The Influence of Medicare Home Health Payment Incentives: Does Payer Source Matter?

During the late 1990s, an interim payment system (IPS) was instituted to constrain Medicare home health care expenditures. Previous research has largely focused on the implications of the IPS for Medicare patients, but our study broadens the analysis to consider patients with other payer sources. Using the National Home and Hospice Care Survey, we found similar effects of the IPS across payer types. Specifically, the IPS was associated with a decrease in access to care for the sickest patients, less agency assistance with activities of daily living, and shorter length-of-use. However, these changes did not translate into worse discharge outcomes.Medicare, health, incentives

The interaction of knowledge sources in word sense disambiguation

Word sense disambiguation (WSD) is a computational linguistics task likely to benefit from the tradition of combining different knowledge sources in artificial in telligence research. An important step in the exploration of this hypothesis is to determine which linguistic knowledge sources are most useful and whether their combination leads to improved results. We present a sense tagger which uses several knowledge sources. Tested accuracy exceeds 94% on our evaluation corpus.Our system attempts to disambiguate all content words in running text rather than limiting itself to treating a restricted vocabulary of words. It is argued that this approach is more likely to assist the creation of practical systems

Policy at the margins: Views from Leeds about local authority tourism policy activity.

This thesis investigates the factors affecting tourism policy making in an English local authority and is developed from a social/human conceptualisation of policy making. It focuses on the experiences and perspectives of the people involved in the development and delivery of policy. The author adopts a qualitative methodology that is developed from grounded theory, but also includes ideas and insights from complexity theory to create a theoretical approach that is grounded in the experiences of policy makers. Interview data is analysed to identify key themes and characteristics of the development and enactment of tourism policy in Leeds in an attempt to broaden understanding of tourism policy making. The findings are presented using the multiple voices of the policy makers and identify the specific complexities associated with tourism policy enactment and delivery in Leeds. These themes and characteristics are investigated in the context of the literature on tourism planning and policy, complexity, public policy and ideology; historical analysis of tourism policy making in England, and in Leeds and primary research into local authority policy making in Cambridge. The research identifies a process where the relationship between tangible policy and the action of policy makers is blurred and sometimes contradictory due to changes in the wider policy environment. It identifies tourism policy occurring on the margins of local authority policy making, in a turbulent environment and with multiple connections with other policy areas. It highlights the extent that tourism policy is the result of communication and negotiation, the importance of intangible activities associated with this communication and the paradoxes and contradictions inherent in policy making. The research questions some of the prevailing conceptualisations of tourism policy and the dominance of positivist approaches to tourism policy making in terms of their linearity and assumptions about causality and association. This research provides an alternative approach to understanding policy that is grounded in the experiences of those in the field. It suggests that a new theoretical approach to understanding tourism policy is needed in order to broaden the conceptualisation of policy making and deepen understanding of tourism policy, taking account of its wider characteristics and their implications and is developed from what happens in practice

Tourism policy making: the policymakers' perspectives

This research explores tourism policy making, from the perspectives of policy makers using grounded theory. It focuses on Leeds, a city in the North of England, which is characterized by its turbulent environment. The paper identifies themes around policy making, including low status, lack of clarity, uncertainty, lack of consensus and congruence and complexity. Its findings indicate policy making is essentially a social process, involving communication and negotiation between people in the context of wider change. It suggests a social conceptualization, and further research to investigate the communications involved in producing policy rather than the current research focus on the tangible outputs of the process such as a plan or a physical development

Developing our claims employees

The Insurance Reserve Fund under the State Fiscal Accountability Authority provides property and liability insurance to all State agencies and various local governmental entities, including Counties, Municipalities, School Districts and special purpose Political Subdivisions. When employees from the private sector come to work for the agency they must transition to governmental claims work. This project seeks to create a standardization of the employee transition process to best provide property and liability insurance products that meet the needs of the governmental customers

Local festivals, social capital and sustainable destination development: experiences in East London

This paper explores the nature of social capital arising from engagement in local festivals and the implications of this for the social sustainability of an emerging destination. Two case studies are developed from a longitudinal research project which investigates local festivals staged in the Hackney Wick and Fish Island area adjacent to Queen Elizabeth Olympic Park in East London, UK between 2008 and 2014. This area has been directly affected by extensive development and regeneration efforts associated with the staging of the London 2012 Olympic Games. The two festivals considered here respond to the challenges and opportunities arising for local people as the area changes. One festival aims to foster a sense of community by creating shared experiences and improving communication across diverse groups. The other draws together the cultural community, links them to the opportunities arising as the area emerges as a destination, and attracts visitors. These festivals increase social capital in the area, but its distribution is very uneven. The accrual of social capital exacerbates existing inequalities within the host community, favouring the “haves” at the expense of the “have nots”. There are tensions between the development of social capital and social sustainability in this emerging destination

Violence Against Women: Effective Interventions and Practices with Perpetrators – A literature Review

First paragraph: This report presents a review of literature on effective interventions and practices to deal with perpetrators of violence against women. The key focus is with those interventions and practices which are aimed at reducing re-offending, rather than primary prevention and or public education work. The review was commissioned by the Scottish Government in order to inform development of Scotland's strategy for preventing the causes and consequences of violence against women