Economic incentives, debt utilization and charitable contributions in the hospice care setting

This dissertation consists of three essays that examine relevant activities within the portion of the US hospice care system that is funded by Medicare. Essay I examines the economic incentives between for-profit (FP) and non-profit (NP) hospice providers and developed patient quality of care proxies within hospice care and finds association between quality of care and the form of hospice provider ownership. Essay II examines the possibility of earnings management among FP hospice providers and finds support that FP providers may be engaging in negative earnings management. Essay III analyzes the association between private charitable donations and the developed patient quality of care proxies from essay I and finds mixed results. The nurse and social worker quality of care proxy was positively associated with private charitable donations but, there is no significant finding for the home-health aide quality of care proxy. Overall this research seeks to add to our understanding of the effects of economic factors in the under-researched area of hospice care within the accounting literature.