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Performance of risk-based models in value-based healthcare: Evidence from accountable care organizations 基于风险的模型在基于价值的医疗保健中的表现:来自负责任的医疗组织的证据
IF 4 2区 管理学 Q1 BUSINESS, FINANCE Pub Date : 2025-12-01 Epub Date: 2025-09-25 DOI: 10.1016/j.aos.2025.101614
Muktak Tripathi , Sezgin Ayabakan , Indranil Bardhan , Rajiv Banker
Prior studies on pay-for-performance programs in healthcare have yielded mixed results with respect to organizational performance. We study the rollout of Accountable Care Organizations (ACOs) under the Medicare Shared Savings Program (MSSP) and evaluate whether ACOs that switched from one-sided to two-sided risk models exhibit better performance based on cost savings and quality outcomes. Based on longitudinal analysis of data from ACOs that participated in the MSSP between 2013 and 2022, our results indicate that ACOs that switched to two-sided risk models exhibit 4.2 % greater generated savings, 1.7 % higher quality score, and 1.5 % greater shared savings, compared to ACOs that remained in the one-sided risk model. These improvements persist for at least two years after switching. Our results are robust to the potential for self-selection of ACOs into two-sided risk models and endogeneity concerns due to unobserved heterogeneity. We also observe improvements across four major quality sub-domains. Specifically, ACOs that switched to two-sided risk models exhibit significant improvements in preventive care, at-risk care, and beneficiary safety dimensions of patient health. In contrast, improvements in the quality of beneficiary care are relatively modest.
先前对医疗保健中绩效薪酬计划的研究在组织绩效方面产生了不同的结果。我们研究了医疗保险共享储蓄计划(MSSP)下的问责医疗组织(ACOs)的推出,并评估从单侧风险模型转换为双侧风险模型的ACOs是否在成本节约和质量结果的基础上表现得更好。基于对2013年至2022年间参与MSSP的ACOs数据的纵向分析,我们的结果表明,与仍在单侧风险模型中的ACOs相比,切换到双边风险模型的ACOs表现出4.2%的生产节约,1.7%的质量得分和1.5%的共享节约。这些改善在转换后至少持续两年。我们的研究结果表明,由于未观察到的异质性,ACOs可能会自我选择进入双边风险模型和内生性问题。我们还观察到四个主要质量子领域的改进。具体而言,转向双边风险模型的ACOs在预防保健、风险保健和患者健康的受益人安全方面表现出显著改善。相比之下,受益人护理质量的改善相对有限。
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引用次数: 0
Audit committee financial expertise, equity compensation and employee whistleblowing 审计委员会财务专业知识,股权薪酬和员工举报
IF 3.6 2区 管理学 Q1 BUSINESS, FINANCE Pub Date : 2025-12-01 Epub Date: 2025-07-26 DOI: 10.1016/j.aos.2025.101609
Gladys Lee
Motivated by the importance of effective oversight in mitigating the risks of employee external whistleblowing, this study investigates the effect of audit committee financial expertise and equity compensation on employee external whistleblowing. Drawing on theories of motivated reasoning and overconfidence, I propose that while audit committee financial expertise could enhance oversight, higher equity compensation can trigger cognitive biases that lead audit committee members to overestimate their monitoring effectiveness and discount or overlook the risks in internal reports of wrongdoing, increasing employee external whistleblowing. Using a sample of U.S. listed firms involved in misconduct, I find that greater audit committee financial expertise is associated with lower levels of employee external whistleblowing when audit committee equity compensation is low, but with higher levels of employee external whistleblowing when equity compensation is high. These findings suggest that audit committee equity compensation may undermine the benefits of financial expertise, offering new insights into the unintended consequences of governance and compensation practices.
基于有效监督对于降低员工外部举报风险的重要性,本研究考察了审计委员会财务专业知识和股权薪酬对员工外部举报的影响。根据动机推理和过度自信理论,我提出,虽然审计委员会的财务专业知识可以加强监督,但更高的股权薪酬可能引发认知偏见,导致审计委员会成员高估其监督有效性,低估或忽视内部不当行为报告中的风险,从而增加员工的外部举报。以涉及不当行为的美国上市公司为样本,我发现,当审计委员会股权薪酬较低时,审计委员会财务专业知识水平越高,员工外部举报水平越低,而当股权薪酬较高时,员工外部举报水平越高。这些发现表明,审计委员会股权薪酬可能会削弱财务专业知识的好处,为治理和薪酬实践的意外后果提供了新的见解。
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引用次数: 0
Inconsistent responses to uncooperative client manager behavior: When auditors’ judgments and actions diverge 对不合作客户经理行为的不一致反应:当审计师的判断和行动出现分歧时
IF 3.6 2区 管理学 Q1 BUSINESS, FINANCE Pub Date : 2025-06-01 Epub Date: 2025-05-02 DOI: 10.1016/j.aos.2025.101593
Michael A. Ricci, Dan Rimkus
Auditors frequently encounter uncooperative clients that make evidence collection more difficult, but prior research points to conflicting perspectives on auditor reactions to this behavior. To add clarity, we conduct four studies. In Study 1, we predict and find that staff auditors increase their skeptical judgments in response to uncooperative clients, but also decrease their skeptical actions, creating an inconsistency that contradicts the audit risk model. We also find that the inconsistency is driven by participant concerns that taking actions against uncooperative clients will induce anxiety. In Study 2, we replicate these results, but also find that the inconsistency is reduced when actions require less interpersonal contact with the uncooperative client. A third experiment (Study 3) and an accompanying survey (Study 4) indicate that client personnel, especially those with more experience, anticipate staff auditor responses to less cooperative behavior and exploit these responses when misreporting or attempting to avoid auditor scrutiny. Altogether, this paper develops theory about inconsistent auditor reactions to uncooperative clients, has methodological implications, and is relevant to practitioners concerned about inconsistency between auditor judgment and action.
审计师经常遇到不合作的客户,这使得证据收集变得更加困难,但先前的研究指出了审计师对这种行为的反应的相互矛盾的观点。为了更加清晰,我们进行了四项研究。在研究1中,我们预测并发现,员工审计人员在面对不合作客户时,会增加怀疑判断,但也会减少怀疑行为,从而产生与审计风险模型相矛盾的不一致。我们还发现,这种不一致是由参与者担心对不合作的客户采取行动会引起焦虑所驱动的。在研究2中,我们重复了这些结果,但也发现当行动需要与不合作的客户进行较少的人际接触时,不一致性就会减少。第三个实验(研究3)和附带的调查(研究4)表明,客户人员,特别是那些经验更丰富的人员,预期员工审计师对不太合作的行为的反应,并在误报或试图逃避审计师审查时利用这些反应。总之,本文发展了关于审计师对不合作客户的不一致反应的理论,具有方法论意义,并且与关注审计师判断和行动之间不一致的从业者相关。
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引用次数: 0
The effects of performance-based incentive frequency on collusion 绩效激励频率对串谋行为的影响
IF 3.6 2区 管理学 Q1 BUSINESS, FINANCE Pub Date : 2025-06-01 Epub Date: 2025-02-17 DOI: 10.1016/j.aos.2025.101591
Ashley K. Sauciuc
A common set of problematic conditions exist across many of the most egregious cases of collusion in recent decades (e.g., Enron, WorldCom, Wells Fargo), including weak internal control systems, intense pressure to reach nearly impossible targets, and social pressure that encourages employees to trade their own morals to conform with group norms. I capture this core set of conditions in a carefully designed laboratory experiment to examine whether and how an important element of compensation contracting—incentive frequency—may foster adverse norms. Specifically, I predict and find that incentive frequency influences how individuals rationalize collusion, thereby affecting the reporting norms that develop within groups. Groups with relatively infrequent incentives oscillate between collusion and truthful reporting, consistent with moral licensing behavior; whereas frequent incentives produce a spillover effect whereby collusion persists, consistent with ethical erosion. These results have important implications for compensation design and the use of management control systems.
近几十年来,在许多令人震惊的共谋案件中(例如,安然、世通、富国银行),存在着一系列共同的问题条件,包括薄弱的内部控制系统,实现几乎不可能实现的目标的巨大压力,以及鼓励员工牺牲自己的道德来遵守群体规范的社会压力。我在一个精心设计的实验室实验中捕捉到了这组核心条件,以检验薪酬契约的一个重要因素——激励频率——是否以及如何可能助长不利的规范。具体而言,我预测并发现激励频率影响个人如何合理化串通,从而影响群体内部发展的报告规范。动机相对较少的群体在串通和如实报道之间摇摆,符合道德许可行为;然而,频繁的激励会产生溢出效应,从而导致串通行为持续存在,这与道德侵蚀是一致的。这些结果对薪酬设计和管理控制系统的使用具有重要意义。
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引用次数: 0
The power of small talk: How small talk and psychological ownership influence managers’ communication defensiveness during audit inquiry 闲聊的力量:闲聊和心理所有权如何影响审计询问中管理者的沟通防御
IF 3.6 2区 管理学 Q1 BUSINESS, FINANCE Pub Date : 2025-06-01 Epub Date: 2025-04-09 DOI: 10.1016/j.aos.2025.101592
Nikki L. MacKenzie , Christopher P. Agoglia
The audit process requires frequent communication between auditors and client managers. Often, the most knowledgeable managers are involved in the work relating to an audit inquiry. As such, they may feel a sense of “ownership” over the related work. When threatened, psychological ownership can cause individuals to behave defensively, which may pose a challenge for auditors. Theory suggests that how auditors begin these inquiries (e.g., using small talk) may influence managers' behavior. Through two experiments, we find that managers with higher psychological ownership are more likely to respond defensively to an audit inquiry relating to a potential inventory obsolescence issue. Additionally, we find that the use of professional small talk magnifies managers’ defensive responses and some evidence that social small talk helps mitigate defensive responses. Further, small talk improves the perceived rapport between the manager and the auditor, compared to no small talk.
审计过程需要审核员和客户经理之间的频繁沟通。通常,最有见识的管理人员会参与审计调查的相关工作。因此,他们可能会对相关工作有一种“所有权”感。当受到威胁时,心理上的所有权会导致个人采取防御行为,这可能会对审计人员构成挑战。理论表明,审计师如何开始这些询问(例如,使用闲聊)可能会影响管理者的行为。通过两个实验,我们发现具有较高心理所有权的管理者更有可能对与潜在库存过时问题相关的审计询问做出防御性反应。此外,我们发现,使用专业闲聊放大了管理者的防御反应,一些证据表明,社交闲聊有助于减轻防御反应。此外,与没有闲聊相比,闲聊可以改善经理和审计师之间的关系。
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引用次数: 0
The entrainment cycle: Understanding professionals’ compliance with extreme work hours in professional service firms 娱乐周期:了解专业服务公司的专业人员对极端工作时间的依从性
IF 3.6 2区 管理学 Q1 BUSINESS, FINANCE Pub Date : 2025-06-01 Epub Date: 2025-05-21 DOI: 10.1016/j.aos.2025.101597
Ioana Lupu, Shanming Liu
Extreme work hours in professional service firms (PSFs) are often attributed to organizational control mechanisms such as time sheets, utilization targets, and performance evaluations. This paper introduces the concept of the entrainment cycle to explore how these controls foster professionals' compliance with extreme work patterns. The entrainment cycle explains how individuals become continuously synchronized with the collective rhythm of the organization. Drawing on 159 interviews with 81 professionals across two PSFs, the study explores how formal and normative controls synchronize individuals with the fast-paced organizational tempo. The findings reveal how bureaucratic and cultural entrainment mechanisms contribute to synchronization. Moreover, emotions and bodily responses play a critical role in making professionals internalize the organization's rhythms. Periods of synchronization trigger positive feedback loops in which heightened emotions and bodily responses reinforce individuals' attachment to work. These synchronized periods contrast with moments of desynchronization in which professionals experience negative feedback loops characterized by guilt, anxiety, and physical withdrawal symptoms. The bodily and emotional mechanisms this study reveals reinforce professionals' synchronization with collective rhythms, locking them into an entrainment cycle that perpetuates long hours and ever-intensifying work. This study offers new insights into how controls affect individuals and organizations in significant, far-reaching, and often unobtrusive ways.
专业服务公司(psf)的极端工作时间通常归因于组织控制机制,如时间表、利用目标和绩效评估。本文介绍了娱乐周期的概念,以探索这些控制如何培养专业人员对极端工作模式的遵从性。夹带循环解释了个人如何不断地与组织的集体节奏同步。通过对两个psf中81名专业人士的159次访谈,该研究探讨了正式和规范的控制如何使个人与快节奏的组织节奏同步。研究结果揭示了官僚主义和文化娱乐机制是如何促进同步的。此外,情绪和身体反应在使专业人员内化组织节奏方面发挥着关键作用。同步的周期会引发积极的反馈循环,在这种循环中,高涨的情绪和身体反应会加强个人对工作的依恋。这些同步的时期与不同步的时刻形成对比,在不同步的时刻,专业人士会经历以内疚、焦虑和身体戒断症状为特征的负反馈循环。这项研究揭示的身体和情感机制加强了专业人士与集体节奏的同步,将他们锁定在一个长时间、高强度工作的娱乐循环中。这项研究提供了新的见解,了解控制如何以重要的、深远的、通常不引人注目的方式影响个人和组织。
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引用次数: 0
The effects of a supportive learning culture and rank on professional skepticism in information search 支持性学习文化和等级对信息搜索专业怀疑态度的影响
IF 3.6 2区 管理学 Q1 BUSINESS, FINANCE Pub Date : 2025-06-01 Epub Date: 2025-01-25 DOI: 10.1016/j.aos.2025.101590
Therese Grohnert , Wim H. Gijselaers , Roger H.G. Meuwissen , Ken T. Trotman
Auditors at all ranks should be skeptical when searching for information throughout audits. However, we lever domain learning theory from educational psychology to posit that their skepticism unlikely develops evenly across ranks, but rather depends on a supportive learning culture, a construct from the management literature. To test that perceived learning culture moderates the association between auditor rank and skeptical information search, we use a laboratory study with 166 Dutch auditors at a Big 4 firm and follow-up interviews with seven top leaders of that firm. A more supportive perceived learning culture is associated with more skeptical information search, but only in audit managers and partners - not in associates and seniors. Interviewees attribute this pattern to values acquired over time through socialization, role expectations, knowledge development, and wider task characteristics.
在整个审计过程中寻找信息时,各级审计员都应该持怀疑态度。然而,我们利用教育心理学的领域学习理论,假设他们的怀疑主义不可能在各个阶层中均匀发展,而是取决于一种支持性的学习文化,这是一种来自管理文献的构建。为了检验感知学习文化是否调节了审计师级别与怀疑信息搜索之间的关系,我们对一家四大会计师事务所的166名荷兰审计师进行了实验室研究,并对该公司的7位高层领导人进行了后续访谈。一个更支持性的感知学习文化与更怀疑的信息搜索相关,但只在审计经理和合伙人中,而不是在助理和高级职员中。受访者将这种模式归因于随着时间的推移通过社会化、角色期望、知识发展和更广泛的任务特征获得的价值观。
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引用次数: 0
Gender diversity performance and voluntary disclosure: Mind the (gender pay) gap 性别多样性绩效和自愿披露:注意(性别薪酬)差距
IF 3.6 2区 管理学 Q1 BUSINESS, FINANCE Pub Date : 2025-06-01 Epub Date: 2025-05-26 DOI: 10.1016/j.aos.2025.101594
June Huang , Shirley Lu
We study whether voluntary gender diversity disclosure is predictive of gender diversity performance. Exploiting a mandate in the United Kingdom that requires firms to disclose 2017 gender pay gap (“GPG”) data for the first time, we find that providing voluntary gender diversity disclosure in 2016 is correlated with having a worse gender pay gap in 2017. Our results are concentrated in industries with worse gender diversity reputations, consistent with legitimacy theory, where firms facing more public pressure use voluntary disclosure to help legitimize their reputations. We further examine whether this disclosure reflects a firm's intent to improve its gender diversity performance over time. We find that forward-looking disclosures, such as gender diversity targets, are positively associated with GPG improvement from 2017 to 2019. Collectively, these gender pay gap findings shed light on how voluntary ESG disclosure can be used to predict current and future ESG performance.
我们研究自愿性别多样性披露是否预测性别多样性绩效。利用英国首次要求企业披露2017年性别薪酬差距(“GPG”)数据的授权,我们发现,2016年提供自愿性别多样性披露与2017年性别薪酬差距加剧相关。我们的研究结果集中在性别多样性声誉较差的行业,这与合法性理论相一致,在这些行业中,面临更多公众压力的公司使用自愿披露来帮助其声誉合法化。我们进一步研究这种披露是否反映了公司随着时间的推移改善其性别多样性绩效的意图。我们发现,从2017年到2019年,性别多样性目标等前瞻性披露与GPG改善呈正相关。总的来说,这些性别薪酬差距调查结果揭示了如何利用自愿ESG披露来预测当前和未来的ESG绩效。
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引用次数: 0
The effect of different approaches to administering a fixed wage raise on employee productivity 管理固定加薪的不同方法对员工生产力的影响
IF 3.6 2区 管理学 Q1 BUSINESS, FINANCE Pub Date : 2025-06-01 Epub Date: 2024-12-13 DOI: 10.1016/j.aos.2024.101587
Chad Stefaniak , Bryan Stikeleather , Nathan Waddoups
Firms frequently implement pay increases as a critical part of the management control system. We investigate how controllable factors related to the timing of such increases affect employee productivity. In practice, significant variation exists between when firms (i) announce a pay increase, (ii) quantify it, and (iii) make it effective. These events can occur concurrently (i.e., in the same pay period) or sequentially at different points in time (i.e., spread across several pay periods). We posit that varying the temporal separation of these events can affect employees’ effort and pattern of productivity. Via an experiment, we find employees respond to concurrent pay increases by initially providing high levels of effort that nonetheless diminishes significantly over time. In contrast, we find that they respond to sequential pay increases with a smaller but more persistent increase in effort, leading to equivalent levels of total output at a lower total compensation cost. However, our study also documents that employees have less satisfaction with the timing of the raise for sequential compared to concurrent raises. Our study provides insights for theory and practice regarding the benefits and costs of concurrent versus sequential raises.
公司经常把增加工资作为管理控制系统的一个关键部分来实施。我们研究了与这种增加的时间相关的可控因素如何影响员工的生产力。在实践中,企业(i)宣布加薪,(ii)量化加薪,以及(iii)使加薪生效之间存在显著差异。这些事件可以同时发生(即,在同一工资期),也可以在不同的时间点依次发生(即,分布在几个工资期)。我们假设改变这些事件的时间分离可以影响员工的努力和生产力模式。通过一项实验,我们发现员工对同时加薪的反应是,最初会付出高水平的努力,但随着时间的推移,这种努力会显著减少。相比之下,我们发现他们对连续加薪的反应是较小但更持久的努力增加,从而在较低的总补偿成本下达到相同的总产出水平。然而,我们的研究也表明,与同期加薪相比,员工对连续加薪时间的满意度较低。我们的研究为并行加薪与连续加薪的利弊提供了理论和实践的见解。
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引用次数: 0
What makes a rating useable? Shifting epistemic practices in the ESG rating field 是什么让评级有用?ESG评级领域认知实践的转变
IF 3.6 2区 管理学 Q1 BUSINESS, FINANCE Pub Date : 2025-06-01 Epub Date: 2025-05-21 DOI: 10.1016/j.aos.2025.101598
Michelle van Weeren , Clarence Bluntz
In the last three decades, a new field has emerged around the production and consumption of ratings seeking to reflect corporate performance concerning environmental, social, and governance (ESG) matters. By studying the production and transformation of a rating in this field, we contribute to recent discussions about “cultural fields of accounting”, where calculative innovations are developed by entities operating beyond formal rules or regulations. We analyze how an ESG rating agency tried to set a standard for a “holistic” ESG rating, while interactions between the agency and diverse field actors led to the shifting and hybridizing of logics underlying its rating practices. Building on the literature on production and consumption thinking in epistemic practice, we analyze how the agency transformed its rating from an “accurate” representation of sustainability performance to a useable reference for market actors. This shift provoked an acceleration of epistemic processes, a hollowing-out of analysts' judgment, and a progressive evaporation of their faith in the ratings' potential to disrupt existing investment practices. We discuss the implications of our findings for a better understanding of rating processes and their effects on the transformative potential of ESG ratings, which are ultimately shaped by investors’ preferences. Our case also hints at potential starting points for the diffusion of alternative logics in market-based accounting fields through a hybrid epistemic approach.
在过去的三十年里,围绕评级的生产和消费出现了一个新的领域,旨在反映企业在环境、社会和治理(ESG)方面的表现。通过研究该领域评级的产生和转换,我们为最近关于“会计文化领域”的讨论做出了贡献,其中计算创新是由超越正式规则或法规的实体开发的。我们分析了一家ESG评级机构如何试图为“整体”ESG评级设定标准,而该机构与不同领域参与者之间的互动导致了其评级实践背后逻辑的转变和混杂。基于认识论实践中关于生产和消费思维的文献,我们分析了该机构如何将其评级从可持续性绩效的“准确”代表转变为市场参与者的可用参考。这种转变引发了认知过程的加速,分析师判断的空心化,以及他们对评级可能破坏现有投资实践的信心的逐渐消失。我们讨论了我们的研究结果对更好地理解评级过程及其对ESG评级变革潜力的影响的影响,这些评级最终由投资者的偏好决定。我们的案例还暗示了通过混合认知方法在以市场为基础的会计领域传播替代逻辑的潜在起点。
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引用次数: 0
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Accounting Organizations and Society
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