Retiree health care costs: a workable plan

Thirty-three million retired Americans have taken for granted the warm security that health care would be provided throughout their retirement--by Medicare, by their employers, certainly by someone, because it must be an inalienable right. As the financial aspects of retiree health care are examined, however, it is important to keep in mind who will pay for it and how much we are willing to spend. This raises three important questions: Are we ready to spend that much? Is that sum enough to produce the system we want? Will we get our money's worth or just start another round of health care inflation? This article suggests two programs, one for addressing this staggering problem and another to deal with the financing of retiree health care.     

Developing critical reflection: An integrated approach

The increasing impact of globalisation and digitalisation on accounting reinforces the need for accounting education to develop students' core professional skills such as communication, analytical skills and critical thinking, as well as their ability to evaluate the relativity of their knowledge and acknowledge learning needs. This paper reports on a comparative study that explores outcomes from surveys of two separate student groups as they engaged with the elements and components of a task designed to develop their skills and ability to reflect on the currency of knowledge. Findings show merit in the design's integrated and interactive approach, including the transition of students' perspectives, with critical reflection developed through sequencing individual and cooperative learning, oral and written exercises, and formative and summative assessment. Survey responses from students indicate that they responded positively to the challenge of critically reflecting upon research and articulating the relativity of their knowledge.     

Combining health education, risk-rated insurance and employee rebates into an integrated health care cost management strategy

Health education, risk rating and employee rebates can be combined into a comprehensive health promotion program within a benefits plan, reflecting health promotion in its truest sense.     

Managed care, consolidation among health care providers, and health care: evidence from mammography

We discuss the effects of managed care on the structure of the health care delivery system, focusing on managed-care-induced consolidation among health care providers. We empirically investigate the relationship between HMO market share and mammography providers. We find evidence of consolidation: increases in HMO activity are associated with reductions in the number of mammography providers and with increases in the number of services produced by remaining providers. We also find that increases in HMO market share are associated with reductions in costs for mammography and with increases in waiting times for appointments, but not with worse health outcomes.     

Choosing health care online: a 7-Eleven case study

This article describes 7-Eleven's success in offering Web-based health care enrollment to its diverse workforce, which made the introduction of such service delivery strategy unusually challenging. Through its efforts, 7-Eleven was able to meet several important objectives, including helping employees better appreciate the value of their benefits, providing employees with increased services and convenience, and encouraging employees to make more cost-effective choices in their health care coverage.     

特色化发展:农发行营销战略的核心

对农发行信贷业务范围的严格限制,决定了农发行不可能像商业银行那样,全方位发展、多元化经营,而应走专业化、特色化的发展道路,实施相应的市场营销战略。随着农村改革和金融改革的不断深化,市场经济的不断发育,农业发展银行业务发展的基础和环境正在发生重大变化。农发行在落实国家调控政策,实现业务快速增长和结构改善的同时,市场营销已成为促进业务发展新的动力。为了更好地促进现代农业和新农村建设,充分发挥     

Educating employees on defined contribution health care: the time is right for an employee-empowering approach

There are many indications that health benefits will be transformed into a consumer-driven business. This article discusses multiple reasons for this change and how the defined contribution approach can be applied to health care. The authors discuss the communication challenges that would accompany this approach as well as other issues to be considered.     

Retiree health care benefits: strategies for a changing workforce.

Demographic, economic and cultural trends foretell a dramatically different environment for retiree health care coverage. This article will focus on the redesign of retiree health benefits to meet the retirement objectives of employers and employees, anticipate changing demographics, and respond to changes in Medicare and other government initiatives, including the Consumer Bill of Rights. The material will discuss recent design trends, including managed care, and present results of a study the author co-authored for the Kaiser Family Foundation on changes in retiree health plans.     

The 4% strategy revisited: a pre-commitment mean-variance optimal approach to wealth management

In contrast to single-period mean-variance (MV) portfolio allocation, multi-period MV optimal portfolio allocation can be modified slightly to be effectively a down-side risk measure. With this in mind, we consider multi-period MV optimal portfolio allocation in the presence of periodic withdrawals. The investment portfolio can be allocated between a risk-free investment and a risky asset, the price of which is assumed to follow a jump diffusion process. We consider two wealth management applications: optimal de-accumulation rates for a defined contribution pension plan and sustainable withdrawal rates for an endowment. Several numerical illustrations are provided, with some interesting implications. In the pension de-accumulation context, Bengen (1994)’s [J. Financial Planning, 1994, 7, 171–180], historical analysis indicated that a retiree could safely withdraw 4% of her initial retirement savings annually (in real terms), provided that her portfolio maintained an even balance between diversified equities and U.S. Treasury bonds. Our analysis does support 4% as a sustainable withdrawal rate in the pension de-accumulation context (and a somewhat lower rate for an endowment), but only if the investor follows an MV optimal portfolio allocation, not a fixed proportion strategy. Compared with a constant proportion strategy, the MV optimal policy achieves the same expected wealth at the end of the investment horizon, while significantly reducing the standard deviation of wealth and the probability of shortfall. We also explore the effects of suppressing jumps so as to have a pure diffusion process, but assuming a correspondingly larger volatility for the latter process. Surprisingly, it turns out that the MV optimal strategy is more effective when there are large downward jumps compared to having a high volatility diffusion process. Finally, tests based on historical data demonstrate that the MV optimal policy is quite robust to uncertainty about parameter estimates.     

Epilogue: health care reform and productivity

Only a health care system that balances the best interests of consumers with those of employers and government payers will ultimately provide quality care at manageable costs. These need not be opposing interests.     

Consumer-driven health care: tangible employer actions

In response to double-digit health care cost increases, leading employers are aiming aggressive strategies at changing participant and provider behaviors--strategies that go well beyond the narrow idea of a new cost-sharing design. This article describes the elements of a comprehensive consumer-driven health care strategy and provides examples of tangible consumer-driven health care initiatives in the areas of design, pricing, contracting, support and public policy.     

Information-sharing in health and social care: Lessons from a socio-technical initiative

Advances in information technology have led to new and innovative approaches in data-sharing, analysis, interpretation, and the potential for real-time responses to changes in health and social care status. However, health and social care information is not only complex but often socially and personally sensitive in ways that do not apply in other domains. This requires adoption of a tailored interdisciplinary (social, ethical, legal, technical and data science) and intersectoral (health and social care, academic and commercial institutions and citizens) approach to technology development. The authors present some important lessons to date from ongoing development of an innovative infrastructure for sharing health and social care data.     

Performance measurement in academic departments: the strategy map approach

This article describes the implementation of the balanced scorecard (BSC) strategy map in a university department. The department is a good example of a complex public sector service organization—therefore the article has relevance beyond universities. The strategy map was found to be an extremely good way of measuring performance. In addition, the BSC/strategy map helps in monitoring and building departmental mission and goals and the authors recommend wider use.     

中国资本市场的发展战略应怎样

今年年初以来,我国资本市场很不正常。大起大落、剧烈波动现象时有发生,市场下跌幅度之大在全球证券市场史上也属罕见,股票价格的快速下跌,对我国资本市场长远发展而言无疑是非常不利的。那么,我国资本市场要取得持续发展,应该在哪些方面做出努力