Preferred provider organizations (PPOs) represent a form of managed care in which providers agree to accept discounted fees in exchange for the expectation that their patient volume will increase or at least be maintained. Managed care plans that rely on discounted fee-for-service (FFS) payments have increased from about 10 plans in 1981 to over 700 plans in 1994. In this study, we document lev...

Health maintenance organizations (HMO's) are paid a capitated amount for enrolled Medicare beneficiaries that is 95 percent of what these enrollees would be expected to cost in the fee-for-service sector. However, it appears that HMO enrollees are less costly than other Medicare beneficiaries. With a simulation model, we demonstrate that with a 95-percent pricing rule, any significant degree of...

Starting around 2006, the Centers for Medicare and Medicaid Services (CMS) progressively reduced Fee-for-Service (M-FFS) payments principal noninvasive cardiac tests, when performed in a cardiologist office (Office), yet kept flat to increasing same hospital-based outpatient (HBO) setting. This produced growing gap between HBO Office thus an incentive hospitals acquire cardiology practices orde...

CONTEXT Trust is the cornerstone of the patient-physician relationship. Payment methods that place physicians at financial risk have raised concerns about patients' trust in physicians to act in patients' best interests. OBJECTIVE To evaluate the extent to which methods of physician payment are related to patient trust. DESIGN Cross-sectional telephone interview survey done between January ...

This paper develops a simple model of payment incentives and empirically evaluates provider payment reform in Hainan Province, China. We use a pre-post study design with a control group to analyse two years of claims data to assess the impact of a January 1997 change to prospective payment for a sub-sample of the hospitals. This difference-in-difference empirical strategy allows us to isolate t...

Service platforms based on network are becoming even more important to physical end-products and services industry. As service platforms will become the founding infrastructure of our economies, the understanding of the value that a service platform can create is of great importance. The development of technology enhances a new way to create the value. Involving customers to co-create value is ...

The simultaneity of decreasing fertility and changing family structures in many European countries has led to a growing interest in fertility behavior in its relation to different family structures. The growing prevalence of higher-order unions (and the consequences for parity progression arising therefrom) is one example of an ongoing change in fertility behavior. Childbearing is not restric...

Software services offer the opportunity to use a component-based approach for the design of applications. However, this needs a deeper understanding of how to develop service-based applications in a systematic manner, and of the set of properties that need to be included in the 'design model'. We have used a realistic application to explore systematically how service-based designs can be create...

Fluorescence fluctuation spectroscopy (FFS) quantifies interactions of fluorescently labeled proteins inside living cells by brightness analysis. Conventional FFS implicitly requires that the sample thickness exceeds the size of the observation volume. This condition is not always fulfilled when measuring cells. Cytoplasmic sections, especially, can be thinner than the axial size of the observa...