Does managed care change the mission of nonprofit hospitals?: evidence from the managerial labor market
This paper examines how the managerial labor market in nonprofit hospitals has adjusted to the negative income pressures created by HMO penetration. Using a panel of about 1500 nonprofit hospitals over the period 1992 to 1996, we find that top executive turnover increases following an increase in HM...
Gespeichert in:
| Hauptverfasser: | , , |
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| Format: | Buch |
| Sprache: | English |
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Cambridge, Mass.
NBER
2000
|
| Schriftenreihe: | NBER working paper series
7924 |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Zusammenfassung: | This paper examines how the managerial labor market in nonprofit hospitals has adjusted to the negative income pressures created by HMO penetration. Using a panel of about 1500 nonprofit hospitals over the period 1992 to 1996, we find that top executive turnover increases following an increase in HMO penetration. Moreover, the increase in turnover is concentrated among the hospitals that have low levels of economic profitability and are more financially leveraged. While the link between top executive pay and for-profit performance measures is on average very weak, HMO penetration substantially tightens that link: as HMO penetration increases, top executives are compensated more for improving the profitability of their hospitals. These results are consistent with the view that HMO penetration increases the importance of for-profit performance objectives among not-for-profit hospitals. Boards appear to fire the managers that are least able to compete in the new competitive environment and reward incumbent managers more for achieving for-profit goals. Consistent with donors' belief that these changes represent a weakening of the nonprofit mission and not simply an attempt by altruistic boards to protect intergenerational equity, we find that public donations fall as HMO market share increases. |
| Beschreibung: | 43 S. graph. Darst. 22 cm |
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| 490 | 1 | |a NBER working paper series |v 7924 | |
| 520 | |a This paper examines how the managerial labor market in nonprofit hospitals has adjusted to the negative income pressures created by HMO penetration. Using a panel of about 1500 nonprofit hospitals over the period 1992 to 1996, we find that top executive turnover increases following an increase in HMO penetration. Moreover, the increase in turnover is concentrated among the hospitals that have low levels of economic profitability and are more financially leveraged. While the link between top executive pay and for-profit performance measures is on average very weak, HMO penetration substantially tightens that link: as HMO penetration increases, top executives are compensated more for improving the profitability of their hospitals. These results are consistent with the view that HMO penetration increases the importance of for-profit performance objectives among not-for-profit hospitals. Boards appear to fire the managers that are least able to compete in the new competitive environment and reward incumbent managers more for achieving for-profit goals. Consistent with donors' belief that these changes represent a weakening of the nonprofit mission and not simply an attempt by altruistic boards to protect intergenerational equity, we find that public donations fall as HMO market share increases. | ||
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| spelling | Arnould, Richard J. Verfasser (DE-588)132788365 aut Does managed care change the mission of nonprofit hospitals? evidence from the managerial labor market Richard Arnould ; Marianne Bertrand ; Kevin F. Hallock Cambridge, Mass. NBER 2000 43 S. graph. Darst. 22 cm txt rdacontent n rdamedia nc rdacarrier NBER working paper series 7924 This paper examines how the managerial labor market in nonprofit hospitals has adjusted to the negative income pressures created by HMO penetration. Using a panel of about 1500 nonprofit hospitals over the period 1992 to 1996, we find that top executive turnover increases following an increase in HMO penetration. Moreover, the increase in turnover is concentrated among the hospitals that have low levels of economic profitability and are more financially leveraged. While the link between top executive pay and for-profit performance measures is on average very weak, HMO penetration substantially tightens that link: as HMO penetration increases, top executives are compensated more for improving the profitability of their hospitals. These results are consistent with the view that HMO penetration increases the importance of for-profit performance objectives among not-for-profit hospitals. Boards appear to fire the managers that are least able to compete in the new competitive environment and reward incumbent managers more for achieving for-profit goals. Consistent with donors' belief that these changes represent a weakening of the nonprofit mission and not simply an attempt by altruistic boards to protect intergenerational equity, we find that public donations fall as HMO market share increases. Führungskräfte / Leistungsorientierte Vergütung / Managed Care / Krankenhaus / Nonprofit-Organisation / USA USA - Gehalt - Krankenhaus - Wettbewerb - Führungskraft - Nonprofit-Bereich Bertrand, Marianne Verfasser (DE-588)128755237 aut Hallock, Kevin F. 1969- Verfasser (DE-588)122296427 aut Erscheint auch als Online-Ausgabe NBER working paper series 7924 (DE-604)BV002801238 7924 http://papers.nber.org/papers/w7924.pdf kostenfrei Volltext |
| spellingShingle | Arnould, Richard J. Bertrand, Marianne Hallock, Kevin F. 1969- Does managed care change the mission of nonprofit hospitals? evidence from the managerial labor market NBER working paper series Führungskräfte / Leistungsorientierte Vergütung / Managed Care / Krankenhaus / Nonprofit-Organisation / USA |
| title | Does managed care change the mission of nonprofit hospitals? evidence from the managerial labor market |
| title_auth | Does managed care change the mission of nonprofit hospitals? evidence from the managerial labor market |
| title_exact_search | Does managed care change the mission of nonprofit hospitals? evidence from the managerial labor market |
| title_exact_search_txtP | Does managed care change the mission of nonprofit hospitals? evidence from the managerial labor market |
| title_full | Does managed care change the mission of nonprofit hospitals? evidence from the managerial labor market Richard Arnould ; Marianne Bertrand ; Kevin F. Hallock |
| title_fullStr | Does managed care change the mission of nonprofit hospitals? evidence from the managerial labor market Richard Arnould ; Marianne Bertrand ; Kevin F. Hallock |
| title_full_unstemmed | Does managed care change the mission of nonprofit hospitals? evidence from the managerial labor market Richard Arnould ; Marianne Bertrand ; Kevin F. Hallock |
| title_short | Does managed care change the mission of nonprofit hospitals? |
| title_sort | does managed care change the mission of nonprofit hospitals evidence from the managerial labor market |
| title_sub | evidence from the managerial labor market |
| topic | Führungskräfte / Leistungsorientierte Vergütung / Managed Care / Krankenhaus / Nonprofit-Organisation / USA |
| topic_facet | Führungskräfte / Leistungsorientierte Vergütung / Managed Care / Krankenhaus / Nonprofit-Organisation / USA USA - Gehalt - Krankenhaus - Wettbewerb - Führungskraft - Nonprofit-Bereich |
| url | http://papers.nber.org/papers/w7924.pdf |
| volume_link | (DE-604)BV002801238 |
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