01

We conducted a Web-based survey of approximately 40,000 Internet users on the purchase of over-the-counter (OTC) medications online in March 2009. The valid response rate was 97.8% and the number of responses was 39,208. The number of people who had purchased OTC medications online was 4,653 (11.9%), prescription medicines 792 (2.0%), and medical contact lenses 1,993 (5.1%). As a result of the multiple logistic regression analysis, independent variables with odds ratios (ORs) >1.5 were experience of purchasing prescription-only medicine online (OR=4.997, 95%CI=4.288-5.824), regular supplement use (OR=2.384, 95%CI=2.233-2.548), experience of purchasing colored contact lenses online (OR=2.206, 95%CI=1.632-2.983), no time to visit drugstores (OR=2.092, 95%CI=1.928-2.270), usage of Web sites of uncertain reliability (OR=1.992, 95%CI=1.857-2.137), and experience of purchasing therapeutic contact lenses online (OR=1.796, 95%CI=1.597-2.020). As some people have purchased prescription-only medicine or medical devices and had problems with drug information sources, the development of awareness of medical and pharmaceutical supplies and health and medical information literacy are key priorities to ensure safe OTC medication sales systems.

Capturing the spectrum of household food and beverage purchasing behavior: a review.

PubMed

French, Simone A; Shimotsu, Scott T; Wall, Melanie; Gerlach, Anne Faricy

2008-12-01

The household setting may be the most important level at which to understand the food choices of individuals and how healthful food choices can be promoted. However, there are few available measures of the food purchase behaviors of households and little consensus on the best way to measure it. This review explores the currently available measures of household food purchasing behavior. Three main measures are described, evaluated, and compared: home food inventories, food and beverage purchase records and receipts, and Universal Product Code bar code scanning. The development of coding, aggregation, and analytical methods for these measures of household food purchasing behavior is described. Currently, annotated receipts and records are the most comprehensive, detailed measure of household food purchasing behavior, and are feasible for population-based samples. Universal Product Code scanning is not recommended due to its cost and complexity. Research directions to improve household food purchasing behavior measures are discussed.

Explaining Counterfeit Alcohol Purchases in Russia.

PubMed

Kotelnikova, Zoya

2017-04-01

Alcohol is a common target of counterfeiting in Russia. Counterfeit alcohol is defined here as the manufacture, distribution, unauthorized placement (forgery) of protected commodity trademarks, and infringement of the exclusive rights of the registered trademark holders of alcoholic beverages. It is often argued that the expansion of the counterfeit product market is due to the steady demand of economically disadvantaged people for low-priced goods. The situation becomes more complicated once deceptive and nondeceptive forms of counterfeiting are taken into account. This study aimed to identify markers of risky behavior associated with the purchase of counterfeit alcohol in Russia. The analysis relied on consumer self-reports of alcohol use and purchase collected nationwide by the Russia Longitudinal Monitoring Survey (RLMS-HSE) in 2012 to 2014. I used a generalized linear mixed-model logistic regression to identify predictors of risky behavior by consumers who purchased counterfeit alcohol, either knowingly or unknowingly, during the 30 days preceding the survey. Purchases of counterfeit alcohol declined slightly from 2012 to 2014, mainly due to a decrease in consumers mistakenly purchasing counterfeit products. Predictors of counterfeit alcohol purchases differed between consumers who knowingly and unknowingly purchased counterfeit products. Nondeceptive purchase of counterfeit alcohol was related primarily to an indifference to alcohol brands. Consumers with social networks that include drinkers of nonbeverage alcohol and producers of homemade alcohol were highly likely to consume counterfeit alcohol deliberately. Problem drinking was significantly associated with a higher risk of both deceptive and nondeceptive purchases of counterfeit alcohol. Poverty largely contributed to nondeceptive counterfeiting. The literature has overestimated the impact of low prices on counterfeit alcohol consumption. Problem drinking and membership in social networks of consumers

Video-Based Grocery Shopping Intervention Effect on Purchasing Behaviors Among Latina Shoppers.

PubMed

Amaro, Hortensia; Cortés, Dharma E; Garcia, Samantha; Duan, Lei; Black, David S

2017-05-01

To compare changes in food-purchasing knowledge, self-efficacy, and behavior after viewing nutrition education videos among Los Angeles, California Latinas responsible for household grocery shopping. From February to May 2015, a convenience sample of 113 Latinas watched 1 video (El Carrito Saludable) featuring MyPlate guidelines applied to grocery shopping (1-video intervention) and another convenience sample of 105 Latinas watched 2 videos (El Carrito Saludable and Ser Consciente), the latter featuring mindfulness to support attention and overcome distractions while grocery shopping (2-video intervention). We administered questionnaires before and after intervention. A preselected sample in each intervention condition (n = 72) completed questionnaires at 2-months after intervention and provided grocery receipts (before and 2-months after intervention). Knowledge improved in both intervention groups (P < .001). The 2-video group improved more in self-efficacy and use of a shopping list (both P < .05) and purchased more healthy foods (d = 0.60; P < .05) at 2 months than did the 1-video group. Culturally tailored videos that model food-purchasing behavior and mindfulness show promise for improving the quality of foods that Latinas bring into the home.

Video-Based Grocery Shopping Intervention Effect on Purchasing Behaviors Among Latina Shoppers

PubMed Central

Cortés, Dharma E.; Garcia, Samantha; Duan, Lei; Black, David S.

2017-01-01

Objectives. To compare changes in food-purchasing knowledge, self-efficacy, and behavior after viewing nutrition education videos among Los Angeles, California Latinas responsible for household grocery shopping. Methods. From February to May 2015, a convenience sample of 113 Latinas watched 1 video (El Carrito Saludable) featuring MyPlate guidelines applied to grocery shopping (1-video intervention) and another convenience sample of 105 Latinas watched 2 videos (El Carrito Saludable and Ser Consciente), the latter featuring mindfulness to support attention and overcome distractions while grocery shopping (2-video intervention). We administered questionnaires before and after intervention. A preselected sample in each intervention condition (n = 72) completed questionnaires at 2-months after intervention and provided grocery receipts (before and 2-months after intervention). Results. Knowledge improved in both intervention groups (P < .001). The 2-video group improved more in self-efficacy and use of a shopping list (both P < .05) and purchased more healthy foods (d = 0.60; P < .05) at 2 months than did the 1-video group. Conclusions. Culturally tailored videos that model food-purchasing behavior and mindfulness show promise for improving the quality of foods that Latinas bring into the home. PMID:28323473

Secondary analysis of a marketing research database reveals patterns in dairy product purchases over time.

PubMed

Van Wave, Timothy W; Decker, Michael

2003-04-01

Development of a method using marketing research data to assess food purchase behavior and consequent nutrient availability for purposes of nutrition surveillance, evaluation of intervention effects, and epidemiologic studies of diet-health relationships. Data collected on household food purchases accrued over a 13-week period were selected by using Universal Product Code numbers and household characteristics from a marketing research database. Universal Product Code numbers for 39,408 dairy product purchases were linked to a standard reference for food composition to estimate the nutrient content of foods purchased over time. Two thousand one hundred sixty-one households located in Victoria, Texas, and surrounding communities who were active members of a frequent shopper program. Demographic characteristics of sample households and the nutrient content of their dairy product purchases were analyzed using frequency distribution, cross tabulation, analysis of variance, and t test procedures. A method for using marketing research data was successfully used to estimate household purchases of specific foods and their nutrient content from a marketing database containing hundreds of thousands of records. Distribution of dairy product purchases and their concomitant nutrients between Hispanic and non-Hispanic households were significant (P<.01, P<.001, respectively) and sustained over time. Purchase records from large, nationally representative panels of shoppers, such as those maintained by major market research companies, might be used to accomplish detailed longitudinal epidemiologic studies or surveillance of national food- and nutrient-purchasing patterns within and between countries and segments of their respective populations.

Influences of packaging attributes on consumer purchase decisions for fresh produce.

PubMed

Koutsimanis, Georgios; Getter, Kristin; Behe, Bridget; Harte, Janice; Almenar, Eva

2012-10-01

Packaging attributes are considered to have an influence on consumer purchase decisions for food and, as a consequence, also on its consumption. To improve the current minimal understanding of these influences for fresh produce, a survey instrument in the form of an online questionnaire has been developed and launched in the US. The first part of the questionnaire covers consumers' preferences for packaging convenience features, characteristics, materials, disposal method, and others for fresh produces in general, and the second focuses on attributes like price, container size, produce shelf life for a specific fresh produce, sweet cherries, to allow us to supply specific values for these factors to the participants. Cluster and conjoint analyses of responses from 292 participants reveal that specific packaging and produce attributes affect consumer purchase decisions of fresh produce in general and of sweet cherries in particular (P ≤ 0.05) and that some are population segment dependent (P ≤ 0.05). For produce packaging in general, 'extend the "best by" date' was ranked as the top convenience feature, the type of packaging material was considered to affect the food product quality (92.7%) and containers made from bio-based materials were highly appealing (3.52 out of 5.00). The most important attributes that affect the purchasing decisions of consumers regarding a specific fresh produce like sweet cherries are price (25%), shelf life (19%) and container size (17.2%). Copyright © 2012 Elsevier Ltd. All rights reserved.

Purchasing in a supply chain environment.

PubMed

Schorr, J E

2000-08-01

Why the interest in purchasing? In the typical company, material costs are 40% to 75% of the cost of goods sold, labor is 5% to 15%, and the balance is burden. The typical company has $4-$5 in purchased cost to $1 in labor. Most companies are implementing material requirements planning (MRP II) and enterprise resource planning systems to control the $1 in labor and have little expectation in the area of purchasing savings. Yet a dollar saved in purchasing goes directly to the bottom line. I ran a survey of 100 Class A users of MRP II; in all 100 of the companies, the biggest payback was in the area of purchasing.

48 CFR 813.202 - Purchase guidelines.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Purchase guidelines. 813.202 Section 813.202 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS CONTRACTING... Threshold 813.202 Purchase guidelines. Open market micro-purchases shall be equitably distributed among all...

Emerging Lessons From Regional and State Innovation in Value-Based Payment Reform: Balancing Collaboration and Disruptive Innovation

PubMed Central

Conrad, Douglas A; Grembowski, David; Hernandez, Susan E; Lau, Bernard; Marcus-Smith, Miriam

2014-01-01

structure for galvanizing payment reform. But to achieve the objectives of reduced cost and improved quality, multistakeholder payment innovation must overcome such barriers as incompatible information systems, the technical difficulties and transaction costs of altering existing billing and payment systems, competing stakeholder priorities, insufficient scale to bear population health risk, providers’ limited experience with risk-bearing payment models, and the failure to align care delivery models with the form of payment. Conclusions From the evidence adduced in this article, multistakeholder, value-based payment reform requires a trusted, widely respected “honest broker” that can convene and maintain the ongoing commitment of health plans, providers, and purchasers. Change management is complex and challenging, and coalition governance requires flexibility and stable leadership, as market conditions and stakeholder engagement and priorities shift over time. Another significant facilitator of value-based payment reform is outside investment that enables increased investment in human resources, information infrastructure, and care management by provider organizations and their collaborators. Supportive community and social service networks that enhance population health management also are important enablers of value-based payment reform. External pressure from public and private payers is fueling a “burning bridge” between the past of fee-for-service payment models and the future of payments based on value. Robust competition in local health plan and provider markets, coupled with an appropriate mix of multistakeholder governance, pressure from organized purchasers, and regulatory oversight, has the potential to spur value-based payment innovation that combines elements of “reformed” fee-for-service with bundled payments and global payments. PMID:25199900

ATTITUDES OF ORTHOPEDIC SPECIALISTS TOWARD EFFECTS OF MEDICAL DEVICE PURCHASING.

PubMed

Lingg, Myriam; Merida-Herrera, Everth; Wyss, Kaspar; Durán-Arenas, Luis

2017-01-01

The aim of this study was to assess viewpoints of end-users concerning the purchasing process of high-risk medical devices and to discuss the relevance of health technology assessments (HTAs) at the hospital level and other potential areas for improvement of purchasing processes. We used a cross-sectional study and assessed the attitudes and thoughts of orthopedic specialists. The study took place between June and October 2015 in Mexico. We collected data from 187 orthopedic surgeons. Involvement of orthopedic specialists in purchasing was reported by 86 percent. However, clinical practice was perceived as negatively influenced by purchasing outcomes by 92 percent. The problems were described as: material failure; effectiveness of medical devices; obsolete medical device technology; incomplete provision of implant / instrument sets; delayed provision of implants and instruments. To prevent sub-standard outcomes of purchasing decisions, this study and the current literature suggest that technologies should be assessed during the purchasing process, end-users should be adequately involved, and decisions should be based on multiple criteria including clinical impact in the short-term (e.g., primary stability of implant) and long-term (e.g., survival of implant). The focus on Mexico is particularly novel and provides insights into a health system where HTA is mainly present at the macro level and can be used for the listing of medical device technologies in the standard list. This study concludes that Mexican stakeholders of the purchasing process underestimate the contribution of HTAs at the level of purchasing decisions. HTA in Mexico has improved over the past years but still requires more advancement.

Occupational health purchasing behaviour by SMEs--a new theoretical model.

PubMed

Harrison, J; Woods, A; Dickson, K

2013-10-01

Factors influencing corporate decisions to purchase occupational health (OH) are unknown. To assist the marketing of OH services to small- and medium-sized enterprises (SMEs) by characterizing purchasing behaviour. We developed a 2×2 model, based on published studies, to describe OH purchasing behaviour by SMEs. We tested the model by analysis of responses to a cross-sectional market research survey carried out in November 2007. The companies surveyed were SMEs employing 30-250 employees, within the localities of five UK National Health Service OH services: West London, Buckinghamshire, Cambridge, Portsmouth and York. We chose a sample representative of all SMEs for each location. The survey explored knowledge of OH and the perceived importance of a variety of services. We obtained responses from 387 companies (19%); 81% indicated that they knew about OH and 24% had purchased OH services. OH was rated 'very important' by 35%, and 65% rated it as 'quite' or 'very important'. Sickness absence and its business impact were monitored by 89%. Enterprises claiming OH understanding were significantly more likely to purchase OH services (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.6-8.0). Companies employing fewer than 90 employees were significantly less likely to purchase such services than larger ones (OR 0.17, 95% CI 0.09-0.3). OH knowledge and company size are key determinants of SME purchasing behaviour. Our findings support our proposed theoretical model. However, more research could explore claimed knowledge of OH with respect to the proposed purchaser types and business benefits.

The impact of embarrassment on condom purchase behaviour.

PubMed

Dahl, D W; Gorn, G J; Weinberg, C B

1998-01-01

A survey on the impact of embarrassment on condom purchase behavior was conducted among 130 individuals. The survey sample (93 males, 37 females) were recruited at the University of British Columbia. The primary independent variable of interest was the embarrassment of the respondents when purchasing condoms. The background variables were also considered which included the assessments of sexual behavior, gender, age, and residency status. A 4-point scale was used to measure the intensity of embarrassment and a 5-category scale was used to determine the frequency of condom purchase. The results for purchase embarrassment indicate that 41% of females and 34% of males expressed no embarrassment when making a condom purchase. Gender, age, number of sexual partners in the past year, and residency status were not significantly correlated with purchase embarrassment. 62% of males vs. 40% of females purchased at least once every 6 months. In summary, young people feel embarrassed about purchasing condoms, thus affecting their purchase behavior. The people who reported being more embarrassed purchasing condoms did so less often and purchased fewer condoms per visit. Subjects also tended to purchase from vending machines when possible in lieu of from store clerks or pharmacists.

48 CFR 8.603 - Purchase priorities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Purchase priorities. 8.603... REQUIRED SOURCES OF SUPPLIES AND SERVICES Acquisition From Federal Prison Industries, Inc. 8.603 Purchase... shall purchase supplies and services in the following priorities: (a) Supplies. (1) Federal Prison...

48 CFR 8.706 - Purchase exceptions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Purchase exceptions. 8.706... Blind or Severely Disabled 8.706 Purchase exceptions. (a) Ordering offices may acquire supplies or... in a purchase exception granted by the designated central nonprofit agency. (b) The central nonprofit...

48 CFR 808.603 - Purchase priorities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Purchase priorities. 808... Industries, Inc. (FPI) 808.603 Purchase priorities. Contracting officers may purchase supplies and services... small businesses, in accordance with procedures set forth in subpart 819.70, without seeking a waiver...

41 CFR 51-5.4 - Purchase exceptions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Purchase exceptions. 51-5... Contracts COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED 5-CONTRACTING REQUIREMENTS § 51-5.4 Purchase exceptions. (a) A central nonprofit agency will normally grant a purchase exception...

48 CFR 2913.301 - Governmentwide commercial purchase card.

Code of Federal Regulations, 2010 CFR

2010-10-01

... purchase card. 2913.301 Section 2913.301 Federal Acquisition Regulations System DEPARTMENT OF LABOR... commercial purchase card. (a) The Government purchase card has far fewer requirements for documentation than other methods of purchasing. However, the same legal restrictions apply to credit card purchases that...

Effects of a 2014 Statewide Policy Change on Cash-Value Voucher Redemptions for Fruits/Vegetables Among Participants in the Supplemental Nutrition Program for Women, Infants, and Children (WIC).

PubMed

Okeke, Janice O; Ekanayake, Ruwani M; Santorelli, Melissa L

2017-10-01

Purpose In 2014, the New Jersey Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) began requiring WIC-authorized stores to stock at least two fresh fruits and two fresh vegetables. We aimed to evaluate the effect of this policy change on fruit and vegetable purchases among WIC-participating households and to assess variation by household access to a healthy food store such as a supermarket or large grocery store. Description Households with continuous WIC enrollment from June 2013 to May 2015 were included (n = 16,415). Participants receive monthly cash-value vouchers (CVVs) to purchase fruits and vegetables. For each household, the CVV redemption proportion was calculated for the period before and after the policy by dividing the total dollar amount redeemed by the total dollar amount issued. Complete redemption was defined as a proportion ≥90% and the change in complete redemption odds was assessed after adjusting for Supplemental Nutrition Assistance Program participation. Assessment We observed a small increase following the policy change [odds ratio (OR) 1.10, 95% confidence interval (CI) 1.04-1.17]; however, the effect varied by healthy food access (p = 0.03). The odds increased for households with access to at least one healthy food store (OR 1.13, 95% CI 1.06-1.20) while no effect was observed for households without such access (OR 0.91, 95% CI 0.76-1.10). Conclusion Policy change was associated with a small increase in purchasing, but only among households with healthy food access. The state is addressing this gap through technical assistance interventions targeting WIC-authorized small stores in communities with limited access.

7 CFR 1780.62 - Utility purchase contracts.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Utility purchase contracts. 1780.62 Section 1780.62..., Constructing and Inspections § 1780.62 Utility purchase contracts. Applicants proposing to purchase water or... may be requested. Form RD 442-30, “Water Purchase Contract,” may be used when appropriate. If the...

48 CFR 217.7003 - Purchase request.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Purchase request. 217.7003... Property 217.7003 Purchase request. Ensure that the requiring activity provides all of the following in support of the purchase request— (a) A certification that the property is eligible for exchange and...

48 CFR 408.706 - Purchase exemptions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Purchase exemptions. 408... People Who Are Blind or Severely Disabled 408.706 Purchase exemptions. Prior to applying to the Committee for a purchase exemption, the chief of the contracting office should provide advance notice to the...

48 CFR 13.202 - Purchase guidelines.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Purchase guidelines. 13.202 Section 13.202 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES SIMPLIFIED ACQUISITION PROCEDURES Actions at or Below the Micro-Purchase Threshold 13.202 Purchase guidelines. (a)...

Expected value analysis for integrated supplier selection and inventory control of multi-product inventory system with fuzzy cost

NASA Astrophysics Data System (ADS)

Sutrisno, Widowati, Tjahjana, R. Heru

2017-12-01

The future cost in many industrial problem is obviously uncertain. Then a mathematical analysis for a problem with uncertain cost is needed. In this article, we deals with the fuzzy expected value analysis to solve an integrated supplier selection and supplier selection problem with uncertain cost where the costs uncertainty is approached by a fuzzy variable. We formulate the mathematical model of the problems fuzzy expected value based quadratic optimization with total cost objective function and solve it by using expected value based fuzzy programming. From the numerical examples result performed by the authors, the supplier selection problem was solved i.e. the optimal supplier was selected for each time period where the optimal product volume of all product that should be purchased from each supplier for each time period was determined and the product stock level was controlled as decided by the authors i.e. it was followed the given reference level.

Institute on Human Values in Medicine. Human Values Teaching Programs for Health Professionals.

ERIC Educational Resources Information Center

Society for Health and Human Values, Philadelphia, PA.

This document contains descriptions of 19 teaching programs which share the common goal of emphasizing human values as an important area of education in the health professions. This listing is the result and expansion of the Institute on Health and Human Values Conference. Three broad areas are outlined which the 19 schools emphasize in their…

Value-based assessment of robotic pancreas and liver surgery

PubMed Central

Patti, James C.; Ore, Ana Sofia; Barrows, Courtney; Velanovich, Vic

2017-01-01

Current healthcare economic evaluations are based only on the perspective of a single stakeholder to the healthcare delivery process. A true value-based decision incorporates all of the outcomes that could be impacted by a single episode of surgical care. We define the value proposition for robotic surgery using a stakeholder model incorporating the interests of all groups participating in the provision of healthcare services: patients, surgeons, hospitals and payers. One of the developing and expanding fields that could benefit the most from a complete value-based analysis is robotic hepatopancreaticobiliary (HPB) surgery. While initial robot purchasing costs are high, the benefits over laparoscopic surgery are considerable. Performing a literature search we found a total of 18 economic evaluations for robotic HPB surgery. We found a lack of evaluations that were carried out from a perspective that incorporates all of the impacts of a single episode of surgical care and that included a comprehensive hospital cost assessment. For distal pancreatectomies, the two most thorough examinations came to conflicting results regarding total cost savings compared to laparoscopic approaches. The most thorough pancreaticoduodenectomy evaluation found non-significant savings for total hospital costs. Robotic hepatectomies showed no cost savings over laparoscopic and only modest savings over open techniques. Lastly, robotic cholecystectomies were found to be more expensive than the gold-standard laparoscopic approach. Existing cost accounting data associated with robotic HPB surgery is incomplete and unlikely to reflect the state of this field in the future. Current data combines the learning curves for new surgical procedures being undertaken by HPB surgeons with costs derived from a market dominated by a single supplier of robotic instruments. As a result, the value proposition for stakeholders in this process cannot be defined. In order to solve this problem, future studies

Value-based assessment of robotic pancreas and liver surgery.

PubMed

Patti, James C; Ore, Ana Sofia; Barrows, Courtney; Velanovich, Vic; Moser, A James

2017-08-01

Current healthcare economic evaluations are based only on the perspective of a single stakeholder to the healthcare delivery process. A true value-based decision incorporates all of the outcomes that could be impacted by a single episode of surgical care. We define the value proposition for robotic surgery using a stakeholder model incorporating the interests of all groups participating in the provision of healthcare services: patients, surgeons, hospitals and payers. One of the developing and expanding fields that could benefit the most from a complete value-based analysis is robotic hepatopancreaticobiliary (HPB) surgery. While initial robot purchasing costs are high, the benefits over laparoscopic surgery are considerable. Performing a literature search we found a total of 18 economic evaluations for robotic HPB surgery. We found a lack of evaluations that were carried out from a perspective that incorporates all of the impacts of a single episode of surgical care and that included a comprehensive hospital cost assessment. For distal pancreatectomies, the two most thorough examinations came to conflicting results regarding total cost savings compared to laparoscopic approaches. The most thorough pancreaticoduodenectomy evaluation found non-significant savings for total hospital costs. Robotic hepatectomies showed no cost savings over laparoscopic and only modest savings over open techniques. Lastly, robotic cholecystectomies were found to be more expensive than the gold-standard laparoscopic approach. Existing cost accounting data associated with robotic HPB surgery is incomplete and unlikely to reflect the state of this field in the future. Current data combines the learning curves for new surgical procedures being undertaken by HPB surgeons with costs derived from a market dominated by a single supplier of robotic instruments. As a result, the value proposition for stakeholders in this process cannot be defined. In order to solve this problem, future studies

Children's purchase behavior in the snack market: Can branding or lower prices motivate healthier choices?

PubMed

Hartmann, Monika; Cash, Sean B; Yeh, Ching-Hua; Landwehr, Stefanie C; McAlister, Anna R

2017-10-01

Children's dietary-related diseases and their associated costs have expanded dramatically in many countries, making children's food choice a policy issue of increasing relevance. As children spend a considerable amount of money on energy-dense, nutrient-poor (EDNP) products, a better understanding of the main drivers of children's independent food purchase decisions is crucial to move this behavior toward healthier options. The objective of the study is to investigate the role of branding and price in motivating children to choose healthier snack options. The study investigates snack choices of children ages 8 to 11, using a survey and a purchase experiment. The research took place in after-school programs of selected schools in the Boston area. Participants included 116 children. Products in the choice experiment differed on three factors: product type, brand, and price. Data were analyzed using aggregated and mixed logit models. Children's purchase decisions are primarily determined by product type (Importance Value (IV) 56.6%), while brand (IV 22.8%) and price (IV 20.6%) prove to be of less relevance. Only those children who state that they like the familiar brand reveal a preference for the branded product in their purchase decision. Price is a significant predictor of choice when controlling for whether or not children obtain an allowance. It is not simple brand awareness but a child's liking of the brand that determines whether a brand is successful in motivating a child to choose a product. The extent of children's experience with money influences their price responsiveness. To the extent that children who receive an allowance are primarily the ones buying food snacks, higher prices for EDNP snacks could be successful in motivating children to choose a healthier option. Copyright © 2017 Elsevier Ltd. All rights reserved.

76 FR 10089 - Value-Added Producer Grant Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-23

..., business plans, and marketing strategies. The program will also provide working capital for expenses such as implementing an existing viable marketing strategy. The Agency will implement the program to meet... projects that develop mid-tier value marketing chains. DATES: This interim rule is effective March 25, 2011...

7 CFR 17.3 - Purchase authorizations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 1 2010-01-01 2010-01-01 false Purchase authorizations. 17.3 Section 17.3 Agriculture... THE AGRICULTURAL TRADE DEVELOPMENT AND ASSISTANCE ACT OF 1954, AS AMENDED § 17.3 Purchase authorizations. (a) Issuance. After an agreement is signed, the GSM will issue a purchase authorization to the...

48 CFR 8.704 - Purchase priorities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Purchase priorities. 8.704... Blind or Severely Disabled 8.704 Purchase priorities. (a) The Javits-Wagner-O'Day Act requires the Government to purchase supplies or services on the Procurement List, at prices established by the Committee...

Fruit and vegetable consumption and food values: National patterns in the United States by Supplemental Nutrition Assistance Program eligibility and cooking frequency

PubMed Central

Wolfson, Julia A.; Bleich, Sara N.

2015-01-01

Background More frequent cooking at home may help improve diet quality and be associated with food values, particularly for individuals participating in the Supplemental Nutrition Assistance Program (SNAP). Objective To examine patterns of fruit and vegetable consumption and food values among adults (aged 20 and older) in the United States, by SNAP participation and household cooking frequency. Methods Analysis of cross-sectional 24-hour dietary recall data obtained from the National Health and Nutrition Examination Survey 2007-2010 (N=9,560). Results A lower percentage of SNAP participants consumed fruit (total: 35% vs. 46%, p=0.001; fresh: 30% vs. 41%, p<0.001) and vegetables (total: 49% vs. 58%, p=0.004; fresh: 35% vs. 47%, p<0.001) than those ineligible for SNAP. Among SNAP participants, cooking > 6 times/week was associated with greater vegetable consumption compared to cooking < 2 times/week (175 grams vs. 98 grams, p=0.003). SNAP-eligible individuals who cooked ≥ 2 times/week were more to report price (medium cookers: 47% vs. 33%, p=0.001; high cookers: 52% vs. 40%, p<0.001), ease of preparation (medium cookers: 36% vs. 28%, p=0.002; high cookers: 36% vs. 24%, p<0.001) and how long food keeps (medium cookers: 57% vs. 45%, p<0.001; high cookers: 61% vs. 50%, p<0.001) as important compared to SNAP-ineligible individuals. Conclusions Fruit and vegetable consumption in the United States is low regardless of cooking frequency. Efforts to improve diet quality should consider values on which food purchases are based. PMID:25847732

Fruit and vegetable consumption and food values: National patterns in the United States by Supplemental Nutrition Assistance Program eligibility and cooking frequency.

PubMed

Wolfson, Julia A; Bleich, Sara N

2015-07-01

More frequent cooking at home may help improve diet quality and be associated with food values, particularly for individuals participating in the Supplemental Nutrition Assistance Program (SNAP). To examine patterns of fruit and vegetable consumption and food values among adults (aged 20 and older) in the United States, by SNAP participation and household cooking frequency. Analysis of cross-sectional 24-hour dietary recall data obtained from the National Health and Nutrition Examination Survey 2007-2010 (N=9560). A lower percentage of SNAP participants consumed fruit (total: 35% vs. 46%, p=0.001; fresh: 30% vs. 41%, p<0.001) and vegetables (total: 49% vs. 58%, p=0.004; fresh: 35% vs. 47%, p<0.001) than those ineligible for SNAP. Among SNAP participants, cooking >6times/week was associated with greater vegetable consumption compared to cooking <2times/week (175g vs. 98g, p=0.003). SNAP-eligible individuals who cooked ≥2times/week were more to report price (medium cookers: 47% vs. 33%, p=0.001; high cookers: 52% vs. 40%, p<0.001), ease of preparation (medium cookers: 36% vs. 28%, p=0.002; high cookers: 36% vs. 24%, p<0.001) and how long food keeps (medium cookers: 57% vs. 45%, p<0.001; high cookers: 61% vs. 50%, p<0.001) as important compared to SNAP-ineligible individuals. Fruit and vegetable consumption in the United States is low regardless of cooking frequency. Efforts to improve diet quality should consider values on which food purchases are based. Copyright © 2015 Elsevier Inc. All rights reserved.

NASA Scientific Data Purchase Project: From Collection to User

NASA Technical Reports Server (NTRS)

Nicholson, Lamar; Policelli, Fritz; Fletcher, Rose

2002-01-01

NASA's Scientific Data Purchase (SDP) project is currently a $70 million operation managed by the Earth Science Applications Directorate at Stennis Space Center. The SDP project was developed in 1997 to purchase scientific data from commercial sources for distribution to NASA Earth science researchers. Our current data holdings include 8TB of remote sensing imagery consisting of 18 products from 4 companies. Our anticipated data volume is 60 TB by 2004, and we will be receiving new data products from several additional companies. Our current system capacity is 24 TB, expandable to 89 TB. Operations include tasking of new data collections, archive ordering, shipment verification, data validation, distribution, metrics, finances, customer feedback, and technical support. The program has been included in the Stennis Space Center Commercial Remote Sensing ISO 9001 registration since its inception. Our operational system includes automatic quality control checks on data received (with MatLab analysis); internally developed, custom Web-based interfaces that tie into commercial-off-the-shelf software; and an integrated relational database that links and tracks all data through operations. We've distributed nearly 1500 datasets, and almost 18,000 data files have been downloaded from our public web site; on a 10-point scale, our customer satisfaction index is 8.32 at a 23% response level. More information about the SDP is available on our Web site.

Country and regional variations in purchase prices for essential cancer medications.

PubMed

Cuomo, Raphael E; Seidman, Robert L; Mackey, Tim K

2017-08-24

Accessibility to essential cancer medications in low- and middle-income countries is threatened by insufficient availability and affordability. The objective of this study is to characterize variation in transactional prices for essential cancer medications across geographies, medication type, and time. Drug purchase prices for 19 national and international buyers (representing 29 total countries) between 2010 and 2014 were obtained from Management Sciences for Health. Median values for drug pricing were computed, to address outliers in the data. For comparing purchase prices across geographic units, medications, and over time; Mann-Whitney U tests were used to compare two groups, Kruskal Wallis H tests were used to compare more than two groups, and linear regression was used to compare across continuous independent variables. During the five-year data period examined, the median price paid for a package of essential cancer medication was $12.63. No significant differences in prices were found based on country-level wealth, country-level disease burden, drug formulation, or year when medication was purchased. Statistical tests found significant differences in prices paid across countries, regions, individual medications, and medication categories. Specifically, countries in the Africa region appeared to pay more for a package of essential cancer medication than countries in the Latin America region, and cancer medications tended to be more expensive than anti-infective medications and cardiovascular medications. Though preliminary, our study found evidence of variation in prices paid by health systems to acquire essential cancer medications. Primarily, variations in pricing based on geographic location and cancer medication type (including when comparing to essential medicines that treat cardiovascular and infectious diseases) indicate that these factors may impact availability, affordability and access to essential cancer drugs. These factors should be taken into

Online Sellers’ Website Quality Influencing Online Buyers’ Purchase Intention

NASA Astrophysics Data System (ADS)

Shea Lee, Tan; Ariff, Mohd Shoki Md; Zakuan, Norhayati; Sulaiman, Zuraidah; Zameri Mat Saman, Muhamad

2016-05-01

The increase adoption of Internet among young users in Malaysia provides high prospect for online seller. Young users aged between 18 and 25 years old are important to online sellers because they are actively involved in online purchasing and this group of online buyers is expected to dominate future online market. Therefore, examining online sellers’ website quality and online buyers’ purchase intention is crucial. Based on the Theory of planned behavior (TPB), a conceptual model of online sellers’ website quality and purchase intention of online buyers was developed. E-tailQ instrument was adapted in this study which composed of website design, reliability/fulfillment, security, privacy & trust, and customer service. Using online questionnaire and convenience sampling procedure, primary data were obtained from 240 online buyers aged between 18 to 25 years old. It was discovered that website design, website reliability/fulfillment, website security, privacy & trust, and website customer service positively and significantly influence intention of online buyers to continuously purchase via online channels. This study concludes that online sellers’ website quality is important in predicting online buyers’ purchase intention. Recommendation and implication of this study were discussed focusing on how online sellers should improve their website quality to stay competitive in online business.

Sex purchasing and associations with HIV/STI among a clinic-based sample of US men.

PubMed

Decker, Michele R; Raj, Anita; Gupta, Jhumka; Silverman, Jay G

2008-07-01

Despite high rates of human immunodeficiency virus/sexually transmitted infection (HIV/STI) among commercial sex workers and international concern that male clients may constitute a critical bridge population for HIV/STI transmission, little empirical data exist within the United States to characterize men who purchase sex or to assess their sexual risk and HIV/STI infection. The study involves the analysis of a community-based survey of men aged 18-35 years attending urban health centers (n=1515) to assess the prevalence of engagement in sex purchasing during the past year and to evaluate relations with self-reported HIV/STI diagnosis and symptoms across this same period. More than 1 in 12 (8.7%) men reported exchanging drugs, money, or a place to stay for sex with a female partner in the past year. Such behavior was associated with additional sexual risk taking and emerged as an independent predictor of self-reported HIV/STI diagnosis [adjusted odds ratio (ORadj)=2.99; 95% confidence interval (CI): 1.51 to 5.94] and STI symptoms (ORadj=2.57; 95% CI: 1.57 to 4.22) in the past year in analyses adjusted for alternate HIV/STI risk sources. Sex purchasing is a common form of HIV/STI risk among the population sampled. Men engaging in such behavior are more likely to be HIV/STI infected and, thus, represent a risk to the sexual health of both commercial and noncommercial sex partners. Further research is needed to inform interventions targeted toward male clients of prostituted women.

The Supplemental Nutrition Assistance Program

PubMed Central

Pomeranz, Jennifer L.; Chriqui, Jamie F.

2015-01-01

Under the current version of the Supplemental Nutrition Assistance Program (SNAP), participants can purchase virtually any food or beverage (collectively, food). Research indicates that SNAP recipients may have worse dietary quality than income-eligible nonparticipants. Policymakers have urged the U.S. Department of Agriculture (USDA) to pilot SNAP purchasing restrictions intended to support a healthier diet, and state legislators have proposed similar bills. The USDA rejected these invitations, stating that it would be administratively and logistically difficult to differentiate among products, amid other concerns. However, the USDA’s Dietary Guidelines for Americans and the Supplemental Nutrition Program for Women, Infants, and Children (WIC) do just that. Further, state governments define and differentiate among foods and beverages for tax purposes. This paper reviews several factors intended to inform future policy decisions: the science indicating that SNAP recipients have poorer diet quality than income-eligible nonparticipants; the public’s support for revising the SNAP program; federal, state, and city legislators’ formal proposals to amend SNAP based on nutrition criteria and the USDA’s public position in opposition to these proposals; state bills to amend eligible foods purchasable with SNAP benefits; state retail food tax laws; and the retail administration and program requirements for both WIC and SNAP. The paper finds that the government has a clear ability to align SNAP benefits with nutrition science and operationalize this into law. PMID:26091926

A conceptual schema for government purchasing arrangements for Australian alcohol and other drug treatment.

PubMed

Ritter, Alison; Hull, Philip; Berends, Lynda; Chalmers, Jenny; Lancaster, Kari

2016-09-01

The aim of this study was to establish a conceptual schema for government purchasing of alcohol and other drug treatment in Australia which could encompass the diversity and variety in purchasing arrangements, and facilitate better decision-maker by purchasers. There is a limited evidence base on purchasing arrangements in alcohol and drug treatment despite the clear impact of purchasing arrangements on both treatment processes and treatment outcomes. The relevant health and social welfare literature on purchasing arrangements was reviewed; data were collected from Australian purchasers and providers of treatment giving detailed descriptions of the array of purchasing arrangements. Combined analysis of the literature and the Australian purchasing data resulted in a draft schema which was then reviewed by an expert committee and subsequently finalised. The conceptual schema presented here was purpose-built for alcohol and other drug treatment, with its overlap between health and social welfare services. It has three dimensions: 1. The ways in which providers are chosen; 2. The ways in which services are paid for; and 3. How price is managed. Distinguishing between the methods for choosing providers (such as competitive or individually negotiated processes) from the way in which organisations are paid for their provision of treatment (such as via a block grant or payment for activity) provides conceptual clarity and enables closer analysis of each mechanism. Governments can improve health and wellbeing by making informed decisions about the way they purchase and fund alcohol and other drug treatment. Research comparing different purchasing arrangements can provide a vital evidence-base to inform funders; however a first step is to accurately and consistently categorise current approaches against a typology or conceptual schema. Copyright © 2016 Elsevier Ltd. All rights reserved.

39 CFR 601.104 - Postal purchasing authority.

Code of Federal Regulations, 2011 CFR

2011-07-01

...: INTELLECTUAL PROPERTY RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.104 Postal purchasing..., or terminating any contract regarding the acquisition of property, services, and related purchasing...

36 CFR 14.55 - Consultation with local bureau officials, program values.

Code of Federal Regulations, 2011 CFR

2011-07-01

... System) § 14.55 Consultation with local bureau officials, program values. An applicant will be expected... right-of-way purposes is consistent with the Service's management program and to agree to such measures as may be necessary to maintain program values. Failure to do so may lead to an unresolvable conflict...

36 CFR 14.55 - Consultation with local bureau officials, program values.