Managed Care Provider Volume

There is considerable evidence that patients that are treated by high volume physicians and hospitals have better health outcomes than patients treated by low volume physicians and hospitals. Thus, as an indirect measure of quality differences between managed care and traditional fee-for-service insurance, we compare the average provider volume of cancer patients covered by these two types of plans. We find that managed care patients tend to be treated by lower volume providers and that the magnitude of the differences varies by the particular cancer and managed care plan.

Entrepreneurship in Equilibrium

This paper compares the financing of new ventures in start-ups (entrepreneurship) and in established firms (intrapreneurship). Intrapreneurship allows established firms to use information on failed intrapreneurs to redeploy them into other jobs. By contrast, failed entrepreneurs must seek other jobs in an imperfectly informed external labor market. While this external labor market leads to ex post inefficient allocations, it provides entrepreneurs with high-powered incentives ex ante. We show that two types of equilibria can arise (and sometimes coexist). In a low entrepreneurship equilibrium, the market for failed entrepreneurs is thin, making internal labor markets and intrapreneurship particularly valuable. In a high entrepreneurship equilibrium, the active labor market reduces the value of internal labor markets and encourages entrepreneurship. We also show that there can be too little or too much entrepreneurial activity. There can be too little because entrepreneurs do not take into account their positive effect on the quality of the labor market. There can be too much because a high quality labor market is bad for entrepreneurial incentives.

Organizational Scope and Investment: Evidence from the Drug Development Strategies and Performance of Biopharmaceutical Firms

This paper compares the clinical trial strategies and performance of large, established ("mature") biopharmaceutical firms to those of smaller ("early stage") firms that have not yet successfully developed a drug. We study a sample of 235 cancer drug candidates that entered clinical trials during the period 1990-2002 and were sponsored by public firms. Early stage firms are more likely than mature firms to advance drug candidates from Phase I to Phase II clinical trials. However, early stage firms have much less promising clinical results in their Phase II trials and their Phase II drug candidates are also less likely to advance to Phase III and to receive Food and Drug Administration approval. This pattern is more pronounced for early stage firms with large cash reserves. The evidence points to an agency problem between shareholders and managers of single-product early stage firms who are reluctant to abandon development of their only viable drug candidates. By contrast, the managers of mature firms with multiple products in development are more willing to drop unpromising drug candidates. The findings appear to be consistent with the benefits of internal capital markets identified by Stein (1997).

Entrepreneurial Spawning: Public Corporations and the Genesis of New Ventures, 1986-1999

This paper examines the factors that lead to the creation of venture capital backed start-ups, a process we term entrepreneurial spawning.' We contrast two alternative views of the spawning process. In one view, employees of established firms are trained and conditioned to be entrepreneurs by being exposed to the entrepreneurial process and by working in a network of entrepreneurs and venture capitalists. Alternatively, individuals become entrepreneurs because the large bureaucratic companies for which they work are reluctant to fund their entrepreneurial ideas. Controlling for a firm's size, patent portfolio and industry, we find that the most prolific spawning firms were public companies located in Silicon Valley and Massachusetts that were themselves once venture capital backed. Less diversified firms are also more likely to spawn new firms. Spawning levels for these firms rise as their sales growth declines. Firms based in Silicon Valley and Massachusetts and originally backed by venture capitalists are more likely to spawn firms only peripherally related to their core businesses. Overall, these findings appear to be more consistent with the view that entrepreneurial learning and networks are important factors in the creation of venture capital backed firms.

Bank Monitoring and Investment: Evidence from the Changing Structure of Japanese Corporate Banking Relationships

During this decade the structure of corporate finance in Japan has changed dramatically. Japanese firms that once used bank debt as their prime source of financing now rely more heavily on the public capital markets. This trend was facilitated by the substantial deregulation of the Japanese capital markets. In an earlier paper (Moshi, Kashyap, and Scharfstein 1988). we demonstrated that investment by firms with close bank relationships appears to be less liquidity constrained than investment by firms without close bank ties. We interpreted this finding as evidence that bank ties tend to mitigate information problems in the capital market. This paper tracks the investment behavior of firms that have recently weakened their bank ties in favor of greater reliance on the bond market. The results suggest that these firms are now more liquidity constrained. The paper concludes with a discussion of why firms would loosen their bank ties in light of these liquidity costs.

Social Skills And Social Acceptance In Childhood Anxiety Disorders

The present study examined the social skills and social acceptance of children with SAD (n=20), children with GAD (n=18), and typically developing (TD) children (n=20). A multimodal assessment paradigm was employed to address three study objectives: (a) to determine whether social skills deficits are unique to children with SAD or extend to children with GAD, (b) to assess whether skills vary as a function of social context (in vivo peer interaction Wii Task versus hypothetical Social Vignette Task) and (c) to examine the relationship between anxiety diagnosis and social acceptance. Parent questionnaire data indicated that both youth with SAD and GAD experienced difficulties with assertiveness, whereas children with SAD experienced a broader range of social skills difficulties. Blinded observers’ ratings during the behavioral assessment social tasks indicated that compared to children with GAD and TD children, children with SAD have deficits in social behaviors and social knowledge across settings, including speech latency, a paucity of speech, few spontaneous comments, questions and exclamations, and ineffective social responses. In addition, vocal analysis revealed that children with SAD were characterized by anxious speech patterns. By comparison, children with GAD exhibited non-anxious speech patterns and did not differ significantly from TD youth on social behaviors, with the exception of fewer spontaneous comments and questions. Lastly, children with SAD were perceived as less likeable and less socially desirable by their peers than both children with GAD and TD children. Clinical implications of these findings are discusse

Elucidating The Social Skills Deficits In Children With Asperger\u27s Disorder: A Comparative Study

Children with Asperger\u27s Disorder are considered to have impairments in social interaction, but to date few studies have empirically addressed this issue. This study examined the existence of social skills deficits in children with Asperger\u27s Disorder, children with social phobia, and children with no psychological disorder. Using direct observation of social skills during role-play tasks, blinded observers rated an overall impression of social effectiveness and three specific categories of social skill: pragmatic behavior (e.g., effort to maintain conversation, latency to respond), speech and prosodic behavior (e.g., vocal inflection, voice volume), and paralinguistic conversational behaviors (e.g., facial orientation, motor movement). Children with Asperger\u27s Disorder did not display predicted social skills deficits when compared to typically developing children. When compared to children with social phobia, children with Asperger\u27s Disorder were rated as significantly more socially effective and were rated as more skilled on the molecular conversational behaviors that create an overall impression of social effectiveness. These results suggest that children with Asperger\u27s Disorder display adequate social skill during brief social interactions. Furthermore, the social skills deficits present in children with social phobia are not the same deficits found in children with Asperger\u27s Disorder. Implications of the findings are discussed