Converting Hospitals from Not-for-profit to For-profit Status

David Cutler and Jill R. Horwitz

No 6672, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: Over the past twenty-five years, about 330 (7 percent) of the country's 5,000 not-for-profit hospitals have converted to for-profit form This paper explores the causes and effects of conversions through two case studies -- Wesley Medical Center in Wichita, Kansas and the Columbia/HealthOne system in Denver, Colorado. We identify two primary explanations of why hospitals convert: financial concerns and board culture-perceived mission. Financial concerns are multifaceted and include expectations about future profits, anticipated problems servicing debt, and pessimism regarding the future of government reimbursement policies. The effects of these conversions are mixed. There are some efficiencies associated with conversions such as cost-cutting, increased access to capital, and debt-burden relief. However, profits are often derived from increasing reimbursement from the public sector. Further, conversions are likely to cause fragmentation of the hospital market between rich and poor. The results show that not-for-profit hospitals are likely to copy the undesirable behavior of for-profit hospitals in their markets.

Date: 1998-08
New Economics Papers: this item is included in nep-pub
Note: EH
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (25)

Published as The Changing Hospital Inudstry: Comparing Not-for-Profit and For-Profit Institutions, Cutler, David M., pp. 45-79, (National Bureau of Economics Research, 2000).

Downloads: (external link)
http://www.nber.org/papers/w6672.pdf (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:nbr:nberwo:6672

Ordering information: This working paper can be ordered from
http://www.nber.org/papers/w6672

Access Statistics for this paper

More papers in NBER Working Papers from National Bureau of Economic Research, Inc National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.. Contact information at EDIRC.
Bibliographic data for series maintained by ().