Firstly I have installed a fresh copy of Xampp onto a test machine. This comes with Zend Optimizer files in the PHP directory. However by default it is disabled. From googling I found that there is a value in the PHP. Zend Framework Installation: WAMP (1). Enjoy Zend Framework and the installation should get you up and running. Install Zend Framework 2 in Xampp. Posted on February 3, 2013 by David Kryzaniak. Installing the Zend Framework on IIS is. Installing Zend Framework 2 on XAMPP in Windows. This is easily handled by running the command line interface with. Installing Zend Framework on Xampp and. Tutorial for installing Yii framework in XAMPP on Ubuntu / Linux by Inforbiro. We wrote how to install Yii framework in XAMPP on. Zend Framework Questions and. XAMPP is an open source cross. Installing them as services. Integrated with Zend Server and Zend PHP MVC. I have assumed that you are running PHP 5.2.4 or higher with the Apache web. Zend Framework’s controller reserves a special action called index as a default. How to install Zend Framework 2 on ubuntu? Xampp is not running on ubuntu. Getting Xdebug to work with Apache/XAMPP to debug PHP. Note that if you are running Zend Studio. Getting Xdebug to work with Apache/XAMPP to debug PHP Tags. Installing the zend framework under XAMPP is actually a lot simpler. 14 Responses to “How to install Zend framework with XAMPP. Optimizer to work. At this point I discovered that entries are also required in the httpd. Apache webserver. As far as I can tell there are currently no entries to do with the Optimizer in this file (how could the Xampp version then have ever worked??)This is the second part of my problem. I have downloaded and installed the latest version of the Optimizer. During the installation process I specify the location of my php. When the installation is finished I can see that the process has edited the php. Also during the installation process I am asked to specify the root folder of my webserver. I provide C: \xampp\apache as this is where Apache is installed. However when the installation process is finished no changes have been made to the httpd. Installing And Running The Zend Framework On Xampp ControlWhen I then try to verify the Optimizer installation I have the same problems. Also when I try to run the installation for 1. I get a page displayed in my browser telling me that. In order to run it, please install the Zend Optimizer (available without charge), version 3. Please download and install the Zend Optimizer (available without charge) on the Web Server. I have searched on the internet and I can't find anyone having a problem like mine. Am I doing something silly or has anyone any ideas? My computer is in danger of leaving my desk and flying out the window at the moment so even some help debugging the problem as such would be very much appreciated. Thanks in advance. Erin*One other thing I forgot to mention. During the installation process I am prompted that Apache is not installed as a Windows service on my machine. However Apache is installed as a Windows service by the Xampp installation. Does this indicate that the installation is having problems with my Apache installation? It is the default Xampp installation of Apache - literally nothing changed. Also Apache is stopped before I start the installation.
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Special Article from The New England Journal of Medicine — Fitness Memberships and Favorable Selection in Medicare Advantage. Improving risk adjustment in the Medicare program C hapter 2 Chapter summary Health plans that participate in the Medicare Advantage (MA) program receive. Favorable Selection, Risk Adjustment, and the Medicare Advantage Program' title='Share on Facebook '>Facebook Twitter Google1 Email Favorable Selection, Risk Adjustment, and the Medicare Advantage Program' title='Share on. Title: Favorable selection, risk adjustment, and the Medicare Advantage program. Author: admin Created Date: 9/6/2016 11:54:49 PM. Title: Favorable selection, risk adjustment, and the Medicare Advantage program. Publication Type: Journal Article: Year of Publication: 2013: Authors: Morrisey, MA, Kilgore, ML, Becker, DJ, Smith, W, Delzell, E: Journal. Favorable Selection, Risk Adjustment, and the Medicare Advantage Program - Morrisey - 2. Health Services Research. Objectives. To examine the effects of changes in payment and risk adjustment on (1) the annual enrollment and switching behavior of Medicare Advantage (MA) beneficiaries, and (2) the relative costliness of MA enrollees and disenrollees. Insurers use fitness memberships to select the healthy. Fitness Memberships and Favorable Selection in Medicare Advantage Plans. The Medicare Advantage program offers an opportunity to study. Medicare drastically changed its risk adjustment program starting in 2004 and made a number of other. Does Risk Adjustment Reduce Selection in the Private Health Insurance Market? New Evidence from the Medicare Advantage Program September 2010 Preliminary and Incomplete Jason Brown U.S. Department of the Treasury Mark Duggan. New risk-adjustment system was associated with reduced favorable selection in medicare advantage. Data. From 1. 99. Medicare claims data from the 5 percent longitudinal sample of Parts A and B expenditures. Study Design. Retrospective, fixed effects regression analysis of July enrollment and year- long switching into and out of MA. Similar regression analysis of the costliness of those switching into (out of) MA in the 6 months prior to enrollment (after disenrollment) relative to nonswitchers in the same county over the same period. Findings. Payment generosity and more sophisticated risk adjustment were associated with substantial increases in MA enrollment and decreases in disenrollment. Claims experience of those newly switching into MA was not affected by any of the policy reforms, but disenrollment became increasingly concentrated among high- cost beneficiaries. Conclusions. Enrollment is very sensitive to payment levels. The use of more sophisticated risk adjustment did not alter favorable selection into MA, but it did affect the costliness of disenrollees. Private Medicare plans shockingly game risk adjustment. The Consequences of Risk Adjustment in the Medicare Advantage Program. The National Bureau of Economic Research. NBER Digest On. Line, September 2. Since the 1. 98. 0s, people eligible for Medicare have been able to choose between the regular fee- for- service plan, under which the federal government pays a set fee to health care providers for each service provided, and Medicare Advantage (MA), whereby the government pays private health plans a fee for each individual they enroll. Almost one quarter of Medicare beneficiaries are currently enrolled in Medicare Advantage plans. Paying the same amount for every person enrolled in a health plan encourages plans to enroll low- cost people and to avoid high- cost ones. Because of this, the federal government historically overpaid for MA enrollees relative to their costs in traditional Medicare. So, in 2. 00. 4 the Medicare program began to adjust its payments to private plans for enrollees health status. As a result, a plan would, for example, receive a higher ? Evidence for the Medicare Advantage Program. Jason Brown, Mark Duggan, Ilyana Kuziemko, and William Wollston study individual- level data for 5. Medicare Current Beneficiary Survey (MCBS) from the period 1. Prior to risk adjustment, insurers simply had an incentive to enroll individuals with low costs. After risk adjustment, insurers instead had an incentive to enroll individuals with low costs conditional on their medical conditions. The main reason for this is that the risk adjustment formula pays the plans the average cost of the average person in a particular risk category. The authors demonstrate that, because individuals with less costly cases of diabetes and other health conditions enrolled in MA plans after the move to risk adjustment, overpayments to these plans actually increased. The risk adjustment formula that is used also explains only 1. The formula systematically over- predicts costs for those with below average costs, and systematically under- predicts costs for those with above average costs. The authors find that individuals who are more expensive than the average person to insure are less likely to enroll in Medicare Advantage plans. So on balance, the government ends up paying the average cost for people who, had they stayed in fee- for- service Medicare, would have cost the government much less. Before risk- adjustment began in 2. Medicare to Medicare Advantage increased average individual Medicare spending by $1,8. The authors calculate that using risk adjustment formulas on the population that enrolled before 2. Medicare Advantage overpayments by more than $8. But when the reimbursement formula changed, so did the pattern of enrollment in Medicare Advantage plans. After 2. 00. 4, switching from fee- for- service to Medicare Advantage increased Medicare spending by approximately $3,0. Thus the shift to risk adjustment actually increased Medicare spending. Although Medicare Advantage plans did enroll people with higher . Furthermore, both before and after risk adjustment, MA enrollees in poor health expressed greater dissatisfaction with their medical care relative to their counterparts in traditional Medicare. This pattern suggests that MA plans invest more resources in their relatively healthy enrollees, perhaps to differentially retain them. Thus the authors conclude that the Medicare Advantage program both increased total Medicare spending and transferred Medicare resources from the relatively sick to the relatively healthy, and that risk- adjustment was not able to address either of these problems. And.. How does Risk Selection Respond to Risk Adjustment? Evidence from the Medicare Advantage Program. By Jason Brown, Mark Duggan, Ilyana Kuziemko, William Woolston. NBER Working Paper No. April 2. 01. 1We close by returning to the potential distributional consequences of our results. Regardless of how the surplus described above is split, the MA program appears to expand the cost of Medicare while also transferring relative expenditures from the FFS population toward the financing of care for the MA population. As those switching into MA have, throughout the sample period, lower baseline costs and better self- reported health than do those remaining in FFS, the MA program transfers Medicare expenditure to those who likely have less need for it. Moreover, as we show in Section 7, the gradient of satisfaction with one's health care is a more positive function of self- reported health for MA enrollees than FFS enrollees, consistent with MA plans treating their healthier (and thus more profitable) enrollees better so as to differentially retain them. Indeed, exit rates out of MA plans are differentially higher among those in poor health. Therefore, the MA program appears not only to transfer aggregate Medicare expenditures from the relatively higher- cost FFS population to the relatively lower- cost MA population, but it seems to effect a similar transfer within the MA population. These results suggest that governments may wish to take special care in . Imperfect pricing - whereby the government overpays a private firm relative to the cost and quality of in- house production - is, of course, a potential concern every time governments contract with a private party and has received great attention in the literature (see, for example, Hart et al. In the case of, say, paving a road, the consequences of imperfect pricing would seem limited to whatever amount the government overpaid. With social insurance programs, however, imperfect pricing can induce private firms to cream- skim, exacerbating the utility consequences of the underlying inequality the program was initially intended to mitigate. At least in the case of Medicare, we find little evidence that risk adjustment has solved this problem. Comment: By Don Mc. Canne, MDNever underestimate the ability of the private insurance industry to stick it to us. This shocking study on risk adjustment in the Medicare Advantage program should have been a front page story across the nation. It shows us how the private insurers have used risk adjustment - designed to correct their cheating through favorable selection - to further reap their own rewards by upending the adjustments so that they steal even more funds from us! How could this be? Some history. Congress was sold on the concept that private insurers could provide higher quality at lower costs than could the traditional, government- run Medicare program. The Medicare + Choice program was established to do this. Even though the plans were able to selectively enroll healthier, lower- cost patients (favorable selection), the concept still was a failure and plans began withdrawing from the markets. They could not fulfill their promise of lower costs for comparable care. The conservatives would not give up. It was essential that a robust market for private Medicare plans be established as an initial step toward privatizing the entire Medicare program (a concept still very much alive in the Paul Ryan proposal which was approved in the House of Representatives). They were successful in passing legislation that gave private Medicare plans (now Medicare Advantage) a new life by paying them about 1. As is that weren't enough, the plans continued to selectively enroll healthier, less expensive patients, further expanding their margins. To counter this, risk adjustment was applied to the payment rates. If the plans' beneficiaries were healthier than average, they would be paid less. If they were subject to adverse selection - enrolling a greater portion of sicker patients - they would be paid more. Enter this study. Although it is 5. The plans continued to favorably select their patients, not only by enrolling the healthy, but even more by selecting fairly healthy patients that had just a touch of illness that would allow the insurers to move them into intensified diagnostic groups that increased their payments much more than the level of illness would warrant. The authors explain that firms have been able to decrease . These terms might be obscure to us, but what isn't obscure is that this chicanery on the part of the insurers allowed them to escape the risk adjustments that would have reduced their overpayments from $1,8. The authors conclude that . We need to throw the damn crooks out, fix our traditional Medicare program, and then provide it for everyone. However, if you still want to use the Run box in Vista or Windows 7, you can type Run in the Search box and press Enter. Determine whether your computer can run. Determine whether your computer can run Windows Vista If you are. You can run programs that were. You can transfer data. Where is RUN in Windows Vista? Are you using Windows 7? How to Find RUN in Windows 7? You can access RUN in two ways: Press “Windows” and “R” keys simultaneously. Customize the START menu, taking these steps: Right- click on the TASKBAR. Select “PROPERTIES“Check “Run command“. Click OK. And you’re done!——————————————————————————————————Are you using Windows 7? How to Find RUN in Windows 7? Find the best way to do that How to Delete a Registry Key in Windows Vista?————————————————————————————————————————————————————————————————————Looking for the information how to edit a registry key in Windows Vista? 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