Medicaid Expansion and Not-For-Profit Hospitals’ Financial Status: National and State-Level Estimates Using IRS and CMS Data, 2011-2016

2021 ◽  
pp. 107755872110097
Author(s):  
Tatiane Santos ◽  
Simone Singh ◽  
Gary J. Young
Keyword(s):  
Hospital Costs ◽  
State Level ◽  
Medicaid Expansion ◽  
Financial Status ◽  
For Profit ◽  
Not For Profit ◽  
Percentage Points ◽  
The Difference ◽  
Using Data ◽  
The Impact

Several studies have shown that Medicaid expansion has improved hospital financial performance. All of these studies have either used data from the Internal Revenue Service (IRS) or the Centers for Medicare and Medicaid Services (CMS), and none of them has examined the state-level impact of expansion on hospital finances. Using data for not-for-profit hospitals from both IRS and CMS for 2011-2016, we described the difference in costs related to uncompensated care and Medicaid shortfalls. We then estimated the impact of Medicaid expansion on hospitals’ financial status nationally and by state. Nationally, the estimated net effect of expansion reduced not-for-profit hospital costs by 2 percentage points based on IRS data and 0.83 percentage points based on CMS data. Across expansion states, the estimated net effects varied widely with approximately a 10-fold difference for hospitals based on IRS data and a 2-fold difference based on CMS data. Future studies should further explore the differences across IRS and CMS data.

The Impact of Public Policy on Support Services for Indigenous Families with Children with Special Education Needs

2017 ◽  
Vol 47 (2) ◽  
pp. 198-205 ◽  
Author(s):  
Karen Trimmer ◽  
Roselyn Dixon
Keyword(s):  
National Policy ◽  
Disability Services ◽  
For Profit ◽  
The Past ◽  
Not For Profit ◽  
Special Education Needs ◽  
Provision Of Services ◽  
Education Needs ◽  
Families With Children ◽  
The Impact

In Australia and Europe, government agencies and not-for-profit organisations (NFPOs) have had long involvement in the funding and provision of community disability services. Significant change has occurred in Australia over the past two decades in the way government funds are expended, with marketplace mechanisms increasingly being used. As a consequence of economic and governance imperatives, funding of services via NFPOs has changed significantly with a move away from the provision of grants to the contracting of these organisations for the provision of services. In 2013, a new national policy, the National Disability Insurance Scheme (NDIS), was introduced that has impacts for the provision of disability services for children and their families. In particular, Indigenous families are likely to experience barriers in accessing services. This paper reviews the impact of international changes in policy and associated funding models and considers the impacts and research implications of Australia's initial experience of implementation of the NDIS.

The Impact of Customer Loyalty and Restaurant Sanitation Grades on Revisit Intention and the Importance of Narrative Information: The Case of New York Restaurant Sanitation Grading System

2017 ◽  
Vol 59 (3) ◽  
pp. 275-284 ◽  
Author(s):  
Min Gyung Kim ◽  
Hyunjoo Yang ◽  
Anna S. Mattila
Keyword(s):  
New York ◽  
New York City ◽  
Customer Loyalty ◽  
York City ◽  
Letter Grades ◽  
The Difference ◽  
Revisit Intentions ◽  
Using Data ◽  
The Impact ◽  
Loyal Customers

New York City launched a restaurant sanitation letter grade system in 2010. We evaluate the impact of customer loyalty on restaurant revisit intentions after exposure to a sanitation grade alone, and after exposure to a sanitation grade plus narrative information about sanitation violations (e.g., presence of rats). We use a 2 (loyalty: high or low) × 4 (sanitation grade: A, B, C, or pending) between-subjects full factorial design to test the hypotheses using data from 547 participants recruited from Amazon MTurk who reside in the New York City area. Our study yields three findings. First, loyal customers exhibit higher intentions to revisit restaurants than non-loyal customers, regardless of sanitation letter grades. Second, the difference in revisit intentions between loyal and non-loyal customers is higher when sanitation grades are poorer. Finally, loyal customers are less sensitive to narrative information about sanitation violations.

The Effects of the Expansion of For-Profit Colleges on Student Enrollments and Outcomes at Community Colleges

2018 ◽  
Vol 40 (4) ◽  
pp. 631-652 ◽  
Author(s):  
Adela Soliz
Keyword(s):  
Community College ◽  
Postsecondary Education ◽  
Large Scale ◽  
Higher Education System ◽  
For Profit ◽  
Education Data ◽  
Education Levels ◽  
Short And Long Term ◽  
Using Data ◽  
The Impact

This study is the first large-scale examination of the impact of for-profit colleges on the enrollment and outcomes of students at other postsecondary institutions. Using data primarily from the Integrated Postsecondary Education Data System (IPEDS) and a differences-in-differences approach, I estimate the effect of a new for-profit college opening on community college enrollments and degree completions, as well as county education levels. My results suggest that community college enrollments and degree completions do not decline when a new degree-granting for-profit college opens nearby. Furthermore, I find evidence that the county-level production of short- and long-term certificates increases after a new for-profit college opens, though the number of associate’s degrees does not increase. This evidence should serve to broaden conversations about the role of for-profit colleges in the larger landscape of the American higher education system.

scholarly journals Sensitivity analysis of Economic Value Added as a dominant indicator of concept of economic profit

2021 ◽  
Vol 129 ◽  
pp. 03014
Author(s):  
Dusan Karpac ◽  
Viera Bartosova
Keyword(s):  
Sensitivity Analysis ◽  
Economic Value ◽  
Value Added ◽  
Economic Value Added ◽  
Financial Status ◽  
Economic Profit ◽  
Methods Of Synthesis ◽  
The Difference ◽  
Individual Variables ◽  
The Impact

Research background: The modern goal of enterprises, value creation, is achieved through the concept of economic profit. Profit, as part of profit or loss, is one of the most important flows, pointing to how efficiently corporate capital is used in an entity (Coatney & Poliak, 2020). The article deals with the difference between accounting and economic profit, the selected form of economic profit - the EVA indicator. The economic value added (EVA) indicator is one of the best-known modern indicators of a company's performance (Siekelova et al., 2019). It shows whether the given entity increases its value or only earns for its economic survival. The benefit of this indicator is the valuation of equity and taking into account the risk. It is difficult to express the economic profit itself, therefore the article also addresses the issue of its calculation (Shah et al., 2016). The company needs to know its financial status and the direction it is heading, so we decided to calculate a selected form of economic profit. Purpose of the article: The company needs to know its financial status and the direction it is heading, so we decided to calculate a selected form of economic profit. When expressing the value of the economic value added indicator, it is also important to know the items and components of the calculation that have the strongest meaning and effect on the possible amount of the indicator. Given this, we decided to use a sensitivity analysis, which points to the effect of individual variables that participate in the construction of the EVA calculation. Methods: In this work, the methods of induction, deduction, and comparison were used to obtain a true picture of the subject issue. Methods of synthesis and analysis of the researched issues were also used. Findings & Value added: In the paper there is pointed out the intensity of the impact of individual variables that entered into the calculation of the economic value added indicator as a dominant indicator of concept of economic profit.

Quantifying changes in bicycle volumes using crowdsourced data

2022 ◽  
pp. 239980832110661
Author(s):  
Ali Al-Ramini ◽  
Mohammad A Takallou ◽  
Daniel P Piatkowski ◽  
Fadi Alsaleem
Keyword(s):  
Machine Learning ◽  
The United States ◽  
Crowdsourced Data ◽  
Machine Learning Approach ◽  
Bicycle Infrastructure ◽  
The Difference ◽  
Infrastructure Investments ◽  
Using Data ◽  
The Impact ◽  
The City

Most cities in the United States lack comprehensive or connected bicycle infrastructure; therefore, inexpensive and easy-to-implement solutions for connecting existing bicycle infrastructure are increasingly being employed. Signage is one of the promising solutions. However, the necessary data for evaluating its effect on cycling ridership is lacking. To overcome this challenge, this study tests the potential of using readily-available crowdsourced data in concert with machine-learning methods to provide insight into signage intervention effectiveness. We do this by assessing a natural experiment to identify the potential effects of adding or replacing signage within existing bicycle infrastructure in 2019 in the city of Omaha, Nebraska. Specifically, we first visually compare cycling traffic changes in 2019 to those from the previous two years (2017–2018) using data extracted from the Strava fitness app. Then, we use a new three-step machine-learning approach to quantify the impact of signage while controlling for weather, demographics, and street characteristics. The steps are as follows: Step 1 (modeling and validation) build and train a model from the available 2017 crowdsourced data (i.e., Strava, Census, and weather) that accurately predicts the cycling traffic data for any street within the study area in 2018; Step 2 (prediction) use the model from Step 1 to predict bicycle traffic in 2019 while assuming new signage was not added; Step 3 (impact evaluation) use the difference in prediction from actual traffic in 2019 as evidence of the likely impact of signage. While our work does not demonstrate causality, it does demonstrate an inexpensive method, using readily-available data, to identify changing trends in bicycling over the same time that new infrastructure investments are being added.

The impact of relative CEO compensation on not-for-profit contributions

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Stacey Kaden ◽  
Gary Peters ◽  
Juan Manuel Sanchez ◽  
Gary M. Fleischman
Keyword(s):  
Large Scale ◽  
Ceo Compensation ◽  
Drop Out ◽  
Content Type ◽  
For Profit ◽  
Not For Profit ◽  
Survivorship Bias ◽  
Excess Cash ◽  
The Impact ◽  
A Current

PurposeThe authors extend research suggesting that external funders reduce their contributions to not-for-profit (NFP) organizations in response to media-reported CEO compensation levels.Design/methodology/approachEmploying a maximum archival sample of 44,807 observations from US Form 990s, the authors comprehensively assess the extent that high relative NFP CEO compensation is associated with decreases in future contributions.FindingsThe authors find that donors and grantors react negatively to high relative CEO compensation but do not react adversely to high absolute executive compensation. Contributors seem to take issue with CEO compensation when they perceive it absorbs a relatively large portion of the organizations’ total expenses, which may hinder the NFP’s mission. Additional findings suggest that excess cash held by the NFP significantly exacerbates the negative baseline relationship between future contributions and high relative CEO compensation. Finally, both individual donors and professional grantors are sensitive to cash NFP CEO compensation levels, but grantors are more sensitive to CEO noncash compensation.Research limitations/implicationsThe authors’ data are focused on larger NFP organizations, so this limits the generalizability of the study. Furthermore, survivorship bias potentially influences their time-series investigations because a current year large-scale decrease in funding due to high relative CEO compensation may cause some NFP firms to drop out of the sample the following year due to significant funding reductions.Originality/valueThe study makes three noteworthy contributions to the literature. First, the study documents that the negative association between high relative CEO compensation levels and future donor and grantor contributions is much more widespread than previous literature suggested. Second, the authors document that high relative CEO compensation levels that trigger reductions in future contributions are significantly exacerbated by excess cash held by the NFP. Finally, the authors find that more sophisticated grantors are more sensitive to noncash CEO compensation levels as compared with donors.

Association of Medicaid expansion under the Affordable Care Act with access to elective spine surgical care

2021 ◽  
pp. 1-9
Author(s):  
Jacob K. Greenberg ◽  
Derek S. Brown ◽  
Margaret A. Olsen ◽  
Wilson Z. Ray
Keyword(s):  
United States ◽  
Spine Surgery ◽  
Surgical Procedures ◽  
Affordable Care Act ◽  
Surgical Care ◽  
The United States ◽  
Medicaid Expansion ◽  
Percentage Points ◽  
The Affordable Care Act ◽  
The Impact

OBJECTIVE The Affordable Care Act expanded Medicaid eligibility in many states, improving access to some forms of elective healthcare in the United States. Whether this effort increased access to elective spine surgical care is unknown. This study’s objective was to evaluate the impact of Medicaid expansion under the Affordable Care Act on the volume and payer mix of elective spine surgery in the United States. METHODS This study evaluated elective spine surgical procedures performed from 2011 to 2016 and included in the all-payer State Inpatient Databases of 10 states that expanded Medicaid access in 2014, as well as 4 states that did not expand Medicaid access. Adult patients aged 18–64 years who underwent elective spine surgery were included. The authors used a quasi-experimental difference-in-difference design to evaluate the impact of Medicaid expansion on hospital procedure volume and payer mix, independent of time-dependent trends. Subgroup analysis was conducted that stratified results according to cervical fusion, thoracolumbar fusion, and noninstrumented surgery. RESULTS The authors identified 218,648 surgical procedures performed in 10 Medicaid expansion states and 118,693 procedures performed in 4 nonexpansion states. Medicaid expansion was associated with a 17% (95% CI 2%–35%, p = 0.03) increase in mean hospital spine surgical volume and a 23% (95% CI −0.3% to 52%, p = 0.054) increase in Medicaid volume. Privately insured surgical volumes did not change significantly (incidence rate ratio 1.13, 95% CI −5% to 34%, p = 0.18). The increase in Medicaid volume led to a shift in payer mix, with the proportion of Medicaid patients increasing by 6.0 percentage points (95% CI 4.1–7.0, p < 0.001) and the proportion of private payers decreasing by 6.7 percentage points (95% CI 4.5–8.8, p < 0.001). Although the magnitude of effects varied, these trends were similar across procedure subgroups. CONCLUSIONS Medicaid expansion under the Affordable Care Act was associated with an economically and statistically significant increase in spine surgery volume and the proportion of surgical patients with Medicaid insurance, indicating improved access to care.

On the Association between Donor-Imposed Financial Inflexibility and Future Donations to Charitable Organizations

2014 ◽  
Vol 27 (1) ◽  
pp. 63-79 ◽  
Author(s):  
Krishnamurthy Surysekar ◽  
Elizabeth H. Turner ◽  
Clark M. Wheatley
Keyword(s):  
Organizational Performance ◽  
Managerial Discretion ◽  
Costs And Benefits ◽  
Charitable Organizations ◽  
Financial Flexibility ◽  
Negative Relation ◽  
For Profit ◽  
Not For Profit ◽  
The Impact

ABSTRACT We address the impact of financial flexibility on organizational performance in a not-for-profit (NFP) setting. Specifically, we examine the link between donor-imposed financial inflexibility and subsequent donations. Donors sometimes impose restrictions on NFP use of the donated resources. These restrictions arise because of donors' preferences regarding how the assets are used, or as a mechanism for donors to monitor the actions of NFP management. Restricted donations cause financial inflexibility and limit managerial discretion. We examine the costs and benefits of restricting managerial discretion and find a negative relation between future donations and high levels of donor restriction. Specifically, we empirically demonstrate that when restricted assets comprise a high percentage of total assets, additional increases in restricted assets are associated with an overall reduction in future donations.

Sign in / Sign up

Export Citation Format

Share Document