Medicaid Policies for Alcohol SBI Reimbursement

The purpose of this report was to review existing reimbursement policies by state Medicaid agency, including the District of Columbia (D.C.), in order to understand similarities and differences associated with financial compensation for alcohol screening and brief intervention (SBI) services. Alcohol SBI is an evidence-based practice known to help reduce atrisk alcohol consumption among patients who drink too much. 1 Although alcohol SBI was designed to be a population-based approach to address unhealthy alcohol consumption, its current utilization is limited. 2 Implementation of the practice into routine clinical care remains a challenge at the health system level even with support from federal resources (e.g., SBIRT: Screening, Brief Intervention, and Referral to Treatment). One way to encourage the uptake of alcohol SBI/SBIRT among providers is to ensure that the service is reimbursable by third-party payers. However, reimbursement opportunities vary by state and payer, and in some locations are non-existent. Information about the current status of policies will assist in the development of policies and incentives to encourage healthcare providers and systems to submit claims for alcohol SBI/SBIRT and potentially increase the routine uptake of the service in clinical careCenters for Disease Control and Prevention Cooperative Agreement Number DD00114

Spray coating apparatus having a rotatable workpiece holder

A spray coating apparatus is provided for rotating a workpiece relative to a spray station to obtain a uniform coating of the workpiece. In a typical example, the workpiece comprises a ceramic tile which is to be coated with a ceramic coating and the tile is to be used as a reusable component of the thermal protection system for a space shuttle. The apparatus for rotating the workpiece includes a base support having a first rotatable stage for rotation in the horizontal plane and a second rotatable stage for rotation in a second plane inclined at an angle, such as 45 degrees, to the horizontal plane and the workpiece is supported on this second stage. Thus the workpiece is rotatable in both of two planes of rotation

Double Bubbles in Assets Markets with Multiple Generations

We construct an asset market in a finite horizon overlapping-generations environment. Subjects are tested for comprehension of their fundamental value exchange environment, and then reminded during each of 25 periods of its declining new value. We observe price bubbles forming when new generations enter the market with additional liquidity and bursting as old generations exit the market and withdrawing cash. The entry and exit of traders in the market creates an M shaped double bubble price path over the life of the traded asset. This finding is significant in documenting that bubbles can reoccur within one extended trading horizon and, consistent with previous cross-subject comparisons, shows how fluctuations in market liquidity influence price paths. We also find that trading experience leads to price expectations that incorporate fundamental value.Asset Markets, Price Bubbles, Laboratory Experiments, Overlapping Generations

Recasting Economics as if the Climate and Global Ecology Really Mattered

Peer reviewedPublisher PD

Radio Spectrum and the Disruptive Clarity OF Ronald Coase.

In the Federal Communications Commission, Ronald Coase (1959) exposed deep foundations via normative argument buttressed by astute historical observation. The government controlled scarce frequencies, issuing sharply limited use rights. Spillovers were said to be otherwise endemic. Coase saw that Government limited conflicts by restricting uses; property owners perform an analogous function via the "price system." The government solution was inefficient unless the net benefits of the alternative property regime were lower. Coase augured that the price system would outperform the administrative allocation system. His spectrum auction proposal was mocked by communications policy experts, opposed by industry interests, and ridiculed by policy makers. Hence, it took until July 25, 1994 for FCC license sales to commence. Today, some 73 U.S. auctions have been held, 27,484 licenses sold, and $52.6 billion paid. The reform is a textbook example of economic policy success. We examine Coase‘s seminal 1959 paper on two levels. First, we note the importance of its analytical symmetry, comparing administrative to market mechanisms under the assumption of positive transaction costs. This fundamental insight has had enormous influence within the economics profession, yet is often lost in current analyses. This analytical insight had its beginning in his acclaimed early article on the firm (Coase 1937), and continued into his subsequent treatment of social cost (Coase 1960). Second, we investigate why spectrum policies have stopped well short of the property rights regime that Coase advocated, considering rent-seeking dynamics and the emergence of new theories challenging Coase‘s property framework. One conclusion is easily rendered: competitive bidding is now the default tool in wireless license awards. By rule of thumb, about$17 billion in U.S. welfare losses have been averted. Not bad for the first 50 years of this, or any, Article appearing in Volume II of the Journal of Law & Economics.

The Effect of Bidding Information in Ascending Auctions.

We study the effect of the drop out and reenter information in an environment where bidders' values involve both private and common value components. We find that (1) providing bidding information does not have a significant effect on expected revenue and expected efficiency. (2) The effect of information on winner's expected profit depends on the range of uncertainty of the common value component and the level of Nash profit prediction, which the auctioneer has no a priori knowledge. In our environment, where bidders have a private component to their value and the auction takes place in ascending clock format, (3) bidders do not suffer from the winner's curse when information is not provided. (4) Information substantially increases the variability of revenue and winner?s profit when the range of uncertainty of the common value component is large. (5) Bidders? response to information depends on the range of uncertainty.

PATHOLOGICAL CHANGES IN 37 HUMAN RENAL HOMOTRANSPLANTS TREATED WITH IMMUNOSUPPRESSIVE DRUGS

Pathological changes in thirty‐seven human renal homotransplants are described. All the patients had been treated with Imuran, prednisone and actinomycin C; ten had also received local X‐irradiation to the transplant. Fifteen of the transplants were from patients in a rejection phase. Most of these kidneys were enlarged because of interstitial oedema and several were speckled with petechial hemorrhages. There was fibrinoid necrosis of afferent arterioles and interlobular arteries in twelve of the transplants, and the peritubular capillaries were disrupted in ten. Swelling of the arteriolar endothelial cells, fibrino‐platelet and fibrous intimal thickening of interlobular arteries were also common. In most of the transplants there was a light infiltration with small lymphocytes, plasma cells and a few larger pyroninophilic cells. Similar changes were present in the pelvis and ureter. Twelve of the transplants came from patients whose last rejection episode had been clinically reversed 14 to 117 days previously. AH these kidneys were enlarged because of compensatory hypertrophy. Seven showed some intimal thickening of the interlobular arteries and in three there was fibrinoid necrosis of arteriolar walls. Tubular atrophy, interstitial fibrosis and a light cellular infiltration were also common changes. Only one kidney appeared normal. Three transplants came from patients who had not experienced clinical evidence of a rejection episode. One showed acute tubular necrosis due to prolonged ischemia at the time of transplantation; one was almost normal; the third showed vascular lesions suggestive of old unrecognised rejection. Seven transplants had either not functioned or developed some complication necessitating their early removal. One of these was infarcted due to obstruction of the venous drainage; two showed massive acute tubular necrosis due to ischaemia; two, which were incompatible with their hosts on the basis of ABO blood groups, failed to excrete urine and showed distension of the arterioles and glomerular capillaries with erythrocytes; one bled uncontrollably from the pelvis; one came from a patient who died at twelve hours from hyperkalemia and hyponatremia during a massive post‐operative diuresis. This work was aided by grants A‐6283, A‐6344, HE‐07735, AM‐07772, AI‐01452, and OG‐27 from the U.S. Public Health Service, and by a grant from the Medical Research Council. The necropsies on cases described in this paper were either performed or supervised by Drs Coral Cotterall, Doris Courington, Carol Ewing, R. B. Hill, J. Jamroz, D. W. King, D. M. Lang, Martha La Via, Elizabeth Macintyre, N. McGrath, J. C. Maisel, C. G. Massion, D. R. Meekin, H. B. Neustein, S. Ryan, and D. E. Smith. We would like to thank all these pathologists for making this study possible. We are particularly grateful to Dr D. T. Rowlands, who supervised some of the necropsies, for his helpful co‐operation throughout this study. Expert assistance in preparing the sections and photomicrographs was given by Miss Jane Rendall. © 1965 BJU International Compan

Durability, Re-trading and Market Performance

Key differential structural characteristics of environments studied in previous market experiments have documented large divergences in their observed performance, particularly discrepancies in their convergence to expected equilibrium outcomes. We investigate why this should be so. The type of competitive equilibrium where a market clears at a particular price as initiated by Arrow and Debreu (1954) has long been studied in the laboratory. We refer to these experiments as Supply and Demand (SD) experiments. SD experiments are highly reduced in form: items are not re-tradable, buyers and sellers are specialized in these roles, and no second commodity, cash, is used as a medium of exchange, although cash enters as a numeraire qua reward incentive for subjects. Markets with these features that are repeated over time converge rapidly to the predicted equilibrium under a regime of strict private dispersed information on individual values that define the equilibrium predictions. In contrast, consider asset markets, in which shares can be freely re-traded against cash within and across periods, shares have well-defined common values based on common public information on expected cash “dividend” yields, and individuals are not specialized as buyers or sellers. These markets produce price bubbles that converge only with experience across repeat sessions. The prospect of re-trade, and perhaps the lack of buyer/seller specialization, results in market behavior that contrasts sharply with the perishable goods that characterize the SD experiments. Building on this background analysis we report new experiments that combine features of both environments and initiate an investigation of how commodity durability that constrains re-trading characteristics affect the observed variation in market performance.