I get paid fast; what about you?

The process of billing an insurance company for health care services has changed radically. In the past few years, the emphasis has been on automation. The change is fueled by the opinion of cost containment experts who claim that automation will help reduce costs in the U.S. health care delivery system. Key to success for the provider in adapting to this change will be understanding the coding used in the billing process and following standards of accuracy and fairness. This article is not intended to represent the adjudication rules of any particular insurance company. It is the result of experience as a practicing surgeon and as a consultant in the health care field.     

Long range planning— Japan-USA— A comparative study

This article reports on a comparative study carried out in the U.S.A. and Japan. He concludes that in the U.S.A. long range planning is used to integrate the strategies of divisions and to control the divisions. The planning process is usually bottom-up rather than top-down.In Japan, long range planning is used for improving strategic decisions of top management, so the planning process is a centralized interactive process.Project emphasis rather than quantitative planning is a common characteristic in both the U.S.A. and Japan. However American corporations are more advanced in this respect. Many Japanese corporations suggest that project emphasis is the key success factor for planning.To cope with uncertainty, American corporations tend to update their plans every year or even at shorter intervals, while adopting contingency plans.To the same end, Japanese corporations are using two time horizon plans which are composed of a long range strategy and a medium range plan.With respect to follow-up and implementation, American corporations follow-up more closely and long range planning is used for the evaluation of managers of divisions. The quality of plan and accomplishment are reflected to the economic rewards.Japanese corporations are less inclined to follow up the long range plan itself, but it is considered as important to implement it through the budget and also through the project plan. Project teams are quite frequently used.     

Supplier Opportunism in Buyer–Supplier New Product Development: A China‐U.S. Study of Antecedents,Consequences, and Cultural/Institutional Contexts

Collaborating with a supplier in a buying firm's new product development (NPD) project is commonly advocated and adopted, but does not always improve project performance. Some pre‐existing collaboration contexts, such as buyer–supplier NPD projects, are especially exposed to supplier opportunism due to the uncertain nature of the collaboration process. Adopting agency theory and transaction cost theory perspectives, we examine: (i) contextual antecedents and project consequences of supplier opportunism and (ii) if these causal influences vary in different cultural and institutional contexts. Using a survey sample of 214 United States (U.S.) and 212 Chinese buying firms’ responses about buyer–supplier NPD projects, we find that supplier opportunism is significantly influenced by the task and relational contexts. We also show that supplier opportunism damages both design quality and efficiency, two aspects of project performance. When comparing U.S. to China, we find that task and relational contexts have a greater impact on supplier opportunism in the U.S., but design efficiency is less hurt by supplier opportunism there. Finally, we show challenges of preventing supplier opportunism in certain NPD collaboration contexts, and offer solutions for overcoming these challenges.     

Expert Views on Biological Threat Characterization for the U.S. Government: A Delphi Study

Biological threat characterization (BTC) involves laboratory research conducted for the purpose of biological defense. BTC research is important for improving biological risk assessment and informing resource prioritization. However, there are also risks involved in BTC work, including potential for escape from the laboratory or the misuse of research results. Using a modified Delphi study to gather opinions from U.S. experts in biosecurity and biodefense, this analysis explores what principles and safeguards can maximize the benefits of BTC research and ensure that it is conducted safely and securely. Delphi participants were asked to give their opinions about the need for BTC research by the U.S. government (USG); risks of conducting this research; rules or guidelines that should be in place to ensure that the work is safe and accurate; components of an effective review and prioritization process; rules for when characterization of a pathogen can be discontinued; and recommendations about who in the USG should be responsible for BTC prioritization decisions. The findings from this research reinforce the need for BTC research at the federal level as well as a need for continued review and oversight of this research to maximize its effectiveness and reduce the risks involved. It also demonstrates the need for further discussion of what would constitute a “red line” for biothreat characterization research—research that should not be performed for safety, ethical, or practical reasons—and guidelines for when there is sufficient research in a given topic area so that the research can be considered completed.     

Communicating Food Risks in an Era of Growing Public Distrust: Three Case Studies

The communication and regulation of risk has changed significantly over the past 30 years in Europe and to a noticeable but lesser extent in the United States. In Europe, this is partly due to a series of regulatory mishaps, ranging from mad cow disease in the United Kingdom to contamination of the blood supply in France. In the United States, general public confidence in the American government has been gradually declining for more than three decades, driven by a mix of cultural and political conflicts like negative political advertising, a corrosive news media, and cuts in regulatory budgets. While the former approach is based on an objective assessment of the risk, the latter is driven more by the perception of the risk, consumer sentiment, political will, and sectoral advocacy. In this article, the author examines three U.S.‐based food case studies (acrylamide, bisphenol A, and artificial food colorings) where regulations at the local and state levels are increasingly being based on perceived risk advocacy rather than on the most effective response to the risk, be it to food safety or public health, as defined by regulatory interpretation of existing data. In the final section, the author puts forward a series of recommendations for how U.S.‐based regulators can best handle those situations where the perceived risk is markedly different from the fact‐based risk, such as strengthening the communication departments of food regulatory agencies, training officials in risk communication, and working more proactively with neutral third‐party experts.     

Risk Perception in the U.K. Oil and Gas Production Industry: Are Expert Loss‐Prevention Managers' Perceptions Different From Those of Members of the Public?

This article investigates potential differences in risk perception between experts (loss-prevention managers in the U.K. oil and gas production industry) and nonexperts (managers and students). Extant research on expert versus nonexpert perceptions of risk is reviewed, followed by the present study concerning risk perceptions of seven pen-picture scenarios involving the occurrence of hazardous events in the U.K. oil and gas production industry. In contrast to many of the earlier studies of expert versus nonexpert perceptions of risk, the present analysis concludes that experts did not judge the overall riskiness of the portrayed hazardous events as less risky than the nonexperts. Nevertheless, the experts believe more strongly than our nonexperts that the risks portrayed in the scenarios pose little threat to future generations, are more precisely known, and are relatively controllable. Use of multiple regression analysis to help uncover the basis of overall riskiness assessments for expert and lay respondents was inconclusive, however. Finally, little evidence was found that nonexperts were any more heterogeneous in their risk perceptions than experts. It may be that the nature of the risks assessed in the present study may account for the general lack of clear expert versus nonexpert differences in overall perceptions of the riskiness of hazardous events in the North Sea. Earlier findings of strong expert versus nonexpert differences in risk perception assessed hazards of major public concern. It is inferred that using such extreme hazards may have resulted in an exaggerated view of differences in expert versus public (nonexpert) perception of risk.     

Technological change and energy consumption in US iron and steel manufacturing

This paper examines the extent to which the rising relative energy prices of the past decade have influenced managerial decisions in U.S. iron and steel manufacturing. Efforts at energy conservation, as well as opportunities for short-run substitutions among energy sources, were constrained mainly by existing process technology. The actual pattern of substitution can be explained to a large extent by changes in techniques. Decisions concerning such investments were guided by many factors, among which considerations of energy savings played only a minor role. This observation can be explained by the fact that, although the industry in the aggregate is a prodigious consumer of energy, energy costs at any one production stage are but a small fraction of total variable costs. Integrated greenfield plants embodying state-of-the-art technology would achieve much higher levels of energy efficiency than are currently realized, but such new plants are unlikely to be built in the United States, under the current conditions of global excess capacity.     

Validating Expert Systems: A Demonstration Using Personal Choice Expert,A Flexible Employee Benefit System*

A method for validating expert systems, based on validation approaches from psychology and Turing's “imitation game,” is demonstrated using a flexible employee benefits expert system. Psychometric validation has three aspects: the extent to which the system and expert decisions agree (criterionrelated validity), the inputs and processes used by experts compared to the system (content validity), and differences between expert and novice decisions (construct validity). If these criteria are satisfied, then the system is indistinguishable from experts for its domain and satisfies the Turing Test. Personal Choice Expert (PCE) was designed to help employees of a Fortune 500 firm choose benefits in their flexible benefits system. Its recommendations do not significantly differ from those given by independent experts. Hence, if the system-independent expert agreement (criterion-related validity) were the only standard, PCE could be considered valid. However, construct analysis suggests that re-engineering may be required. High intra-expert agreement exists only for some benefit recommendations (e.g., dental care and long-term disability) and not for others (e.g., short-term disability, accidental death and dismemberment, and life insurance). Insights offered by these methods are illustrated and examined.     

Managing the impacts of large public programs

This paper is the result of a research project which investigated the impact of the U.S. space program on the American economy. Based on their field studies of past space program impacts, the authors develop several conclusions regarding the overall management and strategic planning of large public programs. In this article, the author outlines a structured approach to strategic planning and evaluation which will aid public program managers to respond to the challenge of impact management.     

Business values in the Republic of South Africa and the United States: A tale of two countries

This paper reports on a study of the values of two samples of South African managers over a ten year period. It then compares those values to a group of U.S. entrepreneurs, using the same instrument, the Allport-Vernon-Lindzey Study of Values, for both groups. The comparison with the early sample of South African managers noted similarities between the value systems of the two groups. The comparison with the most recent group of managers indicates a shift in the values of the South African managers. There appeared to be little difference between the values of the latter group of managers on the basis of age. This was similar to the findings in the U.S. sample as well as the earlier South African sample. There were differences in the strength of the values, but less of a difference in the pattern of values exhibited based on industry backgrounds. The reasons for these shifts are discussed, including the potential impact on the education process in South Africa.     

Engaging Expert Peers in the Development of Risk Assessments

The participation of external technical experts in the development of risk assessment documents and methodologies has expanded and evolved in recent years. Many government agencies and authoritative organizations have experts peer review important works to evaluate the scientific and technical defensibility and judge the strength of the assumptions and conclusions (OMB, 2004; IPCS, 2005; IARC, 2006; Health Canada, 2007; U.S. EPA, 2006). Expert advice has been solicited in other forms of peer involvement, including peer consultation in, for example, the U.S. EPA's Voluntary Children's Chemical Evaluation Program (VCCEP). This article discusses how the principles and practices of peer review can be extended to other types of peer involvement activities (i.e., peer input and peer consultation) to develop high-quality risk assessment work products. A comprehensive process for incorporating peer input, peer consultation, and peer review into risk assessment science is outlined. Four key principles for peer involvement-independence, inclusion of appropriate experts, transparency, and a robust scientific process-are discussed. Recent examples of peer involvement in the development of Health Canada's Priority Substances and Domestic Substance List (DSL) programs under the Canadian Environmental Protection Act (CEPA) serve to highlight the concepts.     

科学基金项目立项评估:综合评价信息可靠性的多指标证据推理规则研究

公正合理的科研项目立项评估与选择是国家自然科学基金管理活动的关键环节。综合考虑科研项目的评估指标体系和选择流程,提出了利用历史评估准确性度量专家提供信息可靠性的方法,进而提出了一种系统性的基于证据推理规则的科学基金项目评估决策模型。该模型使用证据推理合成规则对多专家多指标评估信息进行集结。在集结过程中：充分考虑评估指标的权重以及评估等级的多样性;鉴于参与项目评估的专家具有不同的知识背景和经验,提出利用历史评估结果的准确性衡量专家提供的评价信息可靠性的方法;应用信度分布表征项目的整体评价结果,包含了更丰富的信息。国家自然科学基金项目评估的实例分析证明了该评估决策模型的有效性。     

基于改进语言评估标度的专家后验权重确定方法研究

针对大型复杂项目的高度不确定性,专家评价的模糊性和差异性等特点,本文给出了一种实用的语言评估新标度,并提出了不确定扩展语言信息的概念。利用改进的语言评估标度分别探讨确定语言信息、不确定语言信息及不确定扩展语言信息下的专家后验权重的确定方法,认为前两者均为后者的特殊表现形式。最后用型号项目风险评价实例证明了方法的科学有效性以及评价结果的合理性。     

Forty Years of Food Safety Risk Assessment: A History and Analysis

Before the founding of the Society for Risk Analysis (SRA) in 1980, food safety in the United States had long been a concern, but there was a lack of systematic methods to assess food-related risks. In 1906, the U.S. Congress passed, and President Roosevelt signed, the Pure Food and Drug Act and the Meat Inspection Act to regulate food safety at the federal level. This Act followed the publication of multiple reports of food contamination, culminating in Upton Sinclair's novel The Jungle, which highlighted food and worker abuses in the meatpacking industry. Later in the 20th century, important developments in agricultural and food technology greatly increased food production. But chemical exposures from agricultural and other practices resulted in major amendments to federal food laws, including the Delaney Clause, aimed specifically at cancer-causing chemicals. Later in the 20th century, when quantitative risk assessment methods were given greater scientific status in a seminal National Research Council report, food safety risk assessment became more systematized. Additionally, in these last 40 years, food safety research has resulted in increased understanding of a range of health effects from foodborne chemicals, and technological developments have improved U.S. food safety from farm to fork by offering new ways to manage risks. We discuss the history of food safety and the role risk analysis has played in its evolution, starting from over a century ago, but focusing on the last 40 years. While we focus on chemical risk assessment in the U.S., we also discuss microbial risk assessment and international food safety.     

Testing Multiple Forecasters

We consider a cross‐calibration test of predictions by multiple potential experts in a stochastic environment. This test checks whether each expert is calibrated conditional on the predictions made by other experts. We show that this test is good in the sense that a true expert—one informed of the true distribution of the process—is guaranteed to pass the test no matter what the other potential experts do, and false experts will fail the test on all but a small (category I) set of true distributions. Furthermore, even when there is no true expert present, a test similar to cross‐calibration cannot be simultaneously manipulated by multiple false experts, but at the cost of failing some true experts.     

Control exercised by U.S. multinationals over their overseas affiliates: does location make a difference?

Using data collected through personal interviews with senior managers at U.S. multinational headquarters and their U.K., Thai, Malaysian, and Singaporean affiliates, this study examines whether U.S. multinationals adjust the amount of control they use over their culturally different overseas affiliates. Results showed no overall difference in the amount of control that U.S. multinationals exercise over their U.K. and Southeast Asian affiliates. However, differences emerged between these two cultural groups when industry and affiliate top manager type were taken into account. In particular, U.K. locally run affiliates were given significantly more autonomy than their Southeast Asian counterparts. Locally run affiliates in both countries were also given significantly greater autonomy than were expatriate-run ones. Consumer goods affiliates in Southeast Asia enjoyed more autonomy than the industrial affiliates did.     

Modeling Uncertainties in Mining Pillar Stability Analysis

Many countries are now facing problems related to their past mining activities. One of the greatest problems concerns the potential surface instability. In areas where a room-and-pillar extraction method was used, deterministic methodologies are generally used to assess the hazard of surface collapses. However, those methodologies suffer from not being able to take into account all the uncertainties inherent in any hazard analysis. Through the practical example of the assessment of a single pillar stability in a very simple mining layout, this article introduces a logical framework that can be used to incorporate the different kinds of uncertainties related to data and models, as well as to specific expert's choices in the hazard or risk analysis process. Practical recommendations and efficient tools are also provided to help engineers and experts in their daily work.     

Airline Safety Improvement Through Experience with Near‐Misses: A Cautionary Tale

In recent years, the U.S. commercial airline industry has achieved unprecedented levels of safety, with the statistical risk associated with U.S. commercial aviation falling to 0.003 fatalities per 100 million passengers. But decades of research on organizational learning show that success often breeds complacency and failure inspires improvement. With accidents as rare events, can the airline industry continue safety advancements? This question is complicated by the complex system in which the industry operates where chance combinations of multiple factors contribute to what are largely probabilistic (rather than deterministic) outcomes. Thus, some apparent successes are realized because of good fortune rather than good processes, and this research intends to bring attention to these events, the near‐misses. The processes that create these near‐misses could pose a threat if multiple contributing factors combine in adverse ways without the intervention of good fortune. Yet, near‐misses (if recognized as such) can, theoretically, offer a mechanism for continuing safety improvements, above and beyond learning gleaned from observable failure. We test whether or not this learning is apparent in the airline industry. Using data from 1990 to 2007, fixed effects Poisson regressions show that airlines learn from accidents (their own and others), and from one category of near‐misses—those where the possible dangers are salient. Unfortunately, airlines do not improve following near‐miss incidents when the focal event has no clear warnings of significant danger. Therefore, while airlines need to and can learn from certain near‐misses, we conclude with recommendations for improving airline learning from all near‐misses.     

Quantifying the Effects of Expert Selection and Elicitation Design on Experts’ Confidence in Their Judgments About Future Energy Technologies

Expert elicitations are now frequently used to characterize uncertain future technology outcomes. However, their usefulness is limited, in part because: estimates across studies are not easily comparable; choices in survey design and expert selection may bias results; and overconfidence is a persistent problem. We provide quantitative evidence of how these choices affect experts’ estimates. We standardize data from 16 elicitations, involving 169 experts, on the 2030 costs of five energy technologies: nuclear, biofuels, bioelectricity, solar, and carbon capture. We estimate determinants of experts’ confidence using survey design, expert characteristics, and public R&D investment levels on which the elicited values are conditional. Our central finding is that when experts respond to elicitations in person (vs. online or mail) they ascribe lower confidence (larger uncertainty) to their estimates, but more optimistic assessments of best‐case (10th percentile) outcomes. The effects of expert affiliation and country of residence vary by technology, but in general: academics and public‐sector experts express lower confidence than private‐sector experts; and E.U. experts are more confident than U.S. experts. Finally, extending previous technology‐specific work, higher R&D spending increases experts’ uncertainty rather than resolves it. We discuss ways in which these findings should be seriously considered in interpreting the results of existing elicitations and in designing new ones.