Designing a guideline-based utilization management program

Many public and private organizations are developing and publishing clinical guidelines to assist health care providers and patients in making appropriate medical decisions. Unless clinical guidelines are part of a well-designed managed care program, they have little effect on physician practice styles. This article explores integral components of an effective guideline-based utilization management program. Initial evaluation of this program suggests that, as part of a well-designed utilization management program, clinical guidelines can inform patients and physicians, and create appropriate incentives for effective health care delivery.     

Diversity and arbitrage in a regulatory breakup model

In 1999 Robert Fernholz observed an inconsistency between the normative assumption of existence of an equivalent martingale measure (EMM) and the empirical reality of diversity in equity markets. We explore a method of imposing diversity on market models by a type of antitrust regulation that is compatible with EMMs. The regulatory procedure breaks up companies that become too large, while holding the total number of companies constant by imposing a simultaneous merge of other companies. The regulatory events are assumed to have no impact on portfolio values. As an example, regulation is imposed on a market model in which diversity is maintained via a log-pole in the drift of the largest company. The result is the removal of arbitrage opportunities from this market while maintaining the market’s diversity.     

Sequential bargaining,external effects of agreement,and public intervention

In some bargaining situations, agreement has implications for agents beyond the parties involved, and if so, delays in reaching an agreement or failing to reach an agreement, when this would be profitable, may imply significant welfare losses. The question raised in this paper is whether the intervention of a government, who has a positive valuation of agreement and therefore offers a subsidy, will reduce such delays and inabilities to reach agreement? Based on a perfect Bayesian equilibrium in a sequential bargaining game with intervention, we show that in equilibrium intervention always reduces the ex ante equilibrium inefficiency and conditionally reduces expected delays in trade. However, for intervention in the form of a subsidy to take place, the aggregate of the seller’s reservation price and the externalities must be (almost) as high as the buyer’s upper valuation limit.     

Reengineering--setting a course for radical change

When you pull up anchor and start reengineering, the seas can look a little rough. Here's what the strategist can expect when retooling some of the typical business processes that make up an average company: manufacturing, sales, information technology, back office/support services, and human resources.     

The environmental Kuznets curve revisited once again

In the past decade, considerable attention has been paid to the hypothesized inverted U-shaped relationship between income level and environmental quality, known as the environmental Kuznets curve (EKC). An overview of empirical studies of this relationship finds limited evidence for an EKC. The strongest evidence is with urban SO2 concentrations. A close examination of a seminal paper in this field, which first reported the relationship between income level and SO2 concentrations, finds the relationship weak at best. Given the limited evidence for an EKC, why is it still accepted as fact? This article suggests that it both serves the interests of powerful groups in society, and it corresponds to a notion that wealthy people care more about environmental quality than do poor people.     

Entrepreneurs' Personal Values,Compensation, and High Growth Firm Performance

We tested whether high growth firms' performance is related to the number of benefits offered and/or the values of the entrepreneur. Using data from the 2007 top 500 fastest growing entrepreneurial firms in America, we discovered that entrepreneurs' values do not relate to the total number of benefits offered, meaning the mediation model does not exist and lending strength to the argument that entrepreneurs' values greatly influence the success of a new venture. However, the total benefits offered are positively related to firm performance. We determine that the entrepreneurs' values and the total benefits offered are instrumental to firm performance.     

Fundamental theorems of asset pricing for piecewise semimartingales of stochastic dimension

This paper has two purposes. The first is to extend the notions of an n-dimensional semimartingale and its stochastic integral to a piecewise semimartingale of stochastic dimension. The properties of the former carry over largely intact to the latter, avoiding some of the pitfalls of infinite-dimensional stochastic integration. The second purpose is to extend two fundamental theorems of asset pricing (FTAPs): the equivalence of no free lunch with vanishing risk to the existence of an equivalent sigma-martingale measure for the price process, and the equivalence of no arbitrage of the first kind to the existence of an equivalent local martingale deflator for the set of nonnegative wealth processes.