Accounting Performance and Capacity Investment Decisions: Evidence from California Hospitals

Capacity decisions involve tradeoffs between the cost of capacity and the opportunity costs of lost sales. Accounting researchers posit that accounting performance provides sufficient information about these tradeoffs and thus can be used to formulate simple rules to assist capacity decisions. Empirical research has not examined the role of accounting information in capacity investment decisions at the department level in a multi-product firm in the presence of social costs. Empirical analyses using department-level data from California hospitals for the period 1998-2005 show that hospitals are more likely to make capacity investments in departments with high accounting performance. However, in the presence of demand variability, the association between accounting performance and capacity investment is attenuated because of the resulting increase in noise in accounting performance measures. Thus the weight on accounting performance as a decision tool for capital investments reduces when there is demand variability. Another factor that reduces the weight on accounting performance is capacity utilization. Higher capacity utilization can lead to turning away or rerouting of patients to other hospitals and negatively impacts reputation and quality of care, which increases the hospital’s social costs. Hence, hospitals do not require high accounting performance before investing in a department with high capacity utilization. This empirical evidence of the role of accounting performance in capacity investment decisions fills a gap in the capacity investment literature and furthers our understanding of the interactions between accounting performance and the operational determinants of firms’ capacity investment behavior.

[1]  William P. Rogerson,et al.  Intertemporal Cost Allocation and Investment Decisions , 2008, Journal of Political Economy.

[2]  Jan A. Van Mieghem,et al.  Commissioned Paper: Capacity Management, Investment, and Hedging: Review and Recent Developments , 2003, Manuf. Serv. Oper. Manag..

[3]  M. Porter Please Note Location of Nearest Exit , 1976 .

[4]  R. Hirth,et al.  Ownership, competition, and the adoption of new technologies and cost-saving practices in a fixed-price environment. , 2000, Inquiry : a journal of medical care organization, provision and financing.

[5]  R. Göx Discussion of “decentralized capacity management and internal pricing” , 2010 .

[6]  S. David Wu,et al.  Coordinating Strategic Capacity Planning in the Semiconductor Industry , 2003, Oper. Res..

[7]  Steven M. Fazzari,et al.  Financing Constraints and Corporate Investment , 1987 .

[8]  Raul Poler,et al.  Models for production planning under uncertainty: A review ☆ , 2006 .

[9]  D. Shepard,et al.  Analysis of Hospital Costs: A Manual for Managers , 2000 .

[10]  Henri Servaes,et al.  The Cost of Diversity : The Diversification Discount and Inefficient Investment , 1997 .

[11]  Rajiv D. Banker,et al.  Demand Uncertainty and Cost Behavior , 2014 .

[12]  Linus Schrage,et al.  OR Practice - A Scenario Approach to Capacity Planning , 1989, Oper. Res..

[13]  Bengt Holmstrom,et al.  Moral Hazard and Observability , 1979 .

[14]  M. Mccue,et al.  Association of Market, Operational, and Financial Factors with Nonprofit Hospitals' Capital Investment , 2008, Inquiry : a journal of medical care organization, provision and financing.

[15]  J. Alexander,et al.  Effects of market position and competition on rural hospital closures. , 1997, Health services research.

[16]  J. Michael Harrison,et al.  Multi-Resource Investment Strategies: Operational Hedging Under Demand Uncertainty , 1997, Eur. J. Oper. Res..

[17]  Canice Prendergast The Provision of Incentives in Firms , 1999 .

[18]  James Henderson,et al.  Learning to time capacity expansions: An empirical analysis of the worldwide petrochemical industry, 1975-95 , 2003 .

[19]  R. Banker,et al.  A Comparative Application of Data Envelopment Analysis and Translog Methods: An Illustrative Study of Hospital Production , 1986 .

[20]  Ranjani Krishnan The Effect of Changes in Regulation and Competition on Firms' Demand for Accounting Information , 2005 .

[21]  S. Zeger,et al.  Longitudinal data analysis using generalized linear models , 1986 .

[22]  Jan A. Van Mieghem,et al.  Risk Mitigation in Newsvendor Networks: Resource Diversification, Flexibility, Sharing, and Hedging , 2007, Manag. Sci..

[23]  B. Rustem,et al.  Robust capacity planning under uncertainty , 1991 .

[24]  R. McDaniel,et al.  Participation in Strategic Decision Making: The Role of Organizational Predisposition and Issue Interpretation* , 1998 .

[25]  D. A. Kenny,et al.  The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. , 1986, Journal of personality and social psychology.

[26]  Linda R Brewster,et al.  Does U.S. hospital capacity need to be expanded? , 2003, Health affairs.

[27]  M. Duggan,et al.  Hospital Ownership and Public Medical Spending , 2000 .

[28]  F. Fisher On the misuse of the profits-sales ratio to infer monopoly power , 1987 .

[29]  Richard A. Lambert,et al.  The prospective payment system, hospital efficiency, and compensation contracts for senior-level hospital administrators , 1995 .

[30]  Rajiv D. Banker,et al.  Product Costing and Pricing , 2016 .

[31]  R. Göx,et al.  Capacity Planning and Pricing Under Uncertainty , 2000 .

[32]  L. Guiso,et al.  Investment and Demand Uncertainty , 1999 .

[33]  J. Spetz,et al.  Managed Care and Medical Technology Growth , 1999 .

[34]  Ling Li,et al.  Hospital capacity management decisions: Emphasis on cost control and quality enhancement , 2003, Eur. J. Oper. Res..

[35]  E B Keeler,et al.  The changing effects of competition on non-profit and for-profit hospital pricing behavior. , 1999, Journal of health economics.

[36]  James Durbin,et al.  Errors in variables , 1954 .

[37]  M Susser,et al.  What is a cause and how do we know one? A grammar for pragmatic epidemiology. , 1991, American journal of epidemiology.

[38]  E. Fama,et al.  Agency Problems and Residual Claims , 1983 .

[39]  K. Sivaramakrishnan,et al.  A Critical Overview of the Use of Full‐Cost Data for Planning and Pricing , 2002 .

[40]  Martin Gaynor,et al.  Uncertain Demand, the Structure of Hospital Costs, and the Cost of Emptyhospital Beds , 1993, Journal of health economics.

[41]  Ryan LaFond,et al.  The Effect of SOX Internal Control Deficiencies on Firm Risk and Cost of Equity , 2008 .

[42]  L. Eldenburg,et al.  Public versus private governance: a study of incentives and operational performance , 2003 .

[43]  Poul Israelsen,et al.  Activity-based costing as a method for assessing the economics of modularization—A case study and beyond , 2006 .

[44]  W. D. White,et al.  Price and Concentration in Hospital Markets: The Switch from Patient-Driven to Payer-Driven Competition , 1993, The Journal of Law and Economics.

[45]  Deepika Nath,et al.  Measuring strategy coherence through patterns of strategic choices , 1994 .

[46]  S. H. Hsu Cost Information and Pricing: Empirical Evidence , 2004 .

[47]  Madhav V. Rajan,et al.  Depreciation Rules and the Relation Between Marginal and Historical Cost , 2009 .

[48]  Madhav V. Rajan,et al.  Cost Accounting: A Managerial Emphasis , 1972 .

[49]  P. Gertler,et al.  How the expansion of hospital systems has affected consumers. , 2005, Health affairs.

[50]  Is the Opportunity Cost of Idle Capacity Zero? Coase (1938)Versus Managerial Accounting Circa 2000 , 2001 .

[51]  Robert E. Verrecchia,et al.  Price versus Non‐Price Performance Measures in Optimal CEO Compensation Contracts , 2003 .

[52]  R. Voelker Mobile hospital raises questions about hospital surge capacity. , 2006, JAMA.

[53]  J. Hausman Specification tests in econometrics , 1978 .

[54]  M. Stano,et al.  Short-term fluctuations in hospital demand: implications for admission, discharge, and discriminatory behavior. , 2008, The Rand journal of economics.

[55]  Daron Acemoglu,et al.  Input and Technology Choices in Regulated Industries: Evidence from the Health Care Sector , 2006, Journal of Political Economy.

[56]  S. Reichelstein,et al.  Decentralized capacity management and internal pricing , 2010 .

[57]  E. Fama,et al.  Separation of Ownership and Control , 1983, The Journal of Law and Economics.

[58]  Anneliese M Gerland,et al.  Construction activity in U.S. hospitals. , 2006, Health affairs.

[59]  Andrew B. Abel Optimal Investment under Uncertainty , 1983 .

[60]  K. Sivaramakrishnan,et al.  CAPACITY PLANNING WITH DEMAND UNCERTAINTY , 1997 .

[61]  Theodore E. Keeler,et al.  Hospital Costs and Excess Bed Capacity: A Statistical Analysis , 1993 .

[62]  Rajiv D. Banker,et al.  Sensitivity, Precision, and Linear Aggregation of Signals for Performance Evaluation , 1989 .

[63]  P. Bromiley Testing a Causal Model of Corporate Risk Taking and Performance , 1991 .

[64]  De-Min Wu,et al.  Alternative Tests of Independence between Stochastic Regressors and Disturbances , 1973 .

[65]  S. H. Hsu Cost Information and Pricing: Empirical Evidence*: Cost Information and Pricing: Empirical Evidence , 2011 .

[66]  Gerald A. Feltham,et al.  Performance Measure Congruity and Diversity in Multi-Task Principal/Agent Relations , 2007 .

[67]  Paul L. Joskow,et al.  Digitized by the Internet Archive in 2011 with Funding from Boston Library Consortium Iviember Libraries Working Paper Department of Economics the Effects of Competition and Regulation on Hospital Bed Supply and the Reservation Quality of the Hospital , 2022 .

[68]  Srikant M. Datar,et al.  Balancing Performance Measures , 2001 .

[69]  H. White A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity , 1980 .

[70]  J. Hawkins Cost Accounting: A Managerial Emphasis , 2006 .

[71]  W. Lynk,et al.  Nonprofit Hospital Mergers and the Exercise of Market Power , 1995, The Journal of Law and Economics.

[72]  Rajiv D. Banker,et al.  An empirical analysis of manufacturing overhead cost drivers , 1995 .

[73]  R. Hasnain-Wynia,et al.  The effect of changes in hospital reimbursement on nurse staffing decisions at safety net and nonsafety net hospitals. , 2006, Health services research.

[74]  William J. Baumol,et al.  The Pig in the Python: Is Lumpy Capacity Investment Used and Useful? , 2002 .

[75]  Bala V. Balachandran,et al.  On the Efficiency of Cost-based Decision Rules for Capacity Planning , 1995 .

[76]  Arindam Tripathy,et al.  Use of precedent and antecedent information in strategic cost management , 2013 .

[77]  Richard J. Boucherie,et al.  Managing the overflow of intensive care patients , 2008, Eur. J. Oper. Res..

[78]  Guy David,et al.  The convergence between for-profit and nonprofit hospitals in the United States , 2003, International Journal of Health Care Finance and Economics.