Coordination of a fresh agricultural product supply chain with option contract under cost and loss disruptions

This paper analyzes the option coordination problem of a fresh agricultural product supply chain under two supply chain structures, when the production cost and the loss rate are disrupted simultaneously. This paper provides the explicit option coordination conditions for the disrupted supply chain under two supply chain structures, and then explores the effects of the disruptions and supply chain structure on the option coordination conditions. The results suggest that it is unfavorable to apply the original coordinating contracts without disruptions to coordinate the disrupted supply chain. The coordination of the disrupted supply chain can be achieved with knowledge of the distribution of demand. In two coordinating contracts for the disrupted supply chain, the exercise price is still at the original level without disruptions while the option price deviates from the original level without disruptions. Moreover, the relationships of the coordination conditions in two supply chain structures depend on the value of the profit allocation coefficient. When the profit allocation coefficient exceeds (falls behind) a certain threshold, the option price is set at a higher (lower) value in the supplier-led supply chain structure than in the distributor-led supply chain structure, while the exercise price is set at a lower (higher) value in the supplier-led supply chain structure than in the distributor-led supply chain structure. Finally, the disrupted supply chain with any supply chain structure will perform better in the modified coordinating contracts than in the original coordinating contracts without disruptions.

How Internet Contracts Impact Research: Content Analysis of Terms of Service on Consumer Product Websites

BACKGROUND

Companies use brand websites as a promotional tool to engage consumers on the web, which can increase product use. Given that some products are harmful to the health of consumers, it is important for marketing associated with these products to be subject to public health surveillance. However, terms of service (TOS) governing the use of brand website content may impede such important research.

OBJECTIVE

The aim of this study is to explore the TOS for brand websites with public health significance to assess possible legal and ethical challenges for conducting research on consumer product websites.

METHODS

Using Statista, we purposefully constructed a sample of 15 leading American tobacco, alcohol, psychiatric pharmaceutical, fast-food, and gun brands that have associated websites. We developed and implemented a structured coding system for the TOS on these websites and coded for the presence versus absence of different types of restriction that might impact the ability to conduct research.

RESULTS

All TOS stated that by accessing the website, users agreed to abide by the TOS (15/15, 100%). A total of 11 out of 15 (73%) websites had age restrictions in their TOS. All alcohol brand websites (5/15, 33%) required users to enter their age or date of birth before viewing website content. Both websites for tobacco brands (2/15, 13%) further required that users register and verify their age and identity to access any website content and agree that they use tobacco products. Only one website (1/15, 7%) allowed users to display, download, copy, distribute, and translate the website content as long as it was for personal and not commercial use. A total of 33% (5/15) of TOS unconditionally prohibited or put substantial restrictions on all of these activities and/or failed to specify if they were allowed or prohibited. Moreover, 87% (13/15) of TOS indicated that website access could be restricted at any time. A total of 73% (11/15) of websites specified that violating TOS could result in deleting user content from the website, revoking access by having the user's Internet Protocol address blocked, terminating log-in credentials, or enforcing legal action resulting in civil or criminal penalties.

CONCLUSIONS

TOS create complications for public health surveillance related to e-marketing on brand websites. Recent court opinions have reduced the risk of federal criminal charges for violating TOS on public websites, but this risk remains unclear for private websites. The public health community needs to establish standards to guide and protect researchers from the possibility of legal repercussions related to such efforts.

An empirical analysis of hospital ED pricing power

OBJECTIVES

Empirical evaluation of market power that hospitals gain over health plans through hospitals' ability to cancel their contracts with plans while keeping large shares of plans' emergency patients and getting paid for them at above-market rates.

STUDY DESIGN

Case-study analysis of 5 California hospitals that initially had contracts with most commercial health plans and then cancelled all those contracts at the same time.

METHODS

We conducted a before-and-after case-study analysis comparing volume, price, and net revenues for the 5 study hospitals 3 years before and up to 4 years after the cancellation of their commercial contracts. The volume and price trends in study hospitals were compared with data on control hospitals in the same geographic area over the matching study period.

RESULTS

Despite substantially increasing their prices on a noncontracted basis, the 5 study hospitals collectively retained 50% of their commercial health plan volume in first 2 years after the cancellation and 41% of their commercial volume in years 3 and 4, with net commercial revenues increasing as a result. At the same time, the simulated costs of treating the patients from out-of-network hospitals more than doubled for the health plans.

CONCLUSIONS

In hospital-payer negotiation, many hospitals have an upper hand: Their threat to retain large portions of their emergency patients and revenues after becoming out of network is credible and it imposes disproportionate costs on the payers, which partially explains the continuing rise in hospital prices.

Standardized Letters of Concern and Remediation Contracts: Templates for Program Directors

BACKGROUND

Remediation of the struggling resident is a universal phenomenon, and the majority of program directors will remediate at least 1 resident during their tenure.

OBJECTIVE

The goal of this project was to create a standardized template for program directors to use at all stages of remediation.

METHODS

Between 2017 and 2018, the Council of Residency Directors in Emergency Medicine (CORD-EM) Remediation Committee searched for best practices in the medical literature and compiled a survey that was e-mailed to the CORD-EM listserv. After reviewing all information, a standardized remediation contract was created, reviewed by legal counsel, and distributed to members.

RESULTS

Forty-two percent (110 of 263) of program directors or assistant program directors on the CORD-EM listserv answered the initial survey and provided guidance on current remediation practices. The committee created formal and informal standard remediation contracts as both fillable templates and alterable documents. These were reviewed by CORD-EM general legal counsel and approved by the CORD-EM Board of Directors for distribution. The project took approximately 20 hours to complete over 8 months and involved a cost of $480 for legal fees.

CONCLUSIONS

With program director input and legal counsel review, the CORD-EM Remediation Committee produced standardized remediation contracts, which can be used by all emergency medicine programs after comparison to local institutional policy and local legal review. This process was feasible and can be replicated by other specialties.

Influence of out-of-network payment standards on insurer-provider bargaining: California's experience

OBJECTIVES

To examine the early effects of California's recent policy addressing surprise medical billing (AB-72) on the dynamics among physician, hospital, and insurer stakeholders and to identify the influences of the policy's novel out-of-network (OON) payment standard on provider-payer bargaining. This study can inform current policy formation, given that current federal proposals include a payment standard like that in AB-72.

STUDY DESIGN

Case study of the implementation of AB-72 and stakeholders' perspectives, experiences, and responses in the first 6 to 12 months after policy implementation.

METHODS

Semistructured interviews were conducted with 28 individuals representing policy experts, representatives of advocacy organizations and state-level professional associations, and current executives of physician practice groups, hospitals, and health benefits companies. Related documentation was collected and analyzed, including bill text, rulemaking guidance, testimony before the California Senate Committee on Health, and advocacy letters. Qualitative analysis techniques, such as process tracing and explanation building, were employed to identify key themes.

RESULTS

AB-72 is effectively protecting patients from surprise medical bills. However, stakeholders report that an OON payment standard set at payer-specific local average commercial negotiated rates has changed the negotiation dynamics between hospital-based physicians and payers. Interviewees report that leverage has shifted in favor of payers, and payers have an incentive to lower or cancel contracts with rates higher than their average as a means of suppressing OON prices. Physicians reported that this experience of decreased leverage is exacerbating provider consolidation.

CONCLUSIONS

California's experience demonstrates that OON payment standards can influence the payer-provider bargaining landscape, affecting network breadth and negotiated rates.

Concussions and Contracts: The National Football League's Limitations to Protecting Its Players from Chronic Traumatic Encephalopathy

Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative brain injury that has become prevalent among high-contact professional sports, especially American football. More and more retired players are exhibiting symptoms of CTE and being diagnosed with CTE post-mortem. While the neuroscience community constantly releases studies showing a causal connection between brain trauma and CTE, the National Football League (NFL) continues to deny that any brain injury can arise from playing football. The NFL must implement provisions in their contracts to fully inform and protect players from this lethal brain injury. This article examines the repercussions of CTE, how players' contracts do and do not provide protections, and the possible provisions the NFL can implement in its contracts to adequately protect players of repeated brain trauma.

The Mediating Role of Psychological Contract Violation Between Psychological Contract Breach And Nurses' Organizational Attitudes

This study draws on psychological contract theory, according to which organizational members reciprocate detrimental treatment they perceive with negative work-related attitudes and behaviors. Organizational attitudes were predicted by both breach and violation. This study demonstrates the importance of psychological contract breach and violation to nurses. Nursing administrators and leaders are advised to monitor and balance the expectations of nurses. They should recognize the importance of the interpretive process leading to feelings of betrayal and anger, thus providing the opportunity to manage perceptions of breach.

Finding the 'sweet spot' in value-based contracts

Health systems pursing value-based contracts should address six important considerations: The definition of value. Contracting goals. Cost of implementation. Risk exposure. Contract structure and design. Essential contractual protections.

Authorship issues in multi-centre clinical trials: the importance of making an authorship contract

Discussions about authorship often arise in multi-centre clinical trials. Such trials may involve up to hundreds of contributors of whom some will eventually co-author the final publication. It is, however, often impossible to involve all contributors in the manuscript process sufficiently for them to qualify for authorship as defined by the International Committee of Medical Journal Editors. Therefore, rules for authorship in multi-centre trials are strongly recommended. We propose two contracts to prevent conflicts regarding authorship; both are freely available for use without pay but with reference to the original source.

How can clients improve the quality of transport infrastructure projects? The role of knowledge management and incentives

The aim of this paper is to argue for a number of statements about what is important for a client to do in order to improve quality in new infrastructure projects, with a focus on procurement and organizational issues. The paper synthesizes theoretical and empirical results concerning organizational performance, especially the role of the client for the quality of a project. The theoretical framework used is contract theory and transaction cost theory, where assumptions about rationality and self-interest are made and where incentive problems, asymmetric information, and moral hazard are central concepts. It is argued that choice of procurement type will not be a crucial factor. There is no procurement method that guarantees a better quality than another. We argue that given the right conditions all procurement methods can give good results, and given the wrong conditions, all of them can lead to low quality. What is crucial is how the client organization manages knowledge and the incentives for the members of the organization. This can be summarized as "organizational culture." One way to improve knowledge and create incentives is to use independent second opinions in a systematic way.

Reduction of construction wastes by improving construction contract management: a multinational evaluation

The Canadian construction industry generates 30% of the total municipal solid waste deposited in landfills. Ample evidence can be found in the published literature about rework and waste generation due to ambiguity and errors in contract documents. Also, the literature quotes that disclaimer clauses in contract documents are included in the contractual agreements to prevent contractor claims, which often cause rework. Our professional practice has also noted that there are several disclaimer clauses in standard contract documents which have the potential to cause rework (and associated waste). This article illustrates a comparative study of standard contractual documents and their potential to create rework (and associated waste) in different regions of the world. The objectives of this study are (1) to analyse standard contractual documents in Canada, the USA and Australia in terms of their potential to generate rework and waste, and (2) to propose changes/amendments to the existing standard contract documents to minimise/avoid rework. In terms of construction waste management, all the reviewed standard contract documents have deficiencies. The parties that produce the contract documents include exculpatory clauses to avoid the other party's claims. This approach tends to result in rework and construction waste. The contractual agreements/contract documents should be free from errors, deficiencies, ambiguity and unfair risk transfers to minimise/avoid potential to generate rework and waste.

Essential contractual language for medical necessity in children

The previous policy statement from the American Academy of Pediatrics, "Model Language for Medical Necessity in Children," was published in July 2005. Since that time, there have been new and emerging delivery and payment models. The relationship established between health care providers and health plans should promote arrangements that are beneficial to all who are affected by these contractual arrangements. Pediatricians play an important role in ensuring that the needs of children are addressed in these emerging systems. It is important to recognize that health care plans designed for adults may not meet the needs of children. Language in health care contracts should reflect the health care needs of children and families. Informed pediatricians can make a difference in the care of children and influence the role of primary care physicians in the new paradigms. This policy highlights many of the important elements pediatricians should assess as providers develop a role in emerging care models.

[Patient safety in management contracts]

Patient safety is becoming commonplace in management contracts. Since our experience in patient safety still falls short of other clinical areas, it is advisable to review some of its characteristics in order to improve its inclusion in these contracts. In this paper opinions and recommendations concerning the design and review of contractual clauses on safety are given, as well as reflections drawn from methodological papers and informal opinions of clinicians, who are most familiar with the nuances of safe and unsafe practices. After reviewing some features of these contracts, criteria for prioritizing and including safety objectives and activities in them, and key points for their evaluation are described. The need to replace isolated activities by systemic and multifaceted ones is emphasized. Errors, limitations and improvement opportunities observed when contracts are linked to indicators, information and adverse event reporting systems are analysed. Finally, the influence of the rules of the game, and clinicians behaviour are emphasised.

Commitment contracts as a way to health

Commitment contracts, whereby people deposit money that they receive back only if they succeed, have substantial conceptual appeal as a method of changing health behaviour. Scott Halpern, David Asch, and Kevin Volpp examine the evidence behind them and find many unanswered questions

NAO report examines performance and value

A recently published National Audit Office (NAO) report says that, although most of the 70-plus English PFI hospital contracts now operational are "achieving the value for money expected when the contracts were signed", there "continue to be risks" to the long-term value of others. Entitled The performance and management of hospital PFI contracts, the report concludes that some NHS Trusts are devoting insufficient resources to managing their contracts, and, although many will be expected to make significant efficiency savings over the next few years, the fact that they typically pay index-linked sums for services, and the "complex" nature of many existing PFI contracts, will make it difficult to achieve these without cutting back on key services.

Benchmarking for maximum value

Speaking at the most recent Healthcare Estates conference, Ed Baldwin, of international built asset consultancy EC Harris LLP, examined the role of benchmarking and market-testing--two of the key methods used to evaluate the quality and cost-effectiveness of hard and soft FM services provided under PFI healthcare schemes to ensure they are offering maximum value for money.