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GAO-06-907R Nonprofit Hospital Systems: Survey on Executive Compensation Policies and Practices
A complete and up-to-date legal resource for administrators of tax-exempt healthcare organizations, the Third Edition equips you with a comprehensive, one-volume source of detailed information on federal, state, and local laws covering tax-exempt healthcare organizations. The Third Edition of this practical, down-to-earth book tackles complex legal issues by providing you with plain-English explanations and the appropriate legal citations for further research.
Medical professionals who serve on the boards of private, nonprofit institutions often do so with much more diligence than knowledge. Very little material exists to cover the range of issues that are so vital at a time when health care institutions face patient overloads, budget shortages, and calls for reform. Written by leading health care adv
Two interpretations are possible. Ontario hospital boards may be trading-off the difficulties in implementing a formal pay-for-performance incentive plan with a more subjective and comprehensive evaluation process. This supports the claim that monitoring and bonus plans can both be used as an executive motivational device. Another interpretation, a criticism expressed in current business literature, is that agency problems are unaddressed in current CEO contracting arrangements, and the use of peer comparison and competitive benchmarking simply ratchets up year-to-year CEO compensation. Corporate governance entails monitoring, evaluating and rewarding the performance of the Chief Executive Officer (CEO) of the corporation. An economic approach to understanding CEO compensation predicts that financial incentives will be written into the CEO's compensation contract to align the goals of the owners of the firm with those of the top executive of the firm. At the same time, economic theory predicts that not-for-profit organizations, which have multiple stakeholders, complex multidimensional missions and hard to observe and measure outputs, may be unable to write similar incentive contracts for the CEO and hence suffer from enhanced agency problems. This thesis is an exploratory investigation into the CEO compensation policies employed by the Board of Directors of Ontario public not-for-profit hospitals. A survey of CEOs and boards finds that the majority of Ontario hospitals do base CEO compensation in part on performance, this performance evaluation being a comprehensive review of CEO specific performance goals and objectives, including specific hospital targets. These surveys also highlighted that Ontario hospital boards have had difficulties in establishing formal pay-for-performance systems due in large part to hospital outcomes being perceived as largely beyond the control of the CEO. Guided by equity theory, an empirical model investigates how pay comparisons with peer hospital CEOs influence subsequent CEO compensation adjustments, and finds that changes in CEO compensation are significantly related to the relative inequity position of a CEO compared to its peers.