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Hospital free cash flowby: R. T. Kauer, J. B. Silvers
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AbstractSuboptimal investments by hospital managers often lead to poor returns and less future cash. Inappropriate use of free cash flow (FCF) produces large transaction costs of exit. Hypotheses concerning the current competitive conditions in the health care industry are set forth, and the implications of FCF for risk, capital-market efficiency, and the cost of capital to tax-exempt (TE) institutions is compared to capital-market norms. The theory of FCF is complementary only to those managers who serve shareholder interests rather than their own. FCF theory predicts that investor-owned (IO) institutions will remain only where there are attractive investments to warrant their continued participation. Unless IO managers interfere, capital-market efficiency permits or forces them to avoid FCF difficulties and, in general, lower their exit costs from the industry relative to their TE competitors.
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