students wonder exactly what health economics is. is it about money in health, more health for the same money ? about health in hospitals or health of the country.
students wonder exactly what health economics is. is it about money in health, more health for the same money ? about health in hospitals or health of the country.
Essential Package of Health Services Country Snapshot: The Republic of South ...HFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
Health economics is a branch of economics concerned with issues related to efficiency, effectiveness, value and behavior in the production and consumption of health and healthcare.
Essential Package of Health Services Country Snapshot: PakistanHFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
Budget matters for health: key formulation and classification issuesHFG Project
This policy brief aims to raise awareness on the role of public budgeting – specifically aspects of budget formulation – for non-PFM specialists working in health. As part of an overall WHO programme of work on Budgeting in Health, it will help clarify the characteristics and implications of various budgeting approaches for the health sector.
Improving Efficiency to Achieve Health System Goals in Botswana: Background P...HFG Project
Health outcomes have improved in Botswana over the last few decades. These successes have come at the same time as overall macroeconomic growth, with annual Gross Domestic Product (GDP) growth averaging around 6 percent between 2010 and 2015 (IMF 2015), and Human Development Index ranking above the regional average. These improvements originate in a strong health service delivery system. In 2008, Botswana’s public health system included 338 health posts and 277 health clinics, sufficient to ensure that at least 80 percent of the population has coverage of essential, high-impact services. Management of these services was initially done by the Ministry of Local Government but has been transferred to district health teams under the Ministry of Health (MOH). As of 2008, Botswana’s public health system also had 17 primary hospitals, 14 district hospitals, two referral hospitals, and one mental health hospital; these hospitals are managed by the central government.
Essential Package of Health Services Country Snapshot: IndonesiaHFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
Public Financial Management, Health Governance, and Health SystemsHFG Project
While the importance of governance in a health system is well recognized, there is an overall lack of evidence and understanding of the dynamics of how improved governance can influence health system performance and health outcomes. There is still considerable debate on which governance interventions are appropriate for different contexts. This lack of evidence can result in avoidance of health governance efforts or an over-reliance on a limited set of governance interventions. As development partners and governments are increasing their emphasis on improving accountability and transparency of health systems and strengthening country policies and institutions to move towards universal health coverage (UHC), the need of this evidence is ever rising.
To address this evidence gap, the USAID’s Office of Health Systems (USAID/GH/OHS), the World Health Organization (WHO), and the Health Finance and Governance (HFG) Project launched an initiative in September 2016 to ‘Marshall the Evidence’ on how governance contributes to health system performance and improves health outcomes.
The overall objective of the initiative was to increase awareness and understanding of the evidence of what works and why in how governance contributes to health system performance, and how the field of health governance is evolving at the country level. This report provides a synthesis of the findings across the four themes. This report presents the findings of the Public Financial Management.
Modeling the impact of the health finance and governance projectHFG Project
Over its six-year life (2012-2018), the project worked with more than 40 partner countries to increase their domestic resources for health, manage resources more effectively, and reduce system bottlenecks in order to increase access to and use of priority health services and strengthen health systems overall. HFG provided state-of-the-art and country-specific technical assistance to remove obstacles that impede effective health system functioning and essential reforms. Recognizing the importance of measuring its impact, HFG quantified its return on investment for HFG health systems strengthening efforts.
HFG and its partner Avenir Health conducted a rigorous exercise to estimate the impact of the project’s health systems strengthening activities on its overall goal: increased use of priority health services. We used Spectrum, a suite of modeling tools developed by Avenir Health and partners, to quantify impact on mortality and morbidity based on changes in the coverage of specific priority health services due to the project’s activities aimed at improving access, quality, and use of health care. Given the diverse activities of HFG and the challenge of establishing a measurable causal link between project activities and coverage effects, we adopted a conservative approach and chose for this impact modeling exercise a subset of HFG activities for which a direct link was apparent. Based on these parameters, the exercise was conducted for eight country programs: Bangladesh, Cote d’Ivoire, Cameroon, Ethiopia, Haiti, Nigeria, Senegal, and Vietnam.
Using a methodical approach, we analyzed individual project activities in these countries and the expected effects on service coverage to estimate the impact on morbidity and mortality. We examined how our activities, including implementing strategies for improved human resources for health, operationalizing health insurance schemes, rolling out packages of health services, and using costed plans and packages to advocate for more financial resources, will increase access to health services, which in turn will lead to greater coverage of health services among targeted populations and ultimately to reduced morbidity and mortality. We modeled the impact of HFG’s activities by quantifying the number of deaths that were averted as a result of HFG-supported strategies and reforms.
The modeling results indicate that continued implementation of health systems strengthening strategies like those HFG supported would bring significant expansion of health care coverage and enhanced health outcomes.
This report presents country- and activity-specific results and the methodology for estimating coverage changes and impact. We hope this modeling exercise adds to the global understanding of how the impact of health systems strengthening can be measured. It provides powerful evidence on why investment and effort in strengthening health systems must continue.
Essential Package of Health Services Country Snapshot: IndiaHFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
Essential Package of Health Services Country Snapshot: UgandaHFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
Essential Package of Health Services Country Snapshot: RwandaHFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
The Health Finance and Governance Briefing KitHFG Project
Resource Type: Brief
Authors: Megan Meline, Lisa Tarantino, Jeremy Kanthor, and Sharon Nakhimovsky
Published: September 2015
Resource Description: Getting access to affordable, quality health care is a universal story that touches virtually every family in the world. At the same time, providing quality health services and access to trained health professionals is a challenge for governments. The World Health Organization (WHO) estimates that 150 million people worldwide face “catastrophic expenditure” because of high costs of health care. In other words, they may have to forgo paying for basic needs, such as food, housing, or education to pay for medical treatment instead. These costs include transportation, doctors’ fees, medicine, hospitalization bills, and days lost from work.
Behind these sobering statistics lies a wealth of news and feature stories waiting for the media to investigate and share with national leaders and policymakers as well as civil society groups who can advocate for changes to health budgets and policies. At the heart of these stories are important questions about the financing of health care and the quality of governance that ensures responsive and effective management of those resources and services.
But writing health finance and governance stories can be challenging. Health finance is riddled with complex language, technical economic terms, and numbers – not necessarily a journalist’s comfort zone. The right sources for these stories can be difficult to identify and unwilling to talk. Data may be difficult to locate or to understand. And while corruption makes for splashy headlines, the broader systemic challenges of health governance are not widely understood — and yet they are important.
The Health Finance and Governance Briefing Kit is designed to help journalists and their editors uncover and tell these important health stories that affect people all around the world.
Health economics is a branch of economics concerned with issues related to efficiency, effectiveness, value and behaviour in the production and consumption of health and health care.
In broad terms, health economists study the functioning of health care systems and health- affecting behaviour such as smoking.
It is the discipline of economics applied to the health care.
IntroductionThe budgeting process is an attempt to estab.docxmariuse18nolet
Introduction
The budgeting process is an attempt to establish a set of realistic standards for operating a health care organization. The budget is a set of specific objectives for the year ahead. The finance system provides the cost and revenue data and sometimes assists with other measures.
Formulating a budget is the beginning of the process. Every budgeting system must contain provisions for preparing the budget and implementing a system. This system must include coordination, control, follow-up, and maintenance. An effective budget must be tailored to the organization’s specific needs. The budget must be comprehensible and attainable. There should be innovation and flexibility to meet unexpected occurrences.
A health care organization’s budget provides a fully detailed description of expected financial transactions, by accounting period, for at least an entire year. The review of future expectations is useful in making smooth progress toward financial goals.
The major parts of an annual budget address operational and financial planning needs. The operating budgets are made up of the following:
· Expenditure or cost budgets anticipated by reporting period and responsibility center: Costs are often identified as fixed, semi-variable, or variable. Anticipated volumes of demand or output are incorporated into cost budgets.
· Revenue budgets reflect the receipt of income from services rendered. Standard gross revenue accounting reports a profit increase to the responsibility center, creating an incentive for productive activity.
· Income and expense budgets consist of expected net income and expenses incurred by the organization.
· Financial budgets embrace the effects of the organization’s financial decisions. These plans include a budgeted balance sheet that shows the effects of planned operations and capital investments on assets, liabilities, and equities. The plans also include a cash budget that forecasts the flow of cash and other funds in the business.
· Cash budget is for cash planning and control, presenting expected cash inflow and outflow for a designated time period. The cash budget helps management keep cash balances in a reasonable relationship to needs. You must know how much cash will flow in and out of the organization. You must also have an idea when these will take place. The cash budget is primarily used to spotlight periods of too little or too much cash rather than for continual control.
· Capital budgets are lists of proposed capital expenditures and new or significantly revised programs, with the implications for the operating and cash budgets by period and responsibility center. The capital budgets include all anticipated expenditures for facilities and equipment and for sources of funds.
Cost accounting is the process of determining the full and incremental costs of providing services and goods to patients and customers. To determine the full cost of providing a service, you must ensure that all costs are in.
PRIMARY CARE Scenario
Type of care provided
Scenario
Question 1
Question 2
Care in this type of setting is delivered by physicians, physician assistants, nurse practitioners, and ad-
vanced practice professionals. This area of health care is the most widely used, and it is a major focus
of the Affordable Care Act of 2010, focusing on primary care providers and decreasing the focus on the
utilization of specialty providers.
As an administrator, you need to assess this situation: How would you determine if there was a true need
for another receptionist? Do you need to reinstate the position or can you retrain the current number of
employees? Why?
As an administrator, describe the effects that labor shortages of key personnel and rising costs of labor
have on profitability. How would you determine how to allocate your money? Be sure to think critically
about the impact that quality outcomes and patient outcomes have on financial resources.
A primary care clinic can be an individual-physician practice or a multiple-physician practice organized
as a nonprofit or a for-profit facility. Multiple-physician practices generally specialize in cardiac, women’s
health, pediatrics, or related services. You are the administrator of a local for-profit, multiple-physician
community clinic owned by five local physicians, specializing in internal medicine, women’s health, pe-
diatrics, orthopedics, and oncology. The clinic sees an average of 50 patients per day. Scheduling is
centralized with two receptionists, and each specialty has four staff members to assist the physicians.
All the physicians have visiting privileges at the area hospitals and frequently speak at local and national
conferences on numerous preventative health care topics. The clinic is noted for its use of technology
and has agreements in place with the local hospitals for web-based exchanges of health information on
shared patients.
Action Required:
Your office just underwent an organizational change and one office receptionist was eliminated, saving
the office $25, 000 per year in labor costs. However, there have been a number of complaints that all
patients cannot be processed due to the increased flow of patients. Two weeks later you begin to hear
that wait times for appointments have increased, and one specific patient was not able to be seen. That
patient now has developed an infection and requires surgery.
Question 3
Based on what you have learned so far in this course, what would be your plan of action for the next 30
days? What types of reports would you use to help support your decisions?
Budget Considerations
Operational Budget – This budget focuses on a broader view of the total operations of the organization in which
all departments are reviewed for both their income potential and the costs associated with the work activities used
to generate projected revenues. Each department will have its own budget for the managers to follow and on
wh.
Essential Package of Health Services Country Snapshot: The Republic of South ...HFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
Health economics is a branch of economics concerned with issues related to efficiency, effectiveness, value and behavior in the production and consumption of health and healthcare.
Essential Package of Health Services Country Snapshot: PakistanHFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
Budget matters for health: key formulation and classification issuesHFG Project
This policy brief aims to raise awareness on the role of public budgeting – specifically aspects of budget formulation – for non-PFM specialists working in health. As part of an overall WHO programme of work on Budgeting in Health, it will help clarify the characteristics and implications of various budgeting approaches for the health sector.
Improving Efficiency to Achieve Health System Goals in Botswana: Background P...HFG Project
Health outcomes have improved in Botswana over the last few decades. These successes have come at the same time as overall macroeconomic growth, with annual Gross Domestic Product (GDP) growth averaging around 6 percent between 2010 and 2015 (IMF 2015), and Human Development Index ranking above the regional average. These improvements originate in a strong health service delivery system. In 2008, Botswana’s public health system included 338 health posts and 277 health clinics, sufficient to ensure that at least 80 percent of the population has coverage of essential, high-impact services. Management of these services was initially done by the Ministry of Local Government but has been transferred to district health teams under the Ministry of Health (MOH). As of 2008, Botswana’s public health system also had 17 primary hospitals, 14 district hospitals, two referral hospitals, and one mental health hospital; these hospitals are managed by the central government.
Essential Package of Health Services Country Snapshot: IndonesiaHFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
Public Financial Management, Health Governance, and Health SystemsHFG Project
While the importance of governance in a health system is well recognized, there is an overall lack of evidence and understanding of the dynamics of how improved governance can influence health system performance and health outcomes. There is still considerable debate on which governance interventions are appropriate for different contexts. This lack of evidence can result in avoidance of health governance efforts or an over-reliance on a limited set of governance interventions. As development partners and governments are increasing their emphasis on improving accountability and transparency of health systems and strengthening country policies and institutions to move towards universal health coverage (UHC), the need of this evidence is ever rising.
To address this evidence gap, the USAID’s Office of Health Systems (USAID/GH/OHS), the World Health Organization (WHO), and the Health Finance and Governance (HFG) Project launched an initiative in September 2016 to ‘Marshall the Evidence’ on how governance contributes to health system performance and improves health outcomes.
The overall objective of the initiative was to increase awareness and understanding of the evidence of what works and why in how governance contributes to health system performance, and how the field of health governance is evolving at the country level. This report provides a synthesis of the findings across the four themes. This report presents the findings of the Public Financial Management.
Modeling the impact of the health finance and governance projectHFG Project
Over its six-year life (2012-2018), the project worked with more than 40 partner countries to increase their domestic resources for health, manage resources more effectively, and reduce system bottlenecks in order to increase access to and use of priority health services and strengthen health systems overall. HFG provided state-of-the-art and country-specific technical assistance to remove obstacles that impede effective health system functioning and essential reforms. Recognizing the importance of measuring its impact, HFG quantified its return on investment for HFG health systems strengthening efforts.
HFG and its partner Avenir Health conducted a rigorous exercise to estimate the impact of the project’s health systems strengthening activities on its overall goal: increased use of priority health services. We used Spectrum, a suite of modeling tools developed by Avenir Health and partners, to quantify impact on mortality and morbidity based on changes in the coverage of specific priority health services due to the project’s activities aimed at improving access, quality, and use of health care. Given the diverse activities of HFG and the challenge of establishing a measurable causal link between project activities and coverage effects, we adopted a conservative approach and chose for this impact modeling exercise a subset of HFG activities for which a direct link was apparent. Based on these parameters, the exercise was conducted for eight country programs: Bangladesh, Cote d’Ivoire, Cameroon, Ethiopia, Haiti, Nigeria, Senegal, and Vietnam.
Using a methodical approach, we analyzed individual project activities in these countries and the expected effects on service coverage to estimate the impact on morbidity and mortality. We examined how our activities, including implementing strategies for improved human resources for health, operationalizing health insurance schemes, rolling out packages of health services, and using costed plans and packages to advocate for more financial resources, will increase access to health services, which in turn will lead to greater coverage of health services among targeted populations and ultimately to reduced morbidity and mortality. We modeled the impact of HFG’s activities by quantifying the number of deaths that were averted as a result of HFG-supported strategies and reforms.
The modeling results indicate that continued implementation of health systems strengthening strategies like those HFG supported would bring significant expansion of health care coverage and enhanced health outcomes.
This report presents country- and activity-specific results and the methodology for estimating coverage changes and impact. We hope this modeling exercise adds to the global understanding of how the impact of health systems strengthening can be measured. It provides powerful evidence on why investment and effort in strengthening health systems must continue.
Essential Package of Health Services Country Snapshot: IndiaHFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
Essential Package of Health Services Country Snapshot: UgandaHFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
Essential Package of Health Services Country Snapshot: RwandaHFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
The Health Finance and Governance Briefing KitHFG Project
Resource Type: Brief
Authors: Megan Meline, Lisa Tarantino, Jeremy Kanthor, and Sharon Nakhimovsky
Published: September 2015
Resource Description: Getting access to affordable, quality health care is a universal story that touches virtually every family in the world. At the same time, providing quality health services and access to trained health professionals is a challenge for governments. The World Health Organization (WHO) estimates that 150 million people worldwide face “catastrophic expenditure” because of high costs of health care. In other words, they may have to forgo paying for basic needs, such as food, housing, or education to pay for medical treatment instead. These costs include transportation, doctors’ fees, medicine, hospitalization bills, and days lost from work.
Behind these sobering statistics lies a wealth of news and feature stories waiting for the media to investigate and share with national leaders and policymakers as well as civil society groups who can advocate for changes to health budgets and policies. At the heart of these stories are important questions about the financing of health care and the quality of governance that ensures responsive and effective management of those resources and services.
But writing health finance and governance stories can be challenging. Health finance is riddled with complex language, technical economic terms, and numbers – not necessarily a journalist’s comfort zone. The right sources for these stories can be difficult to identify and unwilling to talk. Data may be difficult to locate or to understand. And while corruption makes for splashy headlines, the broader systemic challenges of health governance are not widely understood — and yet they are important.
The Health Finance and Governance Briefing Kit is designed to help journalists and their editors uncover and tell these important health stories that affect people all around the world.
Health economics is a branch of economics concerned with issues related to efficiency, effectiveness, value and behaviour in the production and consumption of health and health care.
In broad terms, health economists study the functioning of health care systems and health- affecting behaviour such as smoking.
It is the discipline of economics applied to the health care.
IntroductionThe budgeting process is an attempt to estab.docxmariuse18nolet
Introduction
The budgeting process is an attempt to establish a set of realistic standards for operating a health care organization. The budget is a set of specific objectives for the year ahead. The finance system provides the cost and revenue data and sometimes assists with other measures.
Formulating a budget is the beginning of the process. Every budgeting system must contain provisions for preparing the budget and implementing a system. This system must include coordination, control, follow-up, and maintenance. An effective budget must be tailored to the organization’s specific needs. The budget must be comprehensible and attainable. There should be innovation and flexibility to meet unexpected occurrences.
A health care organization’s budget provides a fully detailed description of expected financial transactions, by accounting period, for at least an entire year. The review of future expectations is useful in making smooth progress toward financial goals.
The major parts of an annual budget address operational and financial planning needs. The operating budgets are made up of the following:
· Expenditure or cost budgets anticipated by reporting period and responsibility center: Costs are often identified as fixed, semi-variable, or variable. Anticipated volumes of demand or output are incorporated into cost budgets.
· Revenue budgets reflect the receipt of income from services rendered. Standard gross revenue accounting reports a profit increase to the responsibility center, creating an incentive for productive activity.
· Income and expense budgets consist of expected net income and expenses incurred by the organization.
· Financial budgets embrace the effects of the organization’s financial decisions. These plans include a budgeted balance sheet that shows the effects of planned operations and capital investments on assets, liabilities, and equities. The plans also include a cash budget that forecasts the flow of cash and other funds in the business.
· Cash budget is for cash planning and control, presenting expected cash inflow and outflow for a designated time period. The cash budget helps management keep cash balances in a reasonable relationship to needs. You must know how much cash will flow in and out of the organization. You must also have an idea when these will take place. The cash budget is primarily used to spotlight periods of too little or too much cash rather than for continual control.
· Capital budgets are lists of proposed capital expenditures and new or significantly revised programs, with the implications for the operating and cash budgets by period and responsibility center. The capital budgets include all anticipated expenditures for facilities and equipment and for sources of funds.
Cost accounting is the process of determining the full and incremental costs of providing services and goods to patients and customers. To determine the full cost of providing a service, you must ensure that all costs are in.
PRIMARY CARE Scenario
Type of care provided
Scenario
Question 1
Question 2
Care in this type of setting is delivered by physicians, physician assistants, nurse practitioners, and ad-
vanced practice professionals. This area of health care is the most widely used, and it is a major focus
of the Affordable Care Act of 2010, focusing on primary care providers and decreasing the focus on the
utilization of specialty providers.
As an administrator, you need to assess this situation: How would you determine if there was a true need
for another receptionist? Do you need to reinstate the position or can you retrain the current number of
employees? Why?
As an administrator, describe the effects that labor shortages of key personnel and rising costs of labor
have on profitability. How would you determine how to allocate your money? Be sure to think critically
about the impact that quality outcomes and patient outcomes have on financial resources.
A primary care clinic can be an individual-physician practice or a multiple-physician practice organized
as a nonprofit or a for-profit facility. Multiple-physician practices generally specialize in cardiac, women’s
health, pediatrics, or related services. You are the administrator of a local for-profit, multiple-physician
community clinic owned by five local physicians, specializing in internal medicine, women’s health, pe-
diatrics, orthopedics, and oncology. The clinic sees an average of 50 patients per day. Scheduling is
centralized with two receptionists, and each specialty has four staff members to assist the physicians.
All the physicians have visiting privileges at the area hospitals and frequently speak at local and national
conferences on numerous preventative health care topics. The clinic is noted for its use of technology
and has agreements in place with the local hospitals for web-based exchanges of health information on
shared patients.
Action Required:
Your office just underwent an organizational change and one office receptionist was eliminated, saving
the office $25, 000 per year in labor costs. However, there have been a number of complaints that all
patients cannot be processed due to the increased flow of patients. Two weeks later you begin to hear
that wait times for appointments have increased, and one specific patient was not able to be seen. That
patient now has developed an infection and requires surgery.
Question 3
Based on what you have learned so far in this course, what would be your plan of action for the next 30
days? What types of reports would you use to help support your decisions?
Budget Considerations
Operational Budget – This budget focuses on a broader view of the total operations of the organization in which
all departments are reviewed for both their income potential and the costs associated with the work activities used
to generate projected revenues. Each department will have its own budget for the managers to follow and on
wh.
DISUSSION BOARD DUE WEDNESDAY 250 WORDSBuying expensive item.docxastonrenna
DISUSSION BOARD DUE WEDNESDAY 250 WORDS
Buying expensive items is not easy for individuals with limited economic resources. Even though the budgets of most health care organizations (e.g., hospital, clinic, doctor’s office) are significantly larger than the budget of the average American family, most of these organizations operate with limited resources too. Health care managers use planning and budgeting information to make resource use decisions.
To prepare
for this Discussion, complete the readings in your Learning Resources. Think about a significant purchase you have made in the past. How did you pay for it? Did you shop around for the best deal? What was the impact on your own budget and finances?
Post
a comprehensive response to the following:
Share an example of something that you had to budget and plan to pay for. How does your personal decision-making process differ from what you learned about planning and budgeting in health care?
How do most individuals monitor and control their cash flow? Provide specific examples.
How does the monitoring of cash flow of a health organization compare to the monitoring the cash flow for individuals handling their personal finances? Explain your choice.
Be sure to support your work with specific citations from this week’s Learning Resources and/or additional scholarly sources as appropriate. Your citations must be in APA format. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.
_____________________________________________________________________________
ASSIGNMENT DUE SATURDAY
A financial manager's responsibilities do not cease after he or she develops a budget for execution. On the contrary, the manager's job begins with a completed budget. The manager must track the execution of the budget approved by senior leadership to meet financial goals. Since trends, costs, and other externalities can cause changes or variances in the budget, the financial manager must monitor and adjust spending when necessary to account for those variances.
Even with relatively good control, taxes, rounding effects, and unexpected price increases can negatively affect budget execution. Nickels and dimes add up quickly. If unaccounted for and not closely tracked, those nickels and dimes can derail even the most carefully considered financial plan. Overspending can pose serious threats to projects and the availability of resources for future projects. Under spending can indicate a problem in quality control. Under spending may be a good thing (due to improved efficiency) or it may also be bad (manufacturers cutting corners, which may result in inferior product). The bottom line to remember is that variance happens and health care managers must respond effectively.
To prepare
for this Application Assignment, review the Northeast Health System 2011 Annual Report. As you review, analyze the concept of variance. Consider what fa ...
Article 1ECG management consultants. (2007). The Strategic Imper.docxfredharris32
Article 1
ECG management consultants. (2007). The Strategic Imperative of Adapting the Hospital’s Management Structure. Insight, 1-6. http://www.healthleadersmedia.com/content/86219.pdf
a)
The author points out that many hospitals are struggling with how to execute strategic plans effectively in their organizational structure. These institutions lack efficient decision-making processes, accountability for the performance of key strategies and the recognition of the importance of hospital strategies to propel them to new business. The key challenge in provider-based organizations is their inability to focus their strategies on the provision of high-quality patient care services. Hospitals should stop focusing on performance-driven traditional strategies and instead align their strategies to focus on a service line.
To ensure that such procedures are executed efficiently, it is important that their organizational structures are informed by the care service strategy. The organizational structure should ensure that the strategy is encompassed in their strategic plan, organizational control structure, management responsibilities and physician leadership. In today’s world, patients are seeking more care on their heart conditions, cancer or other illnesses or injuries rather than on traditional hospital departments such as nursing, physical therapy or radiology. By focusing on patient care functions along these service lines, hospitals can optimize performance. The organizational structure should also be streamlined to support key strategies. Laying a strong foundation for the organization structure is important to ensure that key strategies are executed effectively. The control structure should also be flexible enough to adapt to shifts in strategy. Introducing changes such as a focus on traditional performance-driven strategies to a service line is sometimes stalled due to a rigid management structure. It is important to have a flexible control structure to facilitate decision-making processes that are most times challenged by poor leadership structures.
b)
Given the opportunity, I would correct an inefficient hospital strategy by reorganizing the organizational structure to focus entirely on key strategies of a service line. Clinical services, planning, marketing and public affairs are some of the new elements that I would to traditional organizational structures in hospitals. This way, any shifts in strategies can easily be adapted due to a flexible control structure. At the same time, as a leader, I would focus on building value around my employees by assigning them responsibilities based on the right service lines. This will ensure that they remain accountable for their performance and use of resources along with their service lines. A good management structure is also necessary to maintain a good relationship between the business strategy and the performance of my employees.
Article 2
Perera, F. D. P. R., & Peiró, M. (2012). St ...
1 3. Compare and contrast the external financing options t.docxhoney725342
1
3. Compare and contrast the external financing options that are available for healthcare organizations
today.
Reading Assignment
Chapter 4:
Understanding Costs
Unit Lesson
This unit will introduce you to the concept of costs in healthcare. For public service organizations and
healthcare organizations of all kinds, an understanding of costs is absolutely essential. The better that
healthcare managers understand costs, the more accurate their planning will be, and the better they will be
able to control spending for the organization within their areas of responsibility. A solid understanding of costs
will also improve a manager’s ability to make effective decisions on a day-to-day basis for his or her
department. Thus, for many reasons, you need to get a solid understanding of costs. That is what we will
seek to provide in Unit III.
First let us face reality, costs in healthcare are complicated. They are considerably more complicated than
costs in industries such as manufacturing, construction, or retail. One important emphasis of this unit is on
providing a clear understanding of key definitions for widely used cost terms. Such terms include direct costs,
indirect costs, average costs, fixed costs, variable costs, and marginal costs.
In this unit, you will come to realize that finance has its own language, and in order to be effective as a
healthcare manager, you must be able to speak that language. Otherwise you will find yourself in foreign
territory at management team meetings and board of directors meetings. You will also be at great
disadvantage when budget time rolls around each year. Accordingly, in this course, we will teach you the
language of finance so that you can communicate clearly with the chief financial officer (CFO) and other
members of management.
Another focus for Unit III is on understanding how costs change as service volumes change. The relationship
between costs and volume has a dramatic impact on the profits or losses incurred by an organization, and
this relationship is critical to effective decision making. Healthcare organizations must generate black ink on
the income statement in order to survive. That is true for both for-profit and not-for-profit entities, so you must
understand the impact of service volumes on costs.
The old story about the Long Island Tailor comes to mind here. It was said that the tailor lost money on every
single suit that he produced for clients, but he made it up in volume. Well, clearly that will never work. Losing
money on every healthcare service we provide, and then getting busier losing money, will close down the
hospital or clinic in a very short time. In healthcare, we need to find a way to provide services for our patients
at cost levels which allow some margin of revenues over expenses. This may not be true for every patient that
we treat, but it must be true for our patient population overall. Otherwise we could be in a lot of troubl ...
This paper will discuss the most effective and ineffective financial management practices in the healthcare setting. Healthcare is the most difficult industry to prepare financial operating budgets. There are many factors and variables that must be taken into consideration. These factors and variables can change yearly making the preparation of the budget even more difficult.
This is assignment 1 that assignment 2 have to relate to. PLEASE..docxabhi353063
This is assignment 1 that assignment 2 have to relate to. PLEASE.
Financial Statement Analysis
Student name
University
Professor
October 25, 2016
Financial Statement Analysis
Based on your review of the financial statements, suggest a key insight about the financial health of the company. Speculate on the likely reaction to the financial statements from various stakeholder groups (employee, investors, shareholders). Provide support for your rationale.
Health Management Associates, Inc. (NYSE: HMA) is the operator and owner-general acute care centers in the non-urban communities situated in the US, particularly in the Southwest. The organization was founded in 1977. The hospitals provide services such as oncology, emergency room care, general surgery, internal medicine, radiology, pediatric services, coronary care, and diagnostic care (
www.healthcaremanagement.com
).The company is also providing outpatient services like x-ray, respiratory therapy, one-day surgery, laboratory services, physical therapy as well as cardiology therapy. The mission of the Health Management is to provide America’s best local healthcare. They provide processes, capital finance, expertise, and people that can ensure that the local hospitals can accomplish their mission of delivering compassionate and high-quality healthcare that would substantially improve the lives of patients, the communities they serve, and the physicians providing the care
www.healthcaremanagement.com
)
With regard to the review of the current financial statement, HMA is in a dangerous financial state as a result of the present increasing debts and legal woes. The Office of the Inspector General, Justice Department, and the Department of Health and Human Services served the organization with summons regarding a software program that was used by ED doctors and the records from the emergency department. Some reports suggested that there was pressure from the company’s hospitals management to admit patients from emergency rooms so as to maximize profits. Paul Meyer, former compliance director, claimed that HMA’s fraudulent activities could attract government investigation (Britt, 2012).
The common stock of Health Management Associates was owned by almost 850 shareholders, as per the records of December 31, 2012, with hundreds of institutional investors included. HMA had expanded to include 70 hospitals situated in 15 states, with roughly 10,562 present licensed beds. In 2012, HMA realized about $5.9 billion in net revenue (Britt, 2012).
HMA gets payments for the services it renders from the federal government through the Medicare program, the states in which it functions under each Medicaid program, and commercial insurance, among others; and patients, encompassing deductibles and co-payments. Basically, deductibles and co-payments are part of the bill of patients for the medical services provided, which many government and private payers expect the patient to cater for. ...
This document will explain how a comprehensive wellness program works and how much money you should budget in order to have one. If you are ready to kick start health in your organization this is the right place to start.
The Entity chosen was Baptist Healthcare South Florida for years 201.docxtodd701
The Entity chosen was Baptist Healthcare South Florida for years 2017,2018,2019 the stats are online
The course project will require students to select a
healthcare
organization and review its financial operations based on data available from various sources. The entity may be a individual hospital, medical group practice, managed care organization, or government agency delivering healthcare services. Once the group has selected a healthcare entity, it will obtain three years of financial statements to analyze along with appropriate literature reviews about the entity or similar entities. The final paper will be submitted in a case study format, which includes the following sections:
Background
Issues/problems identified
Analysis utilizing ratios and other financial analysis tools
Recommendations
Implementation plan
Monitoring methodology
References demonstrating graduate-level research (only references of the highest quality grade will be accepted)
The page count for this assignment is at least seven (7) pages plus references and title pages. Your paper needs to be submitted in APA 6th format and must have a minimum of 10 current resources four (4) of them from current peer-reviewed articles. The final group assignment paper is submitted Canvas with each team member sharing equally in the development of the group project.
Rubric
Written Grading Rubric (AW) (1) (1)
Written Grading Rubric (AW) (1) (1)CriteriaRatingsPtsThis criterion is linked to a Learning OutcomeIntroduction25.0 pts
This criterion is linked to a Learning OutcomeAccuracy25.0 pts
This criterion is linked to a Learning OutcomeRelevance25.0 pts
This criterion is linked to a Learning OutcomeReference List25.0 pts
This criterion is linked to a Learning OutcomeIn Text Citations and Paraphrasing25.0 pts
This criterion is linked to a Learning OutcomeCritical Thinking25.0 pts
This criterion is linked to a Learning OutcomeCreative Thinking25.0 pts
This criterion is linked to a Learning OutcomeOrganization25.0 pts
Total Points: 200.0
Previous
So far this is whats done but I am only responsible for the Monitoring Methdology Part
Baptist Health South Florida Financial Operations Case Study
Background
Baptist Health South Florida is the biggest healthcare organization in the region, with 11 hospitals, approximately 23,000 employees, more than 4,000 physicians and more than 100 outpatient centers, such as urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. Baptist Health was founded in 1960 and it is well known for having centers in different areas of health care such as cancer, cardiovascular care, orthopedics, sports medicine and neurosciences, which attracts patients from all over the U.S., the Caribbean, and Latin America. It is a not-for-profit organization committed to their faith-based generous mission of medical excellence. Also, Baptist Health has been recognized by Fortune as one of the 100 be.
1. Responsibility accounting in modern health care organization is.docxjackiewalcutt
1. Responsibility accounting in modern health care organization is a type of management accounting which collects and reports both planned and actual accounting information in terms of responsibility centers about the inputs and outputs of responsibility accounting.
A growing trend in the structure of health care organizations is decentralization.
Decentralization is the degree of dispersion of responsibility within a health care organization. In a decentralized organization, decision making is not confined to a few Top Executives but rather spread throughout the organization, with managers at various levels making key operating decisions within their sphere of responsibility.
Health care organizations are divided into responsibility centers, organizational units in which a manager is responsible for operations and evaluates the unit's performance. For example, a nurse manager may be responsible for an inpatient pediatric unit, the manager for a home-care program is responsible for all home-care services that are delivered, and the manager of a housekeeping department is responsible for the cleanliness of the facility. Every program and department in a health care organization can be classified as a responsibility center.
Responsibility accounting provides the information necessary to assist a manager in operating a responsibility center. Responsibility accounting is defined as the classification of financial and statistical data according to the organizational unit that produces the revenue and incurs the expense. There are four major types of responsibility center and cost centers is one.
Cost centers are responsible for providing services and controlling their costs. The types of costs center in health care organizations are production, clinical and administrative cost centers. The production cost centers develop and/or cell products, such as laboratories. Clinical cost centers are responsible for providing health care related services to patients or clients, such as pharmacy, radiology (if services are covered), laboratory (same as radiology) and dietary services, and various nursing units. Administrative cost centers support the clinical cost centers and the organization as a whole. For example the housekeeping department, because it incurs costs, but does not generate revenue.
Within every organization today there is at least one responsibility center that helps the organization function and managers are held accountable for the performance of their responsibility centers. Responsibility refers to the tasks and obligations of a responsibility center; authority is the influence to carry out a given responsibility; and accountability means there are consequences for carrying out responsibilities.
Budget variances are the most universal measure for financial performance. A budget variance is a discrepancy between the predicted cost or revenue in a given account. It’s common for health care organizations to separate their total budge ...
A nursing budget refers to a methodical plan developed by the nurse .docxmakdul
A nursing budget refers to a methodical plan developed by the nurse managers or administrators to provide a draft containing an estimation of the nursing expenses and revenues (Adafin et al., 2020). The budget plays a significant role in projecting the different ways on how the expenses will be covered by the revenue generated. In nursing, budget development entails three distinctive stages: formulation, reviews and presentation, and execution. The complete budget development process is assigned a specific time and the completion date for each stage assigned. The nurse managers are involved in setting goals and designing a budget for the respective healthcare facilities and the nursing unit. When the budget development process is complete, the nurse manager submits the updated budget for approval to the board of directors and the administration. This is a time-consuming process that can result in disapproval and then require modifications due to various factors. The approval of the budget means that the facility has the ability and must deliver the finances for the services planned in the budget throughout the fiscal year.
Strategies of including the team in budget development
As a nurse manager, developing a budget for the entire nursing unit could be a lengthy and dynamic process sometimes full of stress and frustration, but including your team can help draft a satisfactory budget. I prefer including the nursing staff in the process since I am a transformational leader and take into consideration their feedback and views. In my opinion, it is a way to involve them in helping to develop and maintain a budget. It would also allow the staff to know where the money is allotted and understand the overall goal of the facility's needs financially. I will also use strategies like brainstorming, Delphi technique, cons, and pros list, nominal group approach, and ranking the responsibilities.
Brainstorming
Brainstorming sessions are essential in including all the members of the team or unit in making a decision. The sessions focus on getting potential ideas as it provides a practical way for the individuals to share the flowing thoughts with others. The primary purpose of the brainstorming strategy is to generate numerous suggestions that can help generate revenues
and minimize expenses. Therefore, I would encourage all the nurses in my unit to engage in the brainstorming sessions effectively.
Nominal group strategy
In the process of including the team in budget development, I would encourage using the nominal group technique. The technique with brainstorming sessions includes voting. In the process of brainstorming ideas, the team provides suggestions, which not all of them will be included in the budget. Voting will help include all the suggestions that are satisfactory to everyone and remove those that have minimal impacts.
Delphi Strategy
Delphi strategy is an essential strategy that I would apply to include the team in budget deve.
Part 2Goals for Stevens District HospitalKevin HawkinsUn.docxdanhaley45372
Part 2
Goals for Stevens District Hospital
Kevin Hawkins
University of Phoenix
Financialor Economic Goal: Increasing the market share
Stevens District Hospital’s mission is providing high quality care, a wide range of services and exceptional care services. However, attaining this would need a provision of quality care and increasing the range of services so that the hospital can compete favorably with the contenders (Pronovost, & Vohr, 2010). Besides that, the hospital needs to provide exceptional services which would then make it a destination for all the physicians and patients seeking to receive top-notch treatment and optimum working environment respectively. With such objectives, increment of the market share is not only possible but also inevitable.
Measurement of the goal.
Growth in the market share is measured by the use of patient visit statistics. Stevens District Hospital’s visit stats shall be compared with industry data in order to get the percentage of visits to the hospitals out of the total visits. Besides that, the health insurance data shall be invaluable in assessing % change of visits to the hospital. In general, measurement of the market share shall be done by the use of patient visit data.
Milestones that need to be achieved for progress is increasing the use of EMR and a 5% growth in the number of patient visits to the new care center within a year.
In order to achieve the 5% growth in the market share, it is important to first attain an increased amount of visits of patients from 96103 zip code by 5% by the end of the year. This goal shall be measured by the use of the percentage change in the number of visits to the hospital quarterly. The term chosen for the measurement is three months in order to determine whether the goals are being met (Mills & Spencer, 2005). When the hospital has determined whether or not the goals are being met, it can then put in place control strategies to ensure that the plan is implemented in every bit.
Legal or Regulatory Goal: Accommodating Patient Scheduling Requests Due To Changes To The Affordable Care Act.
The changes in the affordable care act has increased the number of patients in the hospital with many of them seeking primary care physician’s services. Due to the shortage of physicians, Stevens District Hospital is unable to counter such a surge in the number of patients. This goal will be in line with Stevens District Hospital’s mission which is to provide exceptional care, provide comprehensive treatment as well as the provision of high quality care. Adjusting and increasing the number of physicians so as to adjust to the changes brought about by affordable care act amendment will also ensure that the physicians have a good working environment that would foster provision of quality care (Pronovost, & Vohr, 2010). It will definitely make Stevens District Hospital’s the destination for both the physicians and the patients.
This goal is going to be measured by the number.
Running Head: FROM THE FRONT LINES1
From the Front Lines
Lisa M. Buentello
HCA 311: Health Care Financing & Information Systems
Professor Kathleen Martocci
May 29, 2015
- 1 -
[no notes on this page]
Future Direction of Health Care 2
From the Front Lines
The break even analysis figures can be used to establish the impacts of various
reimbursements such as Medicare, Medicaid, and Private and self-pay contributions. Notably,
from the break even analysis of the “From the Front lines” facility, increase in Medicare and
Medicaid benefits have an effect of increasing sales volume. Eventually, the value of the gross
margin increases leading to an upsurge of the value of the contribution per unit. This leads to a
reduction in the number of the break-even procedures. Private or self-pays have an effect of
increasing the volume of sales in addition to the increment made by Medicaid and Medicare
benefits. As a result, the break even procedures will become even smaller causing a
corresponding increase in profit margins.
Break even analysis is essentially important in developing my upcoming capital
investment proposal. It will be applicable in clarifying the extent of the viability of my planned
objectives. Specifically, this tool will be of great significance in evaluating expansion
opportunities, new providers, new services or new capital purchases (Cafferky, 2012). Break
even analysis is basically used in establishing whether the planned activity is viable enough to
cover the expected costs that are principally divided into variable and fixed expenses.
Also, I will utilize break analysis values to ascertain whether the capital proposal will be
financially viable. Specifically, it will be applicable in determining the activity level that will
- 2 -
[no notes on this page]
Future Direction of Health Care 3
cover the projected fixed and variable costs of the venture satisfactorily. It is at this point that a
break even analysis will be used to evaluate the critical components of my budget plan.
Typically, break even analysis and the budget plan are used interchangeably while
making financial analysis that concerns various capital investment plan proposals (Cafferky,
2012).
Break Even Analysis
Break Even
Analysis
Sales payment per procedure $885
numbe of procedures in year 1 500
numbe of procedures in year 2-5 850
Total Sales amount
1, 194,
750
Variable costs Cost of each Procedure $175
Total number of procedures 1350
Total Variable costs $236, 250
Contribution Per Unit 710
Gross Margin=sales-variable costs
$958,
500
Fixed Costs Purchasing costs
$ 11,
000
Rennovation Costs $9,000
$20,000
Employees Salaries
$ 336,
000
Total fixed costs
.
Review posts submitted by your classmates. In your responses, propo.docxmichael591
Review posts submitted by your classmates. In your responses, propose suggestions and/or alternate options to strengthen and support the response to the director.
Post #1 Savannah Ventura
As the head of physician contracting at a small community hospital, I have been asked to evaluate whether the hospital should shift its employed physicians away from an annual salary model and into a model that incentivizes quality outcomes. The physicians currently employed by the hospital are paid on salary without any quality or outcome incentives; however, area physicians with hospital privileges used by medical groups are compensated for quality outcomes instead of an annual salary. The first step in approaching the request from the director of contracting, my boss, compares results from doctors paid by salary to those paid by incentives based on quality outcomes (Teitelbaum & Wilensky, 2017). If quality outcome results are better for incentivized physicians, then the change should be recommended and started.
For decades, healthcare costs in America have escalated without comparable improvements in quality (Ryan, Burgess, PEsko, Borden, & Dimick, 2015). Current federal and private policies have turned to a Pay-for-Performance (P4P) model to introduce more powerful incentives for improving care. Physicians get bonuses for meeting certain quality of care standards. These standards can range from demonstrating that they have done procedures that ought to be part of a thorough physical, such as taking blood pressure, to producing a positive health outcome, such as a performance target like lower cholesterol (Herzer & Pronovost, 2015).
Potential competing stakeholder values can affect the direction in which the organization should go. Organizations that put stakeholders' interests ahead of profits generate greater workforce engagement and thus deliver the superior financial results that they have made a secondary goal. At first glance, this may seem counterintuitive until the business is looked at as an ecosystem composed of groups that cooperate to maximize value creation and compete to realize their share of that value. No system can thrive if one member group continually benefits at the expense of others. Any unfairness in treatment will result in suppliers prioritizing other customers, staff leaving to work for other companies, or customers defecting to other suppliers or shareholders selling. In this context, the strategy is the art of balancing how value is shared among different stakeholders so that overall value creation is maximized. It aims to sustain superior profitability over the long run rather than maximize it in the short term (Ryan et al., 2015).
A stepwise plan to respond to the director's request should include the following: start a compensation committee; initiate a pilot plan, optional to physicians between the old plan and the new plan; begin pilot on the primary care arena first; initiate compensation plan with existing incent.
Introduction This chapter describes methods for assessing the.docxAASTHA76
Introduction
This chapter describes methods for assessing the financial health of hospitals and safety net institutions. The examples used are drawn principally from hospitals, but the principles and approaches apply to clinics and other safety net providers. The chapter discusses:
What is meant by financial health of institutions.
Alternative approaches and measures available to assess hospital financial health.
How these approaches and measures can be implemented using alternative data.
Issues and complications in interpreting this data.
The goal of this chapter is to enable the reader to identify potential measures, data sources for implementing these measures, and conceptual and accounting issues in implementing and interpreting these measures. It is not intended to be a primer on accounting or financial management, although accounting and financial management concepts are discussed (Lane, Longstreth, and Nixon, 2001).
Return to Contents
Measuring the Financial Health of Safety Net Hospitals
One definition of the financial health of an institution is its ability to continue to operate as a going concern. There are three dimensions to this ability:
1. Revenues and expenses must be in balance.
2. Adequate resources (that is, capital) must be available to deliver services and finance operations both in the short and long term.
3. The institution must be able to replenish or renew itself.
The first two dimensions are explicitly captured in a variety of measures; the third, ability to renew, is generally inferred from a range of data.
Revenues and Expenses
The first dimension of financial health is that revenues and expenses be in balance. More generally, we should expect that revenues at least match expenses ("break even"), and most financial analysts would expect an institution's revenues to exceed expenses, so as to finance increases in working capital and build funds as a cushion for a financial downturn and for renewal or expansion. The standard measure of profitability is margin:
(Revenues - Expenses) Revenues
Hospitals are multiproduct firms, with multiple sources of revenues. They provide inpatient and outpatient health care services, and they may provide other services to those using the hospital (parking, cafeteria, and so on) or to outside organizations (selling laboratory services, laundry, or catering services, for example, to other hospitals or health care providers). Some hospitals are involved in medical or related education, whereas others conduct research. Some receive philanthropy, government subsidies, or interest and investment income that may not be directly tied to any operational activities. Analyzing the margin requires specifying the level at which revenues are being aggregated and allocating expenses to match the revenues.
There are three common measures of margin. The broadest measure is total margin, which is computed as follows:
(Total revenues from all sources - Total expenses) Total .
Running Head PROBLEM ANALYSIS AND BUDGET IMPACTPROBLEM ANALYSIS.docxtoltonkendal
Running Head: PROBLEM ANALYSIS AND BUDGET IMPACT
PROBLEM ANALYSIS AND BUDGET IMPACT 5
Problem Analysis and Budget Impact
Tanyanika McMillian
South University
The hospitals face different healthcare financial problems which at times can make the delivery of quality care to the patients difficult. Healthcare is one of the major industries facing financial problems. According to Bazzoli et al. (2008), the deficiency in the quality of patient care deteriorated at the time when many hospitals were facing financial crisis. Therefore, the quality of attention given in the hospitals dependent on its financial stability. The purpose of the paper is to create an analysis of the patient care financial problem and to identify more financial problems based on the interviews carried on the management of hospital and the available literature review.
The primary purpose of the hospital is to provide care to the patient, a task which can be costly. Maintaining the health care staff can be expensive. The problems identified were compiled after interviewing more than 150 employees faced with financial challenges. The main basis of the problems in the health care industry as indicated by the chief financial officer and the senior accountant of the hospital is the lack of skilled labor and information to implement the budget (Bazzoli, Chen, Zhao, & Lindrooth, 2008). Few employees are involved in the budget-making of the hospitals. Although budgeting is very instrumental to the success of any organization, lack of skilled labor to implement it poses a challenge to many hospitals. Many hospitals have insufficient workforce who have financial skills (McKeeargue, 2010). Managing the funds becomes a difficult task for the hospitals and it becomes difficult for the hospital to use the available financial resources to achieve quality care resulting in a healthy society.
Report by the Berger (2008) identified another healthcare financial problem as managing investment in a capital strained environment. There are current changes happening in the industry such as frequent change in laws mainly the healthcare reform. Another change recorded is the expansion of healthcare access and growing patient demands, which can reflect high costs for hospitals if they care for to many patients that do not have health insurance. Besides the increasing demands of patients, there is pressure on the hospitals to cut costs. The restriction is put on how much can be spent on improving the patient’s health. Therefore, the rising demands for services from the patients is another cause of health care financial problems.
Also, hospitals are also facing challenges in adapting the market forces. They have adopted the market forces as any other conventional business (Karanikolos, 2013). A good example is the mergers that have become prevalent in the health industry. It is a current landscape that hospitals are adopting. Many small hospitals are hospitals consolidating and joinin ...
Read the scenario that you will use for the Individual Projects in ea.pdfashokarians
Read the scenario that you will use for the Individual Projects in each week of the course. The
Centers for Medicare and Medicaid Services (CMS) has taken on a more visible role in health
care delivery. Many changes have transpired to improve patient safety along with the
implementation of additional quality metrics, and these changes impact reimbursement rates
Likewise, the Patient Protection and Affordable Care Act has changed the reimbursement fee
structure of Medicare and Medicaid reimbursement for health care services. Other legislation
including the HITECH Act and the Medicare Authorization and CHIP Reactivation Act of 2015
(MACRA) all impact how healthcare organizations receive reimbursement and demonstrate use
of data to improve quality and delivery of patient care Mr. Magone, CEO of Healing Hands
Hospital, has asked you to join the \"Future of Healing Hands Task Force, and your first
assignment is to work with the Hospital Chief Financial Officer, Mr. Johnson, and provide a
summary of the current regulations regarding Medicare reimbursement including how MACR
impact reimbursement if/when Healing Hands coordinates delivery of services by affiliating with
physician practices For this assignment, write a 2-3 page report that you will deliver to Mr.
Magone on how the new CMS initiatives and regulations impact the organization\'s revenue
structure. In your presentation, address the following questions: Why did CMS become more
involved in the reimbursement component of health care? How does CMS\'s involvement impact
the reimbursement model for Healing Hands Hospital and other health care organizations If
CMS reimbursement regulations for Medicare and Medicaid change, does it follow that other
insurance providers change heir policies on reimbursement? What tools can be implemented to
ensure organizations such as Healing Hands Hospital and physician practices are meeting the
policies and procedures set forth by CMS? Identify 3 tools from the CMS Web site that are
helpful in meeting the requirements for Medicare reimbursement set forth by CMS
Solution
Part-a & part-b:
The physician’s work, practice expense, and malpractice, RVU values, CMS (centers for
Medicare and Medicaid services) is required to control overall expenditures in health care
organization. Therefore, CMS become highly involved in the reimbursement component of
health care to patients as per their \"insurance packages\". The CMS\' involvement in “budget
Neutrality” & the reimbursement model at Healing Hand hospital & other health care
organizations is mainly for physician RVU based payments from Medicare & Medicare that can
control its physician costs by adjusting physician payment rates based on “previous periods in a
calendar year” as per federal acts and regulations. The Medicare is going to control physicians
costs according to “medical procedures and medical visits of their record” in a Jan- 1 ending Dec
31. Conversion Factor is main basis to control the physician costs ac.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
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June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
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- Prix Galien International Awards Ceremony
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Budget
1. Running head: A PERSONNEL BUDGET FOR HOME CARE 1
A Personnel Budget for Home Care
Debra A. Vitelle
DeSales University
2. A PERSONNEL BUDGET FOR HOME CARE 2
Abstract
Up until recently nurses have had very little involvement in the budget process.
“Nursing was generally classified as a non-income producing service and nurses input into the
budgeting process was undervalued” (Marquis, & Huston, 2012). However, health care
organizations have now begun to realize the importance of nurse’s involvement in financial
planning. The reality is that salaries make up the greatest portion of expenditures in a health
care institutions budget (Fishbein, & Vehaun, 2009). There are three major types of budgets
that nursing/managers may be involved in which include operating, personnel and capital
budgets. Although managers usually don’t have full responsibility for budgeting it is important
to understand the basics. All health care providers need to realize that they are responsible for
cost containment which refers to “effective and efficient delivery of services while generating
needed revenues for continued organizational productivity” (Marquis, & Huston, 2012). This
paper will propose a personnel budget for a home care agency including the potential variances
and strategies that can be implemented to help with those variances.
3. A PERSONNEL BUDGET FOR HOME CARE 3
A Personnel Budget for Home Care
Discussion
Up until recently nurses/managers had minimal opportunities or experience in the
budget process. However, because the greatest expenditure in a health care budget is salaries
managers are becoming more involved in looking at budgeting and cost containment. This
paper will create a calendar year personnel budget for a home care agency. The rationale for
this budget is this is the type of budget the hospital uses and the home health agency is a
department of the hospital.
In preparing to create the budget the first step was assessment, which included
determining what personnel needed to be included in the budget (Marquis, & Huston, 2012).
The second step in the budget process was the diagnosis or the goal of what the proposed
budget is trying to accomplish, in this case the goal of the budget is cost containment while
providing efficient, effective services to generate the needed revenue with the current number
of available resources (Marquis, & Huston, 2012). The third step is the plan which was done
through budget forecasting. This was done by reviewing the previous twelve rolling months of
expenses compared to the current budgeted expenses for the purpose of projecting next year’s
budget. (Rolling months mean that if the budget process begins in July for example we would
look at the previous twelve months from that time). The fourth and fifth steps in the budget
process are implementation and evaluation this is completed by the Director of the
department, as she is notified of the projected budget and deviations from that budget on a
monthly basis; she is then required to notify administration as to what could be affecting the
budget deviations.
4. A PERSONNEL BUDGET FOR HOME CARE 4
The budget proposed for home health is based on the number of employees including a
staffing mix of fulltime and part time registered nurses, therapists including physical therapy,
occupational therapy, speech therapy, social workers, a dietician, and clerical personnel.
Additionally, the budget includes shift differential, on call hours, overtime, holiday overtime
and new hires.
Currently the home health department has the following productive staff:
Twenty FTE (fulltime) Nurses = 80hours per pay period
1. Director salary: $115,000.00
2. Two Clinical Supervisors salaries: $200,000.00
3. Two Team Leaders salaries: $175,000.00
4. Clinical Informatics Nurse salary: $90,000.00
5. Telehealth Nurse salary: 72,800.00
6. Thirteen Direct Care RN’s salaries based on $ 42.00/hour = $ 1,135,680.00
Part time and Perdiem Nurses:
1. Five Part time RN’s (.6= 48 hours per pay period) @ $42.00/hr=$ 262,080.00
2. Three per diem RN’s (.4=32 hours per pay period) @ $32.00/hr=$ 79,872.00
Therapy Staff:
1. Therapy Supervisor salary: $114,000.00
2. Seven fulltime physical therapists ( 80 hours per pay period ) @ $50.00/hour=
$728,000.00
3. Five part time physical therapists (.6 = 48 hours per pay period) @ $ 50.00/hr =
$ 312,000.00
5. A PERSONNEL BUDGET FOR HOME CARE 5
4. One full time occupational therapist (1.0 = 80 hours per pay period) @ $ 45.00/hr =
$93,600.00
5. One part time occupational therapist (.6= 48 hours per pay period) @ $45.00/hr=
$56,100.00
6. Two part time speech therapists (.4= 32hours per pay period) @ $ 60.00/hr= $99,840.00
7. One part time social worker (.8= 64 hours per pay period) @ $ 29.00/hr=$ 48,256.00
8. One per diem social worker (.4= 32 hours per pay period) @ $ 29.00/hr = $ 24,128.00
Shift differential for RN’s = $ 1,000.00/month = $12,000.00/year (.2 FTE’s) based on figures
from previous year.
RN on Call: $ 604.00/month = $ 7,248.00/year (.1 FTE) based on figures from previous year.
RN overtime: (.8 FTE = 64hours/month) @ $ 63.00/hr =$ 4,032.00/month = $ 48,384.00/year
RN holiday overtime: (7 holidays /year based on 5 nurses /holiday) @ $ 63.00/hr x 8hours =
$504.00 x 5 nurses =$ 2,520.00 x 7 holidays = $ 17,640.00/yr.
New Hire RN: based on previous year of 32,481.00 visits with a 2% growth would increase visits
by 650 allowing for the hiring of one part time RN (.6 = 48 hours per pay period) @ $40.00/hr =
$ 49,920.00
Four Clerical Personnel: (non productive personnel)
1. Receptionist (1 FTE 80 hours per pay period) @ $12.50/hr= $ 26,000.00/yr
2. Three team assistants ( 80 hours per pay period) @ $ 13.75/hr= $ 28,600.00
Total Personnel Budget for 2014 = $ 3,796,148.00
The home care budget is a hospital system budget and is not changed until the following
year regardless of the variances. One of the strengths of this budget is that it is part of a larger
6. A PERSONNEL BUDGET FOR HOME CARE 6
system which then other departments/programs help to offset costs or expenses when revenue
is down in the department. A major weakness of the budget is that the hospital system still
looks at the budget for home care based on visits made and not as a per episode of payment
which is how home care is paid by the Centers for Medicare.
Variances in the budget can be related to an increase or decrease in the patient census.
The census is looked at every morning to determine the need for use of per diem staff, or if
they should be called off. Additionally, other variances can be an increase in overtime
secondary to patient acuity and increased census or travel time. A Bi-monthly review of
overtime is looked at when the pay periods end with a written explanation sent to
administration. Other variances can be tied to a change in reimbursement rates from managed
care companies as well as the pay for performance regulations set forth by the Centers for
Medicare that may reduce revenue when patient outcomes are below the state/national levels.
Additionally, changes in the payer mix will affect the budget for e.g. more managed care or
Medicaid patients can also decrease revenue. With the cut in revenue being felt by many
agencies there is also the potential for encroachment from regional competitors (Nugent,
2011).
Some strategies to help combat the above variances are continued staff education since
pay for performance is tied to the oasis data set, accuracy by the staff is imperative. Increased
utilization of marketing to help increase the agencies referral base and balance the case mix.
Developing and implementing additional programs such as telehealth utilization for
management of other chronic diseases rather than only focusing on those patients with
7. A PERSONNEL BUDGET FOR HOME CARE 7
congestive heart failure. This can help off - set the reimbursement cuts and improve efficiency
by the agency (AHC media, LLC, 2009).
Conclusion
In conclusion nursing leaders must be aware of budgeting in order to help health care
organizations remain viable in this critical time of health care reform. Many variables can affect
a budget but understanding the basics of the budgetary process agencies can remain successful
by holding all practitioners accountable for cost effective quality care. When agencies remain
transparent and share or elicit ideas from staff during the budgetary process they may find that
the staff “has deep insights into avoidable costs, areas of excessive resource consumption and
clinical process improvement initiatives that will help maintain margins in and increasingly
lower reimbursement environment” (Nugent, 2011).
8. A PERSONNEL BUDGET FOR HOME CARE 8
References
AHC media, LLC., (2009). Home health agencies prepare for cuts and changes with health care
reform: Agency representatives make sure legislators have all the facts. Hospital Home
Health, 26(10), 109-11.
Fishbein, J., & Vehaun, D. (2009). Managing the personnel budgeting process. Government
Finance Review, 67-71.
Marquis, B.L., & Huston, C.J. (2012) Leadership and management tools for the new nurse a case
study approach. Philadelphia, PA: Lippincott Williams & Wilkins.
Nugent, M.E. (2011) Budget planning under payment reform. Healthcare Financial
Management, 65(7), 38-42.