Commercialism in nonprofit hospitals

The private nonprofit hospital is the dominant organizational form in the U.S. hospital industry. Various reasons have been advanced for its high market share. As hospitals undergo massive changes due in large part to changes in payment practices, there is widespread concern that nonprofit hospitals may become less committed to noncommercial activities. This may even be more likely when such hospitals convert to for-profit status. The empirical evidence indicates that, on average, hospitals of nonprofit and for-profit ownership are similar in the provision of uncompensated care, the quality of care, and the adoption of technology. Conversion of a nonprofit to for-profit status does not adversely affect the provision of uncompensated care on average. However, for-profits are more likely to be located in areas where consumers have the ability to pay for care. As hospital markets become more competitive and the opportunity for cross-subsidizing more unprofitable, collective-good activities will become increasingly difficult. Support for such activities, if they are to exist, will have to come from explicit public subsidies.     

Organizational form and performance: An empirical investigation of nonprofit and for‐profit job‐training service providers

While research on the distinctions between for‐profit and nonprofit organizations and their changing service sector shares is vast, there is comparatively little empirical evidence on the consequences of their differing attributes for social program outcomes. This article presents research on publicly subsidized for‐profit and nonprofit job‐training service providers, namely whether organizational form influences client enrollment, service delivery activities, or performance, as measured in terms of participant outcomes. The findings show that nonprofit providers were not more likely to serve more disadvantaged clients and that neither for‐profit nor nonprofit service providers were consistently more effective in increasing participants' earn‐ings and employment rates. When performance incentives were included in service providers' contracts, contractors of all forms performed significantly better across all participant outcomes examined. © 2000 by the Association for Public Policy and Management.     

Does government funding alter nonprofit governance? Evidence from New York City nonprofit contractors

Government contracting has raised a collection of issues with respect to adequate oversight and accountability. This paper explores one avenue through which contracting agencies may achieve these tasks: through the governance practices of the contractor's board. Oversight and monitoring are a board's key responsibilities, and influencing a board's practices is one way a governmental agency can help to insure quality performance. Agencies could thus use both their selection process and their post‐contracting power to influence board practice. Using a new, rich data set on the nonprofit contractors of New York City, a series of hypotheses were tested on the relationship between government funding and board practices. Significant differences were found to exist in board practices as a function of government funding levels, differences that mark a shift of energy away from some activities (i.e., traditional board functions, such as fund‐raising) towards others (financial monitoring and advocacy). This suggests that government agencies may indeed use their contracting choices with an eye to particular governance practices. This increased emphasis on such activities appears to crowd out other activities, and is not unambiguously to the benefit of nonprofit board governance. © 2002 by the Association for Public Policy Analysis and Management.     

非营利组织志愿者的管理与开发

志愿者是现实社会生活中重要的社会资源,也是非营利组织中最具特色的人力资源。随着非营利组织的发展壮大,志愿者在中国社会中的价值越来越明显。但由于各种原因,非营利组织志愿者管理问题日益突出,成为非营利组织可持续发展的难题之一。因此,加强对非营利组织的志愿者管理与开发研究,不仅具有理论价值,更具有极强的现实意义。     

Unintended consequences: Regulating the quality of subsidized day care

Advocates for the poor frequently support uniform, high federal standards for subsidized social services. While such standards may improve the quality of services for those who qualify, they can also have unintended but important side effects. Stringent regulations may actually curtail the supply of services, promote segregation, and expand the role of large subsidized for-profit firms. All these possibilities are illustrated by the history of federal regulation in subsidizing child day care. The federal government's retreat from regulation in 1980 and 1981 may have had results that—even if unintended—were in many ways salutary.     

Why most private hospitals are nonprofit.

In recent decades, restrictions that have been imposed on hospitals organized for profit have served to restructure the industry, generating a constant trend toward nonprofit organizations. Small proprietary hospitals in particular have disappeared while corporate chains have come to dominate what is left of the for-profit hospital sector. The trend toward nonprofit hospitals is not explained by the failure of the health service markets and is not the result of a desire to serve the public interest more effectively. Although a number of arguments have been advanced to explain the shift, the hypothesis that seems most consistent with the existing evidence is that the nonprofit form of organization serves most effectively to strengthen the restrictive character of the market for physicians' services and thereby to serve the individual economic interests of the physicians.     

Does federally subsidized rental housing depress neighborhood property values?

Few communities welcome federally subsidized rental housing, with one of the most commonly voiced fears being reductions in property values. Yet there is little empirical evidence that subsidized housing depresses neighborhood property values. This paper estimates and compares the neighborhood impacts of a broad range of federally subsidized rental housing programs, using rich data for New York City and a difference‐in‐difference specification of a hedonic regression model. We find that federally subsidized developments have not typically led to reductions in property values and have, in fact, led to increases in some cases. Impacts are highly sensitive to scale, though patterns vary across programs. © 2007 by the Association for Public Policy Analysis and Management     

The role of subsidized housing in reducing homelessness: An empirical investigation using micro-data

Additional funding for subsidized housing is one of the most commonly proposed solutions to the problem of homelessness. For example, the Interagency Council on the Homeless has called for a $2 billion increase in the budget of the Department of Housing and Urban Development (HUD) to address the shortage of subsidized housing. However, research on the effect of subsidized housing in reducing homelessness is far from conclusive. This study combines data from the American Housing Survey (AHS) with a survey of the homeless to estimate the effectiveness of subsidized housing in reducing homelessness. The results indicate that subsidized housing has not targeted those most at risk of being homeless, and therefore a simple expansion of existing housing programs will have little effect on the number of homeless.     

Signaling virtue: voluntary accountability programs among nonprofit organizations

This article examines the structure of nonprofit voluntary accountability and standard-setting programs, arguing that these programs can be understood as collective action institutions designed to address information asymmetries between nonprofits and their stakeholders. Club theory and the economics of certification suggest that such programs have the potential to provide a signal of quality by setting high standards and fees and rigorously verifying compliance. Such mechanisms can signal quality because higher participation costs may allow only high-quality organizations to join. The article examines the implications of signaling theory using an original dataset on the structure of 32 nonprofit accountability programs across the globe. While many programs set high standards for compliance, the key distinction between strong and weak programs is the use of disclosure or verification mechanisms to enforce compliance. Contrary to theoretical expectations, compliance standards and verification do not appear to be substitutes in creating stronger voluntary programs.

组织视域中的事业单位改革

我国的事业单位在结构和功能上存在冲突和非和谐性,直接妨害了组织自身的运行逻辑,面临着进行系统性地组织诊断和变革的要求。从组织视角考察,边界的模糊性、体制的依附性、管理结构形式的单一化以及环境约束的软化等组织弊端,决定了事业单位的改革应以建构非营利组织为主体的现代公共事业、变革组织的产权结构、营设治理化的约束环境为主要路径。     

Differential taxation of nonprofits and the commercialization of nonprofit revenues

The effects of the favorable tax treatment of nonprofit commercial activities are best understood in a framework that explicitly accounts for a number of interactions. These involve differential taxation of nonprofits and for-profits and of nonprofits’ “related” and “unrelated” activities; the preferences of nonprofit executives who may be averse to commercial activity; donors whose giving may be sensitive to nonprofit organization commercial activity; and cost-complementarities between nonprofit core mission-related activities and their secondary money-raising efforts. Differential taxation encourages nonprofits to pursue otherwise avoided commercial ventures by providing excess financial returns that nonprofits can exploit because of their tax-exempt status. Data from the 1992 Statistics of Income (SOI) public use file of Internal Revenue Service (IRS) Form-990 returns indicate that the propensity of nonprofit organizations to undertake both tax-exempt and taxable activities depends on their primary mission-related output and size, the relative importance of government versus private contributions, and the size of the excess return created by differential taxation of nonprofit and for-profit business. Additional analyses of SOI data also show that organizations that engage in taxable commercial activities are likely to allocate joint costs in ways that reduce, and in most cases eliminate, their taxable income.     

The nonprofit advantage: Producing quality in thick and thin child care markets

Nonprofit child care centers are frequently observed to produce child care which is, on average, of higher quality than care provided in commercial child care centers. In part, this nonprofit advantage is due to different input choices made by nonprofit centers—lower child‐staff ratios, better‐educated staff and directors, higher rates of professional development for staff. Nonprofit centers may have an additional productivity advantage, due to unmeasured staff motivation and abilities or to better management of the production of good‐quality child care. However, where nonprofit and for‐profit child care firms compete in the same local markets, we speculate that this extra advantage should only appear where demand is sufficiently “thick” to permit a quality differentiation strategy to be financially viable for nonprofits. We estimate the effect of nonprofit status on quality, controlling for differences in financial resources available to the center, differences in the clientele served, and differences in staff and center inputs. In this conventional examination, nonprofit status has a moderately positive impact on quality. However, when we account for the unobserved heterogeneity and separate markets into “thick” and “thin,” a particularly strong nonprofit advantage is found in thick markets, but no productivity advantage for nonprofits is found in thin markets. This finding suggests a clear role for nonprofit organizations in improving the cost‐quality trade‐off faced by parents, but also identifies the market conditions that affect the ability of nonprofit managers to employ this advantage. © 2009 by the Association for Public Policy Analysis and Management.