MMHA 6999 Accountable Health Care Organizations Project

Sustainable Competitive Advantage for Accountable Care Organizations Macfarlane, Michael Alex Journal of Healthcare Management; Jul/Aug 2014; 59, 4; ProQuest Central pg. 263 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Letters There is a limit of 300 words for letters to the editor. Health Affairs reserves the right to edit all letters for clarity, length, and tone. Letters can be submitted by e-mail, letters@healthaffairs.org, or the Health Affairs website, http:// www.healthaffairs.org. doi: 10.1377/hlthaff.2014.0145 Value-Based Purchasing’s Effect On Quality And Costs James Robinson and Timothy Brown (Aug 2013) demonstrated how a valuebased purchasing design (VBPD) program can lower costs by influencing patients’ choice of surgical facility and driving price competition among providers. In 2011 Anthem Blue Cross of California, the administrator of the VBPD program for the California Public Employees’ Retirement System (CalPERS), requested that our research team carry out an analysis evaluating the program, including an examination of health outcomes and use of services after surgery. Robinson and Brown noted that they did not explore the possibility of cost shifting as a result of the VBPD program. To address this limitation, we compared 180-day costs following total joint replacement (TJR) surgery before and after the VBPD program was implemented for the same patient population. We found no increases in the use of acute rehabilitation centers or follow-up care, such as physical therapy and orthopedic surgeon visits, during implementation. Robinson and Brown also specified that acceptable quality was a selection criterion for VBPD facilities. However, an important element that is not within their scope of analysis was whether a VBPD program that saves money for payers has any unintended health consequences for plan members. In our claims analysis, we found no increase in rates of TJR-related complications, such as pulmonary embolism and sepsis, during the implementation period and no increase in emergency department admissions or hospital readmission rates following surgery.1 Combining our analysis, which found no evidence of cost shifting or negative health consequences, with the cost reduction reported by Robinson and Brown, the CalPERS experience demonstrates that the VBPD program is an effective way to curb rising health care costs while maintaining the quality of care. MMHA 6999 Accountable Health Care Organizations Project

 

Winnie Chia-hsuan Chi, Sze-jung Wu, and Andrea DeVries HealthCore WILMINGTON , DELAWARE NOTE 1 Li C, Wu S, Belman M, DeVries A. Effects of a reference-based purchasing design program on healthcare utilization and outcomes of knee and hip replacement surgeries. Oral presentation at: AcademyHealth Annual Research Meeting, Baltimore, MD, 2013 Jun 22. April 2 014 33:4 Downloaded from content.healthaffairs.org by Health Affairs on April 13, 2014 by Rachel McCartney H e a lt h A f fai r s 723 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Asian Social Science; Vol. 11, No. 12; 2015 ISSN 1911-2017 E-ISSN 1911-2025 Published by Canadian Center of Science and Education Consumer Legal Literacy, Values and Consumerism Practices among Members of Consumer Association in Malaysia Nurazlina Dol1, Elistina Abu Bakar2,3 & Aini Mat Said2 1 Department of Resource Management and Consumer Studies, Faculty of Human Ecology, Universiti Putra Malaysia, Serdang, Malaysia 2 Centre of Excellence for Sustainable Consumption, Faculty of Human Ecology, Universiti Putra Malaysia, Serdang, Malaysia 3 Halal Product Research Institute, Universiti Putra Malaysia, Serdang, Malaysia Correspondence: Nurazlina Dol, Department of Resource Management and Consumer Studies, Faculty of Human Ecology, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia. E-mail: ina_8908@yahoo.com Received: December 6, 2014 doi:10.5539/ass.v11n12p189 Accepted: January 20, 2015 Online Published: April 30, 2015 URL: http://dx.doi.org/10.5539/ass.v11n12p189 Abstract Self-protection is an important component that has been outlined under the Malaysian National Consumer Policy (NCP). It is essential to achieve government’s vision through promoting the community of consumers who are constantly aware and knowledgeable of their rights and responsibilities. Respondents are comprised of members of consumer association (GPS) found in Institute of Higher Education. Therefore, this study aims to determine the level of consumer legal literacy, values of the consumers and their consumerism practices in the marketplace. A total of 400 respondents among the members of GPS have been selected through systematic sampling technique and the data were collected using a survey. It was found that the respondents were more aware of their rights rather than their responsibilities. Respondents also have poor in knowledge regarding logos and consumer legal literacy. While the value that possessed by the respondents is focused on the environmental values and consumerism practices are more likely to seek information. Based on profiling of the respondents, it can be concluded that the characteristics of respondents who should have given emphasis to are the member of GPS, aged between 18-20 years, studying at public universities, pursuing in Arts, member with less than one year of membership and only being ordinary members in the association. Accordingly, the results of this study can be beneficial to the government, consumer organizations and universities in the development of policy, conducting educational activities, improves the current learning modules so that consumerism programs in the future could be upgraded. Keywords: consumer legal literacy, consumer value, consumerism practice, self-protection 1. Introduction In order to increase well-being, consumers need to know their rights as well as their responsibilities in the market or being engaged in ‘self-protection’ as stated in the Malaysian National Consumer Association (NNA) (Jariah, Sharifah, & Laily, 2013). Through the rationalization of National Consumer Policy (NCP), this policy is required to achieve the vision of the Malaysian government in promoting both the consumers and the suppliers who are concern and knowledgeable about their rights and responsibilities. MMHA 6999 Accountable Health Care Organizations Project

 

Accordingly, Gerakan Pengguna Siswa (GPS) is established to form a group of consumers among university students who are smart, rational and responsible in the market. GPS is an initiative of the Malaysian government through the Ministry of Domestic Trade, Cooperatives and Consumerism (MDTCC) to produce citizens who are knowledgeable so that they can be the driving force in consumer education. Up until 2014, the number of GPS members has reached 25,000 people, although it has been only established in November 2011. With this amount of members, it is hope that the programs being organized are in line with the main goal of GPS to improve the consumerism knowledge gradually. Moreover, the members of GPS hopefully not only become a club member but also involved as a volunteer in any consumer association or voluntary organization after their graduation. This involvement is consumer’s responsibility in engaging with consumer associations that would be implemented and become a role model to society in general. 189 www.ccsenet.org/ass Asian Social Science Vol. 11, No. 12; 2015 Furthermore, being actively involved in GPS can improve consumerism especially among university students as it is very important when they have graduated later. According to the statistics from the Department of Insolvency (2012), the number of bankruptcy has increased by 40 percent among the youth after graduation every five years and it is expected this number will reach as much as 100, 000 by the year 2020. This fact is very alarming and may occur because this people are less knowledgeable about consumer rights, information regarding the goods and services and less aware of the responsibility as a consumer to themselves, society and the environment. Therefore, even if the GPS is newly operated, this study attempts to explore the level of consumer legal literacy and to identify their consumerism practices. Consequently, appropriate programs can be implemented in the future to make this group as an example to other consumers. Thus, the objectives of this study are to identify the level of consumer legal literacy, consumer values and consumerism practices with the aim to do the profile of GPS members. 2. Related Previous Studies Consumerism practice known as any activity undertaken by people to protect their rights and interests as a consumer (Irfahani, 2009). Yet, consumerism practice in this study refers to the frequency of consumer behavior in the execution of the five responsibilities as consumer. Five responsibilities are the awareness to criticize, involvement and action, social responsibility, environmental and united as outlined by the Consumer International (CI). Responsibility of the consumer is the main focus in nurturing consumerism practice. Consumer responsibilities refer to consumer involvement in engaging consumerism activities, community, nation and environment. Based on Huda and Zulfiqar (2011), countries that have relatively stable economies such as Japan, India and Turkey make a progress in consumerism. Now, consumerism in Malaysia has grown throughout the country, but they are not the same level as in developed countries and the developing world. For Asian countries, consumerism in India is at a stronger level than the developing countries like Pakistan. They are very concerned with customer satisfaction and consumer safety rights (Huda et al., 2011). More than 600 non-government organizations in India are actively protecting consumer interest and educating the consumer in consumerism, providing education to women in consumerism, conducting seminars and published reading materials. However, in Pakistan, they also have a lot of active consumer organizations and strong law in protecting consumer interests. There is a court in Pakistan that has been actively involved in helping the consumers to make a claim for compensation against the dealers. As results, improving in quality issues, connecting industry management code and enhancing justice for consumer (Silbey, 1981). MMHA 6999 Accountable Health Care Organizations Project

 

Similarly in Turkey, a few organizations have been proven in protecting the consumer, including non-government agencies and courts. While in Japan, there are two types of consumer organizations; the organization that control product quality and advocacy group act as an advisor and protector for consumer rights. Japan is one of the Asian countries involved in the consumer organization at the international level to fight for consumer rights, consumer policy globally and policies related to the nation economy. These developments have shown awareness of consumerism in Asian countries is getting better and being actively involved. In Malaysia, based on the study of the consumerism conducted by Jariah, Fazli and Sharifah (2013) among the rural consumers found that more than 70 percent of respondents regularly buy goods and inspect items before paying. This reflects that the consumer has the awareness to criticize quality of goods in the market. Awareness to criticize refers to the responsibility to be more alert and argue about the price and quality of goods and services supplied. Similarly to a study conducted by Jariah et al. (2013b), which also is related to the consumerism practices. Generally, the respondents have awareness to criticize than concerned about the price. The researchers suggested that consumerism practices should be seen in detail through five responsibilities as being laid down by CI which are awareness to criticize, involvement and action, social responsibility, environmental and being united. There are two theories utilized in this study which are Empowerment Theory and Social Cognitive Theory to describe the consumerism practices. Consumerism practices in this study means to implement consumer actions in five responsibilities as a consumer based on consumer legal literacy and consumer values that they have possessed. According to the founder of Empowerment Theory, Zimmerman (1990), defines Empowerment Theory as a combination of process and outcome of the empowerment. He explained that process is referring to activity such as education programs, actions or specific authorization structure to endeavor, when the result is a stage and effectiveness empowerment power given to the individual or the community. Empowerments as a process rather than a state transition to a state unempower to empower over one’s life (Zimmerman and Perkins, 1995). This theory has been used in the Basic Consumer Strategy European Unity (EU) from 2007 to 2013 190 www.ccsenet.org/ass Asian Social Science Vol. 11, No. 12; 2015 which comprised of several components which include knowledge, skills and involvement of consumer in the market (Nardo, Loi, Rosati, & Manca, 2011). So that, two components from this theory are formed in this study which are consumer legal literacy and consumerism practices. Consumer legal literacy refers to knowledge of GPS members towards the eight consumer rights, five consumer responsibilities, knowledge on consumer definition, legal framework of the law on goods and services, compensation mechanism and the logos as outlined by Malaysian law. Consumer knowledge is very important in any study of consumer practices (Albam & Hutchinson, 1987). Consumers play an important role in the market because they need to communicate or express their dissatisfaction or complaints before legal action are taken (Donoghue & De Klerk, 2009). MMHA 6999 Accountable Health Care Organizations Project

 

According to Jariah et al. (2013b) the low levels of consumer knowledge in consumer rights makes it difficult for them to act as a savvy consumer. Those rights are the right to receive adequate and accurate information, the right to voice out, the right to get basic needs, the right to be protected from harmful products, the right to live and the right to work in healthy and safe environment. Based on their findings, almost half of the respondents responded all eight consumer rights correctly, but there were respondents responded to other statements that are not consumer rights. This indicates that the level of the consumer knowledge is still at low level. Therefore, the consumer is expected to have knowledge regarding their rights, for example, complaints procedure and appropriate action in accordance with the legislations. However, there is certain time the law is not the best way to protect consumer rights, but depends on the consumers themselves (Sakina, Suzanna, & Azimon, 2012). Thus, consumers must actively participate in supporting the enforcing process of their rights against exploitation market. This is because the low level of consumerism cause difficulties in self-defense against the cunning merchants and may cause deterioration of the consumers’ ability to carry out their rights as a consumer and also failed to force the dealer to act accordingly (Suraiya & Nur Faridah, 2012). This problem not only occurs in Malaysia, but in Turkey as well. According to a research by Kaynak, Kucukemiroglu and Odabasi (1992), the number of compensation claims has increased since 1981. This indicates that Turkey consumers are increasingly focused on their rights as a consumer. Besides consumer rights that are recognized around the world, consumers also at the same time should fulfill their responsibility to produce balanced and responsible consumer in the market. Past research demonstrates that consumer behavior is influenced by value, attitude and knowledge (Laroche, Bergeron, & Barbero-Folio, 2001). Due to these aspects, especially knowledge guides consumer in decision-making, the level of knowledge towards sustainability consumerism is vital. Besides that, Social Cognitive Theory asserts learning concept in a social context that is, a reciprocal interaction or triangular relationship between individual factors, environment and behavior (Wood & Bandura, 1989). There are several components in the individual factors which are cognitive, affective, motivation, skills, and self-efficiency. However, these studies only focus on cognitive and affective components. The cognitive component is related to the knowledge whether they know or not about consumerism which will give the impression to their consumerism practices. However, affective component is consumer acceptance of something cause based on the values held by them. Two components are formed in these studies which are knowledge and consumer values. Consumer value which is a new element in the NCP 2010, is an important principle drives the consumer towards a prosperous life in the market.MMHA 6999 Accountable Health Care Organizations Project

 

Consumer values refer to the principles held by the consumer based on the five basic values that should be held by the consumer accordingly; (as responsible consumers, we must ensure that our consumption patterns and lifestyles do not contribute to the economic exploitation and oppression that disregard human and humane values), money (consumers must ensure that for the benefit of all they should not contribute to any loss in the value of our hard-earned income brought about by indiscriminate purchases and wasteful spending habits), environment (the pre-condition for the life-support system to continue to function is an ecologically balanced environment that is able to regenerate itself on an uninterrupted, continuous basis), democracy (as members of the civil society, consumers give the mandate to members of civil society through the process of election to govern them. Government in a democracy is the servant of the people, and citizens as consumers have a right to government services that are responsible, transparent and accountable) and justice value (consumers, through their role as consumers and citizens, owe a responsibility to ensure value for justice, not only for ourselves as consumers but also for the trader, the investor and others involved in the economic and social system) (Fazal & Bishan, 1991). These values are introduced by Bishan one of the prominent consumerism figure in Malaysia which are capable of influencing consumer practices and decision-making. Tabara and Giner (2004) stated that, high knowledge level accompanied by values and cultural perspective is the main essence to educate people in the modern society. Jariah et al. (2013b) conducted a study among Malaysian consumers regarding consumer well-being found that consumers are more focus on value of money instead of 191 www.ccsenet.org/ass Asian Social Science Vol. 11, No. 12; 2015 higher values like environment and justice value. However, consumers should appreciate of each the value so that consumer rights and responsibilities go hand in hand, while to ensure self-protection that will be done by the consumer is effective. 3. Methodology The dependent variable in this study is consumerism practice refers to the frequency of behavior or co…