SCDNET: A novel convolutional network for semantic change detection in high resolution optical remote sensing imagery

Abstract With the continuing improvement of remote-sensing (RS) sensors, it is crucial to monitor Earth surface changes at fine scale and in great detail. Thus, semantic change detection (SCD), which is capable of locating and identifying "from-to" change information simultaneously, is gaining growing attention in RS community. However, due to the limitation of large-scale SCD datasets, most existing SCD methods are focused on scene-level changes, where semantic change maps are generated with only coarse boundary or scarce category information. To address this issue, we propose a novel convolutional network for large-scale SCD (SCDNet). It is based on a Siamese UNet architecture, which consists of two encoders and two decoders with shared weights. First, multi-temporal images are given as input to the encoders to extract multi-scale deep representations. A multi-scale atrous convolution (MAC) unit is inserted at the end of the encoders to enlarge the receptive field as well as capturing multi-scale information. Then, difference feature maps are generated for each scale, which are combined with feature maps from the encoders to serve as inputs for the decoders. Attention mechanism and deep supervision strategy are further introduced to improve network performance. Finally, we utilize softmax layer to produce a semantic change map for each time image. Extensive experiments are carried out on two large-scale high-resolution SCD datasets, which demonstrates the effectiveness and superiority of the proposed method

The Effects Of Medicare Payment Changes On Nursing Home Staffing

In light of persistent shortcomings in nursing home care quality and evidence that lower nurse staffing levels could be harmful to residents, we examine whether staffing levels are affected by changes in Medicare reimbursement rates. We exploit a 2006 change in Medicare’s methodology for adjusting provider payments for geographic differences in costs, a change that generated plausibly exogenous variation in nursing facility reimbursement rates. Our method compares facilities with higher and lower shares of Medicare resident days, which were differentially exposed to the payment changes we examine. Using panel data on US nursing homes from 2003 through 2009, we find that higher Medicare payments increased nurse staffing hours per resident day. Additional results suggest that changes in Medicare payments did not affect other measures of quality

Consumer Response To Composite Ratings Of Nursing Home Quality

Health-care report cards are intended to address information asymmetries and enable consumers to choose providers of better quality. However, the form of the information may matter to consumers. Nursing Home Compare, a website that publishes report cards for nursing homes, went from publishing a large set of indicators to a composite rating in which nursing homes are assigned one to five stars. We evaluate whether the simplified ratings motivated consumers to choose better-rated nursing homes. We use a regression discontinuity design to estimate changes in new admissions six months after the publication of the ratings. Our main results show that nursing homes that obtained an additional star gained more admissions, with heterogeneous effects depending on baseline number of stars. We conclude that the form of quality reporting matters to consumers, and that the increased use of composite ratings is likely to increase consumer response

Consumer Response To Composite Ratings Of Nursing Home Quality

Health-care report cards are intended to address information asymmetries and enable consumers to choose providers of better quality. However, the form of the information may matter to consumers. Nursing Home Compare, a website that publishes report cards for nursing homes, went from publishing a large set of indicators to a composite rating in which nursing homes are assigned one to five stars. We evaluate whether the simplified ratings motivated consumers to choose better-rated nursing homes. We use a regression discontinuity design to estimate changes in new admissions six months after the publication of the ratings. Our main results show that nursing homes that obtained an additional star gained more admissions, with heterogeneous effects depending on baseline number of stars. We conclude that the form of quality reporting matters to consumers, and that the increased use of composite ratings is likely to increase consumer response

Is there dynamic adverse selection in the life insurance market?

This paper finds evidence of dynamic adverse selection in the life insurance market. Lower-risk individuals are more likely to cancel a policy, and to cancel one of greater face value conditional on cancelation, than are individuals with higher mortality risk.Dynamic adverse selection Reclassification risk Mortality risk Lapse Life insurance

Tax incentives and the decision to purchase long-term care insurance

This paper studies the impact of the tax incentive prescribed in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) on individuals' long-term care insurance purchasing behavior. Using data from the Health and Retirement Study, we find that the tax incentive in HIPAA increased the take-up rate of private LTC insurance by 3.3 percentage points, or 25%, for those eligible. Despite this seemingly strong response, our results imply that even an above-the-line tax deduction would not increase the coverage rate of seniors beyond 13%, indicating that tax incentives alone are unlikely to expand the market substantially. We also present, to our knowledge, the first estimate of the price elasticity of demand for LTC insurance of around - 3.9, suggesting that demand is highly elastic at the current low ownership rate. Finally, we evaluate the net fiscal impact of the tax incentive and find that the tax deductibility of LTC insurance premiums leads to a net revenue loss for the government, as the reduced tax revenue from granting the tax incentive exceeds the savings in Medicaid's LTC expenditures.Long-term care Long-term care insurance Tax incentive HIPAA Medical expenses Itemization Demand elasticity Fiscal impact

The Role Of Medical Expenditure Risk In Portfolio Allocation Decisions

Economic theory suggests that medical spending risk affects the extent to which households are willing to accept financial risk, and consequently their investment portfolios. In this study, we focus on the elderly for whom medical spending represents a substantial risk. We exploit the exogenous reduction in prescription drug spending risk because of the introduction of Medicare Part D in the U.S. in 2006 to identify the causal effect of medical spending risk on portfolio choice. Consistent with theory, we find that Medicare-eligible persons increased risky investment after the introduction of prescription drug coverage, relative to a younger, ineligible cohort