Nonprofit Hospital Board Involvement in the Strategic Decision Process PDF Download
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Author: Steve Richard Andersen
Publisher:
ISBN:
Category : Nonprofit organizations
Languages : en
Pages : 232
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Book Description
Author: Steve Richard Andersen
Publisher:
ISBN:
Category : Nonprofit organizations
Languages : en
Pages : 232
Get Book Here
Book Description
Author: Kathryn J. Chang
Publisher:
ISBN:
Category :
Languages : en
Pages : 180
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Book Description
In this dissertation, I attempt to study the equilibrium behaviors of for-profit and nonprofit hospitals in a monopolistic competitive market, and to empirically test whether there is a measurable difference in board governance practices and strategic cost management approach across hospital ownership types. Chapter 1 offers a brief introduction to three manuscripts that analytically and empirically examine the relationship between ownership forms and hospital behaviors pertaining to board governance and strategic cost management. Chapter 2 develops a theoretical model to explain the equilibrium behavior and outcome of nonprofit hospitals as compared to for-profit hospitals in a monopolistic competitive market. I find that nonprofit hospitals tend to maximize quantity of services by offering a broad range of services at relatively low prices, irrespective of the ability of these hospitals to obtain additional funds and the size of the subsidy. However, subsidized hospitals are able to further lower price to attract more patients but still manage to break even. Moreover, nonprofit hospitals are relatively more efficient by maximizing economic welfare (the sum of consumer surplus and producer surplus) and operating at economies of scale. Such finding contradicts the conventional view that for-profit is a more efficient type of ownership form (Clarkson, 1972; Clark, 1980; Cutler and Horwitz, 2000) but is consistent with empirical findings that predominantly favor nonprofit hospitals (Rosenau 2003; Rosenau and Linder 2003; Schlesinger and Gray 2006). Therefore, this paper provides theoretical explanation for the performance paradox of nonprofit hospital. Three propositions derived from the model can be further developed into testable hypotheses for future empirical research. Chapter 3 empirically investigates the relationship between board / CEO turnover and hospital performance, as well as the incremental effects of ownership type on hospital board governance practices. It develops the hypotheses that claim the substandard performance increases board / CEO turnover and the propensity of boards using certain performance measures is different between for-profit and nonprofit hospitals. Departing from prior studies, this paper applies factor analysis to examine the usefulness of multiple financial and nonfinancial performance measures in estimating the determinants and factors leading to board / CEO turnover. Using a sample from California short-term general, acute care hospitals, I find that multiple financial and nonfinancial performance measures are useful accounting signals of board governance practices. Moreover, the sensitivity of boards toward certain performance measures is affected by hospital ownership status only in the CEO replacement decision. Chapter 4 empirically examines the influence of ownership on strategic cost management (SCM) and its performance consequences in the health care industry. Drawing upon the property rights theory and prior accounting literature, it develops the hypotheses that predict the ownership type would affect the extent to which the hospital strategically manages revenues and costs of operation, leading to improvement in financial performance. The results suggest that the ownership type does play a significant role in the choice of SCM strategies along the dimension of revenue-enhancing and cost reduction across a sample of U.S. hospitals. Moreover, there is strong evidence that the association between the extensive use of SCM strategy and hospital financial performance is a function of the "match" between SCM use and a hospital's ownership type, operating characteristic and market environment.
Author: Miriam M. Wood
Publisher: Jossey-Bass
ISBN:
Category : Business & Economics
Languages : en
Pages : 280
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Book Description
Offers detailed case studies that demonstrate the crucial strategic issues facing nonprofit governing boards and offers board members new methods for dealing with them.
Author: John P. McComb
Publisher: Jossey-Bass
ISBN:
Category : Business & Economics
Languages : en
Pages : 208
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Book Description
McComb draws on his more than 40 years of experience as a hospital trustee, consultant, and health care lawyer to provide a thorough overview of the many issues confronting health care executives, including planning and marketing, ensuring fiscal integrity, understanding the board's role in improving quality of care, knowing when and how to restructure, contending with the impact of managed care systems, and adopting alternative strategies for responding to reform proposals. Table of Contents: 1. The Crisis and the Challenge; 2. Understanding the Hospital Setting; 3. The Goals of Governance; 4. Voluntarism and the Nonprofit Corporation; 5. Recruiting and Retaining the CEO; 6. The Committee System of Governance; 7. Board Accountability and Limitations; 8. Responsibilities in Planning and Marketing; 9. Ensuring Fiscal Integrity; 10. Improving Quality for Patients and Staff; 11. Knowing When and How to Restructure; 12. The Impact of Shared Services and Managed Care; 13. Meeting the Challenge and Building Effective Boards.
Author: James R. Schwartz
Publisher: Jossey-Bass
ISBN: 9780787941772
Category : Health & Fitness
Languages : en
Pages : 0
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Book Description
The guide for decision makers, a how-to-do-it manual for everynonprofit hospital director in America. Our country's health carewill be much improved if directors buy and read this book. ?Phillip L. Isenberg, of counsel with the firm of Hyde, Miller,Owen & Trost, former California State Assemblyman and author ofCalifornia's law regulating the sale or joint venturing ofnonprofit hospitals with for-profits Health Care Alliances and Conversions provides nonprofit directors,trustees, and executives with practical advice for understandingthe numerous forms of conversions including the most controversialtype of transactions?joint ventures with for-profit chains. Inconcise and non-legal language, the authors explain directors'fiduciary duties in these complex conversion transactions. The bookclarifies nonprofit directors' and trustees' responsibilities tothe communities they serve and offers solid recommAndations on howto manage the conversion process without damaging reputations. Theauthors describe how to create marketing and valuation strategiesthat will meet the legal standards enforced by governmentregulators. This book is filled with easy-to-understand charts andtables, providing a summary of the legal duties that apply to thesecomplex transactions.
Author: Cathy A. Trower
Publisher: John Wiley & Sons
ISBN: 1118237366
Category : Business & Economics
Languages : en
Pages : 274
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Book Description
THE PRACTITIONER’S GUIDE TO GOVERNANCE AS LEADERSHIP The Practitioner’s Guide to Governance as Leadership offers a resource that shows how to achieve excellence and peak performance in the boardroom by putting into practice the groundbreaking model that was introduced in the book, Governance as Leadership. This proven model of effective governance explores how to attain proficiency in three governance modes or mindsets: fiduciary, strategic, and generative. Throughout the book, author Cathy Trower offers an understanding of the Governance as Leadership model through a wealth of illustrative examples of high-performing nonprofit boards. She explores the challenges of implementing governance as leadership and suggests ideas for getting started and overcoming barriers to progress. In addition, Trower provides practical guidance for optimizing the practices that will improve organizational performance including: flow (high skill and high purpose), discernment, deliberation, divergent thinking, insight, meaningfulness, consequence to the organization, and integrity. In short, the book is a combination of sophisticated thinking, instructive vignettes, illustrative documents, and practical recommendations. The book includes concrete strategies that can help improve critical thinking in the boardroom, a board’s overall performance as a team, as well as information for creating a strong governance culture and understanding what is required of an effective CEO and a chairperson. To determine a board’s fitness and help the members move forward, the book contains three types of assessments: board members evaluate each other; individual board member assessments; and an overall team assessment. This practitioner’s guide is written for nonprofit board members, chief executives, senior staff members, and anyone who wants to reflect on governance, discern how to govern better, and achieve higher performance in the process.
Author: Beth Gazley
Publisher: John Wiley & Sons
ISBN: 1118976746
Category : Business & Economics
Languages : en
Pages : 288
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Book Description
There has never been so much pressure on nonprofit boards ofdirectors to achieve a level of accountability that meets publicand stakeholder expectations. Member-serving association boards maybe especially challenged by their more complex affiliate structuresand a greater emphasis on representative governance. But what doesthe journey to good governance look like? Markedly different fromexisting board development books, this modern approach focuses lesson the behaviors and qualities of "high-performing boards" and moreon the stages and processes that directors and their staff used totransform their boards. Based on research funded by the ASAEFoundation, the book fills a gap in the governance literature byemphasizing diagnosis and problem solving, using the actual toolsand activities implemented by 85 transformed associations.Combining the credibility of scholarly research with lively andcompelling stories, tools, and teachable moments, this book isdesigned to help associations and other nonprofit organizationsachieve the entire journey to good governance, from first to laststeps.
Author: Gerard Magill
Publisher: Routledge
ISBN: 1000036332
Category : Medical
Languages : en
Pages : 220
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Book Description
Drawing on the findings of a series of empirical studies undertaken with boards of directors and CEOs in the United States, this groundbreaking book develops a new paradigm to provide a structured analysis of ethical healthcare governance. Governance Ethics in Healthcare Organizations begins by presenting a clear framework for ethical analysis, designed around basic features of ethics – who we are, how we function, and what we do – before discussing the paradigm in relation to clinical, organizational and professional ethics. It goes on to apply this framework in areas that are pivotal for effective governance in healthcare: oversight structures for trustees and executives, community benefit, community health, patient care, patient safety and conflicted collaborative arrangements. This book is an important read for all those interested in healthcare management, corporate governance and healthcare ethics, including academics, students and practitioners.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 9780309078559
Category : Medical
Languages : en
Pages : 163
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Book Description
This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1983-04 edition. Excerpt: ...compensated by hospitals are more often found in teaching hospitals than in nonteaching hospitals.20 They also are more common in for-profit hospitals than in voluntary hospitals.21 Systematic longitudinal data are not available, but a general reading of the literature and conversations with hospital administrators and medical staffs suggest that physician involvement in governing board activities, participation in committees, and hospital-based compensation arrangements is growing. For example, over the past five years a number of hospitals have added cost containment committees, medical equipment purchase committees, and strategic long-range planning committees, all with physician participation. Thus, there appears to be a growing trend toward the shared authority model of decision making described earlier or at least deliberate attempts to blur the clear demarcation suggested by the dual authority model. Some of the effects of these changes on the cost and quality of patient care are examined below. Hospital/Physician Decision Making and the Cost and Quality of Care The issue of hospital/physician decision making is important primarily as it affects the delivery of patient care services. The relevant question is whether certain patterns of decision making are associated with improvements in the cost-effectiveness of the care delivered. Present research does not provide a clear-cut answer in terms of cause and effect, but the majority of the existing evidence suggests consistent associations between greater physician involvement in hospital decision making and lower costs. Existing research also suggests consistent associations between greater physician participation and higher quality of care. There is little evidence that costs can be...
Author: Mary Alicia Powers
Publisher:
ISBN:
Category : Business planning
Languages : en
Pages : 297
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Book Description
Recently, scholars have shown greater interest in nonprofit organizations. More and more authors are documenting the need for nonprofit organizations to borrow from the management practices of the private sector. Strategic planning is one such practice. Most of the earlier research attempts to link strategic planning with nonprofit organizations have failed to provide the descriptive data necessary for a realistic account of an organization's planning efforts. The intent of this study was to document the strategic planning process conducted by a nonprofit Board of Directors and a public Commission and to describe the influence of the planning process on Board Members and Commissioners. The design of this study used a broad interpretation of action research and was enriched through participant observation. Data was collected during pre- and post-planning interviews with Board Members and Commissioners as well as Strategic Planning Committee meetings. Interview data was analyzed and presented. A narrative of the planning process was compiled in the genre of story telling for each participating organization. Among the conclusions drawn are the following: (a) the planning process is unique to each organization, (b) the product of the planning process is unique to each organization, (c) the planning process serves as an arena for valuable discussion, (d) the selection of the strategic planning committee and its chair is very important, (e) the planning process is a four-part process, (f) the full Board or Commission should be involved in the assessment and implementation phases of planning, (g) the majority of Board Members and Commissioners interviewed defined strategic planning as rational and linear, believed that strategic planning is equally beneficial in all sectors, believed that strategic planning is the responsibility of the Board or Commission (as opposed to staff), preferred using the services of a planning consultant, and believed that the entire Board or Commission must involved in theplanning process.
