Reimbursement policy in a healthcare system with priorities: fee for priority versus bundled priority

2020 ◽  
Author(s):  
Zhongbin Wang ◽  
Jinting Wang
Keyword(s):  
Healthcare Provider ◽  
Healthcare System ◽  
Stackelberg Game ◽  
Minimum Cost ◽  
Equilibrium Strategy ◽  
Reimbursement Policy ◽  
Total Cost ◽  
Cooperative Interactions ◽  
Lump Sum ◽  
Waiting Cost

Abstract This paper studies a healthcare system under two priority charging schemes. The first is a fee-for-priority (FFP) scheme under which the patients can choose to buy the priorities or not at their admission or readmission to the healthcare provider (HCP). The second is a bundled priority (BP) scheme under which the HCP receives a lump sum priority payment from patients for the entire episode of priority visits (regardless of the number of readmissions). Under both schemes, a certain proportion of revenue of the HCP (the reimbursement) is used to improve the service quality for patients. A two-stage Stackelberg game is established that captures the non-cooperative interactions between the HCP and patients, where the HCP is the leader who sets a price of priority and patients are the followers who decide whether to buy the priorities or not. We first characterize the Pareto-dominant equilibrium strategy of patients under the FFP and BP schemes, and we find that the total cost (including delay disutility and priority fee) of patients can be reduced if the patient pool is large. Although patients' minimum cost, including waiting cost and priority payment, is obtained under both the FFP and BP schemes, the prices are more flexible under the former than the latter. Finally, we demonstrate that implementing the FFP scheme can induce higher social welfare than the BP scheme.

Choice Matters

2018 ◽  
Author(s):  
Gordon Moore ◽  
John A. Quelch ◽  
Emily Boudreau
Keyword(s):  
Public Policy ◽  
Social Media ◽  
Healthcare Provider ◽  
Healthcare System ◽  
Consumer Choice ◽  
Marketing Management ◽  
Appropriate Use ◽  
System P ◽  
The U.S

Choice Matters: How Healthcare Consumers Make Decisions (and Why Clinicians and Managers Should Care) is a timely and thoughtful exploration of the controversial role of consumers in the U.S. healthcare system. In most markets today, consumers have more options and autonomy than ever before. Empowered consumers easily shop around for products and services that better meet their needs, and they widely share their reviews on social media to inform and influence other consumers. Businesses have responded with better experiences and prices to compete for consumers’ business. Though healthcare has lagged behind other industries in this respect, there is a rising tide of interest in consumer choice and empowerment in healthcare markets. However, most healthcare provider organizations, individual doctors, and health insurers are unprepared to consider patients as consumers. The authors draw upon the fields of medicine, marketing, management, psychology, and public policy as they take a substantive, in-depth look at consumer choice and point out its appropriate use, as well as its limitations. This book addresses perplexing issues, such as how healthcare differs from other consumer-driven markets, how consumers make healthcare decisions, and how increased consumer choice in healthcare can not only aid and empower American consumers but also improve the overall healthcare system.

Cost-Consequence Analysis of Single-Dose Dalbavancin Versus Standard of Care for the Treatment of Acute Bacterial Skin and Skin Structure Infections in a Multisite Healthcare System

2020 ◽  
Author(s):  
Julia Gonzalez ◽  
Diana Carolina Andrade ◽  
JianLi Niu
Keyword(s):  
Healthcare System ◽  
Treatment Success ◽  
Standard Of Care ◽  
Cost Of Care ◽  
Secondary Outcome ◽  
Total Cost ◽  
Skin Structure ◽  
Cost Consequence ◽  
The Difference ◽  
The Cost

Abstract Background Acute bacterial skin and skin structure infections (ABSSSIs) are common infectious diseases that cause a significant economic burden on the healthcare system. This study aimed to compare the cost-effectiveness of dalbavancin vs standard of care (SoC) in the treatment of ABSSSI in a community-based healthcare system. Methods This was a retrospective study of adult patients with ABSSSI treated with dalbavancin or SoC during a 27-month period. Patients were matched based on age and body mass index. The primary outcome was average net cost of care to the healthcare system per patient, calculated as the difference between reimbursement payments and the total cost to provide care to the patient. The secondary outcome was proportion of cases successfully treated, defined as no ABSSSI-related readmission within 30 days after the initiation of treatment. Results Of the 418 matched patients, 209 received SoC and 209 received dalbavancin. The average total cost of care per patient was greater with dalbavancin vs SoC ($4770 vs $2709, P < .0001). The average reimbursement per patient was $3084 with dalbavancin vs $2633 SoC (P = .527). The net cost, calculated as revenue minus total cost, was $1685 with dalbavancin vs $75 with SoC (P = .013). The overall treatment success rate was 74% with dalbavancin vs 85% with SoC (P = .004). Conclusions Dalbavancin was more costly than SoC for the treatment of ABSSSI, with a higher 30-day readmission rate. Dalbavancin does not offer an economic or efficacy advantage.

Optimizing operations in 3‐D land seismic surveys

Geophysics ◽  
2001 ◽  
Vol 66 (6) ◽  
pp. 1818-1826 ◽  
Author(s):  
Douglas J. Morrice ◽  
Astrid S. Kenyon ◽  
Christian J. Beckett
Keyword(s):  
Minimum Cost ◽  
Seismic Survey ◽  
Production Parameter ◽  
Microsoft Excel ◽  
Trade Off ◽  
Seismic Surveys ◽  
Total Cost ◽  
Decision Variables ◽  
Conduct Sensitivity Analysis ◽  
Operational Constraints

We formulate and solve a mathematical programming optimization model to find a minimum cost solution for an orthogonal split‐spread design in a 3‐D land seismic survey. The model contains decision variables on source and receiver location spacings, the amount of receiver equipment, and the production rate of the seismic crews. The model includes operational constraints for source and receiver movements. It also includes geophysical constraints for fold coverage, offset, and azimuth. To demonstrate the efficacy of the model, we include an example and solve it using the nonlinear optimization solver in Microsoft Excel. The model results demonstrate the classic trade‐off between source and receiver points to satisfy the geophysical requirements. In addition, we conduct sensitivity analysis on an important production parameter: the maximum number of source points that can be shot per day. We show that although changes to this parameter do not impact the decision variables, such changes do have a significant effect on the total cost of the survey.

The timeliness of lung cancer care: A systematic review of systematic/scoping reviews on risk factors and interventions.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18575-e18575
Author(s):  
Jianrong Zhang ◽  
Jasmeen Oberoi ◽  
Napin Karnchanachari ◽  
Paige Druce ◽  
Maarten J. IJzerman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Systematic Review ◽  
Healthcare Provider ◽  
Healthcare System ◽  
Waiting Time ◽  
Time Intervals ◽  
Effective Interventions ◽  
Cancer Services ◽  
Scoping Reviews

e18575 Background: Lung cancer is the leading cause of cancer death worldwide, and over half of lung cancer cases are diagnosed with advanced stage, indicating an urgent need to improve the timeliness of lung cancer services. In this systematic review of systematic and scoping reviews, we summarize the current evidence of risk factors and interventions on diagnostic and treatment intervals. Methods: Eligible articles were published systematic or scoping reviews and meta-analyses that used systematic searching to investigate risk factors for longer time intervals or interventions aimed to reduce time intervals in original studies on lung cancer, based on at least one interval involving the date of diagnosis as the start or end point. Articles were searched via PubMed, Embase, Web of Science, and the Cochrane Library; the date range of the search was from database inception to 6 August 2020 (PROSPERO identifier: CRD42020203530). Results: A total of 16 systematic/scoping reviews published in 2002-2020 were included (10 on risk factors and 9 on interventions). According to these reviews, we found that risk factors had intersected impacts on the increase of diagnostic and treatment intervals. However, these factors could be summarized based on tumor, patient, healthcare provider and healthcare system levels as: (tumor level) adenocarcinoma, small size; (patient level) living in a rural area, lower education level, lower-income level, longer travel distance, non-specific symptom, non-white race (in the USA), fear and lack of knowledge about lung cancer; (healthcare provider level) low index of suspicion, multiple consultations for diagnosis, missed diagnosis; (healthcare system level) long waiting time for hospitalization, health system’s incapacity to treat all patients, high cost, inaccessibility or lack of diagnostic tools/investigations, poor organization and management of health services. To reduce time intervals, these reviews indicated that effective interventions include multidisciplinary teams or clinics, lung-specific clinics, nurse navigation or other care coordination program. In these reviews, we found that the types of time intervals used in original studies were poorly reported. Conclusions: Therisk factors identified from the current reviews indicate disparities in timely access to lung cancer services, as well as potential for improvements to reduce waiting time at the patient, healthcare provider and healthcare system levels. To reduce waiting time, effective interventions suggested from the current reviews should be considered for implementation.

Experiences of Transgender People in the Healthcare System: A Complex Analysis

2018 ◽  
Vol 8 (1) ◽  
pp. 56-61
Author(s):  
Kathryn Rotzinger
Keyword(s):  
Healthcare Provider ◽  
Healthcare System ◽  
Role Models ◽  
Complex Analysis ◽  
Healthcare Access ◽  
Holistic Model ◽  
Transgender People ◽  
Healthcare Needs ◽  
Agents Of Change ◽  
Resolution Strategies

A nursing perspective following McIntyre and McDonald’s framework was used to unpack the complex issue of challenges faced by transgender people in the Canadian healthcare system, considering historical, ethical, legal, social, cultural, political, and economic perspectives. Transgender people have unique healthcare needs which are often misunderstood or unaddressed by healthcare professionals, leading to poorer outcomes and inequities. Issues concerning transgender people are becoming a focus and a higher priority for society. This literature review reveals the complexity of this issue as the roots in historical, ethical, legal, social, cultural, political, and economic contexts are explored. A variety of barriers and facilitators exist to addressing and resolving this issue, including transgender people avoiding healthcare, intolerance, lack of knowledge and understanding, lack of healthcare provider training, media representation, and economic costs. The analysis of this issue can be used to inform resolution strategies to utilize facilitators and overcome barriers, including increasing awareness and knowledge, improving education and healthcare provider competency, and utilizing nurse leaders as advocates, role models, and agents of change. Improving care of transgender people is a nursing leadership priority. By implementing the suggested resolution strategies, the healthcare system can begin to move towards a more inclusive, understanding, and holistic model of care to improve healthcare access and outcomes for transgender people.

scholarly journals Economic Dispatch Solution Using Moth-Flame Optimization Algorithm

2018 ◽  
Vol 214 ◽  
pp. 03007 ◽  
Author(s):  
Mohd Herwan Sulaiman ◽  
Zuriani Mustaffa ◽  
Muhammad Ikram Mohd Rashid ◽  
Hamdan Daniyal
Keyword(s):  
Optimization Technique ◽  
Economic Dispatch ◽  
Minimum Cost ◽  
Ramp Rate ◽  
Total Cost ◽  
Prohibited Operating Zones ◽  
Operating Limits ◽  
Moth Flame Optimization Algorithm ◽  
Ramp Rate Limits ◽  
Practical Constraints

This paper proposes an application of a recent nature inspired optimization technique namely Moth-Flame Optimization (MFO) algorithm in solving the Economic Dispatch (ED) problem. In this paper, the practical constraints will be included in determining the minimum cost of power generation such as ramp rate limits, prohibited operating zones and generators operating limits. To show the effectiveness of proposed algorithm, two case systems are used: 6-units and 15-units systems and then the performance of MFO is compared with other techniques from literature. The results show that MFO is able to obtain less total cost than those other algorithms.

scholarly journals Treatment and Cost of Hepatocellular Carcinoma: A Population-Based Cohort Study in Taiwan

2018 ◽  
Vol 15 (12) ◽  
pp. 2655 ◽  
Author(s):  
Seng-Howe Nguang ◽  
Cheng-Kun Wu ◽  
Chih-Ming Liang ◽  
Wei-Chen Tai ◽  
Shih-Cheng Yang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Healthcare System ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Population Based ◽  
Research Database ◽  
Liver Transplants ◽  
Total Cost ◽  
Real World Evidence

Hepatitis B virus vaccination and antiviral therapies reduce the risk of hepatocellular carcinoma (HCC). However, the lifetime healthcare expenditure involved in caring for HCC patients remains unclear. We examined the use and direct costs of healthcare services for a cohort of HCC patients to the healthcare system using Taiwan national health insurance program research database between 1997 and 2012. Total medical cost for all reimbursed patient encounters, including hospitalizations and outpatient care was cumulated from HCC onset to the end of follow-up or death. The mean follow-up time was 2.7 years (standard deviation, SD = 3.3) for the entire HCC cohort. Insurance payments of approximately US$92 million were made to 5522 HCC patients, with a mean cost of US$16,711 per patient (21,350). On average, the total cost per patient per month was US$2143 (5184); it was 50% higher for advanced cirrhosis patients at the baseline but 23% lower for mild-to-moderate cirrhotic patients. In the two-part regression, patients’ underlying comorbid conditions, liver transplants, hepatectomy, and transarterial chemoembolization were associated with increased total cost, with liver transplants having the greatest impact over time. Hepatocellular carcinoma imposes substantial burden on the healthcare system. Real-world evidence on treatment and cost outcomes highlighted the needs to expand effective screening strategies and to optimize healthcare delivery to meet HCC patients’ clinical needs.

scholarly journals The indexation of periodical payments of damages in tort: the future assured?

Legal Studies ◽  
2010 ◽  
Vol 30 (3) ◽  
pp. 391-407
Author(s):  
Richard Lewis
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Personal Injury ◽  
Total Cost ◽  
Lump Sum ◽  
The Future ◽  
Key Factor ◽  
New Form ◽  
Care Costs

This paper examines the new statutory regime for paying damages for personal injury by means of periodical payments instead of a lump sum. How are such payments to increase in future to take account of rising care costs, especially when these usually form the largest part of a major award? The answer to this question is crucial in determining the extent that the new form of payment will be used. How periodical payments are to be indexed is also a key factor in calculating the total cost of compensation and, in particular, in assessing the liabilities of the National Health Service. The issue gave rise to litigation which was voted by personal injury practitioners as the most important of the year. Here, that litigation and the statutory reforms which gave rise to it are set in their wider academic contexts.

Thermoeconomic Optimization of a Combined Heating and Humidification Coil for HVAC Systems

2016 ◽  
Vol 41 (3) ◽  
Author(s):  
Liliana Teodoros ◽  
Bjarne Andresen
Keyword(s):  
Minimum Cost ◽  
Total Cost Of Ownership ◽  
Total Cost ◽  
Air Handling Unit ◽  
Operation Costs ◽  
Cost Of Ownership ◽  
Optimization Function ◽  
Length Width ◽  
The Cost ◽  
The Relationship

AbstractThe total cost of ownership is calculated for a combined heating and humidification coil of an air-handling unit taking into account investment and operation costs simultaneously. This total cost represents the optimization function for which the minimum is sought. The parameters for the cost dependencies are the physical dimensions of the coil: length, width and height. The term “coil” is used generically since in this setup it generates heating as well as humidification in a single unit. The first part of the paper deals with the constructive optimization and finds the relationship between the dimensions for a minimum cost. The second part of the paper takes the results of the constructive optimization further and, based on the data derived in our previous papers, analyzes the minimum total cost for the humidification coil while balancing the amount of water used to humidify the air and modify its temperature.

Influence of controllable lead time, premium price, and unequal shipments under environmental effects in a supply chain management

2019 ◽  
Vol 53 (4) ◽  
pp. 1427-1451 ◽  
Author(s):  
Baishakhi Ganguly ◽  
Biswajit Sarkar ◽  
Mitali Sarkar ◽  
Sarla Pareek ◽  
Muhammad Omair
Keyword(s):  
Supply Chain ◽  
Lead Time ◽  
Carbon Emission ◽  
Stackelberg Game ◽  
Transportation Cost ◽  
Setup Cost ◽  
Total Cost ◽  
Decision Variables ◽  
Premium Price ◽  
Optimum Cost

Recently, carbon emission becomes a major issue during transportation of products from one player to another player. Due to the increasing number of single-setup-multi-delivery (SSMD) policies by several industries, fixed and variable transportation cost and carbon emission cost are considered. The aim of the model is to reduce the total cost of supply chain for controlling the lead time and to diminish setup cost by a discrete investment. A premium cost is introduced and Stackelberg game policy is employed to obtain the analytical solution. Some numerical examples are given to validate the model. Sensitivity analysis and managerial insights are given to show the applicability of the model. Finally, the outcomes show that the model minimizes the optimum cost at the optimal values of the decision variables. It is found that the total cost is minimized when the multi-buyer is leader and vendor is follower.

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