"Quicker and sicker" under Medicare's prospective payment system for hospitals: new evidence on an old issue from a national longitudinal survey

Medicare's prospective payment system for hospitals (PPS), introduced in the USA in 1983, replaced cost reimbursement with a system of fixed rates which created incentives for hospitals to control costs. Previous studies found that elderly patients were discharged from hospital "quicker and sicker" under PPS and concluded that families were coping at home. We analyse a national longitudinal survey, the first National Health and Nutrition Examination Survey and its Epidemiologic Followup Study, which includes data on more outcomes over a longer period than earlier studies. We find that the rate of admission to nursing homes from the community in the first weeks after a hospital discharge more than tripled under PPS, suggesting that families were not always able to cope. As another response to sicker patients, discharges directly to nursing homes from hospitals, which jumped initially under PPS, may have risen further when payment rates were tightened in the early 1990s. Hospital readmissions fell after the first few years. Our findings are strengthened by the fact that we control for patients' health using health information collected independently of hospital admission.     

Intangible assets and value relevance: Evidence from the Portuguese stock exchange

We assess the value relevance of the amounts for identifiable intangible assets and goodwill reported in the financial statements of all non-finance companies listed on the main market of the Portuguese Stock Exchange from 1998 to 2008. Additionally, we use panel data to explore the impact on value relevance of Portugal’s formal adoption of International Accounting Standards [IAS] and International Financial Reporting Standards [IFRS] in 2005. A distinctive feature of the accounting by our sample companies is that when they adopted IAS 38 and IFRS 3 in 2005, they were no longer required to recognise some intangible assets (such as start-up costs and research expenditures) and were no longer required to amortise goodwill.We find that net earnings, reported goodwill and other intangible assets are highly significantly associated with stock price. However, whereas earnings are related positively to stock prices when Portuguese Generally Accepted Accounting Principles (GAAP) were applied prior to 2005, the value relevance of earnings appears to have declined after the adoption of IAS/IFRS in 2005. Although the change to IAS/IFRS had no impact on the value relevance of identifiable intangibles as a whole, the evidence suggests that there was a positive effect on the value relevance of goodwill. When the subclasses of identifiable intangible assets are considered, we found evidence of an increase in value relevance of goodwill, other intangible assets, and research and development expenditures.     

Mortgage product diversity: responding to consumer demand or protecting lender profit? An asymmetric panel analysis

This article explores determinants of mortgage product diversity for owner-occupied and investment loans in the Australian housing mortgage market. From 2001 to 2012, 65 lenders introduced 1220 mortgage products in Australia. We examine whether the product proliferation was a result of consumer demand or a response to pressure to lower lending rates. We find that consumer demand for mortgages does not have a significant relationship with the number of mortgage products, but that decreases in the policy interest rate are highly significant as an explanatory variable for product proliferation. Such behaviour is consistent with information obfuscation, reducing the ease with which consumers can compare lending rates. Further, the relationship between mortgage products offered and the policy interest rate is asymmetric: decreases in the cash rate are associated with increased mortgage products offered, but increases in the cash rate have a more muted effect on decreasing the number of products.     

Anonymity in Computer-Mediated Communication: More Contrarian Ideas with Less Influence

Anonymity is thought to be an important means for ensuring a free exchange of ideas by encouraging the expression of minority viewpoints. However, we suggest that anonymity’s reduction in awareness of others potentially affects the expression and interpretation of comments that are made during a discussion. In particular, anonymity will increase the likelihood that comments will be made that are contrary to the majority opinion while at the same time decreasing the effect that those contrary arguments have on other group member’s opinions. This paper reports experimental results showing that anonymity led to more overall participation in discussions of ethical scenarios. However, equality of member participation did not differ between anonymous and member-identified groups, and anonymous groups had significantly higher awareness-related comments. This leads to the conclusion that additional participation in anonymous groups accommodates reduced awareness rather than reflecting the increased participation of normally reticent group members. In addition, anonymity led to more arguments in support of questionable behavior, suggesting that the freeing effects of anonymity apply to the social desirability of arguments. Finally, there was less change in opinion under conditions of anonymity than when comments were identified, suggesting that anonymous arguments have less influence on opinions than identified comments.     

Cheap talk, fraud, and adverse selection in financial markets: some experimental evidence

We examine communication in laboratory games with asymmetricinformation. Sellers know true asset qualities. Potential buyersonly know the quality distribution. Prohibiting communication,we document the degree of adverse selection. Then we examinetwo alternative communication mechanisms. Under 'cheap talk',each seller can announce any subset of qualities. Under 'antifraud',the subset must include the true quality. Both mechanisms improvemarket efficiency, but very differently. Relying on sellers'frequently exaggerated claims, buyers often overpay under cheaptalk. Efficiency gains come at the buyer's expense. The antifraudrule improves efficiency further and eliminates the wealth transferfrom buyers to sellers.     

Flood Hazards and Urban Housing Markets: The Effects of Katrina on New Orleans

This study examines the impacts on consumers’ willingness to pay for certain characteristics of housing in greater New Orleans before and after the flooding of Hurricane Katrina. Single-family home sales from January 2004 to August 2006 are collected and used in a hedonic price function to estimate the changes in the value of amenities, and structural, neighborhood and geographic characteristics, including the mean elevation of each property. Elevation, which buyers did not know for certain prior to the storm, but may now be inferred from water level marks in most neighborhoods, is found to have a positive relationship with selling prices. Results indicate that pre-Katrina, there was a premium of only 1.4% per foot in flood-prone areas, and was insignificant in areas not subject to flooding. This increased to 4.6% for flooded areas after Katrina. These findings are attributed to not only the perceived risk of flooding, but also to the potential of higher compliance costs associated with rebuilding under more stringent National Flood Insurance Program (NFIP) guidelines.