Value-driven health care--pipe dream, placebo or prescription for excellence?

The Value-Driven Health Care initiative and the Executive Order (EO) that underpins it invert the cost/quality equation and proceed from the premise that improving quality first--in terms of both care and system management--will reduce costs and elevate value. Equally essential to the success of the initiative is transparency: access to information that will empower consumers to save on quality care. This article describes the four cornerstones of the EO and explains how they will translate into corporate action and value.     

Authentic leadership and intrapreneurial behavior: cross-level analysis of the mediator effect of organizational identification and empowerment

Intrapreneurial activity is positively associated with the organizational growth, and the factors that stimulate such behaviors need to be identified. The general goal of this work is to explore the relationship of authentic leadership with employees’ intrapreneurial behavior and the intervening processes. A correlational study was carried out with 212 employees of Spanish companies, in which two cross-level mediation hypotheses were tested. The results obtained indicate that employees’ organizational identification and organizational empowerment both mediate the relationship between authentic leadership and employees’ intrapreneurial behaviors. In this work, we note the importance of including authentic leadership as an antecedent of intrapreneurship.     

A Laddering Approach to the Use of Methods and Techniques to Reduce the Cycle Time of New-to-the-Firm Products

Millson, Raj, and Wilemon have developed the earliest extant knowledge on the implementation of methods and techniques to reduce new product development (NPD) cycle time by suggesting a hierarchy of generic NPD acceleration approaches. The purpose of this article is to extend Millson, Raj, and Wilemon's hierarchy by recasting and augmenting the conceptual basis of their hierarchy for new-to-the-firm products. Taking this hierarchy of generic NPD acceleration approaches as a starting point, the authors set out to form a number of generic NPD acceleration approaches by surveying the literature and conducting an experience survey with academics and managers. A logical and purposeful implementation sequence subsequently is established by using the laddering technique. The results indicate that managers make tradeoffs in NPD with regard to speed, development costs, and customer value, and that not all generic NPD acceleration approaches need to be implemented in order to obtain the greatest effectiveness. © 1999 Elsevier Science Inc.     

Nationality and differences in auditor risk assessment: A research note with experimental evidence

This study examines whether auditors from different countries come to different conclusions when they perform analytical procedures to assess the risk of misstatement in accounts. During a laboratory experiment, auditors who worked for the same firm in the United Kingdom, France, and the United States performed analytical procedures on identical case materials. Although auditors from all three countries came to similar conclusions about the overall risk of misstatement, they attributed risk differently across the individual financial statement accounts they evaluated.     

Public Professional Accountability: A Conditional Approach

In the past decades, profession(al)s have increasingly been called to account. Several authors have reported that this increased public professional accountability, in the form of showing that professional conduct meets predefined standards or rules, has had severe negative consequences for professionals, their clients and society, and call for ‘intelligent’ forms of accountability; forms of accountability that may inform a wider public about professional conduct but do not harm it. In this paper, we propose a form of ‘intelligent’ public professional accountability. Taking Freidson’s (Professionalism. The third logic, Polity Press, Cambridge, 2001) notion of institutional ethics as a point of departure, we develop a form of accountability that seeks to account for the conditions required for professional conduct. The paper first discusses the current ‘dilemma of professional accountability,’ describes ‘ideal-type professional conduct’ and goes into the conditions it requires. Next, it shows what accounting for these conditions entails and that this form of accountability fits the criteria for intelligent accountability, as set by O’Neill (in: Morris and Vines (eds.) Capital failure: rebuilding trust in financial services, Oxford University Press, Oxford, 2014).     

The economic burden of common adverse events associated with metastatic colorectal cancer treatment in the United States

Aims: Adverse events (AEs) associated with treatments for metastatic colorectal cancer (mCRC) may compromise the course of treatment, impact quality-of-life, and increase healthcare resource utilization. This study assessed the direct healthcare costs of common AEs among mCRC patients in the US.

Methods: Adult mCRC patients treated with chemotherapy or targeted therapies were identified from administrative claims databases (2009–2014). Up to the first three mCRC treatment episodes per patient were considered and categorized as with or without the AE system/organ category during the episode. Total healthcare costs (2014 USD) were measured by treatment episode and reported on a monthly basis. Treatment episodes with the AE category were matched by treatment type and line of treatment to those without the AE category. Adjusted total cost differences were estimated by comparing costs during treatment episodes with vs without the AE category using multivariate regression models; p-values were estimated with bootstrap.

Results: A total of 4158 patients with ≥1 mCRC treatment episode were included (mean age?=?59 years; 58% male; 60% with liver and 14% with lung metastases; 2,261 [54%] with a second and 1,115 [27%] with a third episode). On average, two treatment episodes were observed per patient with an average length of 166 days per episode. Adjusted monthly total cost difference by AE category included hematologic ($1,480), respiratory ($1,253), endocrine/metabolic ($1,213), central nervous system (CNS; $1,136), and cardiovascular ($1,036; all p?Limitations: Claims do not include information on the cause of AEs, and potentially less severe AEs may not have been reported by the physician when billing the medical service. This study aimed to assess the association between costs and AEs and not the causation of AEs by treatment.

Conclusions: The most costly AEs among mCRC patients were hematologic, followed by respiratory, endocrine/metabolic, CNS, and cardiovascular.     

Bank incentives, contract design and bank runs

We study the Diamond-Dybvig [Bank runs, deposit insurance, and liquidity, J. Polit. Econ. 91 (1983) 401-419] model as developed in Green and Lin [Implementing efficient allocations in a model of financial intermediation, J. Econ. Theory 109 (2003) 1-23] and Peck and Shell [Equilibrium bank runs, J. Polit. Econ. 111 (2003) 103-123]. We dispense with the notion of a bank as a coalition of depositors. Instead, our bank is a self-interested agent with a technological advantage in record-keeping. We examine the implications of the resulting agency problem for the design of bank contracts and the possibility of bank-run equilibria. For a special case, we discover that the agency problem may or may not simplify the qualitative structure of bank liabilities. We also find that the uniqueness result in Green and Lin [Implementing efficient allocations in a model of financial intermediation, J. Econ. Theory 109 (2003) 1-23] is robust to our form of agency, but that the non-uniqueness result in Peck and Shell [Equilibrium bank runs, J. Polit. Econ. 111 (2003) 103-123] is not.     

EMPLOYEE PARTICIPATION IN POLLUTION REDUCTION: A SOCIO-TECHNICAL PERSPECTIVE

Is industrial pollution reduction solely a matter of applying technical solutions to technical problems, or do organizational strategies and human factors also play an important part? In 1991 the US Environmental Protection Agency began collecting data on organizational strategies in pollution control as part of its Toxic Release Inventory database. An exploratory analysis of the 1991–1992 Toxic Release Inventory data revealed evidence that internally based, socially driven organizational strategies such as employee participation can have a dramatic impact on pollution reduction. The results are reported here of the second phase of this research: the approach is broadened to define general ‘internal’ versus ‘external’ strategies, and ‘social’ versus ‘technical’ approaches. There is strong evidence that the combination of internal and external strategies is superior to either alone; there is even stronger evidence that a socio-technical approach is better than either alone, and still stronger support for a combination of all of these criteria.     

MULTIPLE OWNERSHIP,COLLUSION AND UNUSUAL RESULT PATTERNS IN SOCCER

Expanding on the literature on antitrust, multiple ownership, and collusion in sports, this paper finds a very unusual result pattern between two clubs competing in the Croatian soccer league—Lokomotiva and Dinamo Zagreb. Their close sporting and business relationship has raised many questions about the possible collusion between them, potentially affecting the integrity of the competition. We analyze all matchups in the competition's 25‐year history to single out those characterized by biggest under‐ and overperformances by competing clubs. Our findings provide some support to the allegations of a possible collusion between the clubs as Lokomotiva's underperformance against Dinamo is so far in the tail of normal distribution that it has a lower occurrence probability than a random person being hit by lightning. (JEL Z29, K21, L83).