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The objective of this study is to shed some light on quality improvement practices of for‐profit and not‐for‐profit hospitals

The scope and effectiveness of several quality improvement efforts are studied for a sample of 110 hospitals. Factor analysis was utilized to analyze the data collected.

The results of this study tended to suggest that for‐profit and not‐for‐profit hospitals were more similar than different with the regard to the effective utilization of quality improvement initiatives, thus underscoring the utility of quality improvement efforts despite differences in operating characteristics, strategies and operating constraints.

The sample used in this study is limited. Thus, the results should be interpreted accordingly.

This study offers decision‐makers in healthcare operational settings empirical evidence of the operational and strategic effectiveness of different quality improvement efforts, thus justifying investments related to the initiation and implementation of such quality improvement efforts.

This study represents an important step toward understanding the effective implementation of quality improvement initiatives in different operational settings.

The purpose of this study is to investigate how two types of drivers, namely, executive compensation and market competition, can affect hospital quality in the USA. Recently, patients, insurers and regulators have increasingly focused on hospital quality. Understanding the interplay of incentives in this industry is important because in 2019, hospital treatment contributed $1.161bn to health-care costs in the USA. This study answers the call for more studies in the so-called “mixed” industry, where ownership differences can affect organizational objectives and operating constraints.

This study explores the roles of hospital executive compensation and industry competition as determinants of health-care quality. Specifically, the study probes the heterogeneity in the factors that influence quality across hospital types in the USA.

Using California hospital data from 2006 through 2020, the findings show that the effects of compensation and competition on hospital quality differ by ownership type. Executive compensation is positively associated with quality in for-profit hospitals but is not associated with that of nonprofit hospitals, suggesting for-profit hospitals are more likely to use higher levels of compensation to attract managers with higher ability, whereas the utility function for nonprofit managers may be multidimensional. Within the nonprofit hospital group, competition is more positively associated with quality for religious nonprofits relative to secular nonprofits, suggesting that competition provides more monitoring for religious hospitals.

Taken together, the findings provide evidence that the drivers of quality vary across hospitals in ways consistent with differences in constraints and objectives across ownership types. The findings are important for regulators seeking to incentivize higher quality. For example, Medicare in the USA has incorporated quality measures into its new hospital reimbursement scheme (value-based purchasing) to incentivize quality. This study proposes that regulators should consider differences across ownership types when evaluating the best ways to incentivize hospital quality.

The purpose of this paper is to investigate the relationship between ownership type and population health initiatives adopted by hospitals using the 2015 American Hospital Association data.

Hospitals of various sizes, ownership structures and geographic locations are represented in the survey. The outcome variables of interest include measures of hospital population health activities.

Findings indicate that nonprofit hospitals are most likely to express commitment to population health and participate in population health activities, with for-profit hospitals being least likely. Implications for policy and practice are discussed.

This study demonstrates that discrepancies in population health approaches exist across ownership status – particularly, nonprofit hospitals appear to be the most likely to be involved in population health efforts.

As we continue to push for population health management in the hospital setting, grappling with the definition and purpose of population health management will be essential.

Overall, these results suggest that nonprofit hospitals are more likely to be implementing population health efforts than for-profit or government-owned hospitals.

Although there are several studies on population health in hospitals, this study is the first to investigate the relationship between ownership type and population health initiatives adopted by hospitals.

In this paper we discuss the potential role capital markets will play in health care restructuring. According to theory, agency costs, asymmetric information and strategic interactions cause the cost of capital for nonprofit entities to slope upward. Freestanding nonprofits are particularly disadvantaged in this regard. We conclude that some organizational forms will be less viable due to problems of capital access. Empirical work examines the capital structure of nonprofit entities. Our results indicate that chain hospitals are able to access more debt, both taxable and tax-exempt, than freestanding hospitals. Capital markets also associate for profit market presence with capital risk. We conclude that freestanding hospitals are at a relative disadvantage is accessing capital markets.

Sound corporate governance is now a mainstream issue of concern in the business world. However, there has been no systematic investigation of corporate governance practices in the healthcare sector. Allowing for a distinction between two types of healthcare organizations (profit and non‐profit), this paper aims to investigate nuances in the application of sound governance principles across different types of healthcare organizations in the context of a developing country, together with differing understanding and applications of corporate social responsibility.

The paper is based on a qualitative interpretive methodology, comprising in‐depth interviews with top hospital executives drawn from 21 Lebanese hospitals representing both the profit and non‐profit varieties.

The findings suggest some basic governance differences between for‐profit and non‐profit hospitals in terms of managerial structure, ownership and the role of the board of directors, as well as differing orientations towards corporate social responsibility. There is a general lack of understanding and application of corporate governance best practices in family‐owned, for‐profit hospitals, whereas non‐profit hospitals are more in line with corporate governance best practices, and more attuned to corporate social responsibility.

This paper presents fresh insights into applications of corporate governance and corporate social responsibility principles in a very important sector that has not received systematic attention and consideration in the literature.

The issue of gender diversity on hospital boards plays a significant role in the financial health and clinical performance of hospitals. The purpose of this paper is to examine the determinants of gender diversity of hospital boards in Ghana. Specifically, this study examined the proportion of females on hospital boards and considered how hospital-level characteristics such as hospital size, age, location and ownership structure explain the board gender diversity of hospital boards in Ghana.

A quantitative approach based on 100 hospitals was used.

The results of the study indicate that women are represented on all hospitals with governing boards but with different proportions depending on ownership form. In all, women represent less than half of board membership. Smaller and older hospitals were found to have more female representation on their board. Also, not-for-profit mission and for-profit private hospitals tend to engage more females than their counterpart public hospitals.

The study examined female representation on hospital boards depending on only hospital-level characteristics such as hospital size, age, location and ownership. Other factors could be determining the appointment of females on hospital boards other than hospital characteristics.

Efforts on improving the role of women on hospital boards need to be encouraged.

Evidence from this study clearly suggests underrepresentation of women in the top echelons of hospitals owned by government or the state, bigger and newer hospitals.

U.S. hospitals face calls for accountability from regulators, professionals, academics and consumers. Transparency and wider dissemination in reporting of financial performance is an integral component of accountability. This paper investigates the extent to which U.S. hospitals have used the Internet to disseminate financial information and demonstrate accountability to the communities they purport to serve. The authors examine the availability of financial information on the websites of the American Hospital Association’s 100 Most Wired healthcare systems. Results of this investigation indicate that the vast majority of the most technically competent U.S. hospitals have yet to embrace the Internet as a tool for financial disclosure. The findings highlight a lack of transparency and an accountability gap for U.S. healthcare systems.

The purpose of this paper is to add to the stream of research examining the difference between the amount of taxes waived for nonprofit hospitals and the amount of charity care they provide.

The study is an archival study.

Almost all nonprofit hospitals in the sample provide enough charity care to cover their waived taxes. Almost none provide enough charity care at the level that has been proposed to the federal government for hospitals to maintain their nonprofit status.

As with most hospital research, a limitation is this study’s focus on a single state to control for regulatory differences among states.

The data on the new Form 990 allow better measurement and transparency regarding a nonprofit hospital’s charity care. For legislators, regulators, and taxpayers, the results from this study raise questions about: the large variations in the amount of charity care provided among nonprofit hospitals and whether enough is being done in terms of providing charity care.

There is great variation among nonprofit hospitals as to the amount of charity care provided. Relying upon a nonprofit hospital’s altruistic nature may not be enough to ensure that they act in the best interest of society.

This study is unique because, for the first time, a true measure of taxes waived is used in the analysis. All previous research has had to proxy taxes.

This study examines whether nonprofit hospitals (NPHs) use price increases to overstate reported charity care spending. Anecdotal evidence points to hospitals raising prices to maximize Medicare's supplemental reimbursement and to maximize collection from self-pay and uninsured patients. This study provides empirical evidence that NPHs raise prices in part to satisfy the state's charity care requirements and to substitute real care with price-valued charity care. The ratio of charges to costs (RCC), price standardized by cost - a measure for comparing revenues generated to estimate costs allocations, is used to test the association between price increases and charity care reporting by NPHs. We hypothesize and find evidence that NPHs facing financial and political pressures in addition to charity care regulations are more likely to report a higher value of charity care.

A nation‐wide survey of hospital providers was conducted in an effort to determine the type and level of promotion and advertising agency utilization. The study indicated that a majority of the hospitals surveyed are engaging in some form of advertising activity. Survey results further showed agency usage was highly correlated to hospital bed size. Additionally, contrary to previous research, hospital ownership status (for‐profit/not‐for‐profit) was not found to significantly affect agency utilization. Specifics about hospital/agency relationships are presented.