Management

Analysis of FY 2012 Budget and Deficit Reduction Plans

Analysis of FY 2012 Budget and Deficit Reduction Plans
Women of Color Policy Network. "Analysis of FY 2012 Budget and Deficit Reduction Plans." April 2011

Women of Color Policy Network
04/01/2011

This month, Chairman of the House Budget Committee Representative Paul Ryan, the Congressional Progressive Caucus (CPC) and President Obama shared three very different FY 2012 budget proposals and deficit reduction strategies. The CPC's People's Budget calls for investments in job creation and deficit elimination by increasing tax revenues from the wealthy. President Obama's deficit reduction plan combines spending cuts, tax reform and enhancing the Affordable Care Act to reduce growth in health care spending. Representative Ryan's proposal extends tax cuts to wealthy individuals and corporations, while cutting social safety net programs such as food stamps, housing assistance, and Pell Grants. This policy brief evaluates each proposal's impact on people of color and recommends investing in job creation and infrastructure to strengthen communities in times of hardship and prosperity.

 

Developing coastal adaptation to climate change in the New York City infrastructure-shed: process, approach, tools, and strategies

Developing coastal adaptation to climate change in the New York City infrastructure-shed: process, approach, tools, and strategies

C. Rosenzweig, W. D. Solecki, R. Blake, M. Bowman, C. Faris, V. Gornitz, R. Horton, K. Jacob, A. LeBlanc, R. Leichenko, M. Linkin, D. Major, M. O’Grady, L. Patrick, E. Sussman, G. Yohe, R. Zimmerman.
02/26/2011

While current rates of sea level rise and associated coastal flooding in the New York City region appear to be manageable by stakeholders responsible for communications, energy, transportation, and water infrastructure, projections for sea level rise and associated flooding in the future, especially those associated with rapid icemelt of the Greenland and West Antarctic Icesheets, may be outside the range of current capacity because extreme events might cause flooding beyond today's planning and preparedness regimes. This paper describes the comprehensive process, approach, and tools for adaptation developed by the New York City Panel on Climate Change (NPCC) in conjunction with the region's stakeholders who manage its critical infrastructure, much of which lies near the coast. It presents the adaptation framework and the sea-level rise and storm projections related to coastal risks developed through the stakeholder process. Climate change adaptation planning in New York City is characterized by a multi-jurisdictional stakeholder-scientist process, state-of-the-art scientific projections and mapping, and development of adaptation strategies based on a risk-management approach.

On the folly of principals' power: Managerial psychology as a cause of bad incentives

On the folly of principals' power: Managerial psychology as a cause of bad incentives
Research in Organizational Behavior, 31, 25-41

Magee, Joe C., Gavin Kilduff, & Chip Heath.
01/01/2011

Faulty and dysfunctional incentive systems have long interested, and frustrated, managers and organizational scholars alike. In this analysis, we pick up where Kerr (1975) left off and advance an explanation for why bad incentive systems are so prevalent in organizations. We propose that one contributing factor lies in the psychology of people who occupy managerial roles. Although designing effective incentive systems is a challenge wrought with perils for anyone, we believe the psychological consequences and correlates of higher rank within organizations make the challenge more severe for managers. Patterns of promotion and hiring typically yield managers that are more competent than their employees, and ascending to management positions increases individuals' workload and power. In turn, these factors make managers more egocentrically anchored and cognitively abstract, while also reducing their available cognitive capacity for any given task, all of which we argue limits their ability to design effective incentives for employees. Thus, ironically, those with the power to design incentives may be those least able to effectively do so. We discuss four specific types of bad incentive systems that can arise from these psychological tendencies in managers: those that over-emphasize compensation, generate weak motivation, offer perverse motivation, or are misaligned with organizational culture.

Consumer Estimation of Recommended and Actual Calories at Fast Food Restaurants

Consumer Estimation of Recommended and Actual Calories at Fast Food Restaurants
Obesity (Silver Spring). Oct 2011; 19(10): 1971–1978.

Elbel, B.
10/04/2010

Recently, localities across the United States have passed laws requiring the mandatory labeling of calories in all chain restaurants, including fast food restaurants. This policy is set to be implemented at the federal level. Early studies have found these policies to be at best minimally effective in altering food choice at a population level. This paper uses receipt and survey data collected from consumers outside fast food restaurants in low-income communities in New York City (NYC) (which implemented labeling) and a comparison community (which did not) to examine two fundamental assumptions necessary (though not sufficient) for calorie labeling to be effective: that consumers know how many calories they should be eating throughout the course of a day and that currently customers improperly estimate the number of calories in their fast food order. Then, we examine whether mandatory menu labeling influences either of these assumptions. We find that approximately one-third of consumers properly estimate that the number of calories an adult should consume daily. Few (8% on average) believe adults should be eating over 2,500 calories daily, and approximately one-third believe adults should eat lesser than 1,500 calories daily. Mandatory labeling in NYC did not change these findings. However, labeling did increase the number of low-income consumers who correctly estimated (within 100 calories) the number of calories in their fast food meal, from 15% before labeling in NYC increasing to 24% after labeling. Overall knowledge remains low even with labeling. Additional public policies likely need to be considered to influence obesity on a large scale.

A la santé de l'oncle Sam: regards croisés sur les systémes de santé; américain et français (To Uncle Sam's Health: Cross perspectives on the American and French Health Systems)

A la santé de l'oncle Sam: regards croisés sur les systémes de santé; américain et français (To Uncle Sam's Health: Cross perspectives on the American and French Health Systems)
Paris, Jacob-Duvernet

Tabuteau, D., Rodwin, V.G.
08/01/2010

Victor Rodwin, professor of health policy and management at NYU Wagner, and his colleague Didier Tabuteau, counselor of state and professor of health policy at the Institut d'Etudes Politiques and the University of Paris Descartes, have published a new book (published by Editions Jacob Duvernet) in which they challenge the conventional wisdom that the French health care system is a government-managed, public and collective enterprise and the American system a private, market-oriented and individualist system. Based on six months of debates in Paris while Professor Rodwin held the Fulbright-Toqueville Chair (spring semester, 2010), this book compares public health, health insurance, the power of physicians, health care reform, and the silent revolution that is transforming health care organization in both France and the United States.

Epidemiological characteristics and resource use in neonates with bronchopulmonary dysplasia: 1993-2006

Epidemiological characteristics and resource use in neonates with bronchopulmonary dysplasia: 1993-2006
Pediatrics. 2010 Aug;126(2):291-7.

Stroustrup A, Trasande L.
08/01/2010

OBJECTIVE:

To determine the trends in incidence of diagnosis of bronchopulmonary dysplasia (BPD) and associated health services use for the neonatal hospitalization of patients with BPD in an era of changing definitions and management.

PATIENTS AND METHODS:

All neonatal hospitalization records available through the Nationwide Inpatient Sample, 1993-2006, were analyzed. Multivariable regression analyses were performed for incidence of BPD diagnosis and associated hospital length of stay and charges. Multiple models were constructed to assess the roles of changes in diagnosis of very low birth weight (VLBW) neonates and different modalities of respiratory support used for treatment.

RESULTS:

The absolute incidence of diagnosis of BPD fell 3.3% annually (P = .0009) between 1993 and 2006 coincident with a 3.5-fold increase in the use of noninvasive respiratory support in patients with BPD. When data were controlled for demographic factors, this significant decrease in incidence persisted at a rate of 4.3% annually (P = .0002). All models demonstrated a rise in hospital length of stay and financial charges for the neonatal hospitalization of patients with BPD. The incidence of BPD adjusted for frequency of prolonged mechanical ventilation also decreased but only by 2.8% annually (P = .0075).

CONCLUSIONS:

The incidence of diagnosis of BPD decreased significantly between 1993 and 2006. In well-controlled models, birth hospitalization charges for these patients rose during the same period. Less invasive ventilatory support may improve respiratory outcomes of VLBW neonates.

Hospital Performance, the Local Economy, and the Local Workforce: Findings from a US National Longitudinal Study

Hospital Performance, the Local Economy, and the Local Workforce: Findings from a US National Longitudinal Study
PLoS Med 7(6): e1000297. doi:10.1371/journal.pmed.1000297

Blustein, J., Borden, W.B., Valentine, M.
06/29/2010

Abstract

Background: Pay-for-performance is an increasingly popular approach to improving health care quality, and the US government will soon implement pay-for-performance in hospitals nationwide. Yet hospital capacity to perform (and

improve performance) likely depends on local resources. In this study, we quantify the association between hospital performance and local economic and human resources, and describe possible implications of pay-for-performance for socioeconomic equity.

Methods and Findings: We applied county-level measures of local economic and workforce resources to a national sample of US hospitals (n = 2,705), during the period 2004–2007. We analyzed performance for two common cardiac conditions (acute myocardial infarction [AMI] and heart failure [HF]), using process-of-care measures from the Hospital Quality Alliance [HQA], and isolated temporal trends and the contributions of individual resource dimensions on performance, using multivariable mixed models. Performance scores were translated into net scores for hospitals using the Performance Assessment Model, which has been suggested as a basis for reimbursement under Medicare’s ‘‘Value-Based Purchasing’’ program. Our analyses showed that hospital performance is substantially associated with local economic and workforce resources. For example, for HF in 2004, hospitals located in counties with longstanding poverty had mean HQA composite scores of 73.0, compared with a mean of 84.1 for hospitals in counties without longstanding poverty (p,0.001). Hospitals located in counties in the lowest quartile with respect to college graduates in the workforce had mean HQA composite scores of 76.7, compared with a mean of 86.2 for hospitals in the highest quartile (p,0.001). Performance on AMI measures showed similar patterns. Performance improved generally over the study period. Nevertheless, by 2007—4 years after public reporting began—hospitals in locationally disadvantaged areas still lagged behind their locationally advantaged counterparts. This lag translated into substantially lower net scores under the Performance Assessment Model for hospital reimbursement.

Conclusions: Hospital performance on clinical process measures is associated with the quantity and quality of local economic and human resources. Medicare’s hospital pay-for-performance program may exacerbate inequalities across regions, if implemented as currently proposed. Policymakers in the US and beyond may need to take into consideration the balance between greater efficiency through pay-for-performance and socioeconomic equity.

Please see later in the article for the Editors’ Summary.

Pages

Subscribe to Management