Article ID: | iaor200971632 |
Country: | United States |
Volume: | 57 |
Issue: | 5 |
Start Page Number: | 1114 |
End Page Number: | 1128 |
Publication Date: | Sep 2009 |
Journal: | Operations Research |
Authors: | Lobo Miguel Sousa, de Vricourt Francis |
Keywords: | health services, developing countries |
Nonprofit firms sometimes engage in for-profit activities for the purpose of generating revenue to subsidize their mission activities. The organization is then confronted with a consumption versus investment trade-off, where investment corresponds to providing capacity for revenue customers, and consumption corresponds to serving mission customers. Exemplary of this approach are the Aravind Eye Hospitals in India, where profitable paying hospitals are used to subsidize care at free hospitals. We model this problem as a multiperiod stochastic dynamic program. In each period, the organization must decide how much of the current assets should be invested in revenue-customer service capacity, and at what price the service should be sold. We provide sufficient conditions under which the optimal capacity and pricing decisions are of threshold type. Similar results are derived when the selling price is fixed, but the banking of assets from one period to the next is allowed. We compare the performance of the optimal threshold policy with heuristics that may be more appealing to managers of nonprofit organizations, and we assess the value of banking and of dynamic pricing through numerical experiments.