Investing in Rural Healthcare: Impact of Private Equity Acquisition on Financial and Utilization Outcomes of Rural Hospitals
by Amanda He
Abstract
Private equity investment in the healthcare sector has risen considerably in recent decades, yet the impact of private equity ownership in rural hospital markets is largely unknown. Existing research points to a correlation between private equity acquisition and increased hospital incomes and charges. Rural hospitals, however, are structurally and operationally different from their urban counterparts, with lower occupancy rates and higher susceptibility to financial distress. This paper seeks to (1) characterize the types of rural hospitals acquired by private equity firms and (2) examine the changes in rural hospital financial, utilization, and survivability outcomes following private equity ownership. Using a 15-year panel of Medicare data, I estimate the impact of 352 private equity deal-hospitals across nine financial and utilization outcomes. Additionally, I estimate the impact of private equity on hospital closures. I find that private equity acquisition improves profitability for both urban and rural hospitals, but the magnitude is smaller for rural hospitals. My results suggest that private equity-owned hospitals increase profits by reducing operating expenses. Among rural hospitals, private equity ownership is associated with fewer discharges and lower occupancy rates, which may be a concern for long-term viability. I find a statistically significant negative correlation between private equity acquisition of rural hospitals and an increased likelihood of closure. PE-acquired hospitals have a negative spillover effect on other hospitals within the same hospital referral region, leading to a higher probability of closing.
Professor Ryan McDevitt, Faculty Advisor
Professor Michelle Connolly, Faculty Advisor
Professor Grace Kim, Faculty Advisor
JEL classification: G23, G33, G34, I10, I11
Do Green Stocks Get You the Green? Differential Impacts of S&P 500 ESG Index Labels on Firm Stock Prices
by Heera Rajavel
Abstract
On January 28, 2019, the S&P Dow Jones Indices launched the ESG S&P 500 Index, aiming to create a sustainable index fund with a similar risk/return profile to the S&P 500 Index. This study assesses the causal mechanisms behind the performance of the S&P 500 ESG Index by running two difference-in-differences estimations using a panel data set of 698 companies. The first difference-in-differences estimation compares the stock prices of companies on the S&P 500 ESG Index to the stock prices of companies S&P 500 Index, determining if companies on the S&P 500 ESG Index received an “ESG label” price premium. Results show that in the short-term and the long-term, companies on the S&P ESG 500 Index experienced statistically significant negative stock price growth relative to companies only on the general S&P 500 Index; the “ESG label” appears to slow stock growth for companies on the S&P 500 ESG Index by $48.24 in the short-term and $65.29 in the long-term. The second difference-in-differences estimation compares the stock prices of companies on the S&P 500 ESG Index to the stock prices of companies with similar ESG qualifications that are not on an S&P Index, determining if companies in the S&P 500 ESG Index received an “S&P label” price premium. These results found that in both the short and the long run, companies on the S&P 500 ESG Index faced statistically significant positive stock price growth relative to companies with similar ESG qualifications; the “S&P label” seems to increase stock price growth for companies on the S&P 500 ESG Index by $2.19 in the short-term and $7.63 in the long term.
Professor Lawrence Kreicher, Faculty Advisor
Professor Michelle Connolly, Faculty Advisor
JEL Codes: G2, G23, Q56
Private Equity IPOs: Long-term Performance and Drivers of Success
by Ignacio Hidalgo Perea
Abstract
In this paper, I explore the impact Private Equity ownership has on portfolio companies post-exit. This thesis aims to add to the discussion of whether the proliferation of Private Equity in the United States is a positive development for the country. Using a proprietary dataset that compiles thousands of IPOs between the years 2000 and 2016, I look at whether there are significant differences in performance between IPOs that come from Private Equity firms and those that go public on their own. Specifically, I use empirical analysis with robust regression to estimate the effects of Private Equity ownership on four key measures of financial success: MCAP growth, Revenue Growth, EBITDA Margin, and EV / EBITDA multiple. By looking at the changes in these measures of performance across three different time windows: 3 years post-IPO, 6 years post-IPO, and 9 years post-IPO, this paper determines how Private Equity ownership affects company performance post-exit and whether those effects persist over time.
Professor Grace Kim, Faculty Advisor
JEL Codes: G23, G24
The Elusive “Stock-Picker’s Market”: Dispersion and Mutual Fund Performance
By Jacob Epstein
This paper explores the relationship between active mutual fund performance and market dispersion from January 1990 to December 2018. I find a significant positive relationship between dispersion and 4-factor alpha overall, providing some evidence of managerial skill. There are large differences in this relationship by decade and fund selectivity. The results suggest active mutual funds were able to take advantage of stock-picking opportunities during the 1990s and 2000s, particularly the most active subset of funds. However, I find a significant negative relationship between dispersion and alpha for funds in the 2010s, indicating this relationship has changed over time. I discuss several possible explanations for this reversal, which could present interesting avenues for further research.
Advisors: Professor Emma Rasiel | JEL Codes: G1, G12, G23
Is Smart Money Smart? The Costs of Hedge Funds Trading Market Anomalies
By Matthew J. Farrell
Do hedge funds earn statistically significant premia on common factor trading strategies after trading costs are accounted for? Furthermore, what is the gap between what a hedge fund would earn and the paper portfolios that they hold? I answer this question by using the latest cutting-edge methodology to estimate trading costs for major financial market anomalies. This methodology uses the familiar asset-pricing Fama-MacBeth procedure to compare the on-paper compensation to factor exposures with those earned by hedge funds. I find that the typical hedge fund does not earn profits to value or momentum, and and low returns to size.
Advisor: Professor Brian Weller | JEL Codes: G12; G14; G23;
The Puzzle of Mobile Money Markets: An Example of Goldilocks Conditions
By Ricardo Martínez-Cid and Gonzalo Pernas
This paper investigates the supply-side and demand-side factors that explain the success of mobile money markets. Namely, we argue that there exists a set of Goldilocks conditions that best supports mobile money services. A population must have exposure to financial services to understand mobile money and have a high enough level of income to have a use for these services. However, the population must also not have access to highly developed banking architecture, such that their banking needs are already satisfied. By comparing El Salvador and Kenya, countries in different stages of development, we find empirical support for our hypothesis. Our evidence suggests that low income regions and households with some exposure to financial services are more likely to use mobile money than fully banked people who enjoy a higher income.
Advisor: Michelle Connolly, Erica Field | JEL Codes: E40, E42, G21, G23, O12, O16, O17
The Rise of Mobile Money in Kenya: The Changing Landscape of M-PESA’s Impact on Financial Inclusion
By Hong Zhu
M-PESA, the hugely popular mobile money system in Kenya, has been celebrated for its potential to “bank the unbanked” and increase access to financial services. This paper provides evidence to support this idea and explores mechanisms through which this might be the case. It specifically looks at the savings products held by individuals and how this changes in relation to M-PESA use. It then constructs an index for measuring the extent to which individuals are integrated into the formal financial sector. This paper argues that M-PESA’s effect on financial inclusion is a growing phenomenon, which suggests that keeping pace with the rapid evolutions of this mobile money system should be a high priority for researchers. As this paper elucidates, M-PESA has become notably more integrated with the formal financial sector in 2013 as compared to 2009, which holds implications for user behavior.
Advisor: Michelle Connolly, Xiao Yu Wang | JEL Codes: D14, E42, G21, G23, O1, O17, O16, O33 | Tagged: Financial Inclusion, Mobile Money, Savings,Technology
