Adverse Selection, Moral Hazard, and Outlier Payment Policy

In this article, we analyze the rationale for introducing outlier payments into a prospective payment system for hospitals under adverse selection and moral hazard. The payer has only two instruments: a fixed price for patients whose treatment cost is below a threshold     and a cost-sharing rule for outlier patients. We show that a fixed-price policy is optimal when the hospital is sufficiently benevolent. When the hospital is weakly benevolent, a mixed policy solving a trade-off between rent extraction, efficiency, and dumping deterrence must be preferred. We show how the optimal combination of fixed price and partially cost-based payment depends on the degree of benevolence of the hospital, the social cost of public funds, and the distribution of patients severity.     

Not all international assignments are created equal: HQ-subsidiary knowledge transfer patterns across types of assignments and types of knowledge

Drawing on 50 semi-structured interviews in a case study of a Belgian multinational and its foreign subsidiary in Poland, we develop new insights into how using different types of international assignments (long-term expatriation, short-term expatriation, short-term inpatriation) allows a HQ-subsidiary dyad to transfer different types of knowledge (declarative, procedural, axiomatic, relational), both from and to HQ, during and after the assignment. We show how each type of assignment acts as a unique knowledge transfer channel, and why it is critical that HQ-subsidiary dyads use an appropriate combination and sequence of international assignments reflecting their specific knowledge transfer needs.     

Co‐workers' voice climate and affective commitment towards the team: A test of mediation and moderation

This article examines the consequences of co‐workers' voice climate, defined as a shared perception regarding how individuals who work together within the same unit and who do not have formal authority over each other judge the ability to participate in decision making inside teams. We argue that co‐workers' voice climate may influence individuals' perception of quality of social exchange with the team, operationalised through team–member exchange. These high‐quality exchanges with the team should, in turn, promote higher individual affective commitment towards the team. Furthermore, we hypothesised that the social exchange with the supervisor, operationalised through leader–member exchange, buffers the effect of co‐workers' voice climate on team–member exchange. These hypotheses were tested using a sample of 183 employees belonging to 31 teams. Our findings supported the theoretical model that was proposed, attesting to the importance of considering co‐workers' justice climate in the prediction of individual work attitudes. The theoretical and practical implications of these results are discussed.     

Cost-effectiveness of telaprevir in combination with pegylated interferon alpha and ribavirin in previously untreated chronic hepatitis C genotype 1 patients

Background:

Telaprevir (T, TVR) is a direct-acting antiviral (DAA) used for the treatment of genotype 1 chronic hepatitis C virus (HCV) infection. The sustained virological response (SVR) rates, i.e., undetectable HCV RNA levels 24 weeks after the end of treatment, is what differentiate treatments. This analysis evaluated the cost-effectiveness of TVR combined with pegylated interferon (Peg-IFN) alfa-2a plus ribavirin (RBV), with Peg-IFN and RBV (PR) alone or with boceprevir (B, BOC) plus Peg-IFN alfa-2b and RBV, in naïve patients.

Methods:

A Markov cohort model of chronic HCV disease progression reflected the pathway of naïve patients initiating anti-HCV therapy. SVR rates were derived from a mixed-treatment comparison including results from Phase II and III trials of TVR and BOC, and trials comparing both PR regimens. SVR has significant impact on survival, quality-of-life, and costs. Incremental cost per life year (LY) gained and quality-adjusted-life-year (QALY) gained were computed at lifetime, adopting the (National Health Service) NHS perspective. Cost and health outcomes were discounted at 3.5%. Uncertainty was assessed using deterministic and probabilistic sensitivity analyses. Sub-group analyses were also performed by interleukin (IL)-28B genotype and fibrosis stage.

Results:

Higher costs and improved outcomes were associated with T/PR relative to PR alone, resulting in an ICER of £12,733 per QALY gained. T/PR retained a significant SVR advantage over PR alone and was cost-effective regardless of IL-28B genotype and fibrosis stages. T/PR regimen ‘dominated’ B/PR, generating 0.2 additional QALYs and reducing lifetime cost by £2758. Sensitivity analyses consistently resulted in ICERs less than £30,000/QALY for the T/PR regimen over PR alone.

Limitations:

No head-to-head trial provides direct evidence of better efficacy of T/PR vs B/PR.

Conclusion:

The introduction of TVR-based therapy for genotype 1 HCV patients is cost-effective for naïve patients at the £30,000 willingness-to-pay threshold, regardless of IL-28B genotype or fibrosis stage.     

Well-being and the Wealth of Nations: How are They to Be Defined?

Questions relating to well-being have recently returned to the limelight, notably with the publication in September 2009 of the Stiglitz-Sen-Fitoussi commission report on the measurement of economic performance and social progress. Has this commission changed the terms of the debate on what a society's wealth and well-being are? Has it proposed new paradigms? In accepting the limitations of GDP as a key indicator of well-being, has it developed a new theoretical foundation and new evaluation criteria suited to a very different situation and to very different priorities from those that prevailed at the time when GDP first became established as a measure of national economic performance? These are the main questions raised and reviewed by this paper.     

Ownership structure,corporate governance and analyst following: A study of French listed firms

This study investigates the effects of some characteristics of the French corporate governance model – deemed to foster entrenchment and facilitate private benefits extraction – on the extent of analyst following. The results show that analysts are more likely to follow firms both with high discrepancy level between ownership and control and those controlled through pyramiding. These findings provide empirical support to the argument that minority shareholders value private information on firms with high expropriation likelihood, asking thence for more analyst services. Additional findings show that analysts are reticent to follow firms managed by controlling family members. This is, in part, explained by these firms’ reliance on private communication channels rather than public disclosure, producing a poor informational environment.     

Conflict displacement and labor market outcomes in post-war Bosnia and Herzegovina

The war in Bosnia and Herzegovina of the early nineties displaced 1.3 million people. This study uses longitudinal data to document the effects of this displacement on labor market outcomes. To account for endogeneity in displacement, I exploit the fact that the level of violence affected the decision to leave and that pre-war economic performance is orthogonal to local violence levels. I find that displaced Bosnians are less likely to be working relative to the people who stayed. Displaced men experience higher unemployment levels, and displaced women are more likely to drop out of the labor force.     

国际酒类展览会2011将如期而至

薄荷胡椒味、浆果杏子味、黑加仑巧克力味等各种口味的葡萄酒一展"酒中时尚",多种窖藏多年的极品红酒香飘四溢,酿酒师花式调酒精彩表演凸显浓浓异国情调,当2010年国际酒类展览会的浓醇酒香还在嘴边回味时,新一届的国际酒类展览会(ProWein 2011)将在3月27～29日如期举行。