Journal of Health Care Finance最新文献

Non-financial measures have found increasing acceptance in the business world--however, their application in the health care industry remains limited. The purpose of this article is to understand the influence of non-financial measures (efficiency, productivity, and quality) on the financial performance of for-profit system hospitals. The sample consists of 499 for-profit system hospitals in the United States from 1999 to 2002. Data analyzed include the American Hospital Association's Annual Survey, Medicare Cost Reports, Joint Commission's quality scores, and the Centers for Medicare & Medicaid Services' Hospital Case Mix Index. Dependent variables consist of financial measures (operating and total margins), while independent variables include measures of efficiency, productivity, and quality. Our results suggest the influence of non-financial performance measures on financial performance; occupancy rate positively influences financial performance while greater labor intensity may have negative implications for financial performance. In addition, we show that quality positively influences financial performance thereby offering a potential business case for quality. This result has important managerial and policy implications as it may incentivize capital and human resource investments required to improve hospital quality of care.

Over the past half decade, teleradiology companies have served as invaluable business partners to local radiology providers grappling with declining reimbursements, shrinking budgets, and an imaging utilization explosion that has rendered workloads unmanageable. The teleradiology business model has helped to stabilize local imaging groups through economies of scale to control costs, by facilitating rapid workflow and report turnaround times, and offering a broad range of subspecialty expertise. Teleradiology has landed radiology at an important crossroads and market forces are actively shaping its future. This article examines the role of technological innovation in teleradiology's success, and suggests that persistent technological and operational limitations raise important questions regarding quality of care. This article also joins the imaging industry's discussion as to whether radiology can be (or has been) commoditized, and explores the feasibility of the commoditization of imaging and its impact on traditional radiology practice. There appears to be an important role for teleradiology in the provision of radiology services going forward, and yet boundaries must be thoughtfully drawn in order to achieve best practices for the specialty's future. tion, commoditization.

We examine reverse mergers (RMs) in the biotechnology industry and find that, when compared to initial public offerings (IPOs), RMs are smaller, have significantly lower market valuations relative to size, and generally invest less. We also find that RMs exhibit positive abnormal returns on the announcement date and throughout the first year after the RM event. In looking at liquidity measures, we find that RMs tend to be less liquid than IPOs and that illiquidity is greater during the six-month lock-up period following the RM event. Thus, RMs may be an appropriate alternative financing vehicle in capital intensive, high-risk biotechnology companies which require accessing deeper and larger pools of investors in public capital markets across multiple milestone periods in a "pay for progress" environment.

Many not-for-profit (NFP) hospitals hold substantial cash reserves. Using a national sample of 608 NFP hospitals over the period 1996-1999, we related theories of cash holdings to NFP hospitals to develop a conceptual framework for understanding cash holdings. We tested whether these hospitals differentially managed operating and strategic cash with respect to establishing target balances and investigated motivations for holding cash. NFP hospitals actively targeted levels of operating cash, but did not target strategic cash balances. Strategic cash balances were positively related to profitability and growth in assets, but negatively associated with the use of debt.

Using a set of state-level longitudinal data from 1954 through 2005, this study investigates the "long-run equilibrium" relationship between cigarette excise taxes and the mortality rates of respiratory cancers in the United States. Statistical tests show that both cigarette excise taxes in real terms and mortality rates from respiratory cancers contain unit roots and are co-integrated. Estimates of co-integrating vectors indicated that a 10 percent increase in real cigarette excise tax rate leads to a 2.5 percent reduction in respiratory cancer mortality rate, implying a decline of 3,922 deaths per year, on a national level in the long run. These effects are statistically significant at the one percent level. Moreover, estimates of co-integrating vectors show that higher cigarette excise tax rates lead to lower mortality rates in most states; however, this relationship does not hold for Alaska, Florida, Hawaii, and Texas.

Many not-for-profit hospitals hold large portfolios of financial investments, making them vulnerable to fluctuations in market performance. This article examines the association of bond and equity market performance with investment in property, plant, and equipment by 194 not-for-profit general hospitals in California over the period 1997 to 2006. The study combines retrospective panel data from the California Office of Statewide Health Planning and Development with year-end returns on the S&P 500 and ten-year US Treasury bonds. Using fixed-effects regression, we find a significant positive association between S&P 500 performance and hospitals' capital investment; investment is not correlated with ten-year Treasury bond performance.

The US hospital service price structures are complex and tend to be significantly higher than the actual cost to provide the service. Health care consumers have been given more authority to drive health care decisions. Transparency in health care is forcing hospitals to critically review and substantiate service prices. It is vital that US hospitals review their pricing strategies in order to continue as strong leaders in the health care market.

This study aims to determine whether the Taiwanese government's implementation of new health care payment reforms (the National Health Insurance with fee-for-service (NHI-FFS) and global budget (NHI-GB)) has resulted in better cost containment. Also, the question arises under the agency theory whether the monitoring system is effective in reducing the risk of information asymmetry. This study uses panel data analysis with fixed effects model to investigate changes in cost containment at Taipei municipal hospitals before and after adopting reforms from 1989 to 2004. The results show that the monitoring system does not reduce information asymmetry to improve cost containment under the NHI-FFS. In addition, after adopting the NHI-GB system, health care costs are controlled based on an improved monitoring system in the policymaker's point of view. This may suggest that the NHI's fee-for-services system actually causes health care resource waste. The GB may solve the problems of controlling health care costs only on the macro side.

Aim: Academic research investigating health care costs in the Palestinian region is limited. Therefore, this study examines the costs of the cardiac catheterization unit of one of the largest hospitals in Palestine. We focus on costs of a cardiac catheterization unit and the increasing number of deaths over the past decade in the region due to cardiovascular diseases (CVDs).

Methods: We employ cost-volume-profit (CVP) analysis to determine the unit's break-even point (BEP), and investigate expected benefits (EBs) of Palestinian government subsidies to the unit.

Results: Findings indicate variable costs represent 56 percent of the hospital's total costs. Based on the three functions of the cardiac catheterization unit, results also indicate that the number of patients receiving services exceed the break-even point in each function, despite the unit receiving a government subsidy.

Conclusions: Our findings, although based on one hospital, will permit hospital management to realize the importance of unit costs in order to make informed financial decisions. The use of break-even analysis will allow area managers to plan minimum production capacity for the organization. The economic benefits for patients and the government from the unit may encourage government officials to focus efforts on increasing future subsidies to the hospital.