의료법인의 영(0)에 근접한 이익조정현상에 관한 연구
The Effects of Korean Hospitals' Earnings Management Incentives on Near-Zero Income Reporting
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초록
현행 의료법인은 대정부 협상과정을 통한 의료행위가격의 결정, 규제산업, 소유형태에 따른 경영자보상체계의 차이 및 기부금수입의 발생이라는 특성을 지니고 있다. 본 연구는 이러한 네 가지 유인들이 동시에 작용할 경우 서로 상쇄되어 결국, 보고이익은 영(0)에 근접한 수준으로 이익조정될 것으로 예상하였다. 본 연구의 결과는 다음과 같다. 첫째, 보험급여수익비율과 영(0)에 근접한 이익조정 간에 통계적으로 유의한 양(+)의 관련성이 관찰되었다. 이러한 현상은 의료법인의 의료수가인상유인으로서 의료행위가격 협상과정에서 대정부 협상력을 높이기 위해 보고이익을 가능하면 줄이거나 영(0)에 근접한 수준으로 이익조정하려는 유인이 작용하고 있음을 시사하고 있다. 둘째, 의료법인의 규모와 영(0)에 근접한 이익조정 간에도 통계적으로 유의한 양(+)의 관련성을 보였다. 규제산업에 속한 의료법인은 규모가 클수록 정부의 규제 및 통제로 인한 정치비용을 부담하기 때문에 가능하면 이익감소 또는 영(0)에 근접한 수준으로 보고이익을 조정한다는 것으로 정치비용가설을 지지하는 결과로 해석된다. 셋째, 민간소유의 의료법인과 영(0)에 근접한 이익조정 사이에 양(+)의 관련성이 나타났다. 이러한 결과는 민간소유의 의료법인일수록 적자회피이익조정 및 영(0)에 근접한 이익조정과 통계적으로 유의한 양(+)의 관련성이 나타났다. 이러한 결과는 민간소유의 의료법인일수록 경영성과와 보상간의 관계를 고려하여 이익을 증가시키거나 영(0)에 근접한 보고이익수준으로 보고하려는 성향이 크다는 것을 시사하고 있다. 넷째, 기부금수익비율과 영(0)에 근접한 이익조정 사이에는 예상과는 다르게 음(-)의 관련성을 관찰할 수 있었다. 기부자는 해당 의료법인의 경영성과에 대한 모니터링을 통해 차후 기부의사결정을 하기 때문에 의료법인의 경영자는 가능하면 이익을 증가시키거나 영(0)에 근접한 수준으로 이익조정할 유인이 작용한다는 Yetman(2003)의 주장과는 다른 결과로, 오히려 적자수준의 경영성과를 보여 기부자들로 하여금 기부금을 유인하려는 것으로 해석된다. 본 연구의 결과는 의료법인의 이익조정유인을 분석하여 다양한 이익조정 유인에 따라서 영(0)에 근접한 이익수준을 보고하는 실증적인 증거를 제시하였다는데 연구의 의의가 있다. 또한 향후 비영리법인에 대한 회계나 조세정책을 입안하고 시행하는 관련 정부당국에 실증적 연구자료로 활용될 수 있으며, 비영리법인의 이익조정현상에 대한 기초적 연구토대를 마련하였다는 점에 연구의 공헌이 있다.
Abstract
This study investigates whether characteristics of Korean hospital industry influence the behavior of earnings management for near zero income reporting. Generally speaking, characteristics of Korean are as follows; First, hospitals have incentives to decrease their reported income or meet near zero in order to enhance the bargaining power in the process of pricing medicare price and/or cost. Second, hospitals have also incentives to decrease or meet their reported income level at around near because medical industry is regulated by government. Especially, this phenomenon conspicuously occurs at lager size of hospital. Third, compensation scheme may differ according to ownership or owner type. Civil owned hospitals may implement the performance based compensation system other than government owned hospitals. So, managers of civil hospital have intent to increase reported income or meet around zero. Finally, hospitals' revenue may be from external donation. These Donor can monitor hospitals' performance, and then make a decision about additional donation. Thus, hospital managers have incentives to increase reported income or meet near zero. In above characteristic, there is two different perspectives about sign of earnings management, positive and negative reported income. we develops four hypothesis regarding relationship between incentives and earnings management for meeting reporting income level to around zero. Offsets may occur from interaction between both sign of earnings management such as increasing or decreasing reported income. Thus, the extent of earnings management, as like reported income level, may be near(around) zero. This study executes logistic regression of profit-avoidance dummy, loss-avoidance dummy and near-zero dummy, measured by methodology of Burgstahler and Dichev(1997), on ratio of insurance revenue to total revenue, size, civil hospital dummy and ration of donation revenue to total revenue. And research samples consist of 616 hospital-year, selected from disclosure system of Korean National Tax Service. The results of this study are as follows. First, there is statistically significant positive relationship between Near-Zero and ratio of insurance revenue and between Profit-Avoid and this ratio. Thus, it is verified that hospitals manage their reported income around zero or avoid profit(positive income) in order to obtain bargaining power against government. Second, size of hospitals has also significantly positive coefficient with Near-Zero and Profit-Avoid.. This results say that large size of hospital tend to avoid profit or meet their income level near zero, in oder to decrease or mitigate political costs. Third, there is statistically significant positive relationship between Near-Zero and civil owned hospital, and also between Loss-Avoid and civil hospital. So, it can be explained that managers of civil hospital rather than governmental hospital have incentives to manage earnings for loss avoidance or meet around zero in order to increase their compensation as they show their performance. Finally, donation ratio has significantly negative coefficient with Near-Zero in contrast with our expectation. Thus, it says that hospitals is likely to manage earnings for far from zero in order to maintain or increase the donors by reporting bad performance to them. This study has implications to practitioners, academics and related authority on accounting of Nonprofit organization. In addition, This study makes contributions to several lines of existing research on earnings management as well.
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