Sticking points: common‐agency problems and contracting in the US healthcare system

We propose a “common‐agency” model for explaining inefficient contracting in the US healthcare system. Common‐agency problems arise when multiple payers seek to motivate a provider to invest in improved care coordination. We highlight the possibility of “sticking points,” that is, Pareto‐dominated equilibria in which payers coordinate around contracts which give weak incentives to the provider. Sticking points rationalize three hard‐to‐explain features of the US healthcare system: widespread fee‐for‐service arrangements; problematic care coordination; and the historical reliance on single‐specialty practices to deliver care. The model also analyzes the effects of policies promoting more efficient contracting between payers and providers.     

Systematic Mortality Improvement Trends and Mortality Heterogeneity: Insights from Individual-Level HRS Data

Providers of life annuities and pensions need to consider both systematic mortality improvement trends and mortality heterogeneity. Although how mortality improvement varies with age and gender at the population level is well studied, how trends vary with risk factors remains relatively unexplored. This article assesses how systematic mortality improvement trends vary with individual risk characteristics using individual-level longitudinal data from the U.S. Health and Retirement Study between 1994 and 2009. Initially a Lee-Carter model is used to assess mortality improvement trends by grouping individuals with similar risk characteristics of gender, education, and race. We then fit a longitudinal mortality model to individual-level data allowing for heterogeneity and time trends in individual-level risk factors. Our results show how survey data can provide valuable insights into both mortality heterogeneity and improvement trends more effectively than commonly used aggregate models. We show how mortality improvement differs across individuals with different risk factors. Significantly, at an individual level, mortality improvement trends have been driven by changes in health history such as high blood pressure, cancer, and heart problems rather than risk factors such as education, marital status, body mass index, and smoker status.     

A new spread estimator

A cynosure of the academic literature relating to initial public offerings (IPOs) is the question of why they are “mispriced” so frequently. The large and growing literature addressing this question is evidence as to its intractability. This paper develops a theory of underwriters’ behavior suggesting that they will exploit their private information to minimize the bilateral risks to themselves of firm-commitment IPOs. That minimization may cause them to knowingly underprice the issue. The main result in this paper is based, in part, on the premise that the random character of the investors’ demand for shares in the secondary market, given the spread, is governed by an estimable conditional probability distribution. The underwriters exploit their private knowledge of that probability distribution to influence the number of shares in the offering in such a way as to minimize their expected loss function.     

Market Model-Based Channel Selection in B2B E-Commerce: Exploring a Buyer's Adoption Decisions

Companies that seek to exploit the cost advantages of business-to-business (B2B) e-Commerce face a variety of strategic options. By analyzing the demand and cost functions for sellers, intermediaries, and buyers, this research develops an economic framework that clarifies the relative advantages of four common B2B e-Commerce channels: private exchange, web-based procurement, public aggregation, and public exchange. This research focuses on addressing two important questions: (1) How does a buyer select a suitable B2B e-Commerce channel (or an e-Marketplace structure) given a variety of market conditions, different levels of product substitution, and a range of purchasing patterns? (2) How does a buyer successfully manage a B2B e-Commerce channel for gaining the highest transaction-level buyer surplus? The analytic and numeric results of our study show that a company's product offerings, the market conditions it faces, and the purchase patterns it implements are all important determinants in the selection of B2B e-Commerce setting. For custom products, private networks (such as the private exchange or web-based procurement models) are more attractive than the public aggregation or exchange models. However, taking market conditions and purchasing behavior into consideration, the web-based procurement model is more suitable for spot purchasing, while the public exchange model is more suitable for systematic purchasing and fragmented markets. On the other hand, the aggregation model is preferable in concentrated markets while the exchange model is more suitable in fragmented markets. These results provide important implications for industrial development of B2B e-Commerce.     

The cash flow statement: The tip of an iceberg

The newly required Statement of Cash Flows provides helpful information, as long as the reader takes care to look below the water line.     

Redressing gender inequality in employment: the national and sub-regional policy 'fit'

This article examines the 'fit' between policy development regarding gender inequality in employment at sub-regional and national (UK) level, in particular focusing on the experience of women. Drawing on research undertaken in Coventry and Warwickshire, the article explores the question of how policy development at sub-regional level fits with national policy, and whether the sub-region is an appropriate, or effective, level at which to develop policy on gender inequality in employment. It is argued that while there needs to be recognition of the limited ability of sub-regional policy to confront structural issues, policy development at this level does offer potential strengths in redressing both gender inequality in employment and the relative lack of a gender dimension in local economic development.