Physicians' views on optimal use and payment system for telemedicine: a qualitative study.

BACKGROUND: Telemedicine is already in use in daily practice, but appropriate reimbursement and physician payment is falling behind in many countries. One reason is the limited availability of research on the matter. This research therefore examined physicians' views on the optimal use and payment modalities for telemedicine. METHODS: Sixty-one semi-structured interviews were conducted with physicians from 19 medical disciplines. Interviews were encoded using thematic analysis. RESULTS: Telephone and video televisits tend not to be used as a first patient contact, except for triage of patients in urgency situations. Several minimum required modalities for the payment system of televisits and telemonitoring were identified. For televisits these were: (i) remuneration of both telephone- and videovisits to increase healthcare equity, (ii) little or no differentiation between videovisit and in-person visit fee to make videovisits financially attractive and sustainable for physicians, (iii) differentiation of televisit fee per medical discipline, and (iv) quality requirements such as mandatory reporting in the patient's medical file. The identified minimum required modalities for telemonitoring were: (i) an alternative payment scheme than fee-for-service, (ii) remunerating not only physicians but also other involved health professionals, (iii) designating and remunerating a coordinator, and (iv) distinguishing sporadic vs. continuously follow-up. CONCLUSIONS: This research investigated the telemedicine usage behavior of physicians. Moreover, several minimum required modalities were identified for a physician-supported payment system of telemedicine, as these innovations necessitate challenging and innovation of the healthcare payment systems as well.

The impact of Covid-19 on electronic payment system: Lesson learned from Indonesian banking

The Indonesian economy suffered a recession due to the COVID-19 pandemic, the first case of which was announced on March 3, 2020. In response to this disaster, various economic sectors carried out digital transformation, including the banking sector. This research is a case study of how Indonesian banking responded to the pandemic through various central bank policies complemented by literature review on the impact of the pandemic on the banking sector in the world, as well as the development of electronic payment systems before, during and after the COVID-19 pandemic. The central bank issued several regulations of relaxation to reduce the impact of the pandemic on the banking sector. From the perspective of society, the pandemic has actually accelerated the use of digital payment systems in Indonesia. The most widely used electronic payment instrument is electronic money, followed by RTGS transactions with data periods ranging from 2016 to 2021. ATM/Debit card transactions show relatively no fluctuating increases, while credit card transactions show a decline during the same observation period. The trend of increasing electronic transactions is expected to continue after the pandemic and will become a necessity in the Indonesian economy onwards. [ FROM AUTHOR] Copyright of Technium Social Sciences Journal is the property of Technium Press Constanta and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Comparison of hospitalization expenses for identical diseases between traditional Chinese medicine and Western medicine hospitals based on interrupted time-series analysis.

Objective In light of the comprehensively implemented reform of medical insurance payments, this study analyzed the impact of the payment intervention and COVID-19 pandemic on hospitalization expenses for identical diseases between traditional Chinese medicine (TCM) and Western medicine hospitals, to provide evidence to promote high-quality coordinated development of hospitals and insurance while reducing patient load. Methods From January 2014 to December 2020, we gathered data including 9 900 individual medical records of woman-related malignant tumors (WMT) from all 23 public hospitals in a district of Shanghai. We developed an interrupted time-series analysis model based on the above two interventions, to compare the inpatient average per-time expenses between different hospitals and different groups. Results The average per-time expenses of WMT in Western hospitals changed from rising to declining after the policy intervention, and increased again during the pandemic. In TCM hospitals, the expenses continued to increase and fluctuated after the pandemic. Conclusion The policy intervention has achieved a good effect on controlling the cost of Western hospitals, rather than the significant increase in TCM hospitals. Meanwhile, the COVID-19 pandemic has had a significant impact on hospitalization expenses. It's urgent to develop a payment model that fits the development and characteristics of TCM, to control the unreasonable growth of expenses. Moreover, the financial compensation methods and supervision mechanism of public hospitals should be improved to effectively resist the threat of public health emergencies for the development of hospitals and the legitimate rights of patients.Copyright © 2023 West China University of Medical Science. All rights reserved.

Comparison of hospitalization expenses for identical diseases between traditional Chinese medicine and Western medicine hospitals based on interrupted time-series analysis.

Objective In light of the comprehensively implemented reform of medical insurance payments, this study analyzed the impact of the payment intervention and COVID-19 pandemic on hospitalization expenses for identical diseases between traditional Chinese medicine (TCM) and Western medicine hospitals, to provide evidence to promote high-quality coordinated development of hospitals and insurance while reducing patient load. Methods From January 2014 to December 2020, we gathered data including 9 900 individual medical records of woman-related malignant tumors (WMT) from all 23 public hospitals in a district of Shanghai. We developed an interrupted time-series analysis model based on the above two interventions, to compare the inpatient average per-time expenses between different hospitals and different groups. Results The average per-time expenses of WMT in Western hospitals changed from rising to declining after the policy intervention, and increased again during the pandemic. In TCM hospitals, the expenses continued to increase and fluctuated after the pandemic. Conclusion The policy intervention has achieved a good effect on controlling the cost of Western hospitals, rather than the significant increase in TCM hospitals. Meanwhile, the COVID-19 pandemic has had a significant impact on hospitalization expenses. It's urgent to develop a payment model that fits the development and characteristics of TCM, to control the unreasonable growth of expenses. Moreover, the financial compensation methods and supervision mechanism of public hospitals should be improved to effectively resist the threat of public health emergencies for the development of hospitals and the legitimate rights of patients.Copyright © 2023 West China University of Medical Science. All rights reserved.

California Hospitals' Rapidly Declining Traditional Medicare Operating Margins.

In recent years, Medicare margins of U.S. short-term acute care hospitals participating in the inpatient prospective payment system (IPPS) have declined nationally by over 10 percentage points, from 2.2% in 2002 to -8.7% in 2019. This trend conceals critical regional variations, with recent studies documenting particularly low and negative margins in metropolitan areas with higher labor costs despite geographic adjustments by the Centers for Medicare & Medicaid Services (CMS). In this article, we describe recent trends in California hospitals' traditional fee-for-service Medicare operating margins compared to hospital operating margins across payers and changes in the CMS hospital wage index (HWI) used to adjust Medicare payments. We conduct an observational study of audited financial reports of IPPS-participating California hospitals using California Department of Health Care Access and Information and CMS data for years 2005-2020 (n = 4429 reports included in the analysis). We describe trends in financial measures by payer and investigate associations between HWI and traditional Medicare margins, focusing on the pre-COVID period of 2005 through 2019. During that period, California hospitals' statewide traditional Medicare operating margin declined from -27 to -40%, and financial shortfalls in caring for fee-for-service Medicare patients more than doubled ($4.1 billion in 2005 to $8.5 billion in 2019, both values in 2019 dollars). Meanwhile, operating margins from commercial managed care patients increased from 21% in 2005 to 38% in 2019. There was a stable negative association between HWI and traditional Medicare operating margins throughout the period (p = 0.000 in 2005; p < 0.0001 in 2006-2020), indicating that areas of California with higher health care wages had persistently worse traditional Medicare operating margins than areas with lower wages.

Sugbo Negosyo Program Digital Card Implementation: Technology Acceptance and Satisfaction among Microentrepreneur-Beneficiaries

The COVID-19 lockdowns upended business operations, impacting microenterprises which prompted the Cebu Province to implement a stimulus grant to revive existing and encourage start-up microenterprises known as the Sugbo Negosyo program. A digital card system (DCS) with a quick response (QR) code payment was utilized to facilitate the disbursement of financial assistance and to enable real-time monitoring of the program beneficiaries' expenditure transactions. This study evaluates the effectiveness of the DCS, investigating how the perceived ease of use, perceived usefulness, and attitude towards its use have influenced the actual use and satisfaction of the DCS use by the beneficiaries. The research, a mix of quantitative and qualitative methods, was participated by 212 beneficiaries through face-to-face surveys. With the Technology Acceptance Method (TAM) as the study's framework, the partial least squares structural equation modeling (PLS-SEM) results show that the DCS is evaluated as useful and easy to use and satisfied the beneficiaries. © 2022, University of San Jose-Recoletos. All rights reserved.

Is Cashless Going Right in Japan? An Observation Report

In this research, we investigated the recent trend of the diffusion of cashless payment in Japan by using the survey data of students in our institute during 2018 and 2021. Cashless payment has achieved remarkable development with the wide usage of smartphones and the prevalence of consequent smartphone-based system. Before the bar code, either two- and single-dimensional, was introduced in the cashless system, the major technology that was used is a smart card or integrated circuit card-based system. We investigated the behavior of technology adoptions to cashless payment, which we called "Smart Payment System"in 2018[5]. Since 2018, we conducted surveys and found that the effect of COVID-19 resulted in the increase adoption to the cashless payment system among students and the increase usage of credit cards. The survey showed that the use of cashless payment system increased after 2020 in comparison to 2018 and 2019. Since the COVID-19 pandemic in spring of 2020, the usage of online shopping increased, and the usage of real stores decreased. Although we did not use big data, such as the log data of mobile phone usages, the results indicated that our observation of the use of cashless payment system among young users is consistent with the common sense. © 2021 ACM.

COVID-19 crisis – an opportunity for mainstreaming digital financial transactions

Digital financial transactions, in comparison to in-cash transactions, provide an efficient and time saving option. Considering the significance of digital financial transactions in the present scenario of the COVID-19 crisis, this study has twin objectives: firstly, to examine the use of digital financial transactions in COVID-19 and secondly, to explore the existence of any relationship between financial literacy and the use of digital financial transactions, especially by low-income groups in India. This study uses secondary data from authorised and government sources for the analysis of the research objectives. Logistic regression model was deployed on National Centre for Financial Education (NCFE) (2019) survey data of around 36,600 low-income group to interpret the relationship between financial literacy and digital financial transactions. The analysis of the data suggested that financial literacy was significant in positively affecting digital financial transactions. In this regard, financial literacy could play an instrumental role, which is also being indicated through our estimated results. Copyright © 2022 Inderscience Enterprises Ltd.

Fuzzy Analytical Hierarchy Process (F-AHP) Method in Evaluating E-Wallet Payment System in Malaysia

A digital wallet also known as "E-wallet" refers as financial transaction that proceeding payment through an electronically system and device. The digital revolution continues to transform most of our everyday lives especially in this challenging world of pandemic Covid-19. In the new norms, government encouraged to utilize e-wallet as a way to prevent contagious by incentive of eBelia also ePenjana. As e-wallet actively used, this has increased the mass growth of E-wallet providers. Due to accumulation of e-wallet, the aim is to provide overall ranking towards e-wallet payment system for consumers in selecting efficient payment system for transaction. For the solution, this research has utilized the Multi-Criteria Decision Making (MCDM) method of Fuzzy Analytical Hierarchy Process (FAHP). In order to assist consumers in selecting a higher-quality digital wallet payment system, this study assess 4 criteria of E-wallet Payment System quality, with the top 3 alternative of e-wallet providers. Based on the highest weightage value, the most preferable criteria and alternatives for e-wallet will established. Touch 'n Go had become the preferable e-wallet with weightage of 0.419. Among all criteria, security became the most essential factor in selecting e-wallet. In the future, researchers are encouraged to use another approach in MCDM. © 2022, Mathematical and Research Society. All rights reserved.

Do Large TARGET2 Balances Bear Risks for the Euro Area?

Large increases in TARGET2 balances in the euro area since 2008 have led to concern and debate about the appropriate interpretation and policy reaction – in particular in TARGET2 creditor countries such as Germany. Against this background, we examine the main drivers of the increases and asymmetries in TARGET2 balances that have emerged in the context of the financial and sovereign debt crises as well as in the context of the Eurosystem’s implementation of quantitative easing (QE) and the COVID-19 pandemic. Moreover, this paper analyzes the potential risks for euro area member states in the case of (i) the unchanged continuity of the monetary union, (ii) the withdrawal of a member state with (large) TARGET2 liabilities, and (iii) the break-up of the whole monetary un-ion. Depending on the outcome of exit negotiations and the operational handling, there can be direct risks in the form of default losses of TARGET2 balances and indirect risks in the form of threat potentials if TARGET2 debtor countries pretend to plan to leave the euro area. Based on this, we discuss adaption options for the TARGET2 payment system and consider an exit from the ECB’s accommodative monetary policy in order to scale back the high amount of excess liquidity in the euro area banking sector which is the pre-requisite for the emergence of TARGET2 balances. © 2022, Duncker und Humblot GmbH. All rights reserved.

Nursing Home COVID Relief Under QIP's Performance-Based Formula: Does Performance Actually Matter, and Should It?

The Quality Incentive Program (QIP) distributed US$2 billion to nursing homes (NHs) that met performance goals primarily related to their COVID-19 infection rates. We examine how QIP affected 15,331 NHs with different facility and community attributes, and the extent to which QIP payments per resident-week (QIP$) were associated with NHs' COVID-related attributes. We find that QIP$ was primarily determined by county (not facility) infection rates. QIP distributed US$2 billion to NHs for months in which they experienced virtually no COVID-19 cases; US$0 was distributed for months in which they experienced more than 300,000 cases. We find that QIP$ was larger for smaller, nonprofit NHs located in more rural and economically distressed communities. Regression analyses reveal that recipients of larger QIP$ maintained greater supplies of personal protective equipment, conducted more staff testing, and limited admissions of infected residents, and that greater staff testing and limited admissions are also associated with NHs' sustained success in receiving QIP payments. Policymakers should consider whether performance-based payment systems are optimal for addressing public health emergencies.

Exploring the Drivers of Cryptocurrency Adoption Intent in Africa

The evolution of technology has made cryptocurrency an alternative form of exchange that has attracted growing interest from individuals and businesses. Its adoption continues to be explosive worldwide and further motivated by the financial behaviors fostered by the COVID-19 crisis. The present study investigates the factors influencing the intention to adopt cryptocurrency in Africa through the Diffusion of Innovation Theory (DOI) and the Theory of Reasoned Action (TRA). We test a sample of 124 individuals using Partial Least Square - Structural Equation Modeling (PLS-SEM). The results show that compatibility, relative advantage, and attitude towards cryptocurrency adoption positively influence the intention. The study provides substantial implications in understanding cryptocurrency adoption in the African context and gives good guidance for developing this kind of currencies in Africa. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Application of a Multiple Carrier Cashless Payment System for Public Transportation in Metro Manila: A New Normal Perspective

Public transportation provides a cost-effective commute for people to reach their destination. In the Philippines, it is dominated by road vehicles such as jeepneys, taxicabs, Asian utility vehicles, and tricycles, with most if not all, commuters go via multiple carriers for the daily routine. The highly contagious coronavirus has put the world on high alert when it comes to touching high contact public surfaces. When it comes to paying for public transport services by cash, contact is inevitably unavoidable. Recent studies have concluded that the coronavirus can persist on inanimate surfaces like metal, glass or plastic for up to 3 days depending on the conditions. Interest would be on how drivers and passengers can be protected in the age of coronavirus and beyond. With the growing concern over the safety of drivers and commuters, it would be much advisable to use contactless payments to reduce the risk of transmission. With no obvious end to the outbreak in sight, the study delved on the feasibility of applying the cashless payment system for the multi-carrier commuting public. Results provided a better understanding of the complexities, issues, requisites and benefits of a Multi-Carrier Contactless Payment System for public transportation and all its stakeholders. © IEOM Society International.

Design of a payment system in private transportation to prevent Covid-19 Contagion - Huancayo

The contagion of Sars-CoV-2 or Covid-19 inside the city of Huancayo is growing, with the transport sector being one of the most affected, so it was planned to reduce the rate of contagion among users of these services. This required the use of RFID-NFC technology in such a way as to prevent direct and indirect contact between passengers and drivers. Technology that is not dependent on the internet, because it was taken into account that, in that city, the technology is not very expanded so, there are places where the internet signal does not arrive. For this reason, the modules created from RFID technology are a good option to be able to slow the advance of the covid-19. © 2021 Association for Computing Machinery.