US budget impact of increased payer adoption of the Flexitouch advanced pneumatic compression device in lymphedema patients with advanced chronic venous insufficiency and multiple infections

Aims: To assess the budget impact to a US commercial health plan of providing access to the Flexitouch (FLX) advanced pneumatic compression device (Tactile Medical) to lymphedema (LE) patients with either comorbid chronic venous insufficiency (CVI) or frequent infections.

Methods: Budget impact was calculated over 2 years for a hypothetical US payer with 10-million commercial members. Model inputs were derived from published sources and from a case-matched analysis of Blue Health Intelligence (BHI) claims data for the years 2012–2016. To calculate the budget impact, the Status Quo budget (i.e. total cost for LE and sequelae-related medical treatment) was compared to the budget under each of three Alternate Payer Policy scenarios which assumed that a sub-set of patients was redistributed from their initial treatment groups to a group that received FLX. Model outputs included cumulative payer costs, net budget impact, and breakeven point. Sensitivity analyses were performed to assess the impact of model inputs on results.

Results: Increasing access to FLX yielded a favorable budget impact in every scenario. For LE patients with comorbid CVI, the three alternate scenarios resulted in cumulative 2-year budget impacts of –$52,841, –$173,317, and –$375,601, respectively. For LE patients with comorbid frequent infections, the three alternate scenarios resulted in cumulative 2-year budget impacts of –$192,729, –$259,339, and –$613,179, respectively.

Limitations: Use of claims data assumes accurate coding and does not allow one to control for disease severity or treatment adherence. Also, the distribution of patients between treatment arms was determined using claims data from a specific payer organization, and could differ for health plans with different coverage policies.

Conclusions: While previous studies have illustrated cost savings with adoption of FLX, US commercial health plans may also achieve tangible cost savings by expanding access to FLX for LE patients with comorbid CVI and multiple infections.     

minimum wage, maximum unemployment

The Minimum Wage is now a controversial part of the political debate in the run-up to the General Election. Martin Summers, a research associate of the Institute of Economic Affairs, reviews the evidence of how the minimum wage has worked in other countries and concludes that the creation of unemployment is almost the least of the evils it causes.     

Particularism around the World

This article presents a new data set on electoral systems andoutlines its potential uses in research on the links betweenelectoral systems and economic outcomes. The data measure theextent to which politicians can advance their careers by appealingto narrow geographic constituencies on the one hand or partyconstituencies on the other.     

Whistleblowing in Organizations: An Examination of Correlates of Whistleblowing Intentions,Actions, and Retaliation

Whistleblowing on organizational wrongdoing is becoming increasingly prevalent. What aspects of the person, the context, and the transgression relate to whistleblowing intentions and to actual whistleblowing on corporate wrongdoing? Which aspects relate to retaliation against whistleblowers? Can we draw conclusions about the whistleblowing process by assessing whistleblowing intentions? Meta-analytic examination of 193 correlations obtained from 26 samples (N = 18,781) reveals differences in the correlates of whistleblowing intentions and actions. Stronger relationships were found between personal, contextual, and wrongdoing characteristics and whistleblowing intent than with actual whistleblowing. Retaliation might best be predicted using contextual variables. Implications for research and practice are discussed.     

‘To help keep the home going’: female labour supply in interwar London

Most prior work on historical female labour supply has been confined to looking at the female labour force participation decision. This article uses the detailed information on weekly hours of work and wages contained in the New Survey of London Life and Labour (NSLLL) (1928–32) to provide the first estimation of both the participation and the hours‐of‐work decisions for female workers prior to the Second World War. The main finding is that the labour supply curve was negatively sloped—women worked longer hours at lower wages. It is also possible to compare the determinants of the labour force participation decision and the hours of work decision among females in the NSLLL. It appears that the labour force participation decision was more strongly related to household income level than to own wages, while the hours of work decision among working women was more strongly related to the wage level than to household income. Finally, the article also examines the differential labour market behaviour of married women, female household heads, and young single women; most striking among these results is the evident added‐worker effect on married women of the onset of the Great Depression in 1930.     

Can Leaders Enhance Follower Innovation by Requiring It?

Organizations today want to become more innovative, but should leaders include innovation as a job requirement for employees? While clear goals and roles enable accountability and results, innovation requires autonomy and risk‐taking amidst uncertain and unstable environments. The current article identifies the pros and cons of requiring innovation, and raises important questions for leaders to consider.     

Competition among Colleges for Students across the Nation

Colleges compete with one another for students. This article overcomes historical data limitations associated with forming a national picture of competition among colleges using the universe of SAT-takers. We identify and measure competition by the overlap within the set of colleges to which students send their SAT scores (Score Sends). We document the competitive landscape for 1152 colleges between 1996 and 2013 including the number of competitors, the intensity of the competition, and characteristics of a college's primary competitors. For example, on average, a college has Score Send overlap with 736 other institutions and their primary competitors are located 104 miles away and have 34.2% Score Send overlap. All of the documented measures of competition vary greatly by institution type but do not change dramatically over the time period examined.     

Accounting narratives and impression management on social media

In this paper, we examine the defensive and assertive impression management strategies and the impact of firm performance on accounting narratives by investigating the earnings disclosures of FTSE 100 companies on Twitter. Social media has become the prevailing venue for organisational self-presentation because it provides firms with more control over the image they intend to establish and maintain through the communication and content they deliver online. Our findings show that firms minimise the disclosures of negative information but employ various patterns and dissemination techniques to emphasise positive information. Specifically, improving performers are more willing to post and disseminate earnings-related tweets to achieve a higher degree of stakeholder engagement than declining performers. Based on these findings, we conclude that firms present themselves on social media opportunistically to construct a positive public image.