Methodology Article
Medicare Utilization and Payment Analysis
Nwaoko Ada*,
Linda Fynn Prah,
Ekow Bediako,
Number Iredia
Issue:
Volume 14, Issue 1, February 2026
Pages:
1-20
Received:
1 November 2025
Accepted:
22 November 2025
Published:
16 January 2026
Abstract: This analysis investigates the key factors driving total program payments in healthcare, focusing on the impact of coinsurance payments and visit frequency per enrollee. Using a combination of linear regression modeling and scenario analysis, we explored how changes in these factors affect overall program costs. The goal was to provide actionable insights for effective cost management in the healthcare program. The analysis proves that Coinsurance payments are a significant driver of total program costs. With each dollar increase in coinsurance payments correlate with an increase in total program payments. In Scenario 1, where coinsurance payments increased by 10% with no change in utilization, total program payments rose significantly to $1.22 billion. This finding underscores the cost sensitivity of the program to changes in out-of-pocket coinsurance amounts. Visit frequency per enrollee also plays a critical role in cost dynamics, though it has a complex relationship with total payments. In Scenario 2, a 5% reduction in coinsurance payments accompanied by a 10% increase in visit frequency led to a decrease in total program payments to $1.01 billion. This result suggests that higher utilization may help in reducing overall costs if it aligns with efficient or preventive care. Conversely, in Scenario 3, a 5% increase in coinsurance payments with a 10% decrease in visits led to a moderate increase in total program payments to $1.17 billion, indicating that lower utilization can reduce costs but may depend on the care's effectiveness. Based on our findings we recommend the following prescriptive analysis. Managing visit frequency per enrollee through preventive care programs or other efficient measures can significantly impact on total program costs, potentially reducing the need for frequent high-cost interventions. Adjusting coinsurance rates offers a lever for managing program costs. Lowering coinsurance might encourage utilization but could increase total program expenses. Conversely, increasing coinsurance payments could offset costs but may raise financial burdens for enrollees. A balanced approach is recommended. Leveraging scenario analysis as shown in this study can support proactive policymaking. This analysis could be relevant to policy makers to evaluate the financial implication of proposed changes to cost sharing mechanisms or programs affecting public health and utilization management.
Abstract: This analysis investigates the key factors driving total program payments in healthcare, focusing on the impact of coinsurance payments and visit frequency per enrollee. Using a combination of linear regression modeling and scenario analysis, we explored how changes in these factors affect overall program costs. The goal was to provide actionable i...
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Research Article
Sustainable Social Disclosure and Performance of Listed Oil and Gas Firms in Nigeria
Issue:
Volume 14, Issue 1, February 2026
Pages:
21-29
Received:
16 December 2025
Accepted:
4 January 2026
Published:
23 January 2026
DOI:
10.11648/j.ijefm.20261401.12
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Views:
Abstract: This study looked at the influence of sustainable social disclosures on performance of Nigerian publicly traded oil and gas firms from 2013 to 2022. An ex-post facto research design was adopted to carry out the investigation. We were able to select seven (7) out of ten (10) firms for the study by employing a purposive sampling technique. Performance was evaluated in terms of market value, and the independent variable was examined using particular Sustainable Social Performance indicators from the GRI (SO1, SO2, SO3, and SO4) that were produced using a score methodology created by other researchers. The research employed a secondary source to acquire information from the identified companies. In this study, OLS regression analysis, descriptive analysis, and Pearson correlation analysis were conducted using E-Views 2009. We observed that exposing social performance has a beneficial and significant effect on market value based on correlation and regression analysis. The results of this study reveal that listed oil and gas firms in Nigeria have a considerable market value impact from sustainable social performance. The report advocated, among other things, that the Sustainability Index be extensively deployed as a tool for pressing firms to prioritize sustainable development issues and pay greater attention to their social impact. Nigerian oil and gas enterprises that are publicly traded should focus reporting on sustainability activities as it has the potential to increase their performance.
Abstract: This study looked at the influence of sustainable social disclosures on performance of Nigerian publicly traded oil and gas firms from 2013 to 2022. An ex-post facto research design was adopted to carry out the investigation. We were able to select seven (7) out of ten (10) firms for the study by employing a purposive sampling technique. Performanc...
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,
John Adedeji Abiola
