Competition between HMO and PPO: A Two-Sided Market Approach

We set-up a two-sided market framework to model competition between a Prefered Provider Organization (PPO) and a Health Maintenance Organization (HMO). Both health plans compete to attract policyholderson one side and providers on the other side. The PPO, which is characterized by a higher diversity of providers, attracts riskier policyholders. Our two-sided framework allows to examine the consequences of this risk segmentation on the providers’ side, especially in terms of remuneration. The outcome of competition mainly depends on two effects: a demand effect, influenced by the value put by policyholders on providers access and an adverse selection effect, captured by the characteristics of the health risk distribution. If the adverse selection effect is too strong, the HMO gets a higher profit in equilibrium. On the contrary, if the demand effect dominates, the PPO profit is higher in spite of the unfavorable risk segmentation. We believe that our model, by highlighting the two-sided market structure of the health plans’ competition, provides new insights to understand the increase in the PPOs’ market share observed during the last decade in the US.

Competition in two-sided markets with common network externalities

We study competition in two sided markets with common network externality rather than with the standard inter-group e¤ects. This type of externality occurs when both groups bene t, possibly with di¤erent intensities, from an increase in the size of one group and from a decrease in the size of the other. We explain why common externality is relevant for the health and education sectors. We focus on the symmetric equilibrium and show that when the externality itself satis es an homogeneity condition then platforms pro ts and price structure have some speci c properties. Our results reveal how the rents coming from network externalities are shifted by platforms from one side to other, according to the homogeneity degree. In the speci c but realistic case where the common network externality is homogeneous of degree zero, platform s pro t do not depend on the intensity of the (common) network externality. This is in sharp contrast to conventional results stating that the presence of network externalities in a two-sided market structure increases the intensity of competition when the externality is positive (and decreases it when the externality is negative). Prices are a¤ected but in such a way that platforms only transfer rents from consumers to providers.

Doctors´ remuneration schemes and hospital competition in two-sided markets with common network externalities

This paper uses a two-sided market model of hospital competition to study the implications of di§erent remunerations schemes on the physiciansí side. The two-sided market approach is characterized by the concept of common network externality (CNE) introduced by Bardey et al. (2010). This type of externality occurs when occurs when both sides value, possibly with di§erent intensities, the same network externality. We explicitly introduce e§ort exerted by doctors. By increasing the number of medical acts (which involves a costly e§ort) the doctor can increase the quality of service o§ered to patients (over and above the level implied by the CNE). We Örst consider pure salary, capitation or fee-for-service schemes. Then, we study schemes that mix fee-for-service with either salary or capitation payments. We show that salary schemes (either pure or in combination with fee-for-service) are more patient friendly than (pure or mixed) capitations schemes. This comparison is exactly reversed on the providersíside. Quite surprisingly, patients always loose when a fee-for-service scheme is introduced (pure of mixed). This is true even though the fee-for-service is the only way to induce the providers to exert e§ort and it holds whatever the patientsívaluation of this e§ort. In other words, the increase in quality brought about by the fee-for-service is more than compensated by the increase in fees faced by patients.

Health care network formation and policyholders' welfare

We develop a model in which two insurers and two health care providers compete for a fixed mass of policyholders. Insurers compete in premium and offer coverage against financial consequences of health risk. They have the possibility to sign agreements with providers to establish a health care network. Providers, partially altruistic, are horizontally differentiated with respect to their physical address. They choose the health care quality and compete in price. First, we show that policyholders are better off under a competition between conventional insurance rather than under a competition between integrated insurers (Managed Care Organizations). Second, we reveal that the competition between a conventional insurer and a Managed Care Organization (MCO) leads to a similar equilibrium than the competition between two MCOs characterized by a different objective i.e. private versus mutual. Third, we point out that the ex ante providers’ horizontal differentiation leads to an exclusionary equilibrium in which both insurers select one distinct provider. This result is in sharp contrast with frameworks that introduce the concept of option value to model the (ex post) horizontal differentiation between providers.

Análisis de la ayuda oficial al desarrollo. estudio de caso: programa conjunto de UNICEF y UNFPA sobre la mutilación genital femenina en Kenia (2008-2012)

El interés de este estudio de caso es analizar el Programa Conjunto de UNFPA y UNICEF sobre MGF/E en Kenia bajo la luz de los postulados poscolonialistas. Partiendo de la idea de que la MGF es una manifestación de las desigualdades de género, se argumenta que el PC reproduce la imagen de la mujer keniana como una víctima del poder masculino. A partir de esta imagen se deslegitima el orden cultural de los grupos que siguen esta tradición, afectando las lógicas de unidad y cohesión de la sociedad. El análisis de este tipo de dinámicas permite comprender mejor los procesos de intervención de las organizaciones internacionales sobre las estructuras sociales de actores frágiles del sistema internacional.

Apoyo social e ideación suicida en pacientes con cáncer

El diagnóstico de cáncer ha sido asociado con un alto riesgo de presentar ideación suicida en comparación con la población no oncológica, sin embargo se ha considerado al apoyo social como un factor protector para la ocurrencia de esta conducta. La presente investigación tuvo como objetivo identificar la relación entre el apoyo social percibido y la ideación suicida en 90 pacientes oncológicos adultos en Bogotá, bajo la hipótesis de que a mayor apoyo social percibido, menor presencia de ideación suicida. Se midió la variable de apoyo social a través del cuestionario Duke UNC y la ideación suicida a través de cuatro instrumentos: Escala de Ideación Suicida (SSI), Escala de Desesperanza de Beck (BHS), el ítem 9 del Inventario de Depresión de Beck (BDI-IA) y una entrevista semiestructurada. Los resultados mostraron que no existe relación entre el apoyo social percibido y la ideación suicida. Por otro lado se identificó una prevalencia de suicidio entre 5,6% y 22,77%, confirmando que el paciente con cáncer considera el suicidio y es fundamental evaluar esta variable en esta población. Se considera importante continuar con la realización de investigaciones que permitan generalizar los resultados a la población oncológica colombiana.

Protocolo interno para la oferta de bienes y servicios y contratación de mano de obra de las comunidades

Los actores involucrados dentro de los proyectos de exploración y perforación de pozos petroleros son variados y tienen necesidades diferentes. El éxito y satisfactorio desarrollo de los proyectos va ligado en gran medida a temas de orden social entre los diferentes actores, que están definidos por regulaciones legislativas, de costumbres comerciales y culturales, políticas de responsabilidad social y procedimientos internos de las compañías involucradas (Operadoras, Prestadoras de Servicios Petroleros, Contratistas y Subcontratistas) Después de analizar la situación de la industria, los resultados de Halliburton SRL Sucursal Colombia, los problemas y sobrecostos generados por temas de orden social. Se identificó que la mayoría de ellos eran causados por falta de comunicación, desconocimiento de elementos clave de las políticas de responsabilidad social de los clientes, desconocimiento de la importancia de la responsabilidad social como práctica y desconocimiento de la normatividad legal vigente aplicable a la industria y a la actividad que desarrolla la compañía. De las necesidades y problemáticas descritas anteriormente surge la idea de crear una herramienta que permita llenar los vacíos de información identificados, alinear a las partes involucradas dentro del proceso y ser una guía para el inicio, desarrollo y cierre de proyectos de exploración y perforación de pozos petroleros que desarrolle Halliburton con sus clientes.

IDELab MapstractionInteractive: API Universal y Políglota

Continuamente aparecen nuevas plataformas de gestión de cartografía web, con el inconveniente de que cada una de ellas utiliza un API propia. Dada la gran heterogeneidad de APIs de Mapas existente, sería conveniente disponer de una librería de mapas capaz de abstraer al desarrollador de las pequeñas diferencias entre ellas. Este es el objetivo de la librería Javascript de código abierto Mapstraction. Este tipo de API recibe el nombre de «API Universal y Políglota». Gracias a Mapstraction se pueden desarrollar aplicaciones en las que el usuario puede visualizar la información cartográfica con varios proveedores, pero presenta el inconveniente de no proporcionar mecanismos de creación y/o edición. En este documento se recogen las principales novedades que presenta la librería IDELab MapstractionInteractive, una extensión de Mapstraction que ofrece nueva funcionalidad para solventar las carencias de ésta. Las nuevas funcionalidades implementadas para los proveedores que se incluyen dentro de la librería brindan al usuario la posibilidad de poder editar y crear geometrías sobre el mapa (puntos, líneas y polígonos). Por otra parte, también se implementan dentro de la librería nuevos eventos para los mapas, de forma que el programador puede tener un mayor control de lo que el usuario hace sobre éstos

Attention and selection behavior on ‘universal search’ result pages

The ISO norm line 9241 states some criteria for ergonomics of human system interaction. In markets with a huge variety of offers and little possibility of differentiation, providers can gain a decisive competitive advantage by user oriented interfaces. A precondition for this is that relevant information can be obtained for entrepreneurial decisions in this regard. To test how users of universal search result pages use those pages and pay attention to different elements, an eye tracking experiment with a mixed design has been developed. Twenty subjects were confronted with search engine result pages (SERPs) and were instructed to make a decision while conditions “national vs. international city” and “with vs. without miniaturized Google map” were used. Different parameters like fixation count, duration and time to first fixation were computed from the eye tracking raw data and supplemented by click rate data as well as data from questionnaires. Results of this pilot study revealed some remarkable facts like a vampire effect on miniaturized Google maps. Furthermore, Google maps did not shorten the process of decision making, Google ads were not fixated, visual attention on SERPs was influenced by position of the elements on the SERP and by the users’ familiarity with the search target. These results support the theory of Amount of Invested Mental Effort (AIME) and give providers empirical evidence to take users’ expectations into account. Furthermore, the results indicated that the task oriented goal mode of participants was a moderator for the attention spent on ads. Most important, SERPs with images attracted the viewers’ attention much longer than those without images. This unique selling proposition may lead to a distortion of competition on markets.

The Economic anI Racial Implications of the Globalization of Knowledge by Catholic Missionaries in Portuguese India, 16th-18th Centuries

The European Missionaries benefitted from the native Asian sources and knowledge providers much more than it is honestly acknowledged.

Comunicação numa empresa de cariz farmacêutico : factores críticos de sucesso

Nesta monografia pretendeu-se compreender de que forma a capacidade de comunicação é um factor preponderante ou não no desempenho de uma empresa. Seja a comunicação interna (para com os seus funcionários) ou externa (para com o público alvo). constatou-se que existem várias maneiras de a fazer, tendo todas elas por base uma análise detalhada da mensagem que se quer passar com fim a determinado efeito no alvo. No que respeita à abordagem do tema proposto foram apenas consideradas as farmácias comunitárias que se inserem nas pequenas e médias empresas portuguesas. Assim, foi feita uma exposição de uma série de mecanismos comunicacionais que têm como objectivo garantir o sucesso da comunicação entre farmacêutico-utente. E, do mesmo modo, através de um inquérito avaliar até que ponto os utentes se encontram satisfeitos com as técnicas comunicacionais dos seus prestadores de cuidados farmacêuticos. De uma maneira geral, a comunicação nos dias de hoje pode determinar o sucesso ou o fracasso de determinada instituição, sendo por isso muito mais do que passar uma simples mensagem. O farmacêutico como profissional de saúde que lida diariamente com os utentes de uma forma privilegiada, deve ser um comunicador por excelência, sendo esta capacidade essencial para que o utente se sinta seguro e capaz no cumprimento da terapêutica.

Aprendizagem de aluno com deficiência intelectual e desenvolvimental em contexto de sala de aula

O presente estudo propôs-se estudar a temática da aprendizagem de um aluno com deficiência intelectual e desenvolvimental em contexto de sala de aula e as implicações no desenvolvimento de processo educativo. Foi realizado com um jovem que atingiu este ano a maioridade e que esteve a frequentar o 9º ano de escolaridade. Este jovem apresenta características que o definem como portador de Deficiência Intelectual e Desenvolvimental (DID). Realizou-se a análise documental através das informações que constam do processo educativo do jovem, das entrevistas efectuadas aos professores que o acompanharam no seu percurso escolar e dos registos de observação de aulas. Procedeu-se à discussão dos resultados, onde se aferiu que as escolas regulares apresentam, actualmente condições para responder às necessidades académicas, pessoais e sociais destes jovens, contudo o processo de aprendizagem destes alunos deveria passar por uma preparação para a vida ativa através do estabelecimento de protocolos com Entidades formadoras, que visam formação a nível técnico e que proporcionam a inclusão em mercado laboral. É imperioso compreender que o processo de aprendizagem destes jovens com Necessidades Edicativas Especiais (NEE) implica uma multiplicidade de aspetos, sendo o direito à igualdade de oportunidades primordial, considerando que todos têm direito a ser diferentes quando a igualdade os descaracteriza.

Aviation solutions

Overview Some of the Challenges - Future Technology - Capacity - Safety Working with Airports, Air Traffic Service Providers and Airlines The Role of the Regulator Air Traffic Service Providers

New ICT sectors: platforms for European growth? Bruegel Policy Contribution 2012/14, August 2012

Europe's failure to specialise in new ICT sectors and firms is likely to hold back Europe’s post-crisis recovery. Europe lacks in particular leading platform providers, who are capturing most of the value in the new ICT ecosystem. • In-depth analysis of some specific new emerging ICT sectors shows that the problem in Europe appears not to be so much in the generation of new ideas, but rather in bringing ideas successfully to market. Among the barriers are the lack of a single digital market, fragmented intellectual property regimes, lack of an entrepreneurial culture, limited access to risk capital and an absence of ICT clusters. • The EU policy framework, particularly the Innovation Union and Digital Agenda EU 2020 Flagships, could better leverage the growth power for Europe of new ICT markets. The emphasis should move beyond providing support for infrastructure and research, to funding programmes for pre-commercial projects. But perhaps most important is dealing with the fragmentation in European digital markets.

GODIVA2: interactive visualization of environmental data on the Web

GODIVA2 is a dynamic website that provides visual access to several terabytes of physically distributed, four-dimensional environmental data. It allows users to explore large datasets interactively without the need to install new software or download and understand complex data. Through the use of open international standards, GODIVA2 maintains a high level of interoperability with third-party systems, allowing diverse datasets to be mutually compared. Scientists can use the system to search for features in large datasets and to diagnose the output from numerical simulations and data processing algorithms. Data providers around Europe have adopted GODIVA2 as an INSPIRE-compliant dynamic quick-view system for providing visual access to their data.