How do non-profits use profits? Evidence from US non-profit hospitals

Non-profit organizations can legally seek profits, but how they use profits is unclear. This study tests and extends Chang and Tuckman's theory of profit accumulation by non-profits. Through a longitudinal analysis of U.S. non-profit hospitals, we find that non-profit hospitals seek profit accumulation over time. Further analysis suggests that non-profit hospitals are more likely to expend accumulated profits to pursue organizational growth and financial stability than to subsidize services to disadvantaged groups and reduce health disparities. Overall, non-profit hospitals tend to prioritize profits to serve organizational benefits over social mission.