Predictive Modelling of Covid-19 Stimulus Funds Paid for Nursing Home Quality Incentive Program

Painstaking measures should be taken to determine how federal dollars are spent. Proper justification for allocation of funds rooted in logic and fairness leads to trust and transparency. The COVID-19 pandemic has warranted rapid response by government agencies to provide vital aide to those in need. Decisions made should be evaluated in hindsight to see if they indeed achieve their objectives. In this paper, the data collected in the final four months of 2020 to determine funding for nursing home facilities via the Quality Incentive Program will be analysed using data mining techniques. The objective is to determine the relationships among numeric variables and formulae given. The dataset was assembled by the Health Resources and Services Administration. Results are given for the reader’s insight and interpretation. With the data collection and analytical process, new questions come to light. These questions should be pondered for further analysis.

Incentive Mechanism for Product Quality of Retailers Based on Platform-Based ECommerce

In order to explore the autonomous incentive mechanism of platform-based e-commerce to online retailers' products, a product quality incentive model based on deposit and commission management is established for single retailer single quality products, single retailer products at multiple quality levels and double-retailer different quality products in three cases. Comparative analysis of the equilibrium results in three cases reveals that the effectiveness of the incentive mechanism of platform discount in the first case depends on the deposit strategy of the platform and the influence of the unit cost of excellent and low-quality products. In the second case, the incentive mechanism of platform discount is completely effective. The platform price discount has a positive incentive effect on retailers. The online retailers' increasing the sales of high-quality products and reducing the sales of low-quality products improve the high-quality product rate in the market. In the third case, the effectiveness of the platform discount incentive mechanism is mainly affected by the unit cost of products.

CMS ESRD quality incentive program has not improved patient dialysis vascular access

Purpose: Over 468,000 patients in the United States use hemodialysis to manage End Stage Renal Disease (ESRD). The purpose of this study was to determine whether the dialysis access Clinical Performance Measures (CPMs) of Centers for Medicare & Medicaid Services (CMS) ESRD Quality Incentive Program (QIP) have increased arteriovenous fistula (AVF) rates and decreased long-term tunneled hemodialysis catheter (TDC) rates among hemodialysis patients in United States. Methods: Retrospective observational study: evaluated reported AVF and long-term TDC rates of 4804 dialysis facilities which reported dialysis access data as part of the ESRD QIP from Payment Year (PY) 2014–2020. Facilities were also sorted by specific additional criteria to examine disparities in dialysis access. Results: Mean AVF rates of included facilities increased from 63.7% in PY 2014 to 67.2% in PY 2016 ( p < 0.05), did not change in PY 2017 ( p > 0.05), and declined significantly in PY 2018–2020 to 64.1% in PY 2020, near AVF rates at the inception of program. Long-term TDC rates decreased from 10.4% in PY 2014 to 9.88% in PY 2015 ( p < 0.05), then increased in PY 2015–PY 2020 to rates higher than at the inception of program, at 11.8% in PY 2020 ( p < 0.05). Facilities serving majority Black ZIP Code Tabulation Areas (ZCTAs) or ZCTAs with median income <$45,000 achieved significantly lower AVF rates ( p < 0.05) with no significant difference in long-term TDC rates ( p > 0.05). AVF rates correlated positively and long-term TDC rates correlated negatively with star rating of facilities ( p < 0.05). Conclusion: As one of the first financial QIPs in healthcare, the ESRD QIP has not achieved the stated goals of the CMS to increase AVF access rates above 68% and reduce long-term TDC clinical rates below 10%. Systemic disparities in race, geographic region, economic status, healthcare access, and education of providers and patients prevent successful attainment of goal metrics.

Assessing the Benefits and Economic Feasibility of Stand Improvement for Central Hardwood Forests

Stand improvement (SI) has been widely accepted as an effective forest management tool. Yet most studies on its economic feasibility for nonindustrial private forest (NIPF) landowners are outdated and focus on the single stand level. The objective of this study was to conduct an economic assessment of SI’s effects and feasibility in hardwood stands for a case study in the White River Basin in Indiana. It is shown that SI could make these forests more productive and sustainable than the prevalent “hands-off” practice by enhancing the timber value of the residual stand (TV), generating regular timber income, and to some degree, reversing the decline in oak dominance. On average, a 25% increment in the TV could be achieved. Although costly for some NIPFs, once combined with voluntary financial incentive programs, SI could meet landowners’ demands for low-cost, high-return investment options. In particular, participation in the Environmental Quality Incentive Program could, on average, increase the net present value of timber income from thinning activities by nearly $1,600 per hectare over the course of 30 years. The spatial analysis revealed that there existed considerable spatial heterogeneity in SI benefits and impacts, suggesting that public incentive programs should be spatially targeted to achieve greater efficiency. Study Implications This study found that stand improvement (SI) could significantly improve the timber value of forestland in the central hardwood region. Participation in voluntary conservation programs, such as the Environmental Quality Incentive Program, could alleviate part of the SI cost thus making it an attractive investment opportunity for private landowners. For the study region, the White River Basin in Indiana, the results suggested that there existed substantial variations in SI’s effectiveness across space. This implied that program administrators of voluntary incentives could improve the efficiency of public funds allocation by considering this spatial variation when evaluating landowners’ applications for incentives.

Storytelling to Inspire Dialysis Patients to Learn about Living Donor Kidney Transplant

<b><i>Background:</i></b> Policy changes including the Advancing American Kidney Health initiative and CMS’s ESRD Quality Incentive Program recommend increasing educational initiatives within dialysis centers to increase living kidney donor transplant (LDKT) rates. LDKT education can be challenging in dialysis centers due to limited provider time to educate, patient fears or reluctance to learn about LDKT, and difficulty educating potential living donors. New educational innovations that increase dialysis patient curiosity about pursuing LDKT are needed. <b><i>Summary:</i></b> Digital first-person storytelling, or the sharing of narratives by individuals in their own words, is a culturally competent, health literate, patient-driven approach to expanding patient understanding about LDKT that can supplement traditional educational strategies without additional burden for dialysis providers. The Living Donation Storytelling Project is an online digital library of over 150 video stories told by diverse kidney recipients, donors, those in search of a donor, and their family/friends. By honestly discussing how they overcame fears and challenges related to LDKT, these stories address sensitive topics that can be hard for providers to introduce by using easily accessible learning methodology that may better connect with racial/ethnic minorities, scared patients, and patients facing health literacy challenges. <b><i>Key Messages:</i></b> Supplementing traditional educational approaches with digital storytelling may help overcome time limitations in educating for busy providers, boost providers’ own knowledge about LDKT, serve as a free supplemental resource for patients, reduce fears and increase self-efficacy about transplant, help more patients to share about transplant with their social networks, and ultimately increase LDKT rates.