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Investment Decisions of Nonprofit Firms: Evidence from Hospitals

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  • MANUEL ADELINO
  • KATHARINA LEWELLEN
  • ANANT SUNDARAM

Abstract

type="main"> This paper examines investment choices of nonprofit hospitals. It tests how shocks to cash flows caused by the performance of the hospitals’ financial assets affect hospital expenditures. Capital expenditures increase, on average, by 10 to 28 cents for every dollar received from financial assets. The sensitivity is similar to that found earlier for shareholder-owned corporations. Executive compensation, other salaries, and perks do not respond significantly to cash flow shocks. Hospitals with an apparent tendency to overspend on medical procedures do not exhibit higher investment-cash flow sensitivities. The sensitivities are higher for hospitals that appear financially constrained.

Suggested Citation

  • Manuel Adelino & Katharina Lewellen & Anant Sundaram, 2015. "Investment Decisions of Nonprofit Firms: Evidence from Hospitals," Journal of Finance, American Finance Association, vol. 70(4), pages 1583-1628, August.
    • Handle: RePEc:bla:jfinan:v:70:y:2015:i:4:p:1583-1628
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    File URL: http://hdl.handle.net/10.1111/jofi.12234
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    Cited by:

    1. NARITA Yusuke & YATA Kohei, 2021. "Algorithm is Experiment: Machine Learning, Market Design, and Policy Eligibility Rules," Discussion papers 21057, Research Institute of Economy, Trade and Industry (RIETI).
    2. Kalodimos, Jonathan, 2017. "Internal governance and performance: Evidence from when external discipline is weak," Journal of Corporate Finance, Elsevier, vol. 43(C), pages 193-216.
    3. Alfonsina Iona & Leone Leonida, 2018. "Sample separation and the sensitivity of investment to cash flow: Is the monotonicity condition empirically satisfied?," Working Papers 862, Queen Mary University of London, School of Economics and Finance.
    4. Atul Gupta & Sabrina T Howell & Constantine Yannelis & Abhinav Gupta, 2024. "Owner Incentives and Performance in Healthcare: Private Equity Investment in Nursing Homes," The Review of Financial Studies, Society for Financial Studies, vol. 37(4), pages 1029-1077.
    5. Gao, Pengjie & Lee, Chang & Murphy, Dermot, 2022. "Good for your fiscal health? The effect of the affordable care act on healthcare borrowing costs," Journal of Financial Economics, Elsevier, vol. 145(2), pages 464-488.
    6. Ren, Junqiushi, 2023. "Financial conditions and incumbent quality responses to entry: Evidence from airlines' on-time performance," Journal of Air Transport Management, Elsevier, vol. 107(C).
    7. Lo, Andrew W. & Thakor, Richard T., 2023. "Financial intermediation and the funding of biomedical innovation: A review," Journal of Financial Intermediation, Elsevier, vol. 54(C).
    8. Yan He & Frank Long, 2020. "DCF Valuation of Nonprofit Universities," Applied Finance and Accounting, Redfame publishing, vol. 6(1), pages 1-8, February.
    9. Alfonsina Iona, 2019. "Modelling the Relation between Managers, Shadow Cost of External Finance and Corporate Investment," Mathematics, MDPI, vol. 7(11), pages 1-10, November.
    10. Nathan E. Wilson, 2021. "The Impact of Competition on Investment: Evidence From California Hospitals," Journal of Industrial Economics, Wiley Blackwell, vol. 69(1), pages 1-32, March.
    11. Matteo Binfarè & Kyle Zimmerschied, 2024. "The Role of Debt in Financing Higher Education," NBER Chapters, in: Financing Institutions of Higher Education, National Bureau of Economic Research, Inc.
    12. Jordan van Rijn & Shuwei Zeng & Paul Hellman, 2021. "Financial institution objectives and auto loan pricing: Evidence from the survey of consumer finances," Journal of Consumer Affairs, Wiley Blackwell, vol. 55(3), pages 995-1039, September.

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