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How do Hospitals Respond to Negative Financial Shocks? The Impact of the 2008 Stock Market Crash

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  • David Dranove
  • Craig Garthwaite
  • Christopher Ody

Abstract

The theory of cost-shifting posits that nonprofit hospitals respond to negative financial shocks by raising prices for privately insured patients. We examine how hospitals responded to the sharp reductions in their endowments caused by the 2008 stock market collapse. We find that the average hospital did not engage in cost-shifting, but average hospitals that likely have substantial market power did cost-shift. Investigating further how hospitals responded to the financial setback, we found no evidence of reductions in treatment costs. However, hospitals with large endowment losses delayed purchases of health information technology and curtailed the offering of unprofitable services.

Suggested Citation

  • David Dranove & Craig Garthwaite & Christopher Ody, 2013. "How do Hospitals Respond to Negative Financial Shocks? The Impact of the 2008 Stock Market Crash," NBER Working Papers 18853, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:18853
    Note: HC HE IO PE
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    References listed on IDEAS

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    1. Jeffrey R. Brown & Stephen G. Dimmock & Jun-Koo Kang & Scott J. Weisbenner, 2014. "How University Endowments Respond to Financial Market Shocks: Evidence and Implications," American Economic Review, American Economic Association, vol. 104(3), pages 931-962, March.
    2. Stein, Jeremy C, 1997. " Internal Capital Markets and the Competition for Corporate Resources," Journal of Finance, American Finance Association, vol. 52(1), pages 111-133, March.
    3. Zuckerman, Stephen, 1987. "Commercial insurers and all-payer regulation : Evidence on hospitals' responses to financial need," Journal of Health Economics, Elsevier, vol. 6(3), pages 165-187, September.
    4. Leemore Dafny, 2009. "Estimation and Identification of Merger Effects: An Application to Hospital Mergers," Journal of Law and Economics, University of Chicago Press, vol. 52(3), pages 523-550, August.
    5. Gaynor, Martin & Town, Robert J., 2011. "Competition in Health Care Markets," Handbook of Health Economics, Elsevier.
    6. Joseph Farrell & Severin Borenstein, 2000. "Is Cost-Cutting Evidence of X-Inefficiency?," American Economic Review, American Economic Association, vol. 90(2), pages 224-227, May.
    7. David Dranove & Chris Forman & Avi Goldfarb & Shane Greenstein, 2014. "The Trillion Dollar Conundrum: Complementarities and Health Information Technology," American Economic Journal: Economic Policy, American Economic Association, vol. 6(4), pages 239-270, November.
    8. Jack Zwanziger & Glenn A. Melnick & Anil Bamezai, 2000. "Can cost shifting continue in a price competitive environment?," Health Economics, John Wiley & Sons, Ltd., vol. 9(3), pages 211-226.
    9. Dranove, David, 1988. "Pricing by non-profit institutions : The case of hospital cost-shifting," Journal of Health Economics, Elsevier, vol. 7(1), pages 47-57, March.
    10. Ballou, Jeffrey P. & Weisbrod, Burton A., 2003. "Managerial rewards and the behavior of for-profit, governmental, and nonprofit organizations: evidence from the hospital industry," Journal of Public Economics, Elsevier, vol. 87(9-10), pages 1895-1920, September.
    11. Gautam Gowrisankaran & Robert J. Town, 1997. "Dynamic Equilibrium in the Hospital Industry," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 6(1), pages 45-74, March.
    12. Cone, Kenneth R & Dranove, David, 1986. "Why Did States Enact Hospital Rate-Setting Laws?," Journal of Law and Economics, University of Chicago Press, vol. 29(2), pages 287-302, October.
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    Cited by:

    1. Dranove, David & Garthwaite, Craig & Li, Bingyang & Ody, Christopher, 2015. "Investment subsidies and the adoption of electronic medical records in hospitals," Journal of Health Economics, Elsevier, vol. 44(C), pages 309-319.
    2. Cooper, Zack & Craig, Stuart & Gaynor, Martin & Van Reenen, John, 2015. "The price ain’t right? hospital prices and healthspending on the privately insured," LSE Research Online Documents on Economics 66059, London School of Economics and Political Science, LSE Library.
    3. David Dranove & Craig Garthwaite & Bingyang Li & Christopher Ody, 2014. "Investment Subsidies and the Adoption of Electronic Medical Records in Hospitals," NBER Working Papers 20553, National Bureau of Economic Research, Inc.

    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L0 - Industrial Organization - - General
    • L21 - Industrial Organization - - Firm Objectives, Organization, and Behavior - - - Business Objectives of the Firm

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