In international corruption indexes, such as Transparency International’s Corruption Perception Index, Sweden often ranks as one of the least corrupt countries in the World. Despite this, the country still experiences corruption scandals, particularly in local government. In the wake of a scandal, municipalities tend to react swiftly and initiate anti- corruption reforms. However, despite such actions, new scandals re-emerge. The purpose of the study is to analyze why the undertaken reforms are not always successful in preventing new scandals from happening. In order to do so, I focus on anti-corruption measures in two large Swedish municipalities that have repeatedly experienced corruption scandals, despite having taken action and putting anti-corruption measures in place: the cities of Norrkoping and Gothenburg. Interviews on the scandals and the anti-corruption reforms were conducted with officials and politicians, and empirical evidence has also been gathered from public documents and audit reports. The principal-agent theory and the ideal types of “value based” and “compliance based” approaches are the theoretical tools which are used to analyze the undertaken anti-corruption reforms. The results show that the reforms undertaken indeed have improved the integrity systems of the cities. However, the reoccurring scandals can best be explained by the fact that the reforms have not been properly incorporated properly in the administrations, which in some cases have resulted in an ignorance of the rules. Some scandals can also be explained by conscious criminal acts from the agents, acts that are difficult to guard oneself against no matter how well-designed the anti-corruption institutions are. The results hence show that it is hard to design institutions that obliterate the corruption that are undertaken on purpose by agents.

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Societies are plagued by growing healthcare expenditures and budgetary constraints. The strategy for solving the issue has been heavily debated, with proposed solutions such as Valuebased healthcare (VBHC), Public-Private Partnerships (PPP) and improved medical treatments. A novel concept that aims to improve medical treatment is strategic biobanking. Strategic biobanking is the act of saving biological samples and clinical data for future research. Access to strategic samples can speed up future clinical trials and studies, provide researchers with more useful research material, enable more thorough analyses of biomarkers, facilitate faster drug development, and increase the power of both retrospective analyses and precision medicine. This thesis studies the shared value effects of a strategic biobanking PPP by drawing on the theoretical fields of VBHC, PPP and Creating Shared Value (CSV). Specifically, the effects of hospital organisational structure, regulatory framework and public interest on strategic biobanking PPPs was studied. The research was carried out through a single holistic case study of Karolinska University Hospital in Stockholm, Sweden and multiple pharmaceutical companies, and data was collected through semi-structured interviews. Data analysis was carried out in accordance with the grounded theory framework. The researchers find that regulatory structure can limit the options when crafting the business model and the industry value proposition for a strategic biobanking PPP. Some strategies on how to deal with these restraints are outlined. Furthermore, the research highlights the importance of longitudinal data-sets and how a hospital organised according to the VBHC principles is more suitable for implementation of longitudinal sampling routines. Finally, the research shows that that the concept of CSV can act as guidance for private partner decision making to increase public interest. By adopting principles of transparency regarding financial incentives and motivations, an industry partner can garner increased trust with the general public as well as their public partner. The shared value effects are pronounced, and the study finds that a strategic biobanking PPP moves the boundary for what is scientifically possible for all stakeholders in the healthcare domain. / Samhällen plågas av skenande sjukvårdskostnader och budgetåtstramningar. Vilken strategi som kan lösa problemet har debatterats flitigt. Lösningar så som Value-based Healthcare (VBHC), Public-Private Partnerships (PPPs) och mer avancerad vård har alla föreslagits som alternativ. Ett nytt koncept som ämnar att förbättra sjukvården är strategisk biobankning. Strategisk biobankning innebär att spara biologiska prover och klinisk data inför framtiden. Detta kan snabba på framtida kliniska prövningar och studier, förse forskare med mer användbart forskningsmaterial, möjliggöra mer grundliga analyser av biomarkörer, snabbare utveckling av mediciner, samt öka potensen hos både retrospektiva studier och precision medicine. Denna uppsats studerar gemensamma värdeeffekter hos ett PPP inom strategisk biobanking genom att använda sig av de teoretiska fälten VBHC, PPP och Creating Shared Value (CSV). Mer specifikt studeras hur PPP inom strategisk biobankning påverkas av sjukhusets organisationsstruktur, rådande regelverk och allmänintresse. Forskningen utfördes genom en enkel, holistisk, fallstudie av Karolinska Universitetssjukhuset i Stockholm, Sverige. Data samlades genom semi-strukturerade intervjuer och analyserades senare enligt ramverket för Grounded Theory. Forskarna finner även att rådande regelverk begränsar möjligheten för utveckling av affärsmodell och värdeerbjudande gentemot privata partners. Några strategier för att hantera dessa begränsningar tas upp i uppsatsen. Vidare belyses vikten av longitudinella dataset, och att ett sjukhus vars organisation är strukturerad enligt VBHC-principer är mer lämpligt för implementation av longitudinell provsamling. Slutligen finner forskarna att privata CSV-conceptet utgör bra vägledning för privata partners för att skapa allmänintresse. Genom att anamma principer som premierar transparans gentemot sina ekonomiska och strategiska incitament så kan förtroende byggas gentemot allmänheten. De gemensamma värdeeffekterna är tydliga, och forskarna finner att tillgång till en strategisk biobank flyttar gränsen för vad som är vetenskapligt möjligt för alla aktörer i det sjukvårdsrelaterade ekosystemet.

Chronic cardiovascular and pulmonary diseases are prevalent in the US home health population. Heart failure and chronic obstructive pulmonary disease are both chronic and terminal, but they are not always perceived as serious illnesses with imminent death. Therefore, they provide a context for advance care planning that is distinct from the diagnostic contexts of cancer, end-stage renal disease, or dementia. Advance care planning is defined as a process that supports adults at any age or stage of health in understanding and sharing their goals, values, and preferences about future medical care, including the designation of a surrogate decision-maker. This study tests the hypothesis that US home health agencies with higher percentages of patients with chronic cardiovascular and pulmonary conditions have less robust advance care planning protocols. The Spearman correlation coefficient was r = 0.22 (S = 74684, P =.025, 1-tailed), which was statistically significant and an unexpected finding. The greater percentage of patients with chronic cardiac and pulmonary diagnoses in an agency, the more robust the advance care planning protocol was. This supports our previous findings and existing literature indicating that agencies may be using exacerbation events marked by acute care use as opportunities to initiate or repeat advance care planning.

This paper’s aim is to analyze value-based pricing strategies in service contracts and how they help companies generate sustainable advantages. Scoop of the analysis will be service contracts in manufacturing industry. A service contract could be defined as an intangible value proposition that includes but not limited to maintaining client’s machines continuously for a negotiated amount of time. By working with a Swedish pricing consultancy firm Navetti AB, a descriptive research was conducted in an effort to answer the research question: “How to utilize a value-based pricing strategy in service contracts?”. By trying to answer this question, authors of this paper wanted to contribute to the developing framework of value-based pricing phenomena. Results of this study indicates that certain steps need to be followed by service providers in manufacturing industry in order to utilize a value-based pricing strategy. Obscure perceived value of customers need to be realized and their value drivers need to be extracted, quantified and analyzed. Findings of this study have implications both in theoretical and industrial perspective. From industrial aspect, service providers need to communicate with their customers deeply and analyze their value drivers, they also need to take cost-based and competition-based pricing strategies into consideration while utilizing a value-based pricing strategy. From the theoretical perspective this study contributes to the field of pricing and price optimization part of industrial management.

In today's work life, values and their importance for organizations are a central and debated issue. Most organizations have a values foundation consisting of a number of specific values that are considered important guidelines for desirable behavior and common goals. This study aims to investigate more closely how the management can make value-based management work by analyzing an organization that works with value-based management, using Etzioni's (1975) compliance theory. The empirical basis of the study rests on eight qualitative semi-structured interviews with managers and employees within the organization. The result indicates that the management has involved the employees in the process of developing the values. The management has different strategies to implement the values: they have clarified the meaning and the scope of use of the values, the values are used as the first assessment within an internal career framework, and they conduct regular feedback conversations regarding the values. Using the compliance theory, these strategies can be understood as normative exercise of power, but with elements of rewarding exercise of power in that the values are used in the career framework. The result further shows that the values land with the employees. The employees are positive about the values and perceive them as important which, using the compliance theory, can be understood as moral commitment. However, a tendency identified in the results is skepticism towards the values being used for evaluation purposes as a first step before they are given the opportunity for promotion through the organization's career framework. The skeptical approach is interpreted as being due to the management exercising normative power and rewarding power at the same time. In general, the results of the study show that the management's value-based management works. Based on Etzioni's (1975) compliance theory, this means that the relationship between the management's strategies for implementing the values and how they resonate with the employees are congruent. The management's normative exercise of power is reflected by the employees' moral commitment. An important result of the study, however, is that value-based management has less effect when two different types of power are combined. This means that a prerequisite for value-based management to work is that the management exercises one type of power, and that it corresponds to the commitment of the employees. / I dagens arbetsliv är värderingar och deras betydelse för organisationer en central och omdiskuterad fråga. De flesta organisationer har en värdegrund bestående av ett antal bestämda värderingar som betraktas som viktiga riktlinjer för önskvärt beteende och gemensamma mål. Denna studie syftar till att undersöka närmare hur ledningen kan göra för att värderingsstyrning ska fungera genom att analysera en organisation som arbetar med värderingsstyrning med hjälp av Etzionis (1975) efterlevnadsteori. Studiens empiri grundar sig på åtta kvalitativa semistrukturerade intervjuer med chefer och medarbetare på organisationen. Resultatet visar att ledningen inkluderat medarbetarna i processen att ta fram värderingarna. Ledningen har olika strategier för att implementera värderingarna: de har tydliggjort värderingarnas innebörd och användningsområde, värderingarna används som första utvärdering i ett internt karriärsramverk, och de håller i regelbundna feedbacksamtal gällande värderingarna. Med hjälp av efterlevnadsteorin går dessa strategier att förstås som mestadels normativt maktutövande, men med inslag av belönande maktutövande. Resultatet visar vidare att värderingarna landar hos medarbetarna. Medarbetarna ställer sig positiva till värderingarna och upplever dem som viktiga, vilket med hjälp av efterlevnadsteorin går att förstås som moraliskt engagemang. En tendens som identifierats i resultatet är emellertid skepticism mot att värderingarna används i utvärderingssyfte som ett första steg innan de får möjlighet till befordran i och med organisationens karriärsramverk. Det skeptiska förhållningssättet tolkas grunda sig i att ledningen utövar normativ makt och belönande makt samtidigt. Generellt visar studiens resultat att ledningens värderingsstyrning fungerar. Utifrån Etzionis (1975) efterlevnadsteori betyder det att relationen mellan ledningens strategier för att implementera värderingarna och hur det landar hos medarbetarna är kongruent. Ett viktigt resultat i studien är emellertid att värderingsstyrningen får mindre effekt när två olika typer av makt kombineras. Det betyder att en möjlig förutsättning för att värderingsstyrningen ska fungera är att ledningen utövar en typ av makt, och att den motsvarar medarbetarnas engagemang.

This dissertation aims to explore the performance of health provider participation inthe Medicare Quality Payment Program by investigating the relationship among the performance metrics of value and quality and the capacities of geography, technology, finance, and administration. There is a theory-practice gap in the research that examines the impact of these capacities on the value and quality of clinical services delivered by healthcare providers participating in the Medicare Quality Payment Program. The study will address this theory-practice gap by applying the capacity-performance paradigm to better understand the influences of geographical, technological, financial, and administrative capacity have on the performance of value and quality metrics of healthcare providers engaging in the Medicare Quality Payment Program. This study also provides prudent findings that demonstrate the impact of the capacities on the performance of value and quality among healthcare providers which can influence programmatic policy reforms by policymakers who are overseeing the Quality Payment Program. This study utilizes the CMS 2021 QPP Experience dataset which contains the performance outcome metrics of value and quality among healthcare providers participating in the program. Ordinary Least Squares (OLS) regression is employed to examine the relationship among the capacities of geography, technology, finance, and administration and the performance providers. The findings of this study show a significant relationship between these capacities and the performance outcome metrics of value and quality among healthcare providers participating in the Medicare Quality Payment Program.

Manufacturing companies are increasingly serving customers through valuebased offers by adding and integrating more services in their businesses. Although, manufacturers mainly still use cost-based pricing, many are reconsidering their pricing strategies to capture a fair share of the value they create through value-based offers. Therefore, adopting to value-based pricing (VBP) becomes a necessity when competing value-driven. This study explores the barriers to VBP among servitising industrial manufacturers. Related concepts to VBP, such as value-based selling (VBS) and service-dominant logic (SDL) are also discussed in this thesis. The study implemented a qualitative multiple-case study. The case companies provided insights to their VBP journey and the barriers they face, where contextual factors are an important aspect to consider. In the findings, the discovered barriers are divided into internal and external barriers. It is evident that companies should work with SDL and VBS as means for overcoming barriers as they affect the outcome of VBP. Hence, this thesis contributes to the emerging research on VBP, and provides guidance to companies that are on their VBP journey.

The new millennium is the time for entrepreneurship both nationally and internationally because the new millennium has many opportunities, afforded by technology and global communications, as it is filled with challenges and uncertainty. The South African government has identified the important role small- and medium-sized enterprises have to play in employment creation. The first step towards economic development is creating new businesses; the second step is ensuring sustainability through value creation. Value-based management can be defined as a management approach that maximises long-term shareholder value, which is incorporated in the business’ strategy and goals, through the identification and management of key value drivers, whereby all employees think and act like shareholders. To ensure value creation takes place, some form of control mechanism is required. Managerial decisions and actions to create shareholder value, therefore, are measured through a metric, and employee performance is linked to the value created. Value-based management is not a staff-driven exercise but focusses on better decision making at all levels. Value-based management metrics are based on the idea of comparing cash flows generated by a company against the cost of capital in generating these flows, and thereby measuring shareholder value. Understanding what drives value in a company is essential for creating shareholder value, as well as how these drivers affect one another. This will enable all stakeholders, from senior management right down to the shop floor, to make the right informed decision that will result in creating and increasing shareholder value. Entrepreneurship can be defined as a dynamic goal-oriented process whereby an individual combines creative thinking to identify marketplace needs and new opportunities with the ability to manage secure resources, and adapt to the environment to achieve desired results, while assuming some portion of risk for the venture. Entrepreneurship is about the exploitation of perceived opportunities by individuals, based solely on personal judgement and visions. These are either not seen by other individuals, or they are unable to bear the risks of acting upon them. Without effective and efficient management by objectives, and management of projects, a small business cannot function. The decision to invest in an entrepreneurial business can be viewed as a hard evidence-oriented, substance-based process and investors discount the figures in a business plan, as these figures are wildly optimistic as well as padded by entrepreneurs. A venture capitalist sometimes chooses to invest in a new venture, even if the discounted cash flow (DCF) analysis results shows that the net present value is a negative reason, being that the DCF approach does not take into account the flexibility obtained by active management. The environment faced by the venture-backed firm is highly uncertain, making overlooking this flexibility a particularly serious problem. Private equity is potentially one of the most expensive forms of capital financing. New and emerging firms are usually the issuers of private equity, as these firms cannot raise money in the public markets, or they are public firms going private that require massive amounts of private financing. Smaller unlisted companies regard the Johannesburg Securities Exchange’s Alternative Exchange (AltX) as a stepping-stone to bigger things, including graduating to the main bourse of the JSE. Capital structure is arguably at the core of modern corporate finance, and a simple capital structure as a form of competitive strategy, as fewer physical assets contribute to organisational flexibility, and as a result, small firm owners often weigh the benefits of expansion against the benefits of remaining small. Performance evaluation is an important tool in continuously improving performance in order to stay competitive. Performance evaluation and benchmarking positively forces any business to constantly improve and evolve. Benchmarking a firm’s financial results against its own peers or industry averages enables management to identify the relative strength and weaknesses of the firms and as a result, ensure better future planning. Data envelopment analysis (DEA) is a non-parametric linear programming technique that computes a comparative ratio of outputs or inputs for each unit, which is reported as the relative efficiency score. DEA assists in identifying areas in which a firm has strengths and weaknesses (relative to competition) and when improvements are needed (relative to peers). DEA can indicate the level of improvement required, and provides a consistent and reliable measure of managerial or operational efficiency. A two-stage DEA model was developed to benchmark performance in terms of value creation in the first stage, and in the second stage, share price performance. The study was designed to evaluate companies at operating level (day-to-day activity) as well as company level. In addition to the two-stage model, a single stage model was developed as a separate analysis in terms of output maximisation regarding share prices. As far as could be determined, it was the first time this type of research was done on South African companies listed on the AltX. Furthermore, the study is the first to apply a benchmarking technique to determine the relative efficiency of companies to convert resources into value-based performance measures and to convert the same measures into share-value. The majority of companies listed on the AltX are not efficient in reflecting company performance in share prices by means of value-based management principles. A very limited number of companies were able to be efficient simultaneously in creating value and reflecting the value created in the share price. Based on the efficiency frontier in terms of value creation, a very limited number of companies listed on the AltX are deemed efficient. The majority of the companies are not able to create value at the levels of the efficient companies. A small fraction of the companies listed on the AltX is deemed efficient based on the efficiency frontier for reflecting value creation in share prices. AltX companies’ share prices have the potential to increase significantly in value, if all companies were efficient in reflecting created value in share prices. Small and medium enterprises should give more attention to value-based management principles in the process to create shareholders’ wealth. In light of the evidence that the value creation process must start with educating the management of small and medium enterprises on the concepts and principles of value-based management, it would also be highly recommended that small and medium enterprises should make value-based management part of the business’ strategies and goals. Small and medium enterprises must identify and manage key value drivers. This process is not a generic process, as each business is unique in its own way. It is important for management to understand the key value drivers in order to get employees to understand them. The management of small and medium enterprises are warned against a short-term value maximisation focus at the expense of long-term shareholder value creation. Any reward and recognition system should not reward short-term benefits, but rather should focus on long-term, sustainable initiatives, that will create value in the long run to the benefit of all stakeholders involved. / PhD (Business Administration), North-West University, Potchefstroom Campus, 2015

The new millennium is the time for entrepreneurship both nationally and internationally because the new millennium has many opportunities, afforded by technology and global communications, as it is filled with challenges and uncertainty. The South African government has identified the important role small- and medium-sized enterprises have to play in employment creation. The first step towards economic development is creating new businesses; the second step is ensuring sustainability through value creation. Value-based management can be defined as a management approach that maximises long-term shareholder value, which is incorporated in the business’ strategy and goals, through the identification and management of key value drivers, whereby all employees think and act like shareholders. To ensure value creation takes place, some form of control mechanism is required. Managerial decisions and actions to create shareholder value, therefore, are measured through a metric, and employee performance is linked to the value created. Value-based management is not a staff-driven exercise but focusses on better decision making at all levels. Value-based management metrics are based on the idea of comparing cash flows generated by a company against the cost of capital in generating these flows, and thereby measuring shareholder value. Understanding what drives value in a company is essential for creating shareholder value, as well as how these drivers affect one another. This will enable all stakeholders, from senior management right down to the shop floor, to make the right informed decision that will result in creating and increasing shareholder value. Entrepreneurship can be defined as a dynamic goal-oriented process whereby an individual combines creative thinking to identify marketplace needs and new opportunities with the ability to manage secure resources, and adapt to the environment to achieve desired results, while assuming some portion of risk for the venture. Entrepreneurship is about the exploitation of perceived opportunities by individuals, based solely on personal judgement and visions. These are either not seen by other individuals, or they are unable to bear the risks of acting upon them. Without effective and efficient management by objectives, and management of projects, a small business cannot function. The decision to invest in an entrepreneurial business can be viewed as a hard evidence-oriented, substance-based process and investors discount the figures in a business plan, as these figures are wildly optimistic as well as padded by entrepreneurs. A venture capitalist sometimes chooses to invest in a new venture, even if the discounted cash flow (DCF) analysis results shows that the net present value is a negative reason, being that the DCF approach does not take into account the flexibility obtained by active management. The environment faced by the venture-backed firm is highly uncertain, making overlooking this flexibility a particularly serious problem. Private equity is potentially one of the most expensive forms of capital financing. New and emerging firms are usually the issuers of private equity, as these firms cannot raise money in the public markets, or they are public firms going private that require massive amounts of private financing. Smaller unlisted companies regard the Johannesburg Securities Exchange’s Alternative Exchange (AltX) as a stepping-stone to bigger things, including graduating to the main bourse of the JSE. Capital structure is arguably at the core of modern corporate finance, and a simple capital structure as a form of competitive strategy, as fewer physical assets contribute to organisational flexibility, and as a result, small firm owners often weigh the benefits of expansion against the benefits of remaining small. Performance evaluation is an important tool in continuously improving performance in order to stay competitive. Performance evaluation and benchmarking positively forces any business to constantly improve and evolve. Benchmarking a firm’s financial results against its own peers or industry averages enables management to identify the relative strength and weaknesses of the firms and as a result, ensure better future planning. Data envelopment analysis (DEA) is a non-parametric linear programming technique that computes a comparative ratio of outputs or inputs for each unit, which is reported as the relative efficiency score. DEA assists in identifying areas in which a firm has strengths and weaknesses (relative to competition) and when improvements are needed (relative to peers). DEA can indicate the level of improvement required, and provides a consistent and reliable measure of managerial or operational efficiency. A two-stage DEA model was developed to benchmark performance in terms of value creation in the first stage, and in the second stage, share price performance. The study was designed to evaluate companies at operating level (day-to-day activity) as well as company level. In addition to the two-stage model, a single stage model was developed as a separate analysis in terms of output maximisation regarding share prices. As far as could be determined, it was the first time this type of research was done on South African companies listed on the AltX. Furthermore, the study is the first to apply a benchmarking technique to determine the relative efficiency of companies to convert resources into value-based performance measures and to convert the same measures into share-value. The majority of companies listed on the AltX are not efficient in reflecting company performance in share prices by means of value-based management principles. A very limited number of companies were able to be efficient simultaneously in creating value and reflecting the value created in the share price. Based on the efficiency frontier in terms of value creation, a very limited number of companies listed on the AltX are deemed efficient. The majority of the companies are not able to create value at the levels of the efficient companies. A small fraction of the companies listed on the AltX is deemed efficient based on the efficiency frontier for reflecting value creation in share prices. AltX companies’ share prices have the potential to increase significantly in value, if all companies were efficient in reflecting created value in share prices. Small and medium enterprises should give more attention to value-based management principles in the process to create shareholders’ wealth. In light of the evidence that the value creation process must start with educating the management of small and medium enterprises on the concepts and principles of value-based management, it would also be highly recommended that small and medium enterprises should make value-based management part of the business’ strategies and goals. Small and medium enterprises must identify and manage key value drivers. This process is not a generic process, as each business is unique in its own way. It is important for management to understand the key value drivers in order to get employees to understand them. The management of small and medium enterprises are warned against a short-term value maximisation focus at the expense of long-term shareholder value creation. Any reward and recognition system should not reward short-term benefits, but rather should focus on long-term, sustainable initiatives, that will create value in the long run to the benefit of all stakeholders involved. / PhD (Business Administration), North-West University, Potchefstroom Campus, 2015