Greater Asset Research Articles

Financial vulnerability of trauma centers: A national analysis.

Trauma centers function as an essential safeguard in the United States health care system. However, there has been minimal study of their financial health or vulnerability. We sought to perform a nationwide analysis of trauma centers using detailed financial data and a recently developed Financial Vulnerability Score (FVS) metric. The RAND Hospital Financial Database was used to evaluate all American College of Surgeons-verified trauma centers nationwide. The composite FVS was calculated for each center using six metrics. Financial Vulnerability Score tertiles were used to classify centers as high, medium, or low vulnerability, and hospital characteristics were analyzed and compared. Hospitals were also compared by US Census region and teaching versus nonteaching hospitals. A total of 311 American College of Surgeons-verified trauma centers were included in the analysis, with 100 (32%) Level I, 140 (45%) Level II, and 71 (23%) Level III. The largest share of the high FVS tier was consisted of Level III centers (62%), with the majority of Level I (40%) and Level II (42%) in the middle and low FVS tier, respectively. The most vulnerable centers had fewer beds, negative operating margins, and significantly less cash on hand. Lower FVS centers had greater asset/liability ratios, lower outpatient shares, and three times less uncompensated care. Nonteaching centers were statistically significantly more likely to have high vulnerability compared with teaching centers (46% vs. 29%). Statewide analysis showed high discrepancy among individual states. With approximately 25% of Levels I and II trauma centers at high risk for financial vulnerability, disparities in characteristics, including payer mix and outpatient status, should be targeted to reduce vulnerabilities and bolster the health care safety net. Prognostic and Epidemiological; Level IV.

Financial Vulnerability of American College of Surgeons-Verified Trauma Centers: A Statewide Analysis.

Although trauma centers represent an integral part of healthcare in the US, characterization of their financial vulnerability has not been reported. We sought to characterize the financial health and vulnerability among California trauma centers and identify factors associated with high and low vulnerability. The RAND Hospital Data financial dataset was used to evaluate all American College of Surgeons (ACS)-verified trauma centers in California. Financial vulnerability of each center was calculated using 6 metrics to calculate a composite Financial Vulnerability Score (FVS). Tertiles of the FVS were generated to classify trauma centers as high, medium, or low financial vulnerability. Hospital characteristics were also analyzed and compared. Forty-seven ACS trauma centers were identified. Nine were Level I, 27 were Level II, and 8 were Level III. Level I centers encompassed the greatest proportion of the high FVS tier (44%), whereas Level II and III centers were the most likely to be in the middle and lower tiers, respectively (44%; 63%). Lower FVS centers had greater asset:liability ratios, operating margins, and days cash on hand compared with the 2 higher tiers, whereas high FVS centers showed a greater proportion of uncompensated care, outpatient share rates, outpatient surgeries, and longer days in net accounts. Lower FVS centers were more likely to be teaching hospitals and members of a larger corporate entity. Many ACS trauma centers are at moderate/high risk for financial vulnerability and disparate impacts of stressor events, and the FVS may represent a novel metric that could be used at the local or statewide level.

Social Comparison and Wealth Inequality in a Leveraged Asset Market

We hypothesize that upward social comparison of asset holdings among traders exacerbates leveraged asset bubbles because traders shift their frame of reference from profit maximization toward quantity maximization, increasing price momentum. In addition, asset prices should inflate even more in markets with wealth inequality because the relative reference shift becomes stronger. We test this theory within the standard asset market experiment environment, where we introduce the ability to borrow using leverage and treatments encouraging social comparison and manipulation of wealth inequality. We find that social comparison leads to asset overpricing, and its impact is the greatest when combined with wealth inequality. On the other hand, wealth inequality alone does not lead to greater asset price bubbles. These findings are consistent with housing market patterns prior to the financial crisis.

Keeping up with the Joneses: Social Status and Wealth Inequality in a Leveraged Asset Market

We hypothesize that growing wealth inequality has exacerbated leveraged asset bubbles in the wealthiest nations over the last several decades through a “keeping up with the Joneses” effect. Rising inequality strengthens the desire of households to improve their social status by owning assets such as homes demanded by those with wealth. Given easy access to credit, relatively low-wealth individuals use leverage to bid up asset prices. We test this theory within the popular asset market experiment of Smith, Suchanek, and Williams (1988) where we combine the option to borrow with treatments for wealth inequality and social status. We find that the social status effect indeed leads to asset overpricing, and the impact is the biggest when combining social status with wealth inequality. On the other hand, wealth inequality alone does not lead to greater asset bubbles.

Internet Financial Reporting dan Faktor-Faktor yang Mempengaruhinya Pada Pemerintah Kota dan Kabupaten Di Indonesia

This research identifies factors affecting the publication of financial reports in the internet or known as internet financial reporting (IFR) after the issuance of Home Minister Instruction No. 188.52/1797/SJ year 2012 on Improving Transparency of Local Budget Management. One hundred and seventy five cities and regencies were selected as samples based on purposive sampling and analysed by using multiple regression. The result shows that political competition and size of local government asset has positive influence on the IFR. This indicates that Heads of local government whose political party is not majority and Heads of local government with greater asset size, had used IFR as media to show their performance to the public. This is consistence with stewardships theory that asymmetric information between local government (stewards) with the public (principals) can be reduced through accountability and transparency of financial management whereby the pressure and ability to do it appeared significantly in local governments with high political competition and with relatively greater asset. In this research, some other potential factors such as leverage, own-source revenue, type of local government (city or regency) and audit opinion are not proven to influence the IFR practices in the local governments.

Equity in adherence to antiretroviral therapy among economically vulnerable adolescents living with HIV in Uganda

ABSTRACTStudies from sub-Saharan Africa indicate that children made vulnerable by poverty have been disproportionately affected by HIV with many exposed via mother-to-child transmission. For youth living with HIV, adherence to life-saving treatment regimens are likely to be affected by the complex set of economic and social circumstances that challenge their families and also exacerbate health problems. Using baseline data from the National Institute of Child and Human Development (NICHD) funded Suubi+Adherence study, we examined the extent to which individual and composite measures of equity predict self-reported adherence among Ugandan adolescents aged 10–16 (n = 702) living with HIV. Results showed that greater asset ownership, specifically familial possession of seven or more tangible assets, was associated with greater odds of self-reported adherence (OR 1.69, 95% CI: 1.00–2.85). Our analyses also indicated that distance to the nearest health clinic impacts youth’s adherence to an ARV regimen. Youth who reported living nearest to a clinic were significantly more likely to report optimal adherence (OR 1.49, 95% CI: 0.92–2.40). Moreover, applying the composite equity scores, we found that adolescents with greater economic advantage in ownership of household assets, financial savings, and caregiver employment had higher odds of adherence by a factor of 1.70 (95% CI: 1.07–2.70). These findings suggest that interventions addressing economic and social inequities may be beneficial to increase antiretroviral therapy (ART) uptake among economically vulnerable youth, especially in sub-Saharan Africa. This is one of the first studies to address the question of equity in adherence to ART among economically vulnerable youth with HIV.

Bankruptcy Discharge and the Emergence of Debtor Rights in Eighteenth Century England

Bankruptcy is a precise legal process defining the rules when debtor fails to repay their debts. These rules determine willingness to lend and to borrow and thus can affect economic growth. In 1706, the English Parliament passed a bankruptcy statute that provided potential rights for bankrupts and represents a fundamental change in the rules regarding bankruptcy. Where previously a bankrupt could exit bankruptcy only upon full repayment of debts, creditors could now choose to discharge a bankrupt prior to full repayment of his debts. In this paper, we develop a simple model to explore why creditors might discharge a bankrupt, and conduct an empirical analysis of archival bankruptcy data to show that discharges actually occurred. Not only did bankrupts benefit when creditors chose to discharge bankrupts prior to full payment, but also we find that creditors could benefit due to greater asset revelation by bankrupts.

Impact of Medicaid reimbursement and eligibility policies on receipt of cancer screening.

6514 Background: State Medicaid programs cover receipt of cancer screening services. However, coverage of cancer screening tests does not guarantee access to these services. Medicaid beneficiaries are less likely to be screened for cancer and more likely to present with advanced stage cancers. State-specific variations in Medicaid program eligibility requirements and reimbursements for medical services may affect cancer screening rates among Medicaid enrollees. This study examined how eligibility and reimbursement policies affected receipt of breast, cervical, colorectal, and prostate cancer screening. Methods: We examined 2007 Medicaid data for individuals age 21-64 enrolled in fee-for-service Medicaid for at least 4 months from 46 states and the District of Columbia. We examined the association of state-specific Medicaid cancer screening test and office visit reimbursements, income and financial asset eligibility requirements, physician copayments, and frequency of Medicaid eligibility renewal on receipt of cancer screening. Analyses used multivariate logistic regressions with generalized estimating equations to control for correlation between beneficiaries within a state. Results: Increased Medicaid screening test reimbursements were significantly associated with small increases in receipt of colonoscopy, mammograms, and PSA tests. Increased reimbursements for office visits were associated with increased receipt of colonoscopy, FOBT, Pap tests, and mammograms. Greater asset thresholds for Medicaid eligibility increased the likelihood of all screening tests except FOBT. Beneficiaries in states requiring more frequent (<12 month) renewal of Medicaid eligibility were more likely to receive FOBT, PSA, or mammograms, but less likely to receive Pap tests. Conclusions: Increasing Medicaid reimbursement rates and asset policies was generally associated with increases in cancer screening. As proposed Medicaid eligibility expansions will almost certainly increase the number of enrollees in this program, it is crucial to provide adequate reimbursements and develop eligibility policies to promote cancer screening and thereby increase early cancer detection among this underserved population.

Biases in Management Forecasts of Venture-Backed Start-Ups Revisited: Evidence From Internal Due Diligence Documents of VC Investors

This study provides evidence of significant biases in multi-year management forecasts by analyzing a proprietary dataset on venture-backed start-ups in Germany. We find that revenues and expenses are highly overestimated in each of the investigated one- to five-year-ahead planning periods. Furthermore, entrepreneurs underestimate one-year-ahead profit forecasts but clearly overestimate their profit forecasts for all longer-term forecast horizons. Additional analyses reveal that teams with prior management experience issue even more overestimated forecasts and misrepresent their forward-looking information. In contrast, greater asset verifiability and corporate lead investors are associated with lower levels of forecast errors. All key results hold if bias is either measured by traditionally comparing forecasts to ex-post realizations or by using a cross-sectional projection approach based on historical accounting data developed by prior research.

The Subprime Virus: Theory and Evidence

We develop a theoretical model demonstrating the potential spillover effects associated with the introduction of risky assets. Specifcally, we examine the potential increase in mortgage default risk on prime mortgages that results from the introduction of subprime mortgages in a local area. The transmission mechanism is that the higher incidence of default by subprime borrowers leads to greater asset price volatility, which in turn impacts the default probability of prime mortgages in the same geographic area. Through numerical analysis, we demonstrate the impact of the origination of subprime mortgages to the risk of a portfolio of prime mortgages. Finally, we offer empirical support for our model by examining the spatial variation in MSA prime mortgage default rates correlated with the level of subprime mortgage activity.

CEO Compensation Structure and Asymmetric Timely Loss Recognition - An Empirical Analysis from Debt Contracting Perspective

This paper examines the relation between CEO compensation structure and the demand for asymmetric timely loss recognition (AT) from debt contracting perspective. Prior studies demonstrate that high CEO compensation risk encourages managers to engage in risk-seeking behavior, thus intensifying agency conflicts between creditors and borrowers. By constraining managers to recognize economic losses in a timely fashion, AT is arguably to reduce managers’ incentive to undertake risky projects, and therefore creditors have greater demand for accounting conservatism when CEO compensation risk is high. We empirically test this prediction and find a positive relation between accounting conservatism and CEO compensation risk, and this positive relation is stronger for firms with high leverage. Further evidence shows that the negative relation between accounting conservatism and cost of debt increases in CEO compensation risk, suggesting that creditors value AT more in the presence of greater asset substitution problem. Last, we find that the positive relation between AT and CEO compensation vega is weakened for firms with high proportional use of short-term debt and for debt contracts containing covenants or collateral restrictions. Hence, the results indicate that accounting conservatism and other contracting mechanisms serve as substitutes in mitigating agency costs of debt arising from CEO compensation incentives.

Drivers of Credit Losses in Australasian Banking

Based on a comprehensive dataset retrieved from original financial reports of 32 Australasian banks (1980-2005), this paper explores factors affecting the credit loss experience of these institutions. It is found that the state of economy as measured by GDP growth and unemployment rate have the expected impact. Asset markets are also important, with the performance of the equity market showing greater explanatory power than property prices. Larger banks, on average, provide more for credit losses while less efficient banks have greater asset quality problems. Strong loan growth translates into significantly higher credit losses with a lag of 2-3 years. Finally, the results show strong evidence of income smoothing activities by banks.

Deal Sponsor and Credit Risk of Asset-Backed and Mortgage-Backed Securities

Gorton and Souleles (2005) and Higgins and Mason (2004) find that sponsors with higher unsecured credit ratings issue credit card securitizations at tighter spreads and have greater market access than lower rated sponsors. We extend this research by examining the performance of securitizations with different types of sponsors in multiple sectors and by discussing the various ways in which sponsors might influence the performance of their securitizations. We measure performance using two metrics, rating downgrade rates and security impairment rates. We utilize a unique dataset, consisting of over 14,000 securitization tranches issued over a 10-year period, covering a wide range of sectors within the asset-backed and mortgage-backed securities markets, and involving over 446 individual sponsors. When all the data is pooled, securitizations issued by investment-grade sponsors appear to outperform those issued by non-investment-grade sponsors, and those issued by banks outperform those of captive finance companies, which outperform those of security firms, which outperform those of specialty finance companies. The prevalence of certain types of sponsors within various asset classes helps explain the wide variation in performance observed across those asset classes. When analyzing relative performance across asset classes, we find weaker performance is strongly associated with having a higher proportion of sponsors that are specialty finance companies. When analyzing relative performance within asset classes, we find the impact of sponsor type is mostly modest or statistically insignificant. The relatively weak nonperformance of securitizations sponsored by specialty finance companies and non-investment-grade firms may be related to their weaker incentives to invest (through conservative asset selection, high quality servicing, or out-right support for troubled transactions)in long-term reputations for issuing strongly performing securities. In addition, in some sectors, if the sponsor is also the servicer and goes bankrupt, the securitization's underlying obligors, themselves, have a weaker incentive or more limited ability to make their debt service payments. Differences in performance may also be related to the tendency of specialty finance and noninvestment-grade sponsors to be more active in sectors that have historically exhibited greater asset volatility. In some of these sectors, sponsors experienced increased competitive pressure over time to grow originations and relax underwriting criteria. As a result, the securitizations of many sponsors operating within these sectors, including those of some banks and investment-grade firms, under-performed relative to securitizations in sectors with relatively few specialty finance and non-investment-grade sponsors.

Diversification and the cost of debt of bank holding companies

In this study, we investigate the relationship between various dimensions of diversification and the cost of debt for publicly traded bank holding companies (BHCs). We find that both domestic geographic diversification of deposits and diversification of assets lead to a lower bond yield-spread. Diversification of non-traditional banking activities leads to a lower cost of debt only when yield-spread and diversification are estimated simultaneously. In addition, we find that medium-sized BHCs experience a greater reduction in bond yield-spread than small-sized and large-sized BHCs. This is consistent with the too-big-to-fail (TBTF) effects in the banking industry. Furthermore, we document that the association between diversification and yield-spread is bidirectional with higher yield-spreads being associated with greater asset and activity diversification and lower geographic deposit dispersion. The effect of diversification on bond yield-spread is robust after accounting for cross-sectional and serial correlation, and the endogeneity of diversification.

La Detroit Urban League, 1916-1930 : am~~liorer le sort d'un peuple, le programme d'aide aux travailleurs de la Detroit Urban League, 1916-1930

As we all know, it is one of the purposes of the League to get Negroes into the more skilled, the better paid and the more healthy processes of industry. Wherever this is accomplished the Negro is able to maintain a better standard of living and is consequently less apt to become dependent, delinquent or destitute. Moreover, the more trades and occupations that the Negro becomes familiar with, the greater asset he is to the community. ~~~Forrester B. Washington (DUL, General Correspondence, 1916)

La Detroit Urban League, 1916-1930: ameliorer le sort d'un peuple, le programme d'aide aux travailleurs de la Detroit Urban League, 1916-1930

As we all know, it is one of the purposes of the League to get Negroes into the more skilled, the better paid and the more healthy processes of industry. Wherever this is accomplished the Negro is able to maintain a better standard of living and is consequently less apt to become dependent, delinquent or destitute. Moreover, the more trades and occupations that the Negro becomes familiar with, the greater asset he is to the community. ~~~Forrester B. Washington (DUL, General Correspondence, 1916)

Imagining a Medieval English Nation ed. by Kathy Lavezzo

REVIEWS troubling to a modern liberal understanding of the social good, and she usefully shows how and why they might be misread without taking account of the two hermeneutical types she has invoked. She also shows, again usefully, how much richer the thinking and writing about these texts become when one keeps always in the front of one’s mind the ordering principle (the glass bowl) that gives and constrains the meanings of the texts. For example, she makes a good point that the hermeneutical Jew, as revealed in certain personal and relational traits of the Jewish characters in the texts, shows a far greater resistance to the totalizing image of transformation that was, in the high theology of the period, supposed to accompany baptism/conversion. This point owes a great deal to an analogy or parallel between the hermeneutical Jew and what I think the author might be willing to call the hermeneutical Alien (stranger to the community) and hermeneutical Racial (the darkskinned ‘‘presence’’ or otherwise racialized presence defined, following recent medieval historiography, according to less somatically obvious distinctions). Finally, to see the past and past texts through these newly aware eyes of the hermeneutical Other is not to condemn the past for its mistakes (‘‘to seek moral reckonings,’’ p. 171), but to ‘‘seek ethical understandings’’ of it. This is a book that one must return to from time to time to elicit its nuggets of insight. It is sometimes a beautiful read, but almost never an easy one. Returning to it, however, can be a genuinely rewarding experience. William Chester Jordan Princeton University Kathy Lavezzo, ed. Imagining a Medieval English Nation. Medieval Cultures 37. Minneapolis: University of Minnesota Press, 2004. Pp. xxxiv, 356. $68.95 cloth, $24.95 paper. Emphasis must fall on the ‘‘imaginary’’ part of Kathy Lavezzo’s title, since concepts of ‘‘nation’’ and ‘‘nationhood’’ are a good deal less present in this volume than the title would seem to imply. Actually, the commendably headstrong contributors are at their best when they jettison the doubtfully applicable concept of medieval nationhood altogether PAGE 331 331 ................. 11491$ CH13 11-01-10 14:02:40 PS STUDIES IN THE AGE OF CHAUCER and strike out on their own. ‘‘Nation’’ is really only gesturally present, as Aranye Fradenburg pursues her recent interest in the underpinnings of sacrifice (with patria hailed as one of its justifications); when Andrew Galloway considers the contributions of Higden and Walsingham to monastic historiography; when Jill Havens reflects on the Lollards as an imagined community within the realm; when Peggy Knapp asks what ‘‘imagination’’ actually meant in the later Middle Ages—to think only of the first four contributions. Although this collection’s blurb declares it to be ‘‘unusually coherent,’’ I would tend to argue otherwise, in favor of the unruliness of its talented contributors, and their commendably centrifugal offerings, as its greater asset. For all its inner diversity, this collection nevertheless does have a recurrent topic, preliminary or incidental to its stated one, and somewhat more agreeably indigenous to the Middle Ages. This is the subject of ‘‘community,’’ in all its ramifications, and most of the contributors turn to it with evident relief. After pondering the possibility that Higden’s interest in English varietas is itself a form of alienated national consciousness , Galloway turns to Walsingham, whose ‘‘most powerful sections access into his notions of English community’’ (p. 75). Havens observes that the polemic of Lollard texts ‘‘sets up an ideal of an imagined community , united by a belief in the ability of the English language to convey sacred truth’’ (p. 100). Kathleen Davis concerns herself with spatial and temporal disjunctions in Chaucer’s Parliament of Fowls, as they create an ‘‘alogical’’ zone in which various impossibilities can be imagined—a completed poem, a consummated marriage, and a harmonious community. Larry Scanlon’s restorative reassertion of Langland’s political radicalism grounds itself on ideals of community and the ‘‘true commons.’’ In his assertion of parallels between Edward III’s and Langland ’s views of the problems and potentialities of monetary exchange, Vance Smith gesturally invokes the concept of a ‘‘national economy,’’ but is more actively concerned with the contribution of the merchants as a group...

Asset divestiture following horizontal acquisitions: a dynamic view

AbstractBusiness acquisition, resource redeployment, and asset divestiture are elements of a dynamic process in which firms change their businesses by recombining internal and external resources. Analyzing 253 horizontal acquisitions, we show that post‐acquisition resource redeployment leads to asset divestiture from the business that receives the redeployed resources, but not from the business that contributes the new resources. Consistent with scale economies rationales, we find that strategic similarity also leads to greater asset divestiture from the target firms. Many theoretical perspectives are skeptical about the positive rationale for acquisitions and many of these believe that asset divestiture is evidence of acquisition failure. Our arguments and analysis help refine the accepted wisdom. In particular, the pattern of resource redeployment and asset divestiture in our analysis suggests that acquisitions provide a means of reconfiguring the structure of resources within firms and that asset divestiture is a logical consequence of this reconfiguration process. Copyright © 2001 John Wiley & Sons, Ltd.

The shifting value of federal deposit insurance: Implications for reform

This research examines the relationship between the value of federal deposit insurance and bank size. We conclude that the value of deposit insurance has often been greater for the largest bank-holding companies since 1981. This differential is consistent with the notion that largest banks have greater ability to circumvent regulatory and/or market discipline. The source of this differential appears to be due to holding less capital rather than greater asset risk. Insurance costs net of the value of deposit insurance are also relatively lower for the largest banks and have become more so since 1981. These results suggest that recent proposals to improve the deposit insurance system should be evaluated based on their ability to effect even-handed discipline throughout the banking industry to eliminate and forestall further creation of this large institution bias.

Lloyd George and Churchill as War Ministers

In March 1915, when the Dardanelles campaign was at its crisis, F. S. Oliver, the author of The Endless Adventure, who had long known many of the leading political figures and the background to politics of his day, wrote to his brother in Canada: ‘The only two men who really seem to understand that we are at war are Winston and Lloyd George. Both have faults which disgust one peculiarly at the present time, but there is a reality about them and they are in earnest, which the others aren't.’ This affinity was recognized by the two men themselves. Churchill's admiration and affection for Lloyd George are well known. ‘There could be no doubt…’, he has written, referring of all years to 1940, ‘that he was our foremost citizen’; and his final verdict on Lloyd George's death was ‘The greatest Welshmanhellip; since the age of the Tudors’. Lloyd George returned the affection to the full, and the admiration to a great, though not to the full, extent. ‘Men with such gifts’, he once remarked of Churchill, ‘are rare—very rare. In an emergency they ought to be utilized to the full, and if you keep a vigilant eye on their activities, they are a greater asset than a legion of the conventional sort.