Impact of standards adoption on healthcare transaction performance: The case of HIPAA

The Health Insurance Portability and Accountability Act (HIPAA) is a standard for the healthcare industry mandating, in part, use of the EDI X12 protocol set for data exchanges among industry members. The motivation underlying this change was the view that lack of a standard format for healthcare data created significant inefficiencies, resulting in increased costs within the industry. With regulators’ supposition that the standard would improve data exchange performance, we set out to determine the actual performance implications of HIPAA.Using data on transactions occurring over 106 months from 1998 to 2004, we study the impact of the HIPAA standardization requirement on transaction performance in the form of transaction delivery time and transaction quality measured as percentage errors. Performance is expected to deteriorate immediately following HIPAA compliance, due to system disruption, before a longer-term trend toward improved performance. Transaction performance immediately following HIPAA compliance shows deterioration in transaction delivery time, as expected, but a surprising improvement in transaction quality. The longer-term trends associated with HIPAA compliance for both transaction quality and transaction delivery time show that both are trending toward improvement. However, when we compare performance three, six, and 12 months before and after HIPAA compliance, we find that neither delivery time nor quality has improved. The implications for practice and theory are discussed.     

Intrapreneurial intentions versus entrepreneurial intentions: distinct constructs with different antecedents

We posit that entrepreneurship and intrapreneurship are distinct entrepreneurial behaviors that differ in terms of their salient outcomes for the individual. Since individuals are likely to differ in their attitudes to these salient outcomes, and in their entrepreneurial self-efficacy, we hypothesize that a different strength of intention for entrepreneurship versus intrapreneurship will be due to individual differences in self-efficacy and in their attitudes to the outcomes from entrepreneurial, as compared to intrapreneurial, behavior. We find that while self-efficacy is significantly related to both entrepreneurial and intrapreneurial intentions, attitudes to income, ownership, and autonomy relate only to entrepreneurial intentions, while attitude to risk relates only to intrapreneurial intentions.     

Takeoffs

This paper identifies factors associated with takeoff—a sustained period of high growth following a period of stagnation. Countries that experience takeoffs average 2.3% annual growth following their stagnation episodes, while those that do not average 0%. Using probit, we find that de jure trade openness is positively and significantly associated with takeoffs. A one‐standard‐deviation increase in de jure trade openness is associated with a 55% increase in the probability of a takeoff in our default specification. Capital account openness encourages takeoff responses, but measures of de facto trade openness are found to be poor predictors of takeoffs. We also examine the determinants of nations achieving “sustained” takeoffs; i.e. those lasting eight years or longer. Takeoffs in countries with more commodity‐intensive output bundles are less likely to be sustained, suggesting that adverse terms‐of‐trade shocks may play a role in ending long‐term high growth episodes.     

The Impact of No-Fault Legislation on Automobile Insurance

Abstract

Since its inception, the effectiveness of no-fault legislation has been highly debated. Although some research suggests that no-fault laws are effective in reducing costs, other evidence suggests that the current no-fault systems may not meet the original objectives. This study provides a detailed assessment of the relation of no-fault laws and automobile insurance losses for the period 1994 to 2007. By examining total automobile insurance losses along with liability and personal injury protection losses, we are able to determine if and how specific provisions of the laws are related to claims costs. We find a negative relation between the presence of a no-fault law and total losses, which suggests that no-fault systems are associated with lower losses than the traditional tort system. In addition, an examination of no-fault-only states suggests that specific provisions of no-fault laws, such as thresholds and limitations on benefits, have some effect on losses. With the sunset of Colorado’s no-fault legislation in 2003, the recent passage of Personal Injury Protection Reform in Florida, and proposed federal choice legislation, the overall impact of no-fault as well as the specific components of the laws are of heightened importance to consumers, insurers, and lawmakers.     

Topical coverage in internal auditing: academic versus practitioner perceptions

This study reports the results of research that investigates whether a gap may exist between academic content and practitioner needs in the area of internal auditing within the USA. Questionnaires were sent to internal auditing faculty and practitioners to identify and quantify the perceived importance of 25 different internal auditing topics, as well as the use of case studies and practitioner classroom visits as pedagogical techniques. Groups were in substantial agreement on the relative importance of the topics. However, some specific topic differences were noted, with educators placing more importance on items including engagement planning, preliminary surveys, audit programmes, risk management and fraud. Practitioners placed more importance on the qualities desired in staff internal auditors, Certificate in International Auditing (CIA) examination preparation, and computer auditing. In addition, there was considerable agreement between the two groups on the use of case studies in the classroom, as well as classroom visits from practicing internal auditors.     

Consumers as researchers – innovative experiences in UK National Health Service Research

Consumer involvement is an established priority in UK health‐ and social‐care service development and research. To date, little has been published describing the process of consumer involvement and assessing ‘consumers’ contributions to research. This paper provides a practical account of the effective incorporation of consumers into a research team, and outlines the extent to which they can enhance the research cycle; from project development and conduct, through data analysis and interpretation, to dissemination. Salient points are illustrated using the example of their collaboration in a research project. Of particular note were consumers' contributions to the development of an ethically enhanced, more robust project design, and enriched data interpretation, which may not have resulted had consumers not been an integral part of the research team.     

Socioeconomic variations in perceived barriers to recreation participation among would‐be participants

Abstract

The effects of fifteen barriers to participation were examined among people who expressed a desire for but were unable to participate in a new recreational activity. Work commitments, overcrowding of facilities, and lack of partners were the three main barriers. The effects of barriers were not perceived uniformly across the sample but varied between subgroups defined according to socioeconomic variables: the people most likely to be affected by barriers to participation included the poor, the elderly, and single parents. The extent to which recreation practitioners can and should respond to these kinds of research findings is discussed, and several ways in which the effects of barriers to participation might be modified or alleviated are evaluated.     

Comparing Costs and Risks of Retirement Plans for Sponsors

This stochastic simulation analysis compares funding costs and volatilities for private sponsors of traditional defined benefit (DB), pension equity (PE), cash balance (CB), and defined contribution (DC) retirement plans. Plan provisions of equivalent benefit generosity in the different plan types are determined. The modeling includes current funding requirements and practices as well as a comprehensive set of uncertainties in asset and labor markets. The results show that costs and risks for sponsors vary significantly with plan types, investment and funding strategies, and participant demographics. The hybrid PE and CB plans exhibit characteristics of cost efficiency, as in the DB plan, and risk reduction, as in the DC plan, for plan sponsors under conventional investment strategies. These features are more saliently observed in the CB plan, but it is also more difficult to implement effective asset–liability management strategies for it.