Elizabeth Plummer

The impact of information technology on performance in the not-for-profit sector

The relation between IT usage and performance has been a central question in the AIS literature since the late 1990s. Empirical research has not yet examined whether organizational-level differences in how IT is used are associated with performance, nor whether the lagged performance effects found in for-profit settings carry over to a not-for-profit setting. Spending on information technology (IT) in K-12 schools has grown significantly in the U.S. over the past decade and performance in this sector has significant spillover effects in other sectors. This study examines the effects on performance of a change in how IT is used on a continuum from an automation role to an informating/transforming approach. A sample of over 6300 organizations (schools) having over 700,000 students in grades 3, 8 and 11 is examined. Both short-term (year-over-year) and longer-term (four-year) performance effects are investigated. We find that a change in how IT is used is associated with an increase in performance in two of the three school levels, and that these mean effects are comparable in magnitude to those found for IT spending in for-profit settings. These effects only become positive after four years, and vary across school level. This is the first study to provide large sample evidence of the performance effect of a change in how IT is used at the organizational level. This has significant implications for research investigating the effects of investments in IT on organizational performance and for stakeholders including policy makers, managers, legislators and taxpayers.

The Affordable Care Act’s Effects On The Formation, Expansion, And Operation Of Physician-Owned Hospitals

The Affordable Care Act (ACA) imposed new restrictions on the formation and expansion of physician-owned hospitals. These restrictions provided incentives for the hospitals and their owners to take preemptive actions before the effective dates of ACA provisions and modify their operations thereafter. We studied 106 physician-owned hospitals in Texas to determine how they responded to ACA restrictions. We found that there were significant pre-ACA increases in the formation, physician ownership, and physical capacity of physician-owned hospitals, which suggests that they reacted quickly to the policy changes. After the ACAs provisions took effect, the hospitals improved the use of their assets to generate increased amounts of services, revenue, and profits. We found no evidence that existing physician-owned hospitals stopped accepting Medicare to avoid the ACA restrictions, although some investors adopted a seemingly unsuccessful strategy of not accepting Medicare at physician-owned hospitals formed after implementation of the ACA. We conclude that the ACA restrictions effectively eliminated the formation of new physician-owned hospitals, thus accomplishing what previous legislative efforts had failed to do.

Using financial statements to provide evidence on the fiscal sustainability of the states

This descriptive study shows how the government-wide financial statements can be used, with adjustments, to provide evidence on a states fiscal sustainability. We compute “adjusted total net assets” (AdjTNA), which equals a state’s assets (not including its capital assets) minus the states liabilities and obligations, including the UAAL for pension and OPEB not reported on the Statement of Net Assets. AdjTNA provides information about a state’s ability to sustain its current fiscal structure, given its current financial resources. Primary results suggest that 40 states have a negative AdjTNA value, with a median -

Equitable Taxation and the Provision of Health Insurance Subsidies

6.7 billion per state (-

GASB 34's Governmental Financial Reporting Model: Evidence on its Information Relevance

5,230 per household). Sensitivity analysis suggests 48 states have a negative AdjTNA value, with a median -

Evidence on the Management of Earnings Components

20.7 billion per state (-

Budget Adjustments in Response to Spending Variances: Evidence of Ratcheting of Local Government Expenditures

16,200 per household). The paper discusses the important policy implications of these results.

Transitory and persistent earnings components as reflected in analysts' short-term and long-term earnings forecasts: evidence from a nonlinear model

Current U.S. income tax laws allow many taxpayers to exclude from taxable income part or all of the cost of acquiring health insurance through an employer‐sponsored benefit plan. This favorable tax treatment generally applies regardless of whether the employer or employee actually pays the health insurance premiums. We describe the effects of this tax policy on the U.S. tax systems horizontal and vertical equity. We also explain how taxpayers covered by employer‐sponsored plans are significantly subsidized by the government in acquiring health insurance, whereas taxpayers who acquire health insurance by other means or who are not covered by health insurance at all receive no such government assistance. We conclude that any prospective health‐care policy initiatives, including modifications to the 2010 health‐care reforms, should contemplate both the horizontal and vertical equity of the tax treatment of health insurance premiums.