Past research has only studied genetic panel scores and feedlot performance. This research combines impacts of genetic panel scores on a cow-calf operation with previously estimated feedlot impacts to evaluate the potential for misaligned economic incentives in the beef industry. Calves that were higher genetic scores for two carcass traits, marbling and tenderness, had lower weaning weights and lower net returns. Correlations between genetic traits and cow size were small and mostly insignificant. The sum of the effects on feedlot and cow-calf sectors of a one-unit higher panel score totaled $-2.83 per cow year for marbling and $-4.93 per cow year for tenderness.

For decision-makers considering new medicines for reimbursement and public use, both value for money and affordability are important considerations. Whereas a cost-effectiveness model provides information about value for money, a budget impact assessment (BIA) is customized to a specific context and estimates the total investment needed; one part of affordability. Both analytic approaches have parameter uncertainty within them, yet comparatively little attention is given to parameter uncertainty in BIA. Currently, within BIA, uncertainty exploration is limited to point estimates for plausible scenarios, prompting the question: can a decision-maker be confident in point estimates? Within this paper, our intent is to revitalize the discussion of uncertainty in BIA. In the context of health technology assessments submitted to support reimbursement decision-making, we propose reliance on probabilistic sensitivity analysis conducted in the cost-effectiveness model. If assumptions made in a cost-effectiveness model are valid, probabilistic cost estimates from the model, with the same perspective adopted as the BIA, should also inform BIA. Mean and variance of population outcomes, given parameter uncertainty in model inputs, are estimable from model outputs. As sufficiently large random samples are drawn from a population, the distribution of sample means will follow an approximately normal distribution. Therefore, when drawing samples from the model to inform estimates of budget impact, the assumption of an approximately normal distribution for costs is reasonable. We propose that the variance in mean costs from the cost-effectiveness model also reflects the variance in budget impact estimates and should be used to estimate budget impact confidence intervals.

This paper provides evidence of racial variation in traffic enforcement responses to local government budget stress using data from policing agencies in the state of Missouri from 2001 through 2012. Like previous studies, we find that local budget stress is associated with higher citation rates; we also find an increase in traffic-stop arrest rates. However, we find that these effects are concentrated among White (rather than Black or Latino) drivers. The results are robust to the inclusion of a range of covariates and a variety of model specifications, including a regression discontinuity examining bare budget shortfalls. Considering potential mechanisms, we find that targeting of White drivers is higher where the White-to-Black income ratio is higher, consistent with the targeting of drivers who are better able to pay fines. Further, the relative effect on White drivers is higher in areas with statistical over-policing of Black drivers: when Black drivers are already getting too many fines, police cite White drivers from whom they are presumably more likely to be able to raise the needed extra revenue. These results highlight the relationship between policing-as-taxation and racial inequality in policing outcomes.

In most accounts, the modern American “tax revolt” begins with Proposition 13, passed by California voters in June 1978. In this telling, the revolt represents an antigovernment, antiliberal shift among white homeowners instrumental in the “rise of the right” and the fall of the “New Deal order” that culminated in Ronald Reagan’s election in 1980 and his subsequent tax cuts. This article challenges that account by demonstrating that the revolt began more than a decade before Prop 13 as approval rates for local levies and bonds reached all-time lows. This local revolt was not limited to whites, nor did it portend rising conservatism. Instead, it was rooted in lower- and middle-income Americans’ frustrations with steep rises in unfair, regressive taxes during the post–World War II decades. The Kennedy-Johnson “Growth Liberals,” who were busy cutting progressive federal taxes at the same time that regressive state and local taxes were soaring, missed this pocketbook squeeze, thereby setting the stage for later events like Prop 13.

Objectives: Value assessments of marketed drug technologies have been developed through disinvestment frameworks. Components of these frameworks are varied and implementation challenges are prevalent. The objective of this systematic literature review was to describe disinvestment framework process components for drugs and to report on framework components, challenges, and solutions.

Methods: A systematic literature search was conducted using the terms: reassessment, reallocation, reinvestment, disinvestment, delist, decommission or obsolescence in MEDLINE, EMBASE, NLM PubMed, the Cochrane Library, and CINAHL from January 1, 2000, until November 14, 2015. Additional citations were identified through a gray literature search of Health Technology Assessment international (HTAi) and the International Network of Agencies for Health Technology Assessment (INAHTA) member Web sites and from bibliographies of full-text reviewed manuscripts.

Results: Sixty-three articles underwent full text review and forty were included in the qualitative analysis. Framework components including disinvestment terms and definitions, identification and prioritization criteria and methods, assessment processes, stakeholders and dissemination strategies, challenges, and solutions were compiled. This review finds that stakeholders lack the political, administrative, and clinical will to support disinvestment and that there is not one disinvestment framework that is considered best practice.

Conclusions: Drug technology disinvestment components and processes vary and challenges are numerous. Future research should focus on lessening value assessment challenges. This could include adopting more neutral framework terminology, setting fixed reassessment timelines, conducting therapeutic reviews, and modifying current qualitative decision-making assessment frameworks.

The American State Administrators Project is a half-century long research program surveying the attitudes and behavior of state agency leaders. The project has produced a voluminous number of publications and conference papers. At the same time it has also faced several difficulties in making its data more widely available to the scholarly community. This paper describes the Project, some of the data difficulties it has faced, and the portion of the data being distributed with this article.

The global recession has wrought havoc on the budgets of libraries worldwide, forcing administrators to reassess priorities and change direction midcourse. Privately funded academic libraries which typically rely heavily on large endowments have not been exempt and in fact have probably been hit the hardest. The challenges encountered by this long drawn financial crisis have ultimately provided opportunities to reassess priorities and conduct business more efficiently. This paper was presented at the BIALL Conference in June 2010 by Femi Cadmus and Blair Kaufmann.

The aim of this paper is to be both educational and thought provoking. The financial risk associated with acute budgets is an issue which affects everyone in primary care, and the calculation of the size of the financial risk is explained in an easy-to-understand way.

The shift in financial responsibility toward practice-based commissioning (PBC) opens the need for a deeper understanding of the actuarial basis of financial risk in healthcare purchasing. This paper first presents the statistical basis for this risk and then looks at the implications to the day to day running of practice budgets, such as what type of reports will be needed, budgets for practices in a group and the issue of overspends.

Poisson, Negative Binomial and Extreme Value distributions lie behind the expression of overall financial risk. Low volume and hence, high-risk events, tend to have a high cost, and the high cost further magnifies the underlying chance risk. Particular diagnoses associated with emergency admissions have an even higher risk profile due to the influence of meteorological and environmental factors. In a capitation-funded environment, where the budget is fixed, the financial risk is higher than acceptable for populations of less then 100 000 head. A large proportion of the overall budget needs to lie within a large regional risk pool in order to allow PBC to flourish within a financially stable environment. These conclusions will also apply to health maintenance organizations in the USA.