Bundled Payment vs. Fee-for-Service: Impact of Payment Scheme on Performance

Healthcare reimbursements in the United States have been traditionally based on a fee-for-service (FFS) scheme, providing incentives for high volume of care, rather than efficient care. The new healthcare legislation tests new payment models that remove such incentives, such as the bundled payment (BP) system. We consider a population of patients (beneficiaries). The provider may reject patients based on the patient’s cost profile and selects the treatment intensity based on a risk-averse utility function. Treatment may result in success or failure, where failure means that unforeseen complications require further care. Our interest is in analyzing the effect of different payment schemes on outcomes such as the presence and extent of patient selection, the treatment intensity, the provider’s utility and financial risk, and the total system payoff. Our results confirm that FFS provides incentives for excessive treatment intensity and results in suboptimal system payoff. We show that BP could lead to suboptimal patient selection and treatment levels that may be lower or higher than desirable for the system, with a high level of financial risk for the provider. We also find that the performance of BP is extremely sensitive to the bundled payment value and to the provider’s risk aversion. The performance of both BP and FFS degrades when the provider becomes more risk averse. We design two payment systems, hybrid payment and stop-loss mechanisms, that alleviate the shortcomings of FFS and BP and may induce system optimum decisions in a complementary manner. This paper was accepted by Serguei Netessine, operations management

Pemanfaatan Tanaman Bambu untuk Membuat Aneka Kerajinan Tangan Khas Suku Dayak Desa sebagai Alternatif Peningkatan Kreativitas Mahasiswadalam Menganalisis Peluang Bisnis

Tujuan penelitian adalah meningkatkan kreativitas mahasiswa dalam menganalisis peluang bisnis dengan cara memanfaatkan tanaman bambu yang banyak tumbuh di alam Kalimantan Barat khususnya kabupaten Sintang. Tanaman bambu dimanfaatkan untuk membuat aneka kerajinan tangan khas suku dayak desa yang dikemas dalam bentuk souvenir dengan kreasi model-model baru merubah ukuran aslinya menjadi miniatur yang lebih kecil ukurannya sehingga cocok digunakan sebagai cindera mata.Adapun jenis kerajinan tangan khas suku dayak desa yang ada di kabupaten Sintang yang telah dimodifikasi menjadi souvenir diantaranya cupai, takin, tanggui, capan, keban, tabung, keranjang bakul dan tikar. Hasil kerajinan tangan ini selanjutnya dipasarkan melalui praktek pemasaran pada matakuliah analisis peluang bisnis dimana mahasiswa diberikan kesempatan untuk menjual hasil kerajinan tangannya di kantin kampus; selain itu produk juga dapat dipesan untuk souvenir pernikahan, souvenir ulang tahun, dan dititipkan pada toko cenderamata. Produk telah berhasil dipasarkan dengan mendatangkan keuntungan sebesar Rp. 864.000 dari 100 unit Produk . Kegiatan ini akan terus berlanjut dan dikembangkan dengan target membuat galeri khusus serta memperluas pangsa pasar

Origen de la identidad peruana en el mito de Huarochiri

El mito de Huarochirí está representado en la sierra central del Perú, en la provincia de Huarochirí, la cual pertenece al departamento de Lima. Este mito, puesto que la cultura quechua no tuvo escritura, fue recopilado de la tradición oral, después de la influencia y afirmación de la religión cristiana sobre las creencias religiosas incas. El fundamento esencial del mito radica en el aspecto religioso que se quiere perpetuar; sobre todo representa la lucha constante que hay, en el ambiente religioso, entre el bien y el mal

Melting of scalar mesons and black-hole quasinormal modes in a holographic QCD model

A holographic model for QCD is employed to investigate the effects of the gluon condensate on the spectrum and melting of scalar mesons. We find the evolution of the free energy density with the temperature, and the result shows that the temperature of the confinement/deconfinement transition is sensitive to the gluon-condensate parameter. The spectral functions (SPFs) are also obtained and show a series of peaks in the low-temperature regime, indicating the presence of quasiparticle states associated to the mesons, while the number of peaks decreases with the increment of the temperature, characterizing the quasiparticle melting. In the dual gravitational description, the scalar mesons are identified with the black-hole quasinormal modes (QNMs). We obtain the spectrum of QNMs and the dispersion relations corresponding to the scalar-field perturbations of the gravitational background, and find their dependence with the gluon-condensate parameter.Comment: 30 pages, 12 figures, 5 table