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Faced with mounting health care costs, the United States needs to learn more cost-cutting options. The U.S. ranks at the top of lists on health care spending by country.1 The factors that drive American spending are complicated, and experts disagree with each other about which ones are most responsible for the country’s high medical costs; some commonly cited cost drivers include Medicaid, Medicare, fee-for-service and malpractice law. There are currently a number of methods employed by the government, hospitals, and insurance companies to keep costs down, including the increased use of Licensed Practical Nurses and Physicians Assistants, acute care and cost shifting,and Health Maintenance Organizations. In order to learn more about ways to save money on health care, the United States should look to other countries for examples. Switzerland enacted universal health care in 1994; in the nearly twenty years since, the government and insurance companies have instituted measures to control spending. These are practices and policies such as, blue letters of warning for seemingly frivolous doctors, no special insurance program or extra coverage for the elderly, and increased competition. Switzerland spends less on health care each year than the United States and yet has a higher life expectancy. 2 Furthermore, Switzerland celebrates twenty years of universal health care in the same year the individual mandate takes effect in the United States, 2014. Now is a timely moment to see if studying Switzerland’s health care system illuminates the options to American policymakers. Drawing information from scholarly articles, web articles, and website data, I will begin with a literature review section that underscores why a comparison between the Swiss and American health care systems can deepen our understanding of the policy options facing contemporary U.S. policymakers. I will then compare and contrast some specific features of the two health care systems. I will conclude by reflecting on whether and how lessons learned from Switzerland's health care policy can guide the American health care debate. / Department of Political Science

This thesis applied the decision support mechanism, Q-Methodology, to an integrated model of issues management and strategic planning. This approach was applied at Riverview Hospital in Noblesville, Indiana in order to respond to the health care reform issue.The research approach involved the three primary stakeholder groups of the hospital: Board of Directors, physicians and managers. The three groups, representing 56 people, attended a planning retreat and identified Riverview's planning options in the form of 77 statements representing future program or service options. These 77 statements were then ranked using Q-methodology.The findings of the study included a QMETHOD computer and researcher analysis of the statements from the perspective of the total group and also the three factors.The final result was a list of statements that comprised Riverview's response to the reform issue in the form of corporate goals and objectives. The conclusions of the study show that:--The integrated approach did provide focus to the strategic planning process. The final list of objectives were all related to the health reform proposal.--Q-Methodology was an appropriate decision support mechanism. It not only provided the final list of corporate objectives but clearly identified potential support and resistance.--A viable set of corporate objectives was developed to respond to the health reform proposal.--All of the stakeholder groups unanimously approved the final list of statements (objectives) in a formal voting process. / Department of Journalism

This thesis critically analyses the definitions of strategy within the management control literature, the relationship between resource-based view of strategy and the balanced scorecard, as well as the impact of these on manager's perceived performance. Contingency theory has been used as the overall framework for this thesis. A longitudinal case study of a technology company was undertaken, with a critical analysis of the implementation of the balanced scorecard at one of the business units. Both qualitative and quantitative research tools were used. The thesis discusses the interaction between changes in management control systems and organisational changes through the use of the Laughlin framework and the three mechanisms of institutional isomorphic suggested by DiMaggio and Powell. / Thesis (PhDBusinessandManagement)--University of South Australia, 2006.

Thesis (Ph.D.)--Electrical and Computer Engineering, Georgia Institute of Technology, 2008. / Committee Chair: Rohatgi, Ajeet; Committee Co-Chair: Begovic, Miroslav; Committee Member: Gaylord, Thomas; Committee Member: Harley, Ronald; Committee Member: Jarrett, Christopher; Committee Member: Kippelen, Bernard

Thesis (M.S.)--University of Michigan, 1991.

Thesis (M.S.)--University of Michigan, 1991.

Thesis (Doctoral (Human Resource Management))--Cape Peninsula University of Technology, 2005 / The image of the Western Cape Education Department (WCED) is influenced by its ability to handle and to develop a system whereby not only will the perceived gap between the expectation and satisfaction of the customers be closed, but the customer will also be able to derive value from the services rendered. In order for this to come to fruition, as well as the fact that the employees know the true picture of the flow of work within the WCED, it is crucial that the employees be involved in the mapping of the strategy, which in turn would be utilised to attain the vision. A key challenge is getting all the parts of the WCED in line with its strategies, which in turn impacts on the mission and vision. Maximum value requires an understanding of its creation and a proactive approach. These are not easily accomplished. Not only is the "education industry" presently confronted with many changes, its stakeholders and customers are making greater demands. As a result of this. the WCED needs to be more efficient, but importantly also to be aware of the "efficiency trap". A decrease in the net operating result of the WCED would result in dissatisfied customers. In order for this not to be an option. the synergy of the balanced scorecard and the whole value chain within a lean environment should be considered as the reduction of occupational crime i.e. human activity absorbing resources, but not creating value or nonvalue creating / adding activities or muda has become a priority. Also by focussing on an occupational crime reduction flow of work, the WCED will be seen as a system of processes and not as a system of separate functions.

O presente trabalho tem como foco principal a gestão de custos de empreendimentos executados por empresas de engenharia e construção (EEC), e propõe modelos que permitem incorporar a geração e análise de cenários em seus processos de gestão de custos. O ponto de partida para este trabalho foi a experiência profissional do autor que, desde 2007, atua na área de planejamento e controle de empreendimentos. Neste período ficou evidente para o autor o quão complexo e multidisciplinar é realizar a gestão de custos de empreendimentos de construção. A gestão de custos é uma tarefa imprescindível para qualquer setor da economia, ainda mais diante da atual conjuntura econômica e política do País. Diante da complexidade e da importância do tema, o presente trabalho discute também a importância da adoção de um sistema de gestão pela empresa de engenharia e construção. Um dos sistemas que podem ser adotados é o descrito na obra Um Guia do Conhecimento em Gerenciamento de Projetos (Guia PMBOK®) elaborado pelo Project Management Institute (PMI). Os conceitos e melhores práticas contidos nesta obra estão cada vez mais difundidos por diversos setores da economia, inclusive na construção civil. No entanto, o setor da construção civil possui diversas peculiaridades, e muitas delas influenciam diretamente na gestão de custos dos empreendimentos. São levantados também outros conceitos e aspectos relacionados ao setor da construção civil, tornando a discussão sobre o tema um pouco mais abrangente, de modo que alguns destes temas podem ser objeto de novos estudos e pesquisas. As ferramentas e modelos propostos baseiam-se dos conceitos levantados, sendo aplicáveis na gestão de custos dos empreendimentos ao longo de sua execução. Essas podem ser vistas, portanto, como uma inovação incremental nos processos e ferramentas adotados pelas EEC, podendo ser aplicáveis também em outros setores da economia. / The main focus of this work is the cost management of projects carried out by engineering and construction companies (EEC), and proposes models that allow incorporating the generation and analysis of scenarios in their cost control processes. The starting point for this work was the professional experience of the author who, since 2007, works with construction projects planning and control. In this period it became evident to the author how complex and multidisciplinary is to perform the cost management of construction projects. Cost management is an essential task for any economy sector, even more due to the current economic and political environment of Brazil. Given the complexity and importance of the theme, this paper also discusses the importance of adopting a management system by these companies. One of the systems that can be adopted is described in the book A Guide to the Project Management Body of Knowledge (PMBOK® Guide) from Project Management Institute (PMI). The concepts and best practices contained in this guide are increasingly disseminated by various sectors of the economy, including construction. However, this sector has several peculiarities, and many of them directly influence the cost management of the projects. Other concepts and aspects related to the construction sector are also raised, making the discussion on the subject a little more embracing, so that some of these themes may be the object of further studies and research. The proposed tools and models are based on these concepts and are applicable in construction projects cost management throughout their execution. These tools and models can be seen, therefore, as an incremental innovation in the processes adopted by engineering and construction companies, and may be applicable also in other sectors of the economy.