Under this regulation, business organizations that spend more than $10,000 on lobbying must register and file reports that disclose lobbying activities and the amount spent on lobbying. Lobbying expenses, however, are the highest in for-profit hospitals, and the lowest in government hospitals, because governmental and charity money cannot be used for lobbying (Andrzejewski 2019; Leech 2006). 2015), we further conduct robustness analyses to test the lagged lobbying effects. The American Hospital Association conducts an annual survey of hospitals in the United States. As AHA pointed out, it doesn't take into account the significant cost of implementing and adopting the EHR system across facilities. Modernizing healthcare payments: exploring the opportunities, challenges and solutions, Leverage a data lakehouse to drive incremental value and quick wins, Nurses' clinical decision-making gets boost from predictive modeling. Hospitals in urban and networked hospitals have more access to all kinds of resources than their rural counterparts. Hospital Lobbying and Performance | Journal of Governmental Therefore, a study that includes the different types of organization ownership within one industry might provide further insights on the effects of lobbying. Second, although we find that the lobbying effects diminish in the second year after lobbying and disappear in the third year, the underlying factors behind this trend remain unclear. It provides special expertise and facilities for the support of vital function and utilizes the skill of medical nursing and other staff experienced in the management of these problems. Therefore, the hospital industry provides us a unique setting to study the different outcomes of lobbying activities among various types of ownership within one industry. A multihospital system is two or more hospitals owned, leased, sponsored, or contract managed by a central organization. Tom Nickels, the top lobbyist at the American Hospital Association, is retiring. In untabulated analyses, we re-estimate the regression models without controlling Leverage. Hospitals, 2022 | Map of Community Hospitals in the United States. The higher the MCI, the more competitive the hospital market. Lobbying is a primary avenue through which business organizations attempt to influence legislation, regulations, or policies. Early Medicaid expansion in Connecticut stemmed the growth in hospital uncompensated care, Affordable Care Act Medicaid expansion reduced uninsured hospital stays in 2014, The causes and consequences of internal control problems in nonprofit organizations, Firm level performance implications of nonmarket actions, Regulation and the rising cost of hospital care, Hospitals known for nursing excellence associated with better hospital experience for patients, Civic engagement and nonprofit lobbying in California, 19982003, Management strategies and financial performance in rural and urban hospitals, Hospital lobbying blitz starts paying off, This site uses cookies. Second, stakeholders are different.2 In NFP hospitals, the employees are one of the major stakeholders (Fritz 2020), an important constituency that can be satisfied with successful lobbying efforts, while investors are the core stakeholders in for-profit hospitals. Because these differences may impact hospital performance, we include state fixed effects, State, to control state variations. Hospitals with higher leverage are more likely to be financially constrained and thus to have limited resources. To test our second set of hypotheses, we develop Model (2) as follows: \begin{equation}\tag{2}Uncom{p_{i,t}} = {\gamma _0} + {\gamma _1}Lobb{y_{i,t - 1}} + \sum {Controls + Yea{r_t}} + Stat{e_i} + {\varepsilon _{i,t}} \end{equation}. We further conduct a supplementary change analysis to show that reverse causality does not drive the association between hospital lobbying expenses and uncompensated care costs. In the NFP and for-profit subsamples, the estimated coefficients 1 on Lobby_dum and Lobby_exp are negative and significant. For the full sample (9,646 observations), the mean of Lobby_dum is 0.774, indicating that 77.4 percent of hospitals have lobbying spending, and the mean (median) of Lobby_exp is 0.012 (0.002). Arizona's Safety Net Care Pool expired in December 2017, and Hawaii's uncompensated care pool expired in June 2016. 2016). The mean (median) of Salary is 0.456 (0.383). Sign up for our newsletter to track moneys influence on U.S. elections and public policy. In all models, we include year fixed effects, Year, to control for temporal variations. 2023 Healthcare IT News is a publication of HIMSS Media. OHA represents hospitals and health systems throughout Ohio. The coefficient on Lobby_dum is 0.0114 (0.0180) in the NFP (for-profit) subsample, suggesting that if an NFP (for-profit) hospital incurs lobbying expenses, the average saving in uncompensated care costs is $3.135 ($2.214) million. And now as the hospital industry stares down a newly empowered Democratic Party eyeing a litany of unprecedented health reforms Nickels is retiring at 68. Therefore, in this study, we can only study the hospitals that spend over $10,000 on lobbying at the federal level. Hospitals Infographics to provide visualizations for this data. Lobbying may have other substantial savings/benefits from the other items, such as employee training and insurance allocations. Provides care to pediatric patients that is of a more The means of MCI, Teaching, and Urban are slightly different from those in prior research because our sample includes more recent data. To request permission for commercial use, please contactus. We predict that Urban and Network are negatively correlated with Uncomp. DC We follow prior studies to select the control variables. American 2. Other intensive care. Medical-surgical intensive care. The American Medical Association was by their side every step of the way, delivering the financial resources and support necessary to keep their practices afloat, American Hospital Assn Lobbying Profile OpenSecrets Table 8 presents the results, which are consistent with those in our main analyses in Table 4. Therefore, a one unit increase in Salary means an increase of $431 million in raw salaries, and a one unit increase in Lobby_exp means an increase of $19.5 million in raw lobbying expenses. In this study, we use the most recent hospital financial and lobbying expense data to examine the effects of hospital lobbying on employee salaries, uncompensated care costs, and ROA. Intensive care bed counts are reported on the AHA Annual Survey by approximately 80% of hospitals. Lobbying is one of the most dominant types of political involvement (Lin 2019; Cao, Fernando, Tripathy, and Upadhyay 2018). Therefore, we expect that lobbying is positively related to employee salaries in NFP and government hospitals, whereas this effect does not exist in for-profit hospitals. AHA Hospital Statistics is published annually by Health Forum, an affiliate of the American Hospital Association. To order print copies of AHA Hospital Statistics, call (800) AHA-2626 or visit the AHA online store. An interactive online version is also available. Note that the ICU beds data is not published in AHA Hospital Statistics. Top 20 healthcare lobbyists by 2021 spending through June It is not a surprise that Uncomp is higher on average in government hospitals compared to either for-profit or NFP hospitals, because Cram et al. 4. To learn the reason for this finding, we conduct one additional test to study the association between hospital lobbying and revenue. Table 4 presents the results from estimating Model (2). In the for-profit subsample, the mean of total assets is $99.9 million. Although our main analyses control for a variety of hospital characteristics that might account for the effects of hospital lobbying on hospital uncompensated care, reverse causality is always a concern. However, unlike for-profit organizations, NFP organizations may have different purposes when they engage in lobbying activities (McFarland 1995). Fast Facts on U.S. Hospitals, 2022 | AHA - American Furthermore, it is important to note that lobbying has complex outcomes, and cost saving is only one of its goals. Unlike government and NFP hospitals, for-profit hospitals can independently determine employee salaries based on profitability and thus are not involved in lobbying related to employee salaries (Barragato 2002). These units are staffed with specially trained nursing personnel and contain monitoring and specialized support equipment for patients who because of shock, trauma or other life-threatening conditions require intensified comprehensive observation and care. Harmonizing Data to Achieve Excellence in Healthcare: Supply Chain Data is Key! To test H3, we develop Model (3) as follows: \begin{equation}\tag{3}RO{A_{i,t}} = {\delta _0} + {\delta _1}Lobb{y_{i,t - 1}} + \sum {Controls + Yea{r_t}} + Stat{e_i} + {\varepsilon _{i,t}} \end{equation}, Hospital staffing, organization, and quality of care: Cross-national findings, Quality improvement and hospital financial performance, Measuring rates of return on lobbying expenditures: An empirical case study of tax breaks for multinational corporations, Lobbying as a potent political marketing tool for firm performance: A closer look, Hospital ownership, performance, and outcomes: Assessing the state-of-the-science, Linking for-profit and nonprofit executive compensation: Salary composition and incentive structures in the U.S. hospital industry, The corporate value of (corrupt) lobbying, Lobbying, political connectedness and financial performance in the air transportation industry, An investigation of economic efficiency in California hospitals. Yangmei Wang, Texas State University, Department of Accounting, San Marcos, TX; Yuewu Li and Jiao Li, Texas Tech University, Rawls College of Business, Lubbock, TX, USA. Lobbying Regression of Hospital Uncompensated Care Costs on Lobbying. Uncompensated care, including charity care and bad debts, is an overall measure of hospital care provided for which no payment is received from patients or insurers (Davidoff et al. Since we predict that lobbying has different effects on employee salaries and/or uncompensated care costs based on the different types of hospital ownership, we further expect that lobbying will have different impacts on return on assets (ROA) among the three types of hospital ownership. Total intensive care beds are not summed because the care provided is specialized. It is reasonable to expect that savings in uncompensated care costs are less than lobbying spending. To regulate lobbying and increase its accountability, the Lobbying Disclosure Act of 1995 became effective on January 1, 1996. Thus, reverse causality does not drive the association between hospital lobbying expenses and uncompensated care costs. In addition to rendering healthcare services, teaching hospitals have responsibilities for training medical/nursing students, which incurs additional human resource costs (i.e., employee salaries). These distinct effects of hospital lobbying provide evidence that NFP hospitals lobby to protect employees' interests, while for-profit hospitals lobby to maximize investors' interests. Hospital characteristics vary widely due to different types of ownership (see Appendix B for a review), and these differences affect their lobbying goals and outcomes. Photo by Freedom to Marry courtesy of Creative Commons license. For example, like educational institution lobbying (de Figueiredo and Silverman 2006), hospital lobbying can also result in more federal funding. 10 Largest Lobbyist Groups In The United As a percentage of all new housing, new HOA construction increased by 34.8%. In this study, we examine the association between lobbying and hospital performance and find that the effects of lobbying activities on hospital performance vary according to the distinct types of hospital ownership. Workforce The coefficients on Lobby are positive and significant in NFP and for-profit hospitals, suggesting that hospital lobbying increases hospital net patient revenue in NFP and for-profit hospitals. A specially staffed, specialty equipped, separate section of a hospital dedicated to the observation, care, and treatment of patients with life-threatening illnesses, injuries, or complications from which recovery is possible. For example, both Collum, Menachemi, and Sen (2016) and Cho, Ke, Atems, and Chang (2018) use the 2010 American Hospital Association survey data. These pools are time limited and created through Medicaid Section 1115 waivers. Two high-ranking Democrats who can throw a lot of weight around are supporting the bill- Ways and Means Chairman Sandy Levin (Mich.-D) and Health subpanel Chairman Pete Stark (Calif.-D). More recently, Brown (2016) finds that lobbying activities are associated with a high ROA, return on invested capital (ROIC), and ROE in Fortune 500 firms. Prior years include spending from January through December. We predict that Size is positively correlated with Salary. Hospital lobbying does not increase employee salaries in for-profit hospitals. Alexander et al. After the introduction, this study is arranged as follows. The Importance of Lobbying for Education - Dorn Policy Group, Inc. American Hospital Association lobbying hard - Healthcare IT News Economies of scale also play a role in hospital financial performance. Rural Hospitals 2022 Infographic PDF, Fast Facts: U.S. Health Systems 2023 Infographic PDF, With Its New Genomics Data Services, AWS Hopes to Facilitate Rapid Advances in Precision Medicine, Data and Analytics | Strengthening the Health Care Workforce, AHA Letter to CMS on Establishment of a National Directory of Health Care Providers and Services (NDH), Section 2 - Data and Technology | Strengthening the Health Care Workforce, HRSA releases data on organ donations, transplants, AHA comments on proposed HIPAA transaction standards for health care attachments, MedPAC adopts payment recommendations for 2024, HRSA to host training webinar for National Practitioner Data Bank administrators, Reminder: Hospital COVID-19 data reporting moves to CDC network Dec. 15, OCR reminder: HIPAA rules apply to online tracking technologies, HRSA releases data on maternity care health professional shortage areas, Congress urged to prevent additional PAYGO cuts to Medicare, CMS: Clinical laboratories must report private payer data beginning Jan. 1, The Current State of Hospital Finances: Fall 2022 Update, Fast Facts: U.S. Health Systems Infographic, Fast Facts: U.S. Lobbying has both negative and positive connotations. As we discussed previously, however, uncompensated care costs are one part of hospital costs. NFP and government hospitals need to lobby for more funding or raising the standard of reasonable compensation to protect employees' incomes. Lee and Baik (2010) find that lobbying can reduce tariffs in import/export businesses. 6. The hospital industry has a broad spectrum of lobbying interests. (2010) find that government hospitals provide significantly more uncompensated care. Will not changing the provision keep multi-campus hospital systems from adopting EHRs? Charity care is never expected to be reimbursed, and it is different from bad debts that hospitals incur when they bill patients but do not receive payment (AHA 2010). The results support our H1c but do not support our H1b. Specifically, NFP and government hospitals protect the interests of their employees, who are their major stakeholders, while for-profit hospitals maximize their investors' interests (Fritz 2020). We predict that Leverage is positively correlated with Uncomp. The beneficiaries of Medicare and Medicaid are less likely to pay their bills in full amounts. It includes the number of hospitals, government hospitals, hospitals in each state, hospital beds, ICU beds, admissions, and expenses in the U.S. Fast Facts on U.S. Hospitals Infographics, Download the Fast Facts on U.S. Hospitals and related healthcare institutions rank the 8th highest in lobbying with expenditures of over $1.79 billion over the past 22 years (Frankenfield 2020), but empirical research on lobbying in the hospital industry is relatively sparse, partially due to hospital data limitations.1 Like other lobbying organizations, hospitals or hospital groups that engage in lobbying usually maintain a close relationship with lawmakers, so they often take advantage of that relationship and alter their business strategies earlier to better prepare for the changing environment (Marmor et al. Therefore, we expect that lobbying activities have different outcomes among the three types of ownership in the hospital industry. In order to protect stakeholders' interests, hospitals lobby legislators to influence policies such as compensation for goods and services, licensing, and oversight (Landers and Sehgal 2004; Pradhan 2020). Regulations on government hospitals, including salary regulations, are stricter than those on other types of hospitals (Becker et al. The average ROA is the lowest (near zero) in government hospitals, slightly positive in NFP hospitals that must self-fund but do not need to reward shareholders, and the highest in for-profit hospitals where shareholders expect a positive return on their investments. Similar to our predictions in Model (1), we predict that the directions of the coefficients on MedicareMix and MedicaidMix are unknown. Both Medicare and Medicaid are government-sponsored health insurance plans. Millions are stuck in dental deserts, with no access to oral health AHA does not claim ownership of any content, including content incorporated by permission into AHA produced materials, created by any third party and cannot grant permission to use, distribute or otherwise reproduce such third party content. In Section V we present supplementary analyses. In Section IV we present and discuss the results of the empirical tests. Dorn Policy Group, Inc. 101 N. 1st Avenue 20th Floor, Suite 2090 Phoenix, Arizona 85003 Telephone: 602-606-4667 Nine states had uncompensated care pools. 20005. For-profit organizations lobby for policies that maximize their profitability, while NFP organizations are also responsive to social needs and public services beyond their own interests (McFarland 1995; Barragato 2002). Thus, we further posit our third hypothesis as follows: We use hospital financial data from Definitive Healthcare, LLC, a subscribed healthcare data provider. WebAMA estimates that 65% of your membership dues are allocable to lobbying activities of the AMA, and therefore are not deductible for income tax purposes. Thus, lobbying business organizations can take advantage of decreasing costs over nonlobbying business organizations in the same industry. The focus of AHA's discontent is the provision that makes hospitals, regardless of how many campuses they have, eligible for only one incentive payment if the multiple facilities share the same Medicare provider number. Hospitals follow regulations to determine whether patient care is classified as either charity care costs or bad debts. According to Milyo, Primo, and Groseclose (2000), business organizations spend approximately ten times more on lobbying than on other political expenses. WebLobbying 2022 2021 $2,720,000 REVOLVING DOOR 9 out of 18 National Education Assn lobbyists in 2021 have previously held government jobs. The latest Updates and Resources on Novel Coronavirus (COVID-19). Search for other works by this author on: To test our first set of hypotheses, we develop Model (1) as follows: \(\def\upalpha{\unicode[Times]{x3B1}}\)\(\def\upbeta{\unicode[Times]{x3B2}}\)\(\def\upgamma{\unicode[Times]{x3B3}}\)\(\def\updelta{\unicode[Times]{x3B4}}\)\(\def\upvarepsilon{\unicode[Times]{x3B5}}\)\(\def\upzeta{\unicode[Times]{x3B6}}\)\(\def\upeta{\unicode[Times]{x3B7}}\)\(\def\uptheta{\unicode[Times]{x3B8}}\)\(\def\upiota{\unicode[Times]{x3B9}}\)\(\def\upkappa{\unicode[Times]{x3BA}}\)\(\def\uplambda{\unicode[Times]{x3BB}}\)\(\def\upmu{\unicode[Times]{x3BC}}\)\(\def\upnu{\unicode[Times]{x3BD}}\)\(\def\upxi{\unicode[Times]{x3BE}}\)\(\def\upomicron{\unicode[Times]{x3BF}}\)\(\def\uppi{\unicode[Times]{x3C0}}\)\(\def\uprho{\unicode[Times]{x3C1}}\)\(\def\upsigma{\unicode[Times]{x3C3}}\)\(\def\uptau{\unicode[Times]{x3C4}}\)\(\def\upupsilon{\unicode[Times]{x3C5}}\)\(\def\upphi{\unicode[Times]{x3C6}}\)\(\def\upchi{\unicode[Times]{x3C7}}\)\(\def\uppsy{\unicode[Times]{x3C8}}\)\(\def\upomega{\unicode[Times]{x3C9}}\)\(\def\bialpha{\boldsymbol{\alpha}}\)\(\def\bibeta{\boldsymbol{\beta}}\)\(\def\bigamma{\boldsymbol{\gamma}}\)\(\def\bidelta{\boldsymbol{\delta}}\)\(\def\bivarepsilon{\boldsymbol{\varepsilon}}\)\(\def\bizeta{\boldsymbol{\zeta}}\)\(\def\bieta{\boldsymbol{\eta}}\)\(\def\bitheta{\boldsymbol{\theta}}\)\(\def\biiota{\boldsymbol{\iota}}\)\(\def\bikappa{\boldsymbol{\kappa}}\)\(\def\bilambda{\boldsymbol{\lambda}}\)\(\def\bimu{\boldsymbol{\mu}}\)\(\def\binu{\boldsymbol{\nu}}\)\(\def\bixi{\boldsymbol{\xi}}\)\(\def\biomicron{\boldsymbol{\micron}}\)\(\def\bipi{\boldsymbol{\pi}}\)\(\def\birho{\boldsymbol{\rho}}\)\(\def\bisigma{\boldsymbol{\sigma}}\)\(\def\bitau{\boldsymbol{\tau}}\)\(\def\biupsilon{\boldsymbol{\upsilon}}\)\(\def\biphi{\boldsymbol{\phi}}\)\(\def\bichi{\boldsymbol{\chi}}\)\(\def\bipsy{\boldsymbol{\psy}}\)\(\def\biomega{\boldsymbol{\omega}}\)\(\def\bupalpha{\bf{\alpha}}\)\(\def\bupbeta{\bf{\beta}}\)\(\def\bupgamma{\bf{\gamma}}\)\(\def\bupdelta{\bf{\delta}}\)\(\def\bupvarepsilon{\bf{\varepsilon}}\)\(\def\bupzeta{\bf{\zeta}}\)\(\def\bupeta{\bf{\eta}}\)\(\def\buptheta{\bf{\theta}}\)\(\def\bupiota{\bf{\iota}}\)\(\def\bupkappa{\bf{\kappa}}\)\(\def\buplambda{\bf{\lambda}}\)\(\def\bupmu{\bf{\mu}}\)\(\def\bupnu{\bf{\nu}}\)\(\def\bupxi{\bf{\xi}}\)\(\def\bupomicron{\bf{\micron}}\)\(\def\buppi{\bf{\pi}}\)\(\def\buprho{\bf{\rho}}\)\(\def\bupsigma{\bf{\sigma}}\)\(\def\buptau{\bf{\tau}}\)\(\def\bupupsilon{\bf{\upsilon}}\)\(\def\bupphi{\bf{\phi}}\)\(\def\bupchi{\bf{\chi}}\)\(\def\buppsy{\bf{\psy}}\)\(\def\bupomega{\bf{\omega}}\)\(\def\bGamma{\bf{\Gamma}}\)\(\def\bDelta{\bf{\Delta}}\)\(\def\bTheta{\bf{\Theta}}\)\(\def\bLambda{\bf{\Lambda}}\)\(\def\bXi{\bf{\Xi}}\)\(\def\bPi{\bf{\Pi}}\)\(\def\bSigma{\bf{\Sigma}}\)\(\def\bPhi{\bf{\Phi}}\)\(\def\bPsi{\bf{\Psi}}\)\(\def\bOmega{\bf{\Omega}}\)\begin{equation}\tag{1}Salar{y_{i,t}} = {\beta _0} + {\beta _1}Lobb{y_{i,t - 1}} + {\beta _2}MC{I_{i,t}} + {\beta _3}MedicareMi{x_{i,t}} + {\beta _4}MedicaidMi{x_{i,t}} + {\beta _5}Siz{e_{i,t}} + {\beta _6}Leverag{e_{i,t}} + {\beta _7}Teachin{g_{i,t}} + {\beta _8}Urba{n_{i,t}} + {\beta _9}Networ{k_{i,t}} + Yea{r_t} + Stat{e_i} + {\varepsilon _{i,t}} \end{equation}. Last, the Lobbying Disclosure Act of 1995 only requires that organizations that spend more than $10,000 on lobbying must register and file reports to disclose the lobbying issues and the amount spent. Therefore, we posit our first set of hypotheses as follows: Hospital lobbying increases employee salaries in NFP hospitals. Lobbying Percentage Healthcare report: How are U.S. healthcare organizations embracing intelligent automation to enhance patient centricity? Washington, We predict that MCI is negatively correlated with Uncomp. 7. Here are some highlights. 2018). How to Become A Lobbyist - Dorn Policy Group, Inc. AMA membership dues Therefore, we expect this cost saving effect only exists in NFP and for-profit hospitals. The results of these studies are not warranted when they are generalized across organization ownership. The HIMSS Global Health Conference & Exhibition is the most influential health information technology event of the year, where 40,000+ professionals throughout the global health ecosystem. Rural Hospitals Infographic, Fast Facts on U.S. Hospitals 2023 Infographics PDF, Fast Facts on U.S. Thus, the combined effects on hospital financial performance are unknown. Copyright 1998 - 2023 American Accounting Association. System affiliation does not preclude network participation. Provides patient care of a more intensive nature than the usual medical and surgical care, on the basis of physicians orders and approved nursing care plans. Thus, if an NFP or government hospital plans to increase its employee salaries and protect their interests, the hospital has to lobby the legislators to raise the standard of reasonable compensation. Pradhan (2020) reports that government and NFP hospitals have been lobbying to protect employees' incomes and interests for a long time. A 501(c)(3) tax-exempt, charitable organization, 1100 13th Street, NW, Suite 800 The major stream of NFP lobbying literature focuses on the characteristics of NFP organizations that engage in lobbying, such as the size, age, location, and charitable status of the organization, as well as factors influencing lobbying decisions and strategies, such as the amount of donations received, IRS status, information technology, cross-sector competition, restrictions on delivering core services, policy network, and the perception of the probability of lobbying success (Chavesc, Stephens, and Galaskiewicz 2004; Child and Grnbjerg 2007; Nicholson-Crotty 2007, 2009; Surez and Hwang 2008; Mosley 2010; Fyall and McGuire 2015; Garrow and Hasenfeld 2014). Excluded are hospitals not accessible by the general public, such as prison hospitals or college infirmaries. 2015). Under the pressure of CMS review, NFP and for-profit hospitals lobbied lawmakers during the waiver review process to keep uncompensated care pool funds (Hawryluk 2015). NOTE: Figures on this page are calculations by OpenSecrets based on data from the Senate Office of Public Records. Get daily news updates from Healthcare IT News. The Center for Responsive Politics (OpenSecrets.org) provides us with hospital lobbying data regarding total lobbying expenses at the federal level. The report was filed on Oct. 2, Except for the Revolving Door section, content on this site is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 United States License by OpenSecrets.org. In the United States, lobbying is practiced primarily by business organizations using either external lobbyists or in-house professionals. The influence of physician board participation on hospital financial performance, Organizational resources and environmental incentives: Understanding the policy advocacy involvement of human service nonprofits, Network structure and hospital financial performance in New York State: 19911995, Politics, policy, and the motivations for advocacy in nonprofit reproductive health and family planning providers, The stages and strategies of advocacy among nonprofit reproductive health providers. Many studies find that NFP organizations that engage in more lobbying receive more donations, grants, or federal funds (e.g., de Figueiredo and Silverman 2006; Nicholson-Crotty 2011; Petrovits, Shakespeare, and Shih 2011). When Lobby_dumt2 and Lobby_expt2 are the variables of interest, the results are consistent with those in Tables 35, except that the magnitude and significance are smaller than those in our main analyses. Whereas some hospitals could benefit from lobbying due to a specific rule or legislation changes, others might be hurt. Distinctive Characteristics of Hospital Ownership Types. Some studies find no relationship or a negative relationship between lobbying and future abnormal returns or Tobin's q (see Coates 2012; Igan, Mishra, and Tressel 2012; Skaife, Veenman, and Werner 2013; Hadani and Schuler 2013; Cao et al. Number of Nongovernment Not-for-Profit Community Hospitals, Number of Investor-Owned (For-Profit) Community Hospitals, Number of State and Local Government Community Hospitals, Number of Nonfederal Psychiatric Hospitals, Intensive Care Beds 3 in Community Hospitals (FY2019 data to be updated 2/21), Medical-Surgical Intensive Care 4 Beds in Community Hospitals, Cardiac Intensive Care 5 Beds in Community Hospitals, Neonatal Intensive Care 6 Beds in Community Hospitals, Pediatric Intensive Care 7 Beds in Community Hospitals, Other Intensive Care 9 Beds in Community Hospitals, Number of Community Hospitals in aSystem 10.