State Oversight of Hospital Conversions: Preserving Trust or Protecting Health?

This paper explores the recent trend of hospital conversions from not-for-profit to for-profit corporate organizational form. Hospital conversions implicate the public interest in charitable assets and affect health policy goals. The paper concludes that current and developing oversight regimes do not adequately protect these interests. The paper finds that state attorneys general are frequently the only government actors with authority to review conversions. In some states, there is no effective regulation of conversions, and/or converted assets are not accurately valued. Without adequate oversight and thorough valuations, assets meant for charitable purposes are transferred to for-profit buyers or executives of the not-for-profit sellers. Even when attorneys general are able to oversee conversion, the doctrines upon which their authority is based -- trust law and corporations law -- hinder the advancement of health policy goals. These doctrinal limitations do not constrain all attorneys general from conducting substantive health policy reviews when they oversee conversions. While conversion statutes and proposed legislation resolve some of the obstacles to oversight, they do not address the conflict between health policy goals and trust and corporations law. The data are drawn primarily from interviews with assistant attorneys general in thirty-two states.This publication is Hauser Center Working Paper No. 10. The Hauser Center Working Paper Series was launched during the summer of 2000. The Series enables the Hauser Center to share with a broad audience important works-in-progress written by Hauser Center scholars and researchers

Galilean Limit of Equilibrium Relativistic Mass Distribution

The low-temperature form of the equilibrium relativistic mass distribution is subject to the Galilean limit by taking $c\rightarrow \infty .$ In this limit the relativistic Maxwell-Boltzmann distribution passes to the usual nonrelativistic form and the Dulong-Petit law is recovered.Comment: TAUP-2081-9

Generalized Boltzmann Equation in a Manifestly Covariant Relativistic Statistical Mechanics

We consider the relativistic statistical mechanics of an ensemble of $N$ events with motion in space-time parametrized by an invariant ``historical time'' $\tau .$ We generalize the approach of Yang and Yao, based on the Wigner distribution functions and the Bogoliubov hypotheses, to find the approximate dynamical equation for the kinetic state of any nonequilibrium system to the relativistic case, and obtain a manifestly covariant Boltzmann-type equation which is a relativistic generalization of the Boltzmann-Uehling-Uhlenbeck (BUU) equation for indistinguishable particles. This equation is then used to prove the $H$-theorem for evolution in $\tau .$ In the equilibrium limit, the covariant forms of the standard statistical mechanical distributions are obtained. We introduce two-body interactions by means of the direct action potential $V(q),$ where $q$ is an invariant distance in the Minkowski space-time. The two-body correlations are taken to have the support in a relative $O( 2,1)$-invariant subregion of the full spacelike region. The expressions for the energy density and pressure are obtained and shown to have the same forms (in terms of an invariant distance parameter) as those of the nonrelativistic theory and to provide the correct nonrelativistic limit

What Do Nonprofits Maximize? Nonprofit Hospital Service Provision and Market Ownership Mix

Conflicting theories of the nonprofit firm have existed for several decades yet empirical research has not resolved these debates, partly because the theories are not easily testable but also because empirical research generally considers organizations in isolation rather than in markets. Here we examine three types of hospitals – nonprofit, for-profit, and government – and their spillover effects. We look at the effect of for-profit ownership share within markets in two ways, on the provision of medical services and on operating margins at the three types of hospitals. We find that nonprofit hospitals’ medical service provision systematically varies by market mix. We find no significant effect of for-profit market share on the operating margins of nonprofit hospitals. These results fit best with theories in which hospitals maximize their own output.

Magnetospheric research

Research concerning the magnetosphere is discussed in terms of satellite data analysis, instrument studies and developments, solar terrestrial studies, meetings, and consultants

Plasma and magnetospheric research

Several programs and variations have been developed to determine statistical means of different plasma parameters when binned in different variables. These parameters include temperature, densities and spacecraft potentials for any of the ion species, as well as ratios of these variables for any other ion species to the corresponding variable for H(+). The variables for binning include L, radial distance, and geomagnetic latitude; and separate statistics are automatically run for local morning and local evening data. These programs all run from output files from the plasma parameter thin sheath analysis program. A variant program also bins for magnetic activity, using either Kp or Dst, which requires an additional magnetic activity input file. These programs can be run either interactively or in batch mode, using file listings generated by a DIRECTORY command. In addition to printed output, these programs generate output files which can be used to plot the results. Programs to plot these averaged data are under development

Estimating acreage by double sampling using LANDSAT data

Double sampling techniques employing LANDSAT data for estimating the acreage of corn and soybeans was investigated and evaluated. The evaluation was based on estimated costs and correlations between two existing procedures having differing cost/variance characteristics, and included consideration of their individual merits when coupled with a fictional 'perfect' procedure of zero bias and variance. Two features of the analysis are: (1) the simultaneous estimation of two or more crops; and (2) the imposition of linear cost constraints among two or more types of resource. A reasonably realistic operational scenario was postulated. The costs were estimated from current experience with the measurement procedures involved, and the correlations were estimated from a set of 39 LACIE-type sample segments located in the U.S. Corn Belt. For a fixed variance of the estimate, double sampling with the two existing LANDSAT measurement procedures can result in a 25% or 50% cost reduction. Double sampling which included the fictional perfect procedure results in a more cost effective combination when it is used with the lower cost/higher variance representative of the existing procedures

Investigation of low energy space plasma

A statistical study of 1982 data for occurrences of equatorially trapped plasma has been extended. The previous survey, which utilized only the MSFC summary fiche, has been supplemented with the GSFC summary fiche, which has had the effect of substantially improving the late 1982 coverage. It was found that in the post midnight region (1 - 3 LT), the trapped plasma is limited to + or - 5 degrees magnetic latitude, while in the early afternoon (13-15 LT), latitude ranges as high as + or 30 degrees are found. This survey has provided a link to earlier ATS-6 and ISEE studies of pancake distributions. Although the most energetic, and most anisotopic plasmas are trapped within a few degrees of the equator, the results of these equatorial interactions extend substantially along the magnetic field line in the afternoon and dusk region and these high latitude extensions were previously studied by the Huntsville group. Results of this study were incorporated into a revision of the equatorial ion paper, which has been resubmitted and accepted for publication

Space plasma research

Temperature and density analysis in the Automated Analysis Program (for the global empirical model) were modified to use flow velocities produced by the flow velocity analysis. Revisions were started to construct an interactive version of the technique for temperature and density analysis used in the automated analysis program. A sutdy of ion and electron heating at high altitudes in the outer plasmasphere was initiated. Also the analysis of the electron gun experiments on SCATHA were extended to include eclipse operations in order to test a hypothesis that there are interactions between the 50 to 100 eV beam and spacecraft generated photoelectrons. The MASSCOMP software to be used in taking and displaying data in the two-ion plasma experiment was tested and is now working satisfactorily. Papers published during the report period are listed

Plasma and magnetospheric research

Research developments in the following areas are discussed: (1) an ion trajectory computer code which plots the paths of ions ejected from the polar cusp ionosphere; (2) the response of plasmaspheric ion temperatures to geomagnetic activity; (3) spacecraft sheath effects; (4) plasma flow; (5) neutral gas temperatures; and (6) instrument fabrication, modification, and maintenance