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Institutional Drivers of Reporting Decisions in Nonprofit Hospitals

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  • RANJANI KRISHNAN
  • MICHELLE H. YETMAN

Abstract

We examine the influence of normative and regulative institutional factors on cost shifting by nonprofit hospitals in their publicly reported statements. We explore whether normative constraints imposed by stakeholders, who prefer that nonprofit hospitals allocate their resources toward patient‐related program services, influence the extent to which nonprofit hospitals shift costs toward program services and away from administrative and fundraising categories, thereby appearing more efficient. We also explore whether regulative factors, such as oversight, influence cost shifting behaviors. Results indicate that nonprofit hospitals facing higher normative pressures to demonstrate efficiency shift costs to a greater extent, and hospitals facing higher regulatory oversight shift costs to a lesser extent. Consistent with prior research, we also find that hospitals that obtain higher donations revenue shift costs to a greater extent. Our results show that, in addition to economic factors documented by prior literature, institutional factors also influence nonprofit hospitals’ cost shifting behaviors.

Suggested Citation

  • Ranjani Krishnan & Michelle H. Yetman, 2011. "Institutional Drivers of Reporting Decisions in Nonprofit Hospitals," Journal of Accounting Research, Wiley Blackwell, vol. 49(4), pages 1001-1039, September.
  • Handle: RePEc:bla:joares:v:49:y:2011:i:4:p:1001-1039
    DOI: 10.1111/j.1475-679X.2011.00413.x
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    1. David Dranove & Mark Shanley, 1995. "Cost reductions or reputation enhancement as motives for mergers: The logic of multihospital systems," Strategic Management Journal, Wiley Blackwell, vol. 16(1), pages 55-74.
    2. Eldenburg, Leslie & Vines, Cynthia C., 2004. "Nonprofit classification decisions in response to a change in accounting rules," Journal of Accounting and Public Policy, Elsevier, vol. 23(1), pages 1-22.
    3. Dranove, David, 1998. "Economies of scale in non-revenue producing cost centers: Implications for hospital mergers," Journal of Health Economics, Elsevier, vol. 17(1), pages 69-83, January.
    4. Michael C. Jensen, 2010. "The Modern Industrial Revolution, Exit, and the Failure of Internal Control Systems," Journal of Applied Corporate Finance, Morgan Stanley, vol. 22(1), pages 43-58, January.
    5. Covaleski, Mark A. & Dirsmith, Mark W. & Michelman, Jeffrey E., 1993. "An institutional theory perspective on the DRG framework, case-mix accounting systems and health-care organizations," Accounting, Organizations and Society, Elsevier, vol. 18(1), pages 65-80, January.
    6. Richard G. Frank & David S. Salkever, 1991. "The Supply of Charity Services by Nonprofit Hospitals: Motives and Market Structure," RAND Journal of Economics, The RAND Corporation, vol. 22(3), pages 430-445, Autumn.
    7. Posnett, John & Sandler, Todd, 1989. "Demand for charity donations in private non-profit markets : The case of the U.K," Journal of Public Economics, Elsevier, vol. 40(2), pages 187-200, November.
    8. M. Tina Dacin & Christine Oliver & Jean‐Paul Roy, 2007. "The legitimacy of strategic alliances: an institutional perspective," Strategic Management Journal, Wiley Blackwell, vol. 28(2), pages 169-187, February.
    9. Thorpe, Kenneth E & Phelps, Charles E, 1991. "The Social Role of Not-for-Profit Organizations: Hospital Provision of Charity Care," Economic Inquiry, Western Economic Association International, vol. 29(3), pages 472-484, July.
    10. Chang, Cyril F. & Steinbart, Paul J. & Tuckman, Howard P., 1993. "Are Medicare audits random or predictable?," Journal of Accounting and Public Policy, Elsevier, vol. 12(2), pages 135-154.
    11. Sansing, Richard, 1998. "The Unrelated Business Income Tax, Cost Allocation, and Productive Efficiency," National Tax Journal, National Tax Association, vol. 51(n. 2), pages 291-302, June.
    12. Ryan, Harley Jr. & Wiggins, Roy III, 2004. "Who is in whose pocket? Director compensation, board independence, and barriers to effective monitoring," Journal of Financial Economics, Elsevier, vol. 73(3), pages 497-524, September.
    13. Okten, Cagla & Weisbrod, Burton A., 2000. "Determinants of donations in private nonprofit markets," Journal of Public Economics, Elsevier, vol. 75(2), pages 255-272, February.
    14. Clemens, Bruce W. & Douglas, Thomas J., 2005. "Understanding strategic responses to institutional pressures," Journal of Business Research, Elsevier, vol. 58(9), pages 1205-1213, September.
    15. Eldenburg, Leslie & Kallapur, Sanjay, 1997. "Changes in hospital service mix and cost allocations in response to changes in Medicare reimbursement schemes," Journal of Accounting and Economics, Elsevier, vol. 23(1), pages 31-51, May.
    16. David L. Deephouse & Suzanne M. Carter, 2005. "An Examination of Differences Between Organizational Legitimacy and Organizational Reputation," Journal of Management Studies, Wiley Blackwell, vol. 42(2), pages 329-360, March.
    17. Weisbrod, Burton A. & Dominguez, Nestor D., 1986. "Demand for collective goods in private nonprofit markets: Can fundraising expenditures help overcome free-rider behavior?," Journal of Public Economics, Elsevier, vol. 30(1), pages 83-96, June.
    18. Mitchell A. Petersen, 2009. "Estimating Standard Errors in Finance Panel Data Sets: Comparing Approaches," The Review of Financial Studies, Society for Financial Studies, vol. 22(1), pages 435-480, January.
    19. Covaleski, Mark A. & Dirsmith, Mark W. & Samuel, Sajay, 2003. "Changes in the institutional environment and the institutions of governance: extending the contributions of transaction cost economics within the management control literature," Accounting, Organizations and Society, Elsevier, vol. 28(5), pages 417-441, July.
    20. Christine Oliver, 1997. "The Influence of Institutional and Task Environment Relationships on Organizational Performance: The Canadian Construction Industry," Journal of Management Studies, Wiley Blackwell, vol. 34(1), pages 99-124, January.
    21. Shijun Cheng & John Evans & Nandu Nagarajan, 2008. "Board size and firm performance: the moderating effects of the market for corporate control," Review of Quantitative Finance and Accounting, Springer, vol. 31(2), pages 121-145, August.
    22. John Child & Terence Tsai, 2005. "The Dynamic Between Firms’ Environmental Strategies and Institutional Constraints in Emerging Economies: Evidence from China and Taiwan," Journal of Management Studies, Wiley Blackwell, vol. 42(1), pages 95-125, January.
    23. Yermack, David, 1996. "Higher market valuation of companies with a small board of directors," Journal of Financial Economics, Elsevier, vol. 40(2), pages 185-211, February.
    24. Sansing, Richard, 1998. "The Unrelated Business Income Tax, Cost Allocation, and Productive Efficiency," National Tax Journal, National Tax Association;National Tax Journal, vol. 51(2), pages 291-302, June.
    25. Michael A. Hitt & David Ahlstrom & M. Tina Dacin & Edward Levitas & Lilia Svobodina, 2004. "The Institutional Effects on Strategic Alliance Partner Selection in Transition Economies: China vs. Russia," Organization Science, INFORMS, vol. 15(2), pages 173-185, April.
    26. Yetman, Michelle H. & Yetman, Robert J., 2003. "The Effect of Nonprofits' Taxable Activities on the Supply of Private Donations," National Tax Journal, National Tax Association;National Tax Journal, vol. 56(1), pages 243-258, March.
    27. Eldenburg, Leslie & Krishnan, Ranjani, 2003. "Public versus private governance: a study of incentives and operational performance," Journal of Accounting and Economics, Elsevier, vol. 35(3), pages 377-404, August.
    28. Michel Lander & Pursey Heugens, 2009. "Structure! Agency! (And Other Quarrels): Meta-Analyzing Institutional Theories of Organization," Post-Print hal-00623835, HAL.
    29. Scott D. Julian & Joseph C. Ofori‐Dankwa & Robert T. Justis, 2008. "Understanding strategic responses to interest group pressures," Strategic Management Journal, Wiley Blackwell, vol. 29(9), pages 963-984, September.
    30. Christine M. Chan & Takehiko Isobe & Shige Makino, 2008. "Which country matters? Institutional development and foreign affiliate performance," Strategic Management Journal, Wiley Blackwell, vol. 29(11), pages 1179-1205, November.
    31. Froot, Kenneth A., 1989. "Consistent Covariance Matrix Estimation with Cross-Sectional Dependence and Heteroskedasticity in Financial Data," Journal of Financial and Quantitative Analysis, Cambridge University Press, vol. 24(3), pages 333-355, September.
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    2. Homonoff, Tatiana & Spreen, Thomas Luke & St. Clair, Travis, 2020. "Balance sheet insolvency and contribution revenue in public charities," Journal of Public Economics, Elsevier, vol. 186(C).
    3. Dominic Cyr & Suzanne Landry & Anne Fortin, 2022. "Management of Charitable Program Expense Ratios in the Charity Sector," Australian Accounting Review, CPA Australia, vol. 32(1), pages 106-123, March.
    4. Jonas Heese, 2017. "The Role of Overbilling in Hospitals’ Earnings Management Decisions," Harvard Business School Working Papers 18-026, Harvard Business School.
    5. McDonald, Bruce D. III & Goodman, Christopher B, 2020. "The Truth about Honesty in the Nonprofit Sector," SocArXiv 48g5c, Center for Open Science.
    6. Maik Lachmann & Rouven Trapp & Felix Wenger, 2016. "Performance Measurement and Compensation Practices in Hospitals: An Empirical Analysis in Consideration of Ownership Types," European Accounting Review, Taylor & Francis Journals, vol. 25(4), pages 661-686, October.
    7. Arya, Anil & Mittendorf, Brian, 2015. "Career concerns and accounting performance measures in nonprofit organizations," Accounting, Organizations and Society, Elsevier, vol. 40(C), pages 1-12.
    8. Amanda Beck & Collin Gilstrap & Jordan Rippy & Brian Vansant, 2021. "Strategic reporting by nonprofit hospitals: an examination of bad debt and charity care," Review of Accounting Studies, Springer, vol. 26(3), pages 933-970, September.
    9. Amanda W. Beck, 2018. "Opportunistic financial reporting around municipal bond issues," Review of Accounting Studies, Springer, vol. 23(3), pages 785-826, September.
    10. Melvin A. Lamboy-Ruiz & James N. Cannon & Olena V. Watanabe, 2019. "Does State Community Benefits Regulation Influence Charity Care and Operational Efficiency in U.S. Non-profit Hospitals?," Journal of Business Ethics, Springer, vol. 158(2), pages 441-465, August.
    11. Lamboy-Ruiz, Melvin A. & Lien, Donald & Smith, Pamela C., 2021. "Nonprofit classification decisions in response to threshold-based charity care incentives," Advances in accounting, Elsevier, vol. 53(C).
    12. Eva Labro & Lorien Stice-Lawrence, 2020. "Updating Accounting Systems: Longitudinal Evidence from the Healthcare Sector," Management Science, INFORMS, vol. 66(12), pages 6042-6061, December.
    13. Dang, Canh Thien & Owens, Trudy, 2020. "Does transparency come at the cost of charitable services? Evidence from investigating British charities," Journal of Economic Behavior & Organization, Elsevier, vol. 172(C), pages 314-343.
    14. Yuan Tian & Chiako Hung & Peter Frumkin, 2020. "Breaking the nonprofit starvation cycle? An experimental test," Journal of Behavioral Public Administration, Center for Experimental and Behavioral Public Administration, vol. 3(1).
    15. Hofmann, Mary Ann & McSwain, Dwayne, 2013. "Financial disclosure management in the nonprofit sector: A framework for past and future research," Journal of Accounting Literature, Elsevier, vol. 32(1), pages 61-87.
    16. Hans B. Christensen & Eric Floyd & Mark Maffett, 2020. "The Only Prescription Is Transparency: The Effect of Charge-Price-Transparency Regulation on Healthcare Prices," Management Science, INFORMS, vol. 66(7), pages 2861-2882, July.
    17. Dominic Cyr & Suzanne Landry & Anne Fortin, 2023. "Financial Disclosure Management by Charitable Organisations: A Conceptual and Operational Framework," Australian Accounting Review, CPA Australia, vol. 33(1), pages 46-65, March.
    18. Cannon, James N. & Lamboy-Ruiz, Melvin A. & Watanabe, Olena V., 2022. "Ownership type and earnings management in U.S. hospitals," Advances in accounting, Elsevier, vol. 58(C).
    19. Koreff, Jared & Weisner, Martin & Sutton, Steve G., 2021. "Data analytics (ab) use in healthcare fraud audits," International Journal of Accounting Information Systems, Elsevier, vol. 42(C).

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