Cash critical care time prices vary substantially by region and hospital ownership: A cross-sectional study

OBJECTIVES

Emergency department (ED) patients may be billed for critical care time (current procedural terminology codes 99291 and 99292) if they receive at least 30 min of critical care services. We sought to determine the median cash (self-pay) prices for critical care time performed in the ED in the United States and assess for associations between hospital characteristics and prices.

METHODS

We performed a cross-sectional analysis of hospital cash prices for critical care time performed in the ED using the first 25 alphabetical states. For each hospital, we recorded hospital characteristics including state, control (nonprofit, governmental, or for-profit), size, teaching status, and system. We then searched for each hospital's cash prices for 99291 and 99292 using Turquoise and hospital websites. We determined the median price for 99291 nationally, regionally, and for large hospital systems. We performed multivariable quantile regression to assess for associations between hospital characteristics and prices for 99291.

RESULTS

Of the 2629 eligible hospitals, 2245 (85.4%) and 1893 (72.0%) reported cash prices for 99291 and 99292, respectively. For 99291, the cash price ranged from $45 to $84,775 with a median of $1816 (IQR: $1039-3237). For 99292, the median price was $567 (IQR: $298-1008). On multivariable analysis, hospitals had higher cash prices for 99291 if they were located in the West, for-profit, or part of a large system. In particular, hospitals owned by Tenet Healthcare charged the most for 99291 (median $28,244).

CONCLUSION

The cash prices for critical care time vary substantially based on hospital characteristics. In particular, for-profit hospitals and those in the West tend to charge the most. Given that patients who require critical care are unlikely to be able to choose the hospital to which they present, standardization of critical care time fees should be considered.

Exploring spatial patterns, and identifying factors associated with insufficient cash or food received from a productive safety net program among eligible households in Ethiopia: a spatial and multilevel analysis as an input for international food aid programmers

BACKGROUND

In low-income countries, households' food insecurity and the undernutrition of children are the main health problems. Ethiopia is vulnerable to food insecurity and undernutrition among children because its agricultural production system is traditional. Hence, the productive safety net program (PSNP) is implemented as a social protection system to combat food insecurity and enhance agricultural productivity by providing cash or food assistance to eligible households. So, this study aimed to explore spatial patterns of households' insufficient cash or food receiving from PSNP, and identify its associated factors in Ethiopia.

METHODS

The 2019 Ethiopian Mini Demographic and Health Survey dataset was used. A total of 8595 households were included in this study. Data management and descriptive analysis were done using STATA version 15 software and Microsoft Office Excel. ArcMap version 10.7 software was used for spatial exploration and visualization. SaTScan version 9.5 software was used for spatial scan statistics reports. In the multilevel mixed effect logistic regression analysis, explanatory variables with a p-value of less than 0.05 were considered significant factors.

RESULTS

Overall, 13.5% (95% CI: 12.81-14.27%) of the households' level beneficiaries received cash or food from PSNP. The spatial distribution of households' benficiaries received cash or food from PSNP was not random, and good access to cash or food from PSNP was detected in Addis Ababa, SNNPR, Amhara, and Oromia regions. Households' heads aged 25-34 (AOR:1.43, 95% CI: 1.02, 2.00), 35-44 (AOR: 2.41, 95% CI: 1.72, 3.37), and > 34 (AOR: 2.54, 95% CI: 1.83, 3.51) years, being female (AOR: 1.51, 95% CI: 1.27,1.79), poor households (AOR: 1.91, 95% CI:1.52, 2.39), Amhara (AOR:.14, 95% CI: .06, .39) and Oromia (AOR:.36, 95% CI:.12, 0.91) regions, being rural residents (AOR:2.18, 95% CI: 1.21,3.94), and enrollment in CBHS (AOR: 3.34, 95% CI:2.69,4.16) are statistically significant factors.

CONCLUSIONS

Households have limited access to cash or food from the PSNP. Households in Addis Ababa, SNNPR, Amhara, and Oromia regions are more likely to receive benefits from PSNP. Encouraging poor and rural households to receive benefits from the PSNP and raise awareness among beneficiaries to use the benefits they received for productivity purposes. Stakeholders would ensure the eligibility criteria and pay close attention to the hotspot areas.

Is cash the panacea of the COVID-19 pandemic: Evidence from corporate performance

This study investigates the impact of COVID-19 crisis on corporate investment and financing policies. Using a difference-in-difference approach, I find while firms suffer from a real negative shock from the pandemic on average, firms with an abundant cash reserve prior to the crisis outperform firms without. Consistent with the precautionary motive behind corporate cash holdings, this paper demonstrates the effect of cash holdings is meaningful to mitigate adverse effect of the aggregate market. My finding also highlights the difficulty in estimating the optimal cash level when rare market condition is considered.

Pandemics, intermediate goods, and corporate valuation

We evaluate whether the changes in valuation of U.S. corporates during the first wave of the COVID-19 pandemic depend on their downstream or upstream industries' exposure to social distancing. Using a new dataset on sectoral dependence on the use and sale of intermediate goods, we find that firms whose downstream sectors are more affected by social distancing suffer from a greater decline in stock prices during the first quarter of 2020. Such an effect is mitigated for large firms.

COVID-19 pandemic increases the divide between cash and cashless payment users in Europe

This paper investigates how the COVID-19 pandemic has changed an important aspect of everyday life, viz. how people make payments. The empirical study is based on a survey of over 5000 respondents from 22 European countries. It shows that consumers who had been making cashless payments prior to the outbreak of the pandemic have been even more likely to do so since it broke out. On the other hand, the consumers who had mostly been paying in cash have often continued to do so. The divide between those who pay in cash and those who do not, therefore, seems to have widened during the pandemic. It may suggest financial inclusion issues. Additionally, we found that the probability of more frequent cashless payments as a result of the pandemic differs considerably between countries and therefore indicate the role of country-specific factors.

"Bird in the hand" cash was more effective than prize draws in increasing physician questionnaire response

OBJECTIVE

To investigate the effects of two monetary incentives on response rates to postal questionnaires from primary care physicians (PCPs).

STUDY DESIGN AND SETTING

The PCPs were randomized into three arms (n=550 per arm), namely (1) €5 sent with the questionnaire (cash); (2) entry into a draw on return of completed questionnaire (prize); or (3) no incentive. Effects of incentives on response rates and item nonresponse were examined, as was cost-effectiveness.

RESULTS

Response rates were significantly higher in the cash (66.1%; 95% confidence interval [CI]: 61.9, 70.4%) and prize arms (44.8%; 95% CI: 40.1, 49.3%) compared with the no-incentive arm (39.9%; 95% CI: 35.4, 44.3%). Adjusted relative risk of response was 1.17 (95% CI: 1.02, 1.35) and 1.68 (95% CI: 1.48, 1.91) in the prize and cash arms, respectively, compared with the no-incentive group. Costs per completed questionnaire were €9.85, €11.15, and €6.31 for the cash, prize, and no-incentive arms, respectively. Compared with the no-incentive arm, costs per additional questionnaire returned in the cash and prize arms were €14.72 and €37.20, respectively.

CONCLUSION

Both a modest cash incentive and entry into a prize draw were effective in increasing response rates. The cash incentive was most effective and the most cost-effective. Where it is important to maximize response, a modest cash incentive may be cost-effective.