Direct contracting-type HMO has exemption revoked

1999 ◽  
Vol 16 (3) ◽  
pp. 3-3
Author(s):  
Bruce R. Hopkins
Keyword(s):  
Direct Contracting

scholarly journals Direct Contracting in Medicare

2020 ◽  
Vol 271 (4) ◽  
pp. 632-634
Author(s):  
Joshua M. Liao ◽  
Amol S. Navathe
Keyword(s):  
Direct Contracting

scholarly journals Data Mining to Identify Anomalies in Public Procurement Rating Parameters

Electronics ◽  
2021 ◽  
Vol 10 (22) ◽  
pp. 2873
Author(s):  
Yeferson Torres-Berru ◽  
Vivian F. López Batista
Keyword(s):  
Supervised Learning ◽  
Public Procurement ◽  
Principal Component ◽  
Support Vector ◽  
Self Organizing Map ◽  
Detection Model ◽  
Process Qualification ◽  
Multi Phase ◽  
Direct Contracting

The awarding of public procurement processes is one of the main causes of corruption in governments, due to the fact that in many cases, contracts are awarded to previously agreed suppliers (favouritism); for this selection, the qualification parameters of a process play a fundamental role, seeing as due to their manipulation, bidders with high prices win, causing prejudice to the state. This study identifies processes with anomalies and generates a model for detecting possible corruption in the assignment of process qualification parameters in public procurement. A multi-phase model was used (the identification of anomalies and generation of the detection model), which uses different algorithms, such as clustering (K-Means), Self-Organizing map (SOM), Support Vector Machine (SVM) and Principal Component Analysis (PCA). SOM was used to determine the level of influence of each rating parameter, K-Means to create groups by clustering, semi-supervised learning with SVM and PCA to generate a model to detect anomalies in the processes. By means of a case study, four groups of processes were obtained, highlighting the presence of the group “null economic offer” where the values for the economic offer do not exceed 1%, and a greater weight is given to other qualification parameters, which include direct contracting. The processes in this cluster are considered anomalous. Following this methodology, a semi-supervised learning model is built for the detection of anomalies, which obtains an accuracy of 95%, allowing the detection of procedures where the aim is to benefit a particular supplier by means of the qualification assignment parameters.

Direct Contracting

1997 ◽  
Vol 28 (5) ◽  
pp. 22???25
Author(s):  
DULCELINA A. STAHL
Keyword(s):  
Direct Contracting

scholarly journals Individualización y riesgo de desempleo en los periódicos del norte de México

2019 ◽  
Vol 31 ◽  
pp. 1-20
Author(s):  
Víctor Hugo Reyna García
Keyword(s):  
Present Article ◽  
Baja California ◽  
Labor Relations ◽  
Unintended Consequences ◽  
Nuevo Leon ◽  
Northern Mexico ◽  
Nuevo León ◽  
Unemployment Risk ◽  
The Relationship ◽  
Direct Contracting

Abstract: The present article analyzes the relationship between the individualization of labor relations and the actualization or staging of unemployment risk in different newspapers in northern Mexico. Once defined as pioneers in the modernization of Mexican journalism, newspapers in the region have also distinguished themselves by their use of direct contracting schemes with their employees. Based on Beck’s theory of labor and fieldwork conducted in Baja California, Nuevo León, and Sonora, this study describes the experiences and perceptions of journalists who work in these organizations concerning their labor relations and employment continuity. Our results revealed the unintended consequences of the modernizing project.

scholarly journals Public financing of human insulins in Brazil: 2009-2017

2020 ◽  
Vol 23 ◽  
Author(s):  
Leticia Lucia dos Santos Dias ◽  
Maria Angelica Borges dos Santos ◽  
Claudia Garcia Serpa Osorio-de-Castro
Keyword(s):  
Federal Government ◽  
Information Service ◽  
Electronic System ◽  
Insulin Analogues ◽  
Administrative Databases ◽  
Public Provision ◽  
Department Of Health ◽  
Defined Daily Doses ◽  
Expenditure Data ◽  
Direct Contracting

ABSTRACT: Background: From 2006 to 2017, the Brazilian federal government provided free of charge traditional insulins for diabetes treatment. This involved public tendering by the Department of Health Logistics of the Ministry of Health (DLOG-MOH) and the reimbursement after direct contracting for supply with commercial private retailers (Brazilian Popular Pharmacy Program - PFPB). Objective: We aim to describe the budget of the Brazilian federal government committed to for the acquisition of insulin, as well as corresponding prices and treatment availability from 2009 to 2017. Methods: Insulin volume and expenditure data were obtained in official administrative databases and in the Electronic System of the Information Service to Citizens. Data were analyzed according to the total provision by the federal government, DLOG-MOH and PFPB. Moreover, data were presented according to insulin type. Volumes were calculated in number of defined daily doses (DDD)/1,000 inhabitants/day. Results: Budgetary commitments due to insulin over nine years amounted to U$1,027 billion in 2017, with an approximate average of U$114.1 million per year. DLOG-MOH was the main insulin provider, despite the increase in PFPB provision along period. DLOG-MOH and PFBP together provided an average of 6.08 DDD/1000 inhabitants/day for nine years. Average prices in PFPB were higher than those in the DLOG series, with a downward trend over the years, narrowing to 2.7 times in 2017, when compared to 2009. Conclusions: Brazil evidenced a moderately sustainable and effective, albeit imperfect, policy for public provision of traditional insulins in the period preceding mandatory free supply of insulin analogues. Future studies must address treatment availability and financial sustainability in the new scenario.

scholarly journals GESTÃO DE COMPRAS EM ORGANIZAÇÕES PÚBLICAS: um estudo de caso a partir das aquisições da UFT entre os anos de 2012 a 2016

2020 ◽  
pp. 67-81
Author(s):  
Pedro Junior Lima SOUZA ◽  
Ana Lucia de MEDEIROS
Keyword(s):  
Public Organizations ◽  
Purchasing Management ◽  
Business Organizations ◽  
Fiscal Constraint ◽  
Efficient Management ◽  
Electronic Auction ◽  
Administrative Units ◽  
The University ◽  
Direct Contracting

Business organizations are reorienting their practices to optimize their operating flows for more efficient management. This scenario of administrative rationalization is also impacting public organizations. In this perspective, the search for more effective management is leading public organizations to seek new answers to address their budgetary limitations. This work aims to study the purchasing management of the Federal University of Tocantins, between 2012 and 2016. This research is a qualitative case study and was conducted with the analysis of institutional documents and bibliographic research. Of the total volume contracted from 2012 to 2016, 72.05% of the total volume was destined to contract services. Hiring through direct contracting represents 73.85% of the number of processes, which may signal weakness in the control related to the fractioning of acquisitions. It was observed that UFT uses the electronic auction as its predominant form for its acquisitions, of the total financial volume contracted 73.91% was through this modality. Even with the fiscal constraint scenario, there was an increase in the global value of acquisitions from 2014. The results showed that the university still lacks robust improvements in the monitoring of procurement processes, especially with regard to the agility of processing orders. demands, which may be explained by the University’s multi-camp reality that makes coordinated actions between administrative units difficult.

Cost And Quality Trends In Direct Contracting Arrangements

2002 ◽  
Vol 21 (1) ◽  
pp. 89-102 ◽  
Author(s):  
Alan Lyles ◽  
Jonathan P. Weiner ◽  
Andrew D. Shore ◽  
Jon Christianson ◽  
Leif I. Solberg ◽  
...  
Keyword(s):  
Direct Contracting

WORK–LIFE BALANCE OF GENERAL PRACTITIONERS IN GERMANY CONSIDERING RECENT REGULATIONS

2021 ◽  
Vol 9 (3) ◽  
pp. 57-63
Author(s):  
Ulrich Weigeldt
Keyword(s):  
Central Element ◽  
Work Life ◽  
Work Life Balance ◽  
Insurance Companies ◽  
Life Balance ◽  
German Government ◽  
Regulatory Measures ◽  
The Government ◽  
Gp Care ◽  
Direct Contracting

Background: In the light of demographic changes in the population and among the doctors, the German government has in the last two decades taken several regulatory steps to address work–life balance and related issues. Objective: This article seeks to identify crucial pieces of legislation that may increase the attractiveness for the GP profession in Germany. Method: The article summarizes important regulatory steps and their results in terms of increasing the attractiveness of the GP profession. Results: Some regulations in Germany including the “Vertragsarztrechtsänderungsgesetz” led to more flexibilization in terms of the location and the internal structure of GP practices, while others addressed the further digitalization. A central element for creating attractive working conditions for GPs is the possibility of selective and direct contracting between the insurance companies and the GPs, parallel to the more general collective contracting. Discussion: While some of these regulations helped to make the GP profession more attractive, they have failed to increase the number of GPs especially in rural socially deprived areas. Conclusion: The government will need to invest more resources in scientific studies (e.g. international comparison) to identifying regulatory measures that help address the growing gap between the amount of GP care needed by the aging population and the level of care provided with the current human resources.

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