IDEAS home Printed from https://ideas.repec.org/a/inm/ormnsc/v66y2020i5p2083-2098.html
   My bibliography  Save this article

Debt and Bargaining Outcomes: Evidence from U.S. Hospitals

Author

Listed:
  • Mitch Towner

    (Eller College of Management, University of Arizona, Tucson, Arizona 85721)

Abstract

Using the healthcare industry as a novel laboratory, I study whether a firm’s use of debt enhances its bargaining power during negotiations with nonfinancial stakeholders. I find that reimbursement rates negotiated between a hospital and insurers for two homogeneous procedures are higher when the hospital has more debt. This relation is stronger among hospitals with less bargaining power relative to insurers ex ante. The evidence is consistent with the idea that debt improves a firm’s bargaining power.

Suggested Citation

  • Mitch Towner, 2020. "Debt and Bargaining Outcomes: Evidence from U.S. Hospitals," Management Science, INFORMS, vol. 66(5), pages 2083-2098, May.
    • Handle: RePEc:inm:ormnsc:v:66:y:2020:i:5:p:2083-2098
    DOI: 10.1287/mnsc.2019.3291
    as

    Download full text from publisher

    File URL: https://doi.org/10.1287/mnsc.2019.3291
    Download Restriction: no
    File URL: https://libkey.io/10.1287/mnsc.2019.3291?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Dasgupta, Sudipto & Nanda, Vikram, 1993. "Bargaining and brinkmanship : Capital structure choice by regulated firms," International Journal of Industrial Organization, Elsevier, vol. 11(4), pages 475-497.
    2. DeAngelo, Harry & DeAngelo, Linda, 1991. "Union negotiations and corporate policy *1: A study of labor concessions in the domestic steel industry during the 1980s," Journal of Financial Economics, Elsevier, vol. 30(1), pages 3-43, November.
    3. Kale, Jayant R. & Shahrur, Husayn, 2007. "Corporate capital structure and the characteristics of suppliers and customers," Journal of Financial Economics, Elsevier, vol. 83(2), pages 321-365, February.
    4. Efraim Benmelech & Nittai K. Bergman & Ricardo J. Enriquez, 2012. "Negotiating with Labor under Financial Distress," The Review of Corporate Finance Studies, Society for Financial Studies, vol. 1(1), pages 28-67.
    5. Titman, Sheridan, 1984. "The effect of capital structure on a firm's liquidation decision," Journal of Financial Economics, Elsevier, vol. 13(1), pages 137-151, March.
    6. Stephen G. Bronars & Donald R. Deere, 1991. "The Threat of Unionization, the Use of Debt, and the Preservation of Shareholder Wealth," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 106(1), pages 231-254.
    7. Wedig, Gerard J & Hassan, Mahmud & Morrisey, Michael A, 1996. "Tax-Exempt Debt and the Capital Structure of Nonprofit Organizations: An Application to Hospitals," Journal of Finance, American Finance Association, vol. 51(4), pages 1247-1283, September.
    8. Mitchell A. Petersen & Raghuram G. Rajan, 1995. "The Effect of Credit Market Competition on Lending Relationships," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 110(2), pages 407-443.
    9. Klasa, Sandy & Maxwell, William F. & Ortiz-Molina, Hernán, 2009. "The strategic use of corporate cash holdings in collective bargaining with labor unions," Journal of Financial Economics, Elsevier, vol. 92(3), pages 421-442, June.
    10. Matthew S. Lewis & Kevin E. Pflum, 2017. "Hospital systems and bargaining power: evidence from out-of-market acquisitions," RAND Journal of Economics, RAND Corporation, vol. 48(3), pages 579-610, August.
    11. Perotti, Enrico C & Spier, Kathryn E, 1993. "Capital Structure as a Bargaining Tool: The Role of Leverage in Contract Renegotiation," American Economic Review, American Economic Association, vol. 83(5), pages 1131-1141, December.
    12. David A. Matsa, 2010. "Capital Structure as a Strategic Variable: Evidence from Collective Bargaining," Journal of Finance, American Finance Association, vol. 65(3), pages 1197-1232, June.
    13. Hennessy, Christopher A. & Livdan, Dmitry, 2009. "Debt, bargaining, and credibility in firm-supplier relationships," Journal of Financial Economics, Elsevier, vol. 93(3), pages 382-399, September.
    14. Jensen, Michael C, 1986. "Agency Costs of Free Cash Flow, Corporate Finance, and Takeovers," American Economic Review, American Economic Association, vol. 76(2), pages 323-329, May.
    15. Israel, Ronen, 1991. "Capital Structure and the Market for Corporate Control: The Defensive Role of Debt Financing," Journal of Finance, American Finance Association, vol. 46(4), pages 1391-1409, September.
    16. Shantanu Banerjee & Sudipto Dasgupta & Yungsan Kim, 2008. "Buyer–Supplier Relationships and the Stakeholder Theory of Capital Structure," Journal of Finance, American Finance Association, vol. 63(5), pages 2507-2552, October.
    17. Chu, Yongqiang, 2012. "Optimal capital structure, bargaining, and the supplier market structure," Journal of Financial Economics, Elsevier, vol. 106(2), pages 411-426.
    18. Wedig, Gerard J., 1988. "Health status and the demand for health : Results on price elasticities," Journal of Health Economics, Elsevier, vol. 7(2), pages 151-163, June.
    19. Avi Dor & Michael Grossman & Siran M. Koroukian, 2004. "Hospital Transaction Prices and Managed-Care Discounting for Selected Medical Technologies," American Economic Review, American Economic Association, vol. 94(2), pages 352-356, May.
    20. Melnick, Glenn A. & Zwanziger, Jack & Bamezai, Anil & Pattison, Robert, 1992. "The effects of market structure and bargaining position on hospital prices," Journal of Health Economics, Elsevier, vol. 11(3), pages 217-233, October.
    21. A. J. Culyer & J. P. Newhouse (ed.), 2000. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, edition 1, volume 1, number 1.
    22. Elena Simintzi & Vikrant Vig & Paolo Volpin, 2015. "Labor Protection and Leverage," The Review of Financial Studies, Society for Financial Studies, vol. 28(2), pages 561-591.
    23. Mark Duggan, 2002. "Hospital Market Structure and the Behavior of Not-For-Profit Hospitals," RAND Journal of Economics, The RAND Corporation, vol. 33(3), pages 433-446, Autumn.
    24. Dasgupta, Sudipto & Sengupta, Kunal, 1993. "Sunk Investment, Bargaining and Choice of Capital Structure," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 34(1), pages 203-220, February.
    25. DeAngelo, H,, 1991. "Union Negotiation and Corporate Policy : A Study of Labor "Givebacks" in the Domestic Stel Industry During the 1980s," Papers 91-24, Southern California - School of Business Administration.
    26. Myers, Stewart C., 1977. "Determinants of corporate borrowing," Journal of Financial Economics, Elsevier, vol. 5(2), pages 147-175, November.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Sertsios, Giorgo, 2020. "Corporate finance, industrial organization, and organizational economics," Journal of Corporate Finance, Elsevier, vol. 64(C).
    2. Qiaohai (Joice) Hu, 2022. "Capital structure and supply chain capacity investment," Production and Operations Management, Production and Operations Management Society, vol. 31(7), pages 2822-2837, July.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Yongqiang Chu & Liying Wang, 2017. "Capital Structure Along the Supply Chain: How Does Customer Leverage Affect Supplier Leverage Decisions?," Quarterly Journal of Finance (QJF), World Scientific Publishing Co. Pte. Ltd., vol. 7(04), pages 1-29, December.
    2. Aney, Madhav S. & Appelbaum, Elie & Banerji, Sanjay, 2019. "Firm boundaries and financing with opportunistic stakeholder behaviour," Journal of Corporate Finance, Elsevier, vol. 56(C), pages 437-457.
    3. Oliveira, Mauro & Kadapakkam, Palani-Rajan & Beyhaghi, Mehdi, 2017. "Effects of customer financial distress on supplier capital structure," Journal of Corporate Finance, Elsevier, vol. 42(C), pages 131-149.
    4. David A. Matsa, 2018. "Capital Structure and a Firm’s Workforce," NBER Working Papers 25125, National Bureau of Economic Research, Inc.
    5. Kale, Jayant R. & Ryan, Harley E. & Wang, Lingling, 2019. "Outside employment opportunities, employee productivity, and debt discipline," Journal of Corporate Finance, Elsevier, vol. 59(C), pages 142-161.
    6. Schmalz, Martin, 2018. "Unionization, Cash, and Leverage," CEPR Discussion Papers 12595, C.E.P.R. Discussion Papers.
    7. Brett W. Myers & Alessio Saretto, 2016. "Does Capital Structure Affect the Behavior of Nonfinancial Stakeholders? An Empirical Investigation into Leverage and Union Strikes," Management Science, INFORMS, vol. 62(11), pages 3235-3253, November.
    8. Akyol, Ali C. & Verwijmeren, Patrick, 2013. "Human capital costs, firm leverage, and unemployment rates," Journal of Financial Intermediation, Elsevier, vol. 22(3), pages 464-481.
    9. Bernini, Michele & Guillou, Sarah & Bellone, Flora, 2015. "Financial leverage and export quality: Evidence from France," Journal of Banking & Finance, Elsevier, vol. 59(C), pages 280-296.
    10. Chino, Atsushi, 2016. "Do labor unions affect firm payout policy?: Operating leverage and rent extraction effects," Journal of Corporate Finance, Elsevier, vol. 41(C), pages 156-178.
    11. Woods, Keegan & Tan, Kelvin Jui Keng & Faff, Robert, 2019. "Labor unions and corporate financial leverage: The bargaining device versus crowding-out hypotheses," Journal of Financial Intermediation, Elsevier, vol. 37(C), pages 28-44.
    12. Qiaohai (Joice) Hu, 2022. "Capital structure and supply chain capacity investment," Production and Operations Management, Production and Operations Management Society, vol. 31(7), pages 2822-2837, July.
    13. Qianqian Huang & Ryoonhee Kim, 2019. "Capital structure decisions along the supply chain: Evidence from import competition," Journal of International Business Studies, Palgrave Macmillan;Academy of International Business, vol. 50(6), pages 873-894, August.
    14. Mauro Oliveira & Palani‐Rajan Kadapakkam, 2021. "Effects of customer horizontal merger on supplier capital structure decisions," International Review of Finance, International Review of Finance Ltd., vol. 21(4), pages 1464-1491, December.
    15. Ahmad, Muhammad Farooq & Kowalewski, Oskar, 2021. "Collective bargaining power and corporate cash policy," International Review of Law and Economics, Elsevier, vol. 68(C).
    16. Matthias Fahn & Valeria Merlo & Georg Wamser, 2019. "The Commitment Role of Equity Financing," Journal of the European Economic Association, European Economic Association, vol. 17(4), pages 1232-1260.
    17. Pagano, Marco, 2020. "Risk Sharing Within the Firm: A Primer," Foundations and Trends(R) in Finance, now publishers, vol. 12(2), pages 117-198, October.
    18. Li, Guangzhong & Wu, Cen & Zheng, Ying, 2020. "Employee protection and the tax sensitivity of wages: International evidence," Journal of International Financial Markets, Institutions and Money, Elsevier, vol. 66(C).
    19. Vincenzo Quadrini & Qi Sun, 2018. "Credit and Firm-Level Volatility of Employment," Journal of the European Economic Association, European Economic Association, vol. 16(5), pages 1433-1475.
    20. Dang, Viet A. & De Cesari, Amedeo & Phan, Hieu V., 2021. "Employment protection and share repurchases: Evidence from wrongful discharge laws," Journal of Corporate Finance, Elsevier, vol. 69(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:inm:ormnsc:v:66:y:2020:i:5:p:2083-2098. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Chris Asher (email available below). General contact details of provider: https://edirc.repec.org/data/inforea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.