HETEROGENEOUS EFFECTS OF THE ACA MEDICAID EXPANSION ON HOSPITAL FINANCIAL OUTCOMES

This study examines the effect of the Affordable Care Act's Medicaid expansion on hospital financial outcomes. A key innovation relative to prior studies is that we explicitly account for heterogeneity across states in the timing and extent of the expansion as well as across hospital types. We find that Medicaid expansion led to a decrease in uncompensated care expenditures and an increase in average operating margins. The effects were larger in states where the Medicaid expansion led to a greater increase in program eligibility. Operating margins improved most for public hospitals and facilities located in rural areas. (JEL I11, I13, I18)     

The Morality of “new” CEO Activism

Journal of Business Ethics - CEOs’ social and environmental activism attracts significant public and research interest. Positioned as an expression of personal morality, such activism is...     

Accounting comparability and relative performance evaluation in CEO compensation

We investigate whether accounting comparability is associated with the likelihood that CEO compensation is tied to relative accounting performance (e.g., return on assets). We predict that higher accounting comparability increases the risk-sharing benefit of accounting-based RPE because peer firm performance better controls for common risk in RPE firm performance. Thus, firms that have higher accounting comparability with potential performance peers will be more likely to include accounting-based RPE as a component of the total CEO compensation contract. We find support for this prediction using (1) an explicit test design that relies on the ex ante terms of CEO compensation contracts obtained from proxy disclosures, and (2) an implicit design that relies on the actual realizations of CEO compensation. To provide further evidence, we examine the association between accounting comparability and the selection of performance peers when the CEO compensation contract includes an accounting-based RPE component. We find that higher comparability between the RPE firm and a potential peer firm increases (decreases) the potential peer firm’s likelihood of being selected into (dropped from) the peer group. Cross-sectional analyses show that this association is less pronounced, or not present, when the relative performance measure is price-based (as opposed to accounting-based), indicating that these results do not merely reflect a more general role of comparability in all RPE contracts.     

Embedding consumer culture in health and social care education – a university office's perspective

Health and social care services are changing – and this change is radical. Service user and carer involvement has been a key aspect of health and social care policy for a number of years. In terms of the National Health Service (NHS), this has been significantly strengthened by the report ‘High Quality Care for All’. The NHS will no longer be a monolith dictating what services it offers. It is beginning to take seriously the views of its consumers: the patients, service users and carers. The NHS is starting to put the patient experience at the centre of everything it does, and its regulators are asking for evidence of public and patient involvement. This process may yet prove to be one of the NHS' greatest challenges as it transforms to prioritize the consumer viewpoint. Social care, though further down the line in relation to involvement, is now responding to the relatively new personalization agenda. This paper will consider what the university sector can do to embed the consumer and service culture within the education of health and social care professionals. It looks at the challenges of involvement and required culture change, highlighting the key points to address in the early and middle stages of involvement from a university office's perspective. It includes examples of consumer involvement in teaching, assessment and the selection of students and how their input is starting to make a difference. Finally, the paper outlines what is needed in a development office to establish and support effective service user and carer involvement on health and social care courses in higher education. The article concludes by acknowledging that there is much more work that needs to be done in this field to embed the work of a development office, but that early steps have been promising.     

The nature of local area social exclusion in England and the role of the labour market

The creation of the Social Exclusion Unit by the present governmentin 1997 is just one example of the increased desire by bothacademics and policy-makers to understand more about the factorsthat lead to individuals and communities becoming excluded frommainstream society. Of the many aspects of social exclusionwhich have featured in recent debate, this article focuses ontwo. The first is to describe the nature and the extent of socialexclusion in the areas in which it is concentrated in the UnitedKingdom. The second is to examine the role that labour-marketfactors play in creating, reducing, or sustaining geographicalconcentrations of social exclusion. The article draws upon theresults of social surveys conducted in deprived areas and discussesthe arguments for tackling local concentrations of social exclusionthrough area-based initiatives.     

Convergence and divergence issues in strategic management – Indonesia's experience with the Balanced Scorecard in HR management

Globalization pressures escalate competitiveness and, in response, global companies tend to adopt a handful of Western management practices. One of these is the Balanced Scorecard. However, empirical evidence assessing the transferability and effectiveness of Western best practices into Asian countries is scarce. In particular, empirical evidence relating to the effectiveness of Balanced Scorecard implementations is limited, as is the impact of Asian Balanced Scorecard contextual variables. This article contributes to this gap through the study of a Central Bank of Indonesia (BI) Balanced Scorecard implementation within a conceptual framework that explores convergence and divergence of global management practices. The lessons learned discuss how divergent factors such as national culture, leadership styles, organizational culture and human resource management practices can influence Asian context Balanced Scorecard implementations.     

Agonism and the Possibilities of Ethics for HRM

This paper provides a critique and re-evaluation of the way that ethics is understood and promoted within mainstream Human Resource Management (HRM) discourse. We argue that the ethics located within this discourse focuses on bolstering the relevance of HRM as a key contributor to organizational strategy, enhancing an organization??s sense of moral legitimacy and augmenting organizational control over employee behaviour and subjectivity. We question this discourse in that it subordinates the ethics of the employment relationship to managerial prerogative. In response, we suggest a different model of the relationship between ethics and HRM??one that finds the possibility of ethics in the contestation and destabilization of HRM. Such ethics arises through resistance to moral normalization and the constraint of freedom and difference. The contribution of our paper is in theorising the possibilities of a relationship between ethics and HRM that does not place HRM at its centre, as chief intermediary of the ethics of the employment relationship, but rather sees HRM as being a powerful player in a set of what Mouffe calls ??agonistic?? socio-ethical relations.     

A framework for strategic decision making and performance among Chinese managers

This study develops an integrative model that explains the relationship between Chinese culture, managers' strategic decision making (SDM) processes, and organizational performance. For the study 1200 participants were randomly selected from a business club's company register, resulting in 204 valid respondents. The results highlighted two significant SDM paths used by managers: (1) the cognitive-speed path, which suggested that Overseas Chinese managers (the Chinese who live outside of Mainland China) focus on the big picture, draw analogies from past experiences, and use extensive networks to reduce the duration of the decision process; and (2) the social-political path which shows that Overseas Chinese managers focus on collective interests, strive to maintain harmony, and to save face while using a collaborative style to handle conflict; this approach reduces dysfunctional political behavior, while reinforcing the decision team's focus on common goals. From these results we concluded that a speedier decision making process (based on intuition, experience, and networks) accompanied by the appropriate use of political behavior (that created harmony, through a hierarchical structure, during conflict management) in the Overseas Chinese managers' strategic decision making process could positively influence organizational performance.