Hospital Affiliation and Capital Structure: How Will Capital Markets Guide Health Care Restructuring? Academic Article uri icon


  • In this paper we discuss the potential role capital markets will play in health care restructuring. According to theory, agency costs, asymmetric information and strategic interactions cause the cost of capital for nonprofit entities to slope upward. Freestanding nonprofits are particularly disadvantaged in this regard. We conclude that some organizational forms will be less viable due to problems of capital access. Empirical work examines the capital structure of nonprofit entities. Our results indicate that chain hospitals are able to access more debt, both taxable and tax-exempt, than freestanding hospitals. Capital markets also associate for profit market presence with capital risk. We conclude that freestanding hospitals are at a relative disadvantage is accessing capital markets.

published proceedings

  • Journal of Public Budgeting, Accounting and Financial Management

author list (cited authors)

  • Wedig, G. J., Hassan, M., Van Horn, R. L., & Morrisey, M. A

complete list of authors

  • Wedig, GJ||Hassan, M||Van Horn, RL||Morrisey, MA

publication date

  • January 1, 1998 11:11 AM