Background The Aceh Health Insurance (JKA) has been established since June 1, 2010. Presently, the provincial Government of Aceh faces difficulty in getting adequate budget to fund JKA program that tends to increase every year. In the year 2010, the second year of JKA implementation, the government was only able to allocate Rp. 382 billion from the total requirement of Rp. 482 billion. The figu...

Machine Learning as a Service (MLaaS) allows clients with limited resources to outsource their expensive ML tasks powerful servers. Despite the huge benefits, current MLaaS solutions still lack strong assurances on: 1) service correctness (i.e., whether works expected); 2) trustworthy accounting bill for resource consumption is correctly accounted); 3) fair payment client gets entire result bef...

These papers are produced by Cambridge Judge Business School, University of Cambridge. They are circulated for discussion purposes only. Their contents should be considered preliminary and are not to be quoted without the authors' permission. In recent years, the performance-based approach to contracting for medical services has been gaining popularity across different healthcare delivery syste...

Preface The Payment Reform: Current and Emerging Reimbursement Models white paper is an American College of Cardiology (ACC) member content-driven educational resource meant to provide baseline knowledge of the payment models proposed in the Patient Protection and Affordable Care Act (PPACA) and the innovative payment pilots already being implemented in the private sector. Recognizing that chal...

This work focuses on the B2B interaction between a service requester and a service provider in a healthcare environment. The requester is the primary caregiver responsible for managing the health of a population of patients. When a patient requires advanced care outside the requester’s expertise, the requester refers the patient to a provider and pays for the referral services. Treatment may su...

Faced with declining payment rates, California providers have implemented various strategies that have strengthened their leverage in negotiating prices with private health plans. When negotiating together, hospitals and physicians enhance their already significant bargaining clout. California’s experience is a cautionary tale for national health reform: It suggests that proposals to promote in...

The Employee Retirement Income Security Act of 19741 ("ERISA" or "the Act") is a comprehensive federal statute which imposes minimum standards on employee benefit plans. To prevent conflicting state regulation, ERISA preempts state laws which "relate to" these plans. 2 ERISA's preemption, however, is not complete. Consistent with the federal policy embodied in the McCarran-Ferguson Act 3 of lea...

We consider a contracting problem in which a …rm outsources its call center operations to a service provider. The outsourcing …rm (which we term the originator) has private information regarding the rate of incoming calls. The per-call revenue (or margin) earned by the …rm and the service level depend on the sta¢ ng decisions by the service provider. Initially, we restrict attention to pay-per-...

Pediatric home health care is an effective and holistic venue of treatment of children with medical complexity or developmental disabilities who otherwise may experience frequent and/or prolonged hospitalizations or who may enter chronic institutional care. Demand for pediatric home health care is increasing while the provider base is eroding, primarily because of inadequate payment or restrict...

BACKGROUND Under new bundled payment models, hospitals are financially responsible for post-acute care delivered by providers such as skilled nursing facilities (SNFs) and home health agencies (HHAs). The hope is that hospitals will use post-acute care more prudently and better coordinate care with post-acute providers. However, little is known about existing patterns in hospitals׳ referrals to...