Search

Background: Across a range of policy areas and geographies, governments and philanthropists are increasingly looking to adopt a social outcomes contracting (SOC) approach. Under this model, an agreement is made that a provider of services must achieve specific, measurable social and/or environmental outcomes and payments are only made when these outcomes have been achieved. Despite this growing interest, there is currently a paucity of evidence in relation to the tangible improvement in outcomes associated with the implementation of these approaches. Although promising, evidence suggests that there are risks (especially around managing perverse incentives).[1] The growing interest in SOC has been accompanied by research of specific programmes, policy domains or geographies, but there has not been a systematic attempt to synthetise this emerging evidence. To address this gap, this systematic review aims to surface the best evidence on when and where effects have been associated with SOC. Methods: This mixed-methods systematic review protocol has been prepared using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) guidelines (Additional File 2) (Shamseer et al., 2010). The review aims to consult policymakers throughout the evidence synthesis process, by adopting a user-involved research process. This will include the establishment and involvement of a Policy Advisory Group (PAG). The PAG will consist of a large, diverse, international group of policy makers who are or have been actively involved in funding and shaping social outcomes contracts (Additional File 3). The following electronic databases will be searched: ABI/INFORM Global, Applied Social Sciences Index & Abstracts (ASSIA), Scopus, International Bibliography of the Social Sciences (IBSS), PAIS Index, PolicyFile Index, Proquest Dissertations and Theses, ProQuest Social Science, Social Services Abstracts, Web of Science, Worldwide Political Science Abstracts and PsycINFO. We will also conduct a comprehensive search of grey literature sources. Studies will be imported into Covidence and screened (after de-duplication) independently by two reviewers, using explicit inclusion/exclusion criteria. We will conduct risk of bias and quality assessment using recommended tools and we will extract data using a pre-piloted, standardised data extraction form. If meta-synthesis cannot be conducted for the effectiveness component, we will carry out a descriptive narrative synthesis of the quantitative evidence, categorised by type of intervention, type of outcome/s, population characteristics and/or policy sector. The qualitative studies will be synthesised using thematic content analysis (Thomas and Harden 2008). If possible, we will also analyse the available economic data to understand the costs and benefits associated with SOC. Finally, we will conduct a cross-study synthesis, which will involve bringing together the findings from the effectiveness review, economic review and qualitative review. We recognise that the proposed conventional effectiveness review method may lead to inconclusive or partial findings given the complexity of the intervention, the likely degree of heterogeneity and the under-developed evidence base. We see a traditional systematic review as an important foundation to describe the evidence landscape. We will use this formal review as a starting point and then explore more contextually rooted review work in future. Discussion: We will use the systematic review findings to produce accessible and reliable empirical insights on whether, when, and where (and if possible, how) SOC approaches deliver improved impact when compared to more conventional funding arrangements. The outputs will support policymakers to make informed decisions in relation to commissioning and funding approaches. Systematic review registration: This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO), on 20th November 2020 and was last updated on 21 January 2021: (registration number PROSPERO CRD42020215207). [1] A perverse incentive in an outcomes-based contract is an incentive that has unintended and undesirable results. For instance, a poorly designed welfare-to-work scheme could create incentives for service providers to prioritise clients who are easier to help and to ‘park’ those who are harder to assist (NAO 2015).

Subsidized insurance is often described as a perverse incentive, moral hazard, or maladaptation that perpetuates coastal residencies in vulnerable homes despite increasing safety and econom...

In recent years, the investment-arbitration and anti-corruption regimes have been in tension. Investment tribunals have jurisdiction to arbitrate disputes between investors and host states under international treaties that provide substantive protections for private investments. But these tribunals will typically decline to exercise jurisdiction over a dispute if the host state asserts that corruption tainted the investment. When tribunals close their doors to ag-grieved investors, tribunals increase the risks for investors and thus raise the cost of international investment. At the same time, the decision to decline jurisdiction creates a perverse incentive for host states to turn a blind eye to corruption. Together, these distorted incentives hinder developmental goals and undermine the fight against corruption. To correct these problems, this Note proposes a framework to guide arbitral tribunals when faced with a corruption-tainted dispute. Specifically, this Note argues that when both parties participate in corruption, arbitral tribunals should invoke equitable estoppel to accept jurisdiction over the dispute. When considering the corruption claims, investment tribunals should use a contributory-fault approach that evaluates each party’s role in the corrupt act to determine the final award. This framework not only helps align the investment-arbitration and anticorruption regimes but also advances developmental objectives.

Analyzing data from a large, nationally distributed group of Japanese hospitals, we found a dramatic decline in both inpatient and outpatient volumes over the three waves of the COVID- 19 pandemic in Japan from February-December 2020. We identified three key reasons for this fall in patient demand. First, COVID-19-related hygiene measures and behavioral changes significantly reduced non-COVID-19 infectious diseases. Second, consultations relating to chronic diseases fell sharply. Third, certain medical investigations and interventions were postponed or cancelled. Despite the drop in hospital attendances and admissions, COVID-19 is said to have brought the Japanese health care system to the brink of collapse. In this context, we explore longstanding systematic issues, finding that Japans abundant supply of beds and current payment system may have introduced a perverse incentive to overprovide services, creating a mismatch between patient needs and the supply of health care resources. Poor coordination among health care providers and the highly decentralized governance of the health care system have also contributed to the crisis. In order to ensure the long-term sustainability of the Japanese health care system beyond COVID-19, it is essential to promote specialization and differentiation of medical functions among hospitals, to strengthen governance, and to introduce appropriate payment reform. O_TEXTBOXHighlights{blacksquare} Patient volumes in Japanese hospitals fell sharply due to the COVID-19 pandemic. {blacksquare}Behavioral changes and appointment cancellations contributed to the decline. {blacksquare}Japans health system reached breaking point due to longstanding systematic issues. {blacksquare}There is a mismatch between patient needs and the supply of health care resources. {blacksquare}Payment reform and stronger governance are needed to future-proof the health system. C_TEXTBOX

With the complexity and interdependency of modern software sharply rising, the impact of security vulnerabilities and thus the value of broadly available patches has increased drastically. Despite this, it is unclear if the current landscape supports the same level of patch discoverability as that of vulnerabilities --- raising questions about whether patches are simply scare or if they are just hard to find (i.e., are there a lot of "secret patches"), and, equally important, what kind of patches are they (e.g., are they micropatchable). We seek to assess the current state of patching by analyzing patches for a four-month period of recent Common Vulnerabilities and Exposures (CVEs). At first glance, the state of patching seems abysmal --- only one-fourth of CVEs have a labelled patch on the National Vulnerability Database (NVD). However, by searching for indicators on other popular security trackers (e.g., Debian's), we were able to find a lot more ``secret patches'', but the ratio of patched CVEs plateaued around fifty percent. Examining the discovered patches, we noticed that many were version updates, and less than one-tenth had machine accessible source-code micropatches. Using a custom tool that leverages contemporary version control, we were able to test the feasibility of automatically applying these micropatches to older versions of the software and found that approximately two-thirds of the patches can be applied to at least one old version. The failure cases were mostly due to lax practices pertaining to security fixes and general software development (e.g., releasing the fix along with other extraneous features). Reflecting on our investigations, we surmise that between existence, discoverability, and versatility of security patches, existence and discoverability are the bigger problems. As to why this is the case, we find that the answer may lie in the perverse incentive structures of the industry. We conclude with possible remediations and hope that our work at least raises public awareness of the current state of patching and encourages future work to improve the situation.

Increasing attention is being paid to the use of policy instruments in promoting progressive waste management and supporting the transition to a circular economy. To be effective in this context, instruments must be balanced, providing the correct amount of sanction and incentive to ensure environmental protection, enhance resource recovery, and promote innovation and investment in beneficial technologies. Focusing on the UK landfill tax, and adopting a stakeholder-oriented approach, this paper presents a case study illustrating how the ineffective implementation of secondary legislation can have unintended consequences on the aims of primary legislation. Specifically, it examines the Landfill Tax (Qualifying Fines) Order 2015 (QFO), which introduced a Loss On Ignition (LOI) test regime to classify fines for tax purposes. Results from a stakeholder survey (n = 44) revealed that the introduction of the QFO has dis-incentivised material recovery and discouraged investment in separation technologies, thereby creating a perverse incentive to landfill waste. Major weaknesses identified include the poorly defined LOI test regime, the timing of and responsibility for conducting LOI testing, the lack of compliance checks, and the marked discontinuity in tax rates at the somewhat arbitrary 10% LOI threshold. Furthermore, the system was widely viewed to be open to abuse by unscrupulous traders. A set of recommendations are made to address these shortcomings, where it is proposed that the LOI threshold should be replaced by multiple tax bands or a sliding scale and ideally combined with a direct incentive for investment such as an enhanced capital allowance for resource efficient technologies.

This paper discusses the ethical implications of perverse incentives with regard to autonomous driving. We define perverse incentives as a feature of an action, technology, or social policy that invites behavior which negates the primary goal of the actors initiating the action, introducing a certain technology, or implementing a social policy. As a special form of means-end-irrationality, perverse incentives are to be avoided from a prudential standpoint, as they prove to be directly self-defeating: They are not just a form of unintended side effect that must be balanced against the main goal or value to be realized by an action, technology, or policy. Instead, they directly cause the primary goals of the actors—i.e., the goals that they ultimately pursue with the action, technology, or policy—to be “worse achieved” (Parfit). In this paper, we elaborate on this definition and distinguish three ideal-typical phases of adverse incentives, where only in the last one the threshold for a perverse incentive is crossed. In addition, we discuss different possible relevant actors and their goals in implementing autonomous vehicles. We conclude that even if some actors do not pursue traffic safety as their primary goal, as part of a responsibility network they incur the responsibility to act on the common primary goal of the network, which we argue to be traffic safety.

In a risk transfer and shifting financial systems, an interest rate based debt contract is an “impossible contract,” since, under the axioms of conventional economics, the borrower has an incentive not to repay the loan. Such impossible contract is made possible by creating a virtual world of certainty through mechanisms such as collateral requirements and an edifice of legal, administrative, policy incentive mechanisms that include positive and negative enforcements that protect the creditor. The society has to bear huge costs to make them possible. Risk sharing has the potential to enhance efficiency as each party to contracts has “skin-in-the-game”, thus eliminating or minimizing the principal-agent problem. Participants in a contract of an economic undertaking can choose higher risk-higher return projects thus increase the efficiency and productivity of the system. It can also create a reciprocal and trusting environment that strengthens social cohesion, promotes social mobility and reduces income inequality without perverse incentive effects.

Local climate governance has become a key focus of the climate change agenda. Much research has been conducted on the topic in northern countries, but more research is needed in the South, where local governments often are less equipped to deal with challenges associated with climate change. This paper discusses different forms of local climate governance, with a specific focus on the relevance of networks. Local climate governance in eThekwini Municipality, South Africa, is used as a case study, particularly focusing on a campaign that was implemented in 2011 before the international climate conference (COP17). The modes of governing in eThekwini are considered through a framework of local climate governing and identified mainly as self-governing and governing through enabling, the campaign being an example of the latter. The campaign also exemplifies how network governance can shape climate policy and significantly alter a project from initiation to implementation. While networks can contribute to improved communication and information exchange, there may be an inherent risk of private partners having a perverse incentive against implementing effective climate policies due to their own interests in maintaining current structures. It is not clear whether the change from regulative governance to governing by enabling will lead to more effective climate policies in the longer term. More research is required to determine this. While this study is too small to make broader generalizations, it does provide insight into how the introduction of network governance may impact climate governance at the local level in the South. Copyright © 2017 John Wiley & Sons, Ltd and ERP Environment

Many developing countries have experienced large-scale capital flight at the same time as they were borrowing from external creditors. The dual phenomena of external debt and capital flight raise important questions. Why does capital flee developing countries even as foreign creditors continue to lend to them? Is there a link between inflows of borrowed money and outflows of capital flight? If so, what is the connection? Simultaneous external borrowing and capital flight reflect perverse incentive structures on both sides of the transactions that foster behaviour that is harmful from the standpoint of the borrowing country and, if the borrower ultimately cannot repay, from the standpoint of creditor institutions as well. Strategies to address the problem of capital flight must include mechanisms to curtail corruption, recover stolen assets, relieve the burdens of external debts, and promote transparency and due diligence in banks and other financial institutions. If well designed and rigorously implemented, such initiatives can curtail malfeasance, improve incentive structures, and contribute to a more efficient and equitable international financial architecture.

Voluntary peer review is generally provided by researchers as a duty or service to their disciplines. They commit their expertise, knowledge and time freely without expecting rewards or compensation. Peer review can be perceived as a reciprocal mission that aims to safeguard the quality of publications by helping authors improve their manuscripts. While voluntary peer review adds value to research, rewarding the quantity or the volume of peer review is likely to lure academics into providing poor quality peer review. Consequently, the quantity of peer review may increase, but at the expense of quality, which may lead to unintended consequences and might negatively affect the quality of biomedical publications. This paper aims to present evidence that while voluntary peer review may aid researchers, pressurized peer review may create a perverse incentive that negatively affects the integrity of the biomedical research record. We closely examine one of the proposed models for rewarding peer review based on the quantity of peer review reports. This article also argues that peer review should remain a voluntary mission, and should not be prompted by the need to attain tenure or promotion.

Visceral leishmaniasis (VL) is a neglected tropical disease (NTD) caused by Leishmania protozoa that are transmitted by female sand flies. On the Indian subcontinent (ISC), VL is targeted by the World Health Organization (WHO) for elimination as a public health problem by 2020, which is defined as

In 2017, Congress drastically reduced the corporate tax rate and provided an unprecedented deduction under section 199A for qualifying passthrough business income. Although purportedly necessary to maintain tax parity between income earned in corporate and noncorporate form, section 199A encourages active high-income passthrough owners to misclassify labor income as business profit, thereby reducing both income and employment taxes. This Article considers how section 199A is likely to affect choice of entity among different passthrough forms. Prior to the 2017 legislation, S corporations had an advantage over other passthroughs because of their ability to convert owner compensation into S corporation income not subject to employment taxes (or the section 1411 tax). Under the 2017 legislation, it is unclear whether S corporations will continue to represent the superior choice of passthrough entity. Section 199A provides a perverse incentive for S corporations to understate or overstate owner compensation depending on which technique minimizes combined income and employment taxes. The Treasury’s decision to limit the reasonable compensation guardrail to S corporations highlights the anachronistic employment-tax treatment of passthrough entities, as well as the lack of any coherent rationale for preferential treatment of passthrough income. The Article concludes that section 199A offers a fertile field for income-shifting and potentially undermines the rationale for maintaining Subchapter S.