Aligning the drivers in the value chain - a new cane payment system for Mackay Sugar

For the 2005 season, Mackay Sugar and its growers agreed to implement a new cane payment system. The aim of the new system was to better align the business drivers between the mill and its growers and as a result improve business decision making. The technical basis of the new cane payment system included a fixed sharing of the revenue from sugar cane between the mill and growers. Further, the new system replaced the CCS formula with a new estimate of recoverable sugar (PRS) and introduced NIR for payment analyses. Significant mill and grower consultation processes led to the agreement to implement the new system in 2005 and this consultative approach has been reflected in two seasons of successful operation.

NFC parking payment system

Este Proyecto Fin de Carrera (PFC) de la Ingeniería Informática (II) se enmarca en otro proyecto de mayor envergadura, cuyo objetivo final es estudiar y desarrollar aplicaciones móviles basadas en Android, que permitan agilizar los pagos de importes bajos, haciendo uso de la tecnología de comunicación inalámbrica, de corto alcance y alta frecuencia (NFC). El proyecto surge de la oportunidad de desarrollar un prototipo de aplicación haciendo uso de una tecnología que apenas se ha empezado a utilizar, que sin embargo las grandes empresas de telecomunicaciones tienen previsto explotar en los próximos años.

An Evaluation of the Impact of the Prospective Payment System on Antidepressant Use in Nursing Home Residents

Objectives: To determine the impact of the prospective payment system (PPS) for skilled nursing facilities on the pharmacologic treatment of depression.

Methods: We used a quasi-experimental study comparing the pharmacological treatment rates for depression in the pre-PPS period (1997) to the post-PPS period (2000) in 8149 residents with documented depression living in over 500 nursing facilities in Ohio. Logistic regression models adjusting for clustering effects of residents residing in homes using generalized estimating equations provided estimates of the PPS effect on use of any antidepressant and the use of selective serotonin reuptake inhibitors (SSRIs). We evaluated the extent to which the PPS effect was modified by organizational characteristics, including structural characteristics, resource characteristics, and staff resources available in the homes.

Results: Overall, there was no difference in the likelihood of any antidepressant [odds ratio (OR), 1.05; 95% confidence interval (CI), 0.93 to 1.18, resident-adjusted model] or an SSRI being used (OR, 0.98; 95% CI, 0.86 to 1.12, resident-adjusted model) after the introduction of PPS compared with 1997 when this reimbursement system was not in place (referent group). These trends did not appear to be modified substantially by organizational characteristics.

Conclusion: Although PPS did not appear to have influenced the treatment of depression in nursing homes, systems that provide checks and balances in relation to PPS are warranted.

European payment system and monetary union

We make a comparative study of payment systems for E.U. -fifteen countries for the 1996-2002 period. Special attention is paid to the introduction of the new European single currency. The overall trend in payments is for a move from cash to noncash payment instruments, although electronic instruments are not widely used yet. We find a significant impact from the introduction of the new banknotes and coins on card use

Production, hidden action, and the payment system

In this paper, we study a model economy that examines the optimal intraday rate. In Freeman’s (1996) paper, he shows that the efficient allocation can be implemented by adopting a policy in which the intraday rate is zero. We modify the production set and show that such a model economy can account for the non-uniform distribution of settlements within a day. In addition, by modifying both the consumption set and the production set, we show that the central bank may be able to implement the planner’s allocation with a positive intraday interest rate.

Experiences in developing a micro-payment system for peer-to-peer networks

Micro-payment systems are an important part of peer-to-peer (P2P) networks and address the "free-rider" problem in most existing content sharing systems. To address this issue, the authors have developed a new micro-payment system for content sharing in P2P networks called P2P-Netpay. This is an offline, debit based protocol that provides a secure, flexible, usable and reliable credit service. This article compares micro-payment with non-micro-payment credit systems for file sharing applications and finds that this approach liberates the "free-rider" problem. The authors analyse the heuristic evaluation performed by a set of evaluators and present directions for research aiming to improve the overall satisfaction and efficiency of the proposed model.

Financial impact of the Medicare prospective payment system on long term acute care hospitals

Objective. Long Term Acute Care Hospitals (LTACs) are subject to Medicare rules because they accept Medicare and Medicaid patients. In October 2002, Medicare changed the LTAC reimbursement formulas, from a cost basis system to a Prospective Payment System (PPS). This study examines whether the PPS has negatively affected the financial performance of the LTAC hospitals in the period following the reimbursement change (2003-2006), as compared to the period prior to the change (1999-2003), and if so, to what extent. This study will also examine whether the PPS has resulted in a decreased average patient length of stay (LOS) in the LTAC hospitals for the period of 2003-2006 as compared to the prior period of 1999-2003, and if so, to what extent. ^ Methods. The study group consists of two large LTAC hospital systems, Kindred Healthcare Inc. and Select Specialty Hospitals of Select Medical Corporation. Financial data and operational indicators were reviewed, tabulated and dichotomized into two groups, covering the two periods: 1999-2002 and 2003-2006. The financial data included net annual revenues, net income, revenue per patient per day and profit margins. It was hypothesized that the profit margins for the LTAC hospitals were reduced because of the new PPS. Operational indicators, such as annual admissions, annual patient days, and average LOS were analyzed. It was hypothesized that LOS for the LTAC hospitals would have decreased. Case mix index, defined as the weighted average of patients’ DRGs for each hospital system, was not available to cast more light on the direction of LOS. ^ Results. This assessment found that the negative financial impacts did not materialize; instead, financial performance improved during the PPS period (2003-2006). The income margin percentage under the PPS increased for Kindred by 24%, and for Select by 77%. Thus, the study’s working hypothesis of reduced income margins for the LTACs under the PPS was contradicted. As to the average patient length of stay, LOS decreased from 34.7 days to 29.4 days for Kindred, and from 30.5 days to 25.3 days for Select. Thus, on the issue of LTAC shorter length of stay, the study’s working hypothesis was confirmed. ^ Conclusion. Overall, there was no negative financial effect on the LTAC hospitals during the period of 2003-2006 following Medicare implementation of the PPS in October 2002. On the contrary, the income margins improved significantly. ^ During the same period, LOS decreased following the implementation of the PPS. This was consistent with the LTAC hospitals’ pursuit of financial incentives.^

Financial impact of the Medicare prospective payment system on long term acute care hospitals

Objective. Long Term Acute Care Hospitals (LTACs) are subject to Medicare rules because they accept Medicare and Medicaid patients. In October 2002, Medicare changed the LTAC reimbursement formulas, from a cost basis system to a Prospective Payment System (PPS). This study examines whether the PPS has negatively affected the financial performance of the LTAC hospitals in the period following the reimbursement change (2003–2006), as compared to the period prior to the change (1999–2003), and if so, to what extent. This study will also examine whether the PPS has resulted in a decreased average patient length of stay (LOS) in the LTAC hospitals for the period of 2003–2006 as compared to the prior period of 1999-2003, and if so, to what extent. ^ Methods. The study group consists of two large LTAC hospital systems, Kindred Healthcare Inc. and Select Specialty Hospitals of Select Medical Corporation. Financial data and operational indicators were reviewed, tabulated and dichotomized into two groups, covering the two periods: 1999–2002 and 2003–2006. The financial data included net annual revenues, net income, revenue per patient per day and profit margins. It was hypothesized that the profit margins for the LTAC hospitals were reduced because of the new PPS. Operational indicators, such as annual admissions, annual patient days, and average LOS were analyzed. It was hypothesized that LOS for the LTAC hospitals would have decreased. Case mix index, defined as the weighted average of patients’ DRGs for each hospital system, was not available to cast more light on the direction of LOS. ^ Results. This assessment found that the negative financial impacts did not materialize; instead, financial performance improved during the PPS period (2003–2006). The income margin percentage under the PPS increased for Kindred by 24%, and for Select by 77%. Thus, the study’s working hypothesis of reduced income margins for the LTACs under the PPS was contradicted. As to the average patient length of stay, LOS decreased from 34.7 days to 29.4 days for Kindred, and from 30.5 days to 25.3 days for Select. Thus, on the issue of LTAC shorter length of stay, the study’s working hypothesis was confirmed. ^ Conclusion. Overall, there was no negative financial effect on the LTAC hospitals during the period of 2003–2006 following Medicare implementation of the PPS in October 2002. On the contrary, the income margins improved significantly. ^ During the same period, LOS decreased following the implementation of the PPS. This was consistent with the LTAC hospitals’ pursuit of financial incentives. ^

Medicare's prospective payment system : strategies for evaluating cost, quality, and medical technology.

"OTA-H-262"--P. [4] of cover.

Including capital expenses in the prospective payment system.

Item 1005-C

Hospital prospective payment system : hearing before the Subcommittee on Health of the Committee on Finance, United States Senate, Ninety-eighth Congress, first session.

Item 1038-A, 1038-B (microfiche)

Rural hospitals and Medicare's prospective payment system.

Mode of access: Internet.