医保医疗款会计核算方法探讨

现阶段,我国基本医疗保险覆盖率达95%,全民医疗保险的制度框架已经建立,医保业务收入占业务收入的实际比重越来越大,未来或将取代现金医疗收入成为医院医疗收入核算的主体,因此,对这部分医保医疗款如何更清晰地核算成为了医院财务管理工作中一个重要的环节,正确、清晰地对这部分医疗收入进行会计核算,会有利于加强医院对医保医疗款的管理。     

The Effects of Customer Satisfaction on Company Profitability: Evidence From the Property and Casualty Insurance Industry

Prior literature presents a positive link between customer satisfaction and firms’ financial outcomes, including greater revenue, profitability, and prices. However, few studies approach the topic of customer satisfaction in the insurance industry. Using a unique data set obtained from J.D. Power, we observe customer satisfaction among U.S. auto insurers and link their customer satisfaction rating to insurer profitability metrics. Our results support the notion that greater customer satisfaction leads to reduced expenses and increased profitability. A potential explanation is that more satisfied customers are more likely to remain with an insurance company and refer others to the insurer, reducing customer acquisition expenses.     

Statistical Implications of the Revenue Transfer Methodology in the Affordable Care Act

The Affordable Care Act (ACA) includes a permanent revenue transfer methodology that provides financial incentives to health insurance plans that have higher than average actuarial risk. In this article, we derive some statistical implications of the revenue transfer methodology in the ACA. We treat as random variables the revenue transfers between individual insurance plans in a given marketplace, where each plan’s revenue transfer amount is measured as a percentage of the plan’s total premium. We analyze the means and variances of those random variables and deduce from the zero-sum nature of the revenue transfers that there is no limit to the magnitude of revenue transfer payments relative to plans’ total premiums. Using data provided by the American Academy of Actuaries and by the Centers for Medicare & Medicaid Services, we obtain an explanation for empirical phenomena that revenue transfers were more variable and can be substantially greater for insurance plans with smaller market shares. We show that it is often the case that an insurer that has decreasing market share will also have increased volatility in its revenue transfers.     

The market’s use of supplier earnings information to value customers

In this paper we examine whether the quarterly earnings announcements of supplier firms contain information about their customer’s earnings. Our evidence suggests that they do. Specifically, we find evidence consistent with the market impounding supplier firm earnings information into the stock prices of the firm’s customers. This is consistent with the market using the supplier’s earnings to help assess the customer firm’s future cash flows and/or uncertainty of those cash flows. We also find that the quality of the earnings influences the magnitude of the customer firm’s stock price reaction. The customer’s stock price reaction is increasing in the revenue growth reported by the supplier and the past persistence of the supplier’s earnings. Additional tests reveal that the market reaction is amplified when the customer firm is more dependent on the supplier. Finally, we find that the relative bargaining power of the customer influences the market reaction to supplier earnings. While prior research has documented that the market uses industry peer earnings and customer earnings in pricing a firm’s stock, this is the first study to provide evidence on the market’s use of supplier earnings information.     

Substitution of Noncash Payment Instruments for Cash in Europe

The substitution of noncash (check, giro, credit and debit card) payments for cash transactions is of interest for monetary policy and for determining central banks' future seigniorage revenue. We develop a novel method for approximating the share of cash transactions using public information on currency stocks, noncash payments, and card payment technology for 10 European countries. We also provide a forecast of future cash use by country. The trend in cash substitution across countries is quite similar, but the countries themselves are at significantly different stages in this process. The spread of debit and credit card payments has been the key factor behind the substitution away from cash as the use of electronic cash is still in its infancy.     

健康险赔付与医院收入长期联动效应分析——基于VAR和VEC模型的实证

近年来我国健康险发展较快,但其高赔付率成了进一步发展的"瓶颈",这主要源于医险市场中的道德风险。本文运用计量经济学方法,对保险赔付和医院收入的关系进行了实证分析。结论:医院医疗收入、门诊收入和住院收入是导致保险赔付上升的原因,健康险赔付对医院收入的影响作用不显著,健康险业务的健康发展离不开医方的紧密协作。建议:保险公司需重视与医院和医生的合作,突出合作重点、改革合作方式和革新合作内容。     

Creating Customer Value in Participating Life Insurance

The value of a life insurance contract may differ depending on whether it is looked at from the customer's point of view or that of the insurance company. We assume that the insurer is able to replicate the life insurance contract's cash flows via assets traded on the capital market and can hence apply risk‐neutral valuation techniques. The policyholder, on the other hand, will take risk preferences and diversification opportunities into account when placing a value on that same contract. Customer value is represented by policyholder willingness to pay and depends on the contract parameters, that is, the guaranteed interest rate and the annual and terminal surplus participation rate. The aim of this article is to analyze and compare these two perspectives. In particular, we identify contract parameter combinations that—while keeping the contract value fixed for the insurer—maximize customer value. In addition, we derive explicit expressions for a selection of specific cases. Our results suggest that a customer segmentation in this sense, that is, based on the different ways customers evaluate life insurance contracts and embedded investment guarantees while ensuring fair values, is worthwhile for insurance companies as doing so can result in substantial increases in policyholder willingness to pay.     

金融机构现金收支对人均GDP的影响——基于建国60年来数据的实证分析

本文运用我国1953～2007年金融机构现金收支与人均GDP数据,实证分析了建国60年来我国金融机构现金收支对人均GDP的影响。Johansen协整检验表明,我国金融机构现金收支与人均GDP之间存在长期的稳定关系;脉冲响应和方差分解表明,金融机构现金收支总额对人均GDP的冲击都存在时滞但方向相反;与金融机构现金收入总额的作用相比,金融机构现金支出总额对人均GDP的方差贡献率相对较大。该实证结果的政策含义是,在我国运用货币政策调节宏观经济是有效的,但政策的制定需要在对宏观经济形势准确预测的基础上具有一定的前瞻性。在全球金融危机发生后,我国及时推行宽松的货币政策,其政策取向是正确的。     

关于股改前后现金股利影响因素的实证研究

对股改前后影响现金股利水平的公司治理变量研究表明,虽然股改矫正了现金股利与增长机会之间的关系,使股改后当存在增长机会时,公司会减少现金股利的发放,但是我国上市公司的现金股利尚未呈现出全流通资本市场上作为降低控股股东与中小股东代理成本工具的现金股利政策应有的特征,突出表现在股改前后影响上市公司现金股利支付水平的股权结构变量并未发生变化,股改前后都存在股权集中度、第一大股东持股比例及第二到第十大股东持股比例与每股现金股利呈显著正相关、而流通(非限售)股比例与每股现金股利呈显著负相关的关系。     

Structural and executional drivers of downstream revenue

Revenue flows that occur at other related organizational units and over time are an important part of customer profitability analysis and resource planning. This study analyzes downstream revenue generated from establishing a series of additional organizational units. The setting is a central hospital which established a group of specialty outreach clinics. Using a specially-collected time-series database I show two distinct patterns, depending on the clinic's specialty. One type triggers immediate incremental downstream revenue to the clinic's sponsoring department. The other type of clinic generates revenue that is smaller in value, later in time and mostly in departments not associated with the sponsoring department's medical specialty. Structural and executional clinic characteristics such as distance and clinic frequency differentially affect the amount of revenue generated, implying a need for tailoring performance measures to “clinic type”. Overall, my results suggest caution in developing performance measures that include financial impact in other organizational units – context matters even in a relatively homogenous setting of specialty clinics in one hospital system.     

The impact of the new Accounting Standards for Business Enterprises (ASBE) on financial results of mainland Chinese listed companies

Effective 1st January 2007, 38 new Accounting Standards for Business Enterprises (ASBE) had become applicable to listed companies in mainland China. Research based on these latest standards will help us understand the current accounting harmonisation process in China. Previous studies, though rather scarce, had compared financial statements of companies simultaneously being listed on the mainland and Hong Kong. However, the very recent impact of the new ASBE has not been taken into account. Therefore, the present study focuses on domestic Chinese companies after implementation of the new ASBE. The financial figures of each item reported under the old Chinese Accounting Rules and Regulations and the new ASBE were collected in pairs and were analysed. Except for the test results on total assets and shareholders' equity, the other results revealed no significant differences between the paired figures of net assets per share, operating revenue, profit before tax, net profit, net profit after extraordinary gains and losses, basic earnings per share, net cash flow from operating activities and the per share value.     

Method and tools for insurance price and revenue optimisation

This paper introduces the emerging field of demand-driven insurance price and revenue optimisation. Following an introduction to the field, a case study is presented, illustrating a typical price optimisation project performed on a car comprehensive insurance portfolio at a direct insurance company. The study describes an actual price optimisation process using price testing, demand estimation, margin optimisation and controlled test validation procedures. Demand data were collected from a sample of 10,582 customers during June–July 2002. The subsequent demand-driven price optimisation process generated a profitability impact assessment of 9 per cent in net profit per a 1 per cent loss in customer retention. This assessment was validated in a controlled test conducted on a sample of 12,077 customers who were randomly assigned optimised or non-optimised prices. Test results validated the optimisation assumptions, generating a 10 per cent improvement in expected annual profit.     

Cash Flow Risk Management in the Property/Liability Insurance Industry: A Dynamic Factor Modeling Approach

This study proposes and demonstrates a dynamic factor model that can be empirically carried out by the utilization of a factor-augmented autoregressive technique to explain and forecast the time-varying patterns of cash flows of insurance companies in the United States. A principal component approach is employed in the Factor-Augmented Autoregressive Model (FAARM) to capture the augmented factors that are to be utilized for forecasting. We describe the cash flow statistical model by a dimension-reduction technique that can depict the dynamic patterns of the cash flows of insurance firms and then measure the FAARM model. Results from the first step (principal component analysis) help capture the macroeconomic variables and the variables pertaining to insurance companies' cash flows, namely, cash flows from investment, underwriting, and risk management activities. Results from the second step offer evidence supporting that the FAARM improves the out-of-sample forecasting accuracy assessed by a forecasted root-mean-squared error (FRMSE). This article presents a set of feasible FAAR models from which an insurance firm can choose one that can be a better fit to the firm corresponding to its specific firm characteristics, such as firm size. Consequently, the chosen FAARM(s) can improve the accuracy of cash flow forecasting and thus can help insurers to manage risk via cash-flow–matching techniques.     

An Empirical Investigation of Market Structure, Efficiency, and Performance in Property-Liability Insurance

This study examines the relationships among market structure and performance in property‐liability insurers over the period 1992–1998 using data at the company and group levels. Three specific hypotheses are tested: traditional structure‐conduct‐performance, relative market power, and efficient structure (ES). The results provide support for the ES hypothesis. The ES hypothesis posits that more efficient firms can charge lower prices than competitors, enabling them to capture larger market shares and economic rents, leading to increased concentration. Both revenue and cost efficiency are used in the analysis, and this is the first study to use revenue efficiency in this type of analysis. The results for the sample period as a whole and by year are consistent. The overall results suggest that cost‐efficient firms charge lower prices and earn higher profits, in conformance with the ES hypothesis. On the other hand, prices and profits are found to be higher for revenue‐efficient firms. Revenue X‐efficiency is derived from activities such as cross‐selling and may rely heavily on the use of detailed information from customer databases to identify potential customers. The implications of this research are that regulators should be more concerned with efficiency (both cost and revenue) rather than the market power that arises from the consolidation activity taking place in insurance.     

Take command of your growth

Ask senior managers to pare costs by 10%, and they know just what to do. Ask them to boost growth by 10%, and they're stymied, assuming that growth is not really something they can influence. But managers can control their company's growth if they have better information about where their revenues are coming from. Rather than sort sales by geographic market, business unit, or product line, they should break them out in a way that reveals which part of their strategy is responsible for what part of their revenue. This article presents a tool--the sources of revenue statement (SRS)--that does just that. Through straightforward calculations using data taken from a company's balance sheet, along with estimations of customer-churn and industry growth rates, the SRS enables managers to classify their revenue according to five sources of growth: continuing sales to established customers (base retention); sales won from the competition (share gain); sales that fell into their laps because the market was expanding (market position); sales from moves into adjacent markets; and sales from entirely new lines of business. Once sorted in this way, revenue can be viewed as the outgrowth of manageable circumstances. At one company, seemingly healthy 10% total revenue growth masked substantial customer defections counter-balanced only by sales in a fast-expanding market--a market that actually grew faster than the company did. Rather than doing well, the company was ceding customers and market share to competitors. Comparing the sources of revenue across divisions can uncover similarly profound insights, which can suggest smart ways to change strategy or set stretch goals. Hundreds of companies are perched atop enormous potential that they can't see and so don't exploit. The SRS can endow them with sight and, more important, with understanding.     

Customers and cash: How relationships affect suppliers' cash holdings

If one customer accounts for a large portion of a supplier's sales, then the loss of that one customer can cripple the supplier's financial health. As a precaution against the additional operating risk induced by being in an important relationship with a customer, I find that suppliers in such relationships hold more cash on average than suppliers that are not in important relationships. Additionally, supplier's cash holdings increase proportionately with the importance of their customer relationships. Being in an important relationship affects cash holdings and leverage differently, indicating that firms manage cash and debt for different purposes. I find that suppliers in relationships primarily accrue cash through issuance of stock as opposed to debt or retained earnings. The results highlight the importance of understanding buyer–supplier relationships when evaluating a firm's financing policy.     

Understanding the Shift in Demand for Cash Value Life Insurance

Ownership of cash value life insurance in the United States has fallen in recent decades. Changes in age cohorts, family composition, and tax laws may have contributed to this decline. We identify factors that influence the demand for cash value life insurance and test whether they alone can explain the sharp decline in ownership. Demographic and tax code changes do not explain the decrease in permanent insurance. There is a consistent downward trend in demand from 1992 to 2010—particularly among middle‐age and younger households. The fewer households who own cash value policies are on average wealthier and more financially sophisticated, suggesting that permanent life insurance is increasingly being used as a tax shield rather than as a hedge against a loss in human capital.     

Alternative settlement methods and Australian individual share futures contracts

Individual share futures contracts have been introduced in Australia since 1994. Initially, the contracts were settled in cash. In 1996, cash settlement was gradually replaced by physical delivery. This study investigates the effects of the settlement method change on Australian individual stock and its futures markets. Specifically, we examine whether return and volatility of each market, correlation between the two markets, basis behavior, and hedging performance of futures markets differ across cash settlement period and physical delivery period. We find that, after the switch from cash settlement to physical delivery, the futures market, the spot market, and the basis all become more volatile. However, each individual share futures contract becomes a more effective hedging instrument. The improvement in hedging effectiveness is particularly impressive for the most recently established individual share futures contracts.     

Investor Response to Cash Flow Information

In this study the usefulness of cash flow data as required by the UK standard, FRS1 , is evaluated and cash flow per share is investigated as a possible specification of cash flow data that may contain information value for security markets. Recent innovation in earnings response models are used to test the robustness of the results and provide further insights into the time series properties of cash flow numbers. The findings indicate that the disaggregation of cash flow as required under FRS1 contains information beyond aggregate cash flow but that the required disaggregation is not optimal from an information standpoint. There is little evidence of any incremental information value of cash flow per share over cash flow numbers.     

Survival Analysis of a Household Portfolio of Insurance Policies: How Much Time Do You Have to Stop Total Customer Defection?

Customer‐side influences on insurance have been relatively ignored in the literature. Using the household as the unit of analysis, this article focuses on the behavior of households having multiple policies of different types with the same insurance company, and who cancel their first policy. How long after the household's cancellation of the first policy does the insurer have to retain the customer and avoid customer defection on all policies to the competition? And, what customer characteristics are associated with customer loyalty? Using logistic regression and survival analysis techniques, an assessment is made of the probability of total customer withdrawal, and the length of time between first cancellation and subsequent customer withdrawal. Using a European database spanning 54 months of household multiple policyholder behavior, the results show that cancellation of one policy is a very strong indicator that other household policies will be canceled. Further, the insurer can have time to react to retain the customer after the first cancellation, however, this time is significantly dependent on the method used to contact the company, household demographics, and the nature of the household's insurance policy portfolio. Surprisingly, core customers having three or more policies in addition to the canceled policy are more vulnerable to total defection on all policies than noncore customers. Further, the potential customer repelling effects of premium increases seem to wear out after 12 months. Strategic implications of the results are presented.