This topic is included with wages and incentives, where as in wages included with Elements of ideal Wage-System,Types of Wages, Merits & Demerits of Wages and in incentives with types of incentives, merits and demerits of incentives. Which can help a student to go through it.
Tax saving reimbursements, the way India Inc perceives it.
Services:
Tax Saving Reimbursements
Fuel reimbursement
Rewards & Recognition
Petrol allowance
Contact for More Details...!! +91 8066905995
Mail: support@zeta.in
Website: www.zeta.in
Compensation Benchmarking Services for New Age Digital Technology CompaniesAshrit Pradhan
This talent consulting services from Zinnov is designed to serve new age, domestic technology startups formulate better compensation and benefits policies.
This topic is included with wages and incentives, where as in wages included with Elements of ideal Wage-System,Types of Wages, Merits & Demerits of Wages and in incentives with types of incentives, merits and demerits of incentives. Which can help a student to go through it.
Tax saving reimbursements, the way India Inc perceives it.
Services:
Tax Saving Reimbursements
Fuel reimbursement
Rewards & Recognition
Petrol allowance
Contact for More Details...!! +91 8066905995
Mail: support@zeta.in
Website: www.zeta.in
Compensation Benchmarking Services for New Age Digital Technology CompaniesAshrit Pradhan
This talent consulting services from Zinnov is designed to serve new age, domestic technology startups formulate better compensation and benefits policies.
Telephone triage nurse: current role and skillsSheila Wheeler
The role of telephone triage nurses will evolve quickly in the coming tele health era. Telephone triage requires expert skill in pattern recognition: identifying emergencies, estimating and ruling out urgencies, and interpreting patient responses. Telenurses will also serve as knowledge workers and medical informaticists.
Educational powerpoint on Emergency patient presentations.
It describes the allocation of a patient triage score based on the clinical condition on arrival in the Emergency Department
Telemedicine presentation delivered at the conference sponsored by HEALTHePRACTICES, ICanNY and Windstream Communications entitled Healthcare Technology and the Networks Which Make it Happen.
Operating BudgetBUDGET SAMPLECurrent YearNew Budget% DifferenceCommentsGROSS REVENUEOutpatient RevenueOffice visits1,000,000immunizations500,000Well Child Exams500,000Pregnancy Care300,000Diabetes education150,000Mammography2,500,000MRI5,000,000Total Gross Patient Services Revenue9,950,000EXPENSESSalariesMD$ 2,500,000MD salaries combinedRN$ 800,000RN salaries combinedLPN$ 350,000Nursing staff salaries combinedOther Staff$ 180,000Admin staff salaries combinedTotal Salary Expense$ 3,830,000SUPPLIESMedical Supplies485,000What is needed for the clinic to operate?Office Supplies265,000What is needed for the clinic to operate?Total Supplies750,000OTHER EXPENSESEquipment$ 250,000.00
Author: Author:
Equipment is 'never' and expense; Fixed assets are to be depreciated over a period of time.
For example, a building is a fixed assets; a vehicle is a fixed asset; a plane is a fixed asset; all of which are to be depreciated (Note: Chapter4 in Principles of Accounting I)Legal Fees$ 108,786Professional Fees152,288Utilities497,694Repairs and Maintenance506,984Equipment Lease183,509Is your capital budget item a lease?Insurance154,996What insurance is required for the practice?Bad Debt Expense80,000Uncollectable accountsTOTAL OTHER EXPENSES$ 1,934,257Total All Expenses$ 6,514,257Excess (Deficit) Revenues over Expenses$ 3,435,743
Capital BudgetCapital Budget SAMPLESpecific Department FY 20XXPROPOSED QUARTER OF PURCHASEITEM REQUESTEDPURPOSE / USEITEM COSTINSTALLATIONTOTAL COST1st2nd3rd4thExample:Floor ScrubberFacilities $ 6,000$ 1,000
Author: Author:
This is funny.
How do you install a floor scrubber? A floor Scrubber is not attached to real property; thus, the asset is not installed. Commercial floor scrubbers are just delivered with a set of instructions, just like one would buy a car.$ 7,000XFloor tile in EntryFacility upgrade$ 7,000$ 3,000$ 10,000XTOTALS$ 13,000$ - 0$ 4,000$ - 0$ 17,000Submitted by:Approved by:Date :Date :
Submission Feedback:
You have a good start here but significant improvement is needed. Please make sure you are reviewing all my materials and taking the time to watch my video and review the rubric. Please read the rubric description - several areas you included were not well defined and lacked context/detail related to the rubric description. Make sure you continue to make the connection between your project and the mission, vision, and values of the facility. This is very important when you approach your board – they want to know how it fits into the overall objectives of the organization. I have provided some detailed feedback above that I think your project could benefit from. Think about what questions an investor or board would ask from a financial and clinical perspective and then answer them. The key is to answer questions before they are asked. One of these questions is, "How long will it take to make my money back?"
Please review each criteria needing revision
Proposal: Or ...
Complete cost benefit analysis on the outsourcing of surgical assistant services to an outside staffing agency such as American Surgical Assistants, Inc.
SpineSearch who's got your back Nurse Practitioner & Physician AssistantsNicola Hawkinson
How Do NP’s and PA’s Facilitate Effective Contract Negotiation, Performance Based Incentive Programs and Foster Career Growth. Five Steps To a Successful Spine Career
Read Contract
Negotiate a Contract
How To Stand Out in Your Profession
Knowing Your Worth
Lifestyle Compatibility
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
.
Part IDescribe the following 4 types of costsFixedVariableS.docxdunnramage
Part I
Describe the following 4 types of costs:
Fixed
Variable
Semivariable
Semifixed
Part II
Dynamic Medical Suppliers, Inc. has sales of $300,000 for the calendar year of 2010. Its total variable costs equal $107,700.
Calculate the contribution margin ratio, and determine whether it presents profit or loss to the organization.
Total
% of Revenue
Sales (Revenue)
$300,000.00
100%
Less variable costs
36%
Costs of medical supplies sold
$65,825.00
Commission
$26,875.00
Delivery fees
$15,000.00
Total variable costs
$107,700.00
Contribution margin
X
X
Less fixed costs
$115,000.00
Operating income
$77,300.00
Part III
Determine the number of full-time employees needed to cover multiple shifts based on information provided within the following scenario:
Health care is a critical field, and some agencies require that staff members be present at all times to ensure that there is adequate staff to care for the patients. For example, a medical center that has both inpatient and outpatient units will require staff be present after normal business hours to provide care to those admitted to the inpatient unit. It is also important to ensure that there is sufficient staff to provide care to the number of patients being treated. This is imperative to managers when it comes to determining costs associated with salary and benefits. If an organization is overscheduling staff, it could have a severe impact on the revenue because the staff-to-patient ratio would not be appropriate.
You create the schedule for the nursing staff in the pediatric intensive-care unit. Your daily staffing uses 6 registered nurses (RNs) working 8 hours and 2 licensed practical nurses (LPNs) working 3 hours. Determine the number of work hours required for 1 day.
Part IV
Understanding financial ratios can help the health care organization analyze its credit. Financial ratios should be compared to other financial information within the organization. Values used in calculating financial ratios are taken from the balance sheet, income statement, and statement of cash flows.
The following are types of ratios:
Liquidity ratios
tell whether the health care agency is able to meet its financial obligations.
Are there assets or cash available to pay the bills?
Solvency ratios
tell whether the organization has the means to meet its long-term obligations.
How solvent is the agency?
Profitability ratios
tell whether the operating revenue outweighs the operating expense.
How well does the medical center use its assets and control its expenses?
Compute ratios using the provided data/information below.
Use the financial reports below to compute the requested financial ratios. Provide a brief statement (1–2 sentences) explaining the outcome of the ratio.
Dominion Plus Surgery Center
Balance Sheet
December 31, 200XX
Assets
Current assets
Cash and cash equivalents
$225,000.00
Accounts receivable (net)
$450,000.00
Inventories
$50,000.00
Prepaid insurance
$18,.
This 17-page document will inspire and guide you through WHY it's time to re-consider your agency technology. Furthermore, this guide will help you answer WHAT you need to know about the shifting home healthcare landscape from a traditional Fee-for-Service model to outcome/bundled reimbursement.
With this guide, you'll learn about topics such as:
1. What is the Bundled Payment Model?
2. Why Home Health Care Agencies Require Technology
3. Steps to Buying a Software Solution
4. Key Factors and Features to Keep in Mind
HealthWaysBudgetTable 1. HealthWays Clinic, Monthly Expense Budget Report, June 2018.ItemJune 2018May 20182018 YTDBudgetActualVarianceActualBudgetActualPhysician FTE1.01.01.01.01.0Nurse PractitionerFTE3.03.03.03.03.0Encounters:Established patients27529128616501671New patients251827150164Total encountersExpenses:Physician Salaries & Benefits$10,500$10,502$10,509$63,000$63,149NP Salaries & Benefits$20,000$20,992$20,191$120,000$122,001Clerical (2 FTE) Salaries & Benefits$6,667$6,771$6,683$40,000$41,978Total personnel expenseMedical supplies$7,500$8,136$7,994$45,000$47,883Office supplies$583$623$508$3,498$3,407Rent$2,917$2,917$2,917$17,502$17,502Depreciation$333$346$346$1,998$2,050Capital Expenses$3,333$3,480$3,480$19,998$20,439Overhead$167$167$167$1,002$1,002Total non-personnel expenseTotal health center expenseInterpretation:Providers:The FTEs have not changed, at least for the first 6 months of 2018.Encounters:The number of encounters, both new and established, is increasing over the year.Personnel expense:Although the FTEs are not changing, the personnel budget is somewhat more than budgeted, particularly the NP and clerical budgets. The management should investigate why this is the case, and better control the personnel budget.Non-personnel expense:Medical supplies are over budget. Office supplies are under budget. Depreciation and capital expenses (new equipment) increased over the budget year. Rent and overhead remain stable, but might be expected to increase next year.Total expenses:The clinic must carefully control expenses as its profitability is very low. Possible strategies might include improving staff productivity, reducing the cost of medical supplies, and postponing further capital purchases.
HealthWaysFinancialsNurse-Run Clinic ScenarioPatient EncountersFY 2018FY 2017Established patients3,3483,204New patients331287Total Encounters3,6793,491 Cash$5,675$12,098Financial Ratios:Expense per Encounter = Total Operating Expenses / Total EncountersTotal Operating Revenue per Encounter = Total Operating Revenue / Total EncountersOperating Margin = Net Income/Total Operating RevenueDays Cash On Hand = (Cash + Cash Equivalents) / (Operating Expenses / Days in Time Period)Table 2. HealthWays Clinic, Income Statement, FY 2018.Table 3. HealthWays Clinic, Balance Sheet, December 31, 2018.FY 2018FY 2017Current AssetsDecember 31, 2018December 31, 2017Current LiabilitiesDecember 31, 2018December 31, 2017Gross Revenue (charges)$558,520$497,221 Cash5,0329,877 Notes Payable27,44950,000Less write-offs & adjustments117,254104,332Short-term Investments40,38934,181 Accounts Payable 78,70269,412Net Patient Revenue (collected)$441,266$392,889 Accounts Receivable63,39259,359 Accrued Expenses:+Other Revenue209,671234,953 Supply Inventories, at Cost16,02914,918 Salaries & Benefits38,26528,274 Prepaid Expenses & Other2,1041,876 Taxes1,4191,398Total Operating Revenue$ 650,937$ 627,842Total Current Assets$ 126,946$ 120 ...
Telephone triage nurse: current role and skillsSheila Wheeler
The role of telephone triage nurses will evolve quickly in the coming tele health era. Telephone triage requires expert skill in pattern recognition: identifying emergencies, estimating and ruling out urgencies, and interpreting patient responses. Telenurses will also serve as knowledge workers and medical informaticists.
Educational powerpoint on Emergency patient presentations.
It describes the allocation of a patient triage score based on the clinical condition on arrival in the Emergency Department
Telemedicine presentation delivered at the conference sponsored by HEALTHePRACTICES, ICanNY and Windstream Communications entitled Healthcare Technology and the Networks Which Make it Happen.
Operating BudgetBUDGET SAMPLECurrent YearNew Budget% DifferenceCommentsGROSS REVENUEOutpatient RevenueOffice visits1,000,000immunizations500,000Well Child Exams500,000Pregnancy Care300,000Diabetes education150,000Mammography2,500,000MRI5,000,000Total Gross Patient Services Revenue9,950,000EXPENSESSalariesMD$ 2,500,000MD salaries combinedRN$ 800,000RN salaries combinedLPN$ 350,000Nursing staff salaries combinedOther Staff$ 180,000Admin staff salaries combinedTotal Salary Expense$ 3,830,000SUPPLIESMedical Supplies485,000What is needed for the clinic to operate?Office Supplies265,000What is needed for the clinic to operate?Total Supplies750,000OTHER EXPENSESEquipment$ 250,000.00
Author: Author:
Equipment is 'never' and expense; Fixed assets are to be depreciated over a period of time.
For example, a building is a fixed assets; a vehicle is a fixed asset; a plane is a fixed asset; all of which are to be depreciated (Note: Chapter4 in Principles of Accounting I)Legal Fees$ 108,786Professional Fees152,288Utilities497,694Repairs and Maintenance506,984Equipment Lease183,509Is your capital budget item a lease?Insurance154,996What insurance is required for the practice?Bad Debt Expense80,000Uncollectable accountsTOTAL OTHER EXPENSES$ 1,934,257Total All Expenses$ 6,514,257Excess (Deficit) Revenues over Expenses$ 3,435,743
Capital BudgetCapital Budget SAMPLESpecific Department FY 20XXPROPOSED QUARTER OF PURCHASEITEM REQUESTEDPURPOSE / USEITEM COSTINSTALLATIONTOTAL COST1st2nd3rd4thExample:Floor ScrubberFacilities $ 6,000$ 1,000
Author: Author:
This is funny.
How do you install a floor scrubber? A floor Scrubber is not attached to real property; thus, the asset is not installed. Commercial floor scrubbers are just delivered with a set of instructions, just like one would buy a car.$ 7,000XFloor tile in EntryFacility upgrade$ 7,000$ 3,000$ 10,000XTOTALS$ 13,000$ - 0$ 4,000$ - 0$ 17,000Submitted by:Approved by:Date :Date :
Submission Feedback:
You have a good start here but significant improvement is needed. Please make sure you are reviewing all my materials and taking the time to watch my video and review the rubric. Please read the rubric description - several areas you included were not well defined and lacked context/detail related to the rubric description. Make sure you continue to make the connection between your project and the mission, vision, and values of the facility. This is very important when you approach your board – they want to know how it fits into the overall objectives of the organization. I have provided some detailed feedback above that I think your project could benefit from. Think about what questions an investor or board would ask from a financial and clinical perspective and then answer them. The key is to answer questions before they are asked. One of these questions is, "How long will it take to make my money back?"
Please review each criteria needing revision
Proposal: Or ...
Complete cost benefit analysis on the outsourcing of surgical assistant services to an outside staffing agency such as American Surgical Assistants, Inc.
SpineSearch who's got your back Nurse Practitioner & Physician AssistantsNicola Hawkinson
How Do NP’s and PA’s Facilitate Effective Contract Negotiation, Performance Based Incentive Programs and Foster Career Growth. Five Steps To a Successful Spine Career
Read Contract
Negotiate a Contract
How To Stand Out in Your Profession
Knowing Your Worth
Lifestyle Compatibility
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
.
Part IDescribe the following 4 types of costsFixedVariableS.docxdunnramage
Part I
Describe the following 4 types of costs:
Fixed
Variable
Semivariable
Semifixed
Part II
Dynamic Medical Suppliers, Inc. has sales of $300,000 for the calendar year of 2010. Its total variable costs equal $107,700.
Calculate the contribution margin ratio, and determine whether it presents profit or loss to the organization.
Total
% of Revenue
Sales (Revenue)
$300,000.00
100%
Less variable costs
36%
Costs of medical supplies sold
$65,825.00
Commission
$26,875.00
Delivery fees
$15,000.00
Total variable costs
$107,700.00
Contribution margin
X
X
Less fixed costs
$115,000.00
Operating income
$77,300.00
Part III
Determine the number of full-time employees needed to cover multiple shifts based on information provided within the following scenario:
Health care is a critical field, and some agencies require that staff members be present at all times to ensure that there is adequate staff to care for the patients. For example, a medical center that has both inpatient and outpatient units will require staff be present after normal business hours to provide care to those admitted to the inpatient unit. It is also important to ensure that there is sufficient staff to provide care to the number of patients being treated. This is imperative to managers when it comes to determining costs associated with salary and benefits. If an organization is overscheduling staff, it could have a severe impact on the revenue because the staff-to-patient ratio would not be appropriate.
You create the schedule for the nursing staff in the pediatric intensive-care unit. Your daily staffing uses 6 registered nurses (RNs) working 8 hours and 2 licensed practical nurses (LPNs) working 3 hours. Determine the number of work hours required for 1 day.
Part IV
Understanding financial ratios can help the health care organization analyze its credit. Financial ratios should be compared to other financial information within the organization. Values used in calculating financial ratios are taken from the balance sheet, income statement, and statement of cash flows.
The following are types of ratios:
Liquidity ratios
tell whether the health care agency is able to meet its financial obligations.
Are there assets or cash available to pay the bills?
Solvency ratios
tell whether the organization has the means to meet its long-term obligations.
How solvent is the agency?
Profitability ratios
tell whether the operating revenue outweighs the operating expense.
How well does the medical center use its assets and control its expenses?
Compute ratios using the provided data/information below.
Use the financial reports below to compute the requested financial ratios. Provide a brief statement (1–2 sentences) explaining the outcome of the ratio.
Dominion Plus Surgery Center
Balance Sheet
December 31, 200XX
Assets
Current assets
Cash and cash equivalents
$225,000.00
Accounts receivable (net)
$450,000.00
Inventories
$50,000.00
Prepaid insurance
$18,.
This 17-page document will inspire and guide you through WHY it's time to re-consider your agency technology. Furthermore, this guide will help you answer WHAT you need to know about the shifting home healthcare landscape from a traditional Fee-for-Service model to outcome/bundled reimbursement.
With this guide, you'll learn about topics such as:
1. What is the Bundled Payment Model?
2. Why Home Health Care Agencies Require Technology
3. Steps to Buying a Software Solution
4. Key Factors and Features to Keep in Mind
HealthWaysBudgetTable 1. HealthWays Clinic, Monthly Expense Budget Report, June 2018.ItemJune 2018May 20182018 YTDBudgetActualVarianceActualBudgetActualPhysician FTE1.01.01.01.01.0Nurse PractitionerFTE3.03.03.03.03.0Encounters:Established patients27529128616501671New patients251827150164Total encountersExpenses:Physician Salaries & Benefits$10,500$10,502$10,509$63,000$63,149NP Salaries & Benefits$20,000$20,992$20,191$120,000$122,001Clerical (2 FTE) Salaries & Benefits$6,667$6,771$6,683$40,000$41,978Total personnel expenseMedical supplies$7,500$8,136$7,994$45,000$47,883Office supplies$583$623$508$3,498$3,407Rent$2,917$2,917$2,917$17,502$17,502Depreciation$333$346$346$1,998$2,050Capital Expenses$3,333$3,480$3,480$19,998$20,439Overhead$167$167$167$1,002$1,002Total non-personnel expenseTotal health center expenseInterpretation:Providers:The FTEs have not changed, at least for the first 6 months of 2018.Encounters:The number of encounters, both new and established, is increasing over the year.Personnel expense:Although the FTEs are not changing, the personnel budget is somewhat more than budgeted, particularly the NP and clerical budgets. The management should investigate why this is the case, and better control the personnel budget.Non-personnel expense:Medical supplies are over budget. Office supplies are under budget. Depreciation and capital expenses (new equipment) increased over the budget year. Rent and overhead remain stable, but might be expected to increase next year.Total expenses:The clinic must carefully control expenses as its profitability is very low. Possible strategies might include improving staff productivity, reducing the cost of medical supplies, and postponing further capital purchases.
HealthWaysFinancialsNurse-Run Clinic ScenarioPatient EncountersFY 2018FY 2017Established patients3,3483,204New patients331287Total Encounters3,6793,491 Cash$5,675$12,098Financial Ratios:Expense per Encounter = Total Operating Expenses / Total EncountersTotal Operating Revenue per Encounter = Total Operating Revenue / Total EncountersOperating Margin = Net Income/Total Operating RevenueDays Cash On Hand = (Cash + Cash Equivalents) / (Operating Expenses / Days in Time Period)Table 2. HealthWays Clinic, Income Statement, FY 2018.Table 3. HealthWays Clinic, Balance Sheet, December 31, 2018.FY 2018FY 2017Current AssetsDecember 31, 2018December 31, 2017Current LiabilitiesDecember 31, 2018December 31, 2017Gross Revenue (charges)$558,520$497,221 Cash5,0329,877 Notes Payable27,44950,000Less write-offs & adjustments117,254104,332Short-term Investments40,38934,181 Accounts Payable 78,70269,412Net Patient Revenue (collected)$441,266$392,889 Accounts Receivable63,39259,359 Accrued Expenses:+Other Revenue209,671234,953 Supply Inventories, at Cost16,02914,918 Salaries & Benefits38,26528,274 Prepaid Expenses & Other2,1041,876 Taxes1,4191,398Total Operating Revenue$ 650,937$ 627,842Total Current Assets$ 126,946$ 120 ...
CHAPTER 4 Estimating CostsIntroduction to managerial account.docxrobertad6
CHAPTER 4
Estimating Costs
Introduction to managerial accounting
Cost classifications
Fixed versus variable
Direct versus indirect (overhead)
Cost behavior
Cost allocation
Activity-based costing
Copyright 2009 Health Administration Press
4 - ‹#›
Managerial Accounting
There are two main areas of accounting:
Financial
Managerial
Financial accounting involves creating financial statements to report the financial status of the overall business. These statements are used primarily by outsiders.
Managerial accounting involves creating information for internal use in managerial decision making. This chapter focuses on managerial accounting.
Copyright 2009 Health Administration Press
4 - ‹#›
Cost Classifications
Cost measurement is a critical part of managerial accounting.
Unfortunately, there is no single definition of the term cost. Different costs are used for different purposes.
Costs are classified in two major ways:
By their relationship to volume
By their relationship to the sub-unit being analyzed
Copyright 2009 Health Administration Press
4 - ‹#›
Is there a difference between a cost and an expense?
Discussion Item
Copyright 2009 Health Administration Press
4 - ‹#›
Cost Behavior
The relationship between costs and the volume of services provided is called cost behavior or underlying cost structure.
If the underlying cost structure is known, managers can forecast costs at different levels of patient volume.
In this context, costs may be
fixed (independent of volume), or
variable (dependent on volume).
Copyright 2009 Health Administration Press
4 - ‹#›
Cost Behavior (cont.)
In the long-run, all costs are variable; hence, the fixed versus variable classification can hold only in the short-run—say, for one year.
Also, no costs are fixed throughout an infinite range of volumes. Thus, the concept of cost classifications according to volume must be applied within some relevant range of patient volume.
Copyright 2009 Health Administration Press
4 - ‹#›
What are some examples of fixed and variable costs for a hospital’s clinical laboratory?
Discussion Item
Copyright 2009 Health Administration Press
4 - ‹#›
Cost Behavior Example: Walk-In Clinic
Variable Costs Per Visit Fixed Costs Per Year
Clinical supplies $20 Facilities $30,000
Other supplies 5 Salaries 190,000
Variable cost rate $25 Overhead 80,000
$300,000
Total Fixed Variable Total Average
Volume Costs Costs Costs Cost
1 $300,000 $ 25 $300,025 $300,025
100 300,000 2,500 302,500 3,025
200 300,000 5,000 305,000 1,525
1,000 300,000 25,000 325,000 325
5,000 300,000 125,000 425,000 85
10,000 300,000 250,000 550,000 55
25,000 300,000 625,000 925,000 37
Note: The rele.
1. | P a g e
COST BENEFIT
ANALYSIS
This document discusses the cost-benefit analysis of employing a nurse
triage services for a self-insured group. The following return on investment
formulas were utilized: Benefit Cost Ratio, Payback Time, Net Benefit and
ROI%
For Nurse Triage
Services for 2011
2. i | P a g e
Table of Contents
What is a CBA?..........................................................................................................................................1
What is Nurse Triage?...............................................................................................................................1
What is this Document?............................................................................................................................1
Benefits of Nurse Triage................................................................................................................................1
Benefits of Having a Nurse-Triage Service................................................................................................1
The Break Down of these Benefits............................................................................................................3
Managing Company Savings .................................................................................................................3
Self-Insured Group and Employee Savings ...........................................................................................5
Costs of Current Nurse Triage.......................................................................................................................5
Costs of Having a Nurse Triage .................................................................................................................5
Break Down of Costs.................................................................................................................................6
Calls to Nurse Triage .............................................................................................................................6
Translation Fees....................................................................................................................................6
New Locations.......................................................................................................................................7
Cost of Client and Company Follow Up Calls ........................................................................................7
Customer Support.................................................................................................................................8
Company Upper Management .............................................................................................................8
IT Department Charges.........................................................................................................................8
Implementation Team Charges.............................................................................................................9
Cost Benefit Analysis Results ........................................................................................................................9
Benefit Cost Ratio .................................................................................................................................9
Payback Time ........................................................................................................................................9
Net Benefit............................................................................................................................................9
ROI%......................................................................................................................................................9
Conclusion...................................................................................................................................................10
3. 1 | P a g e
Introduction
What is a CBA?
A cost benefit analysis (CBA) is an economic decision-making approach to assess a proposed project,
program or policy either in progress or for the future. It involves weighing the total benefits of a project,
program or policy against the total cost of the project, program or policy. After conducting the CBA, the
preparer can see how long the payback for the project, program or policy will be in years.
What is Nurse Triage?
A nurse triage provider is a service that provides workers with a 24/7 access to registered nurses to
facilitate the treatment of work related injuries for a self-insured group.
What is this Document?
This document will showcase the CBA of having a nurse triage service available for employees. It will
showcase a complete list of nurse-triage costs to a self-insured group and its managing company.
Benefits of Nurse Triage
“Benefit” is a term used to measure the willingness of individuals to pay for the outputs of a project in
question. In this document the benefits have a monetary value and reveal the cost of not having a
nurse-triage service available to employees.
Benefits of Having a Nurse-Triage Service
There are many benefits to having a Nurse-Triage service available for employees connected to a self-
insured group. These are listed in Benefits of Current Nurse Triage. Each of these benefits were broken
down by who (the company that manages the self-insured group, the self-insured group or the members
of the self-insured group) it benefits, the cost per unit, the unit used, the average amount of
occurrences for a month, and the total value of the benefit for a single month.
Finally, it provides the Present Value of Benefits or PVB. This value informs a business of how much
benefit they are receiving from having the program for one year.
4. 2 | P a g e
Name of Benefit Who Benefits Cost/Unit Unit
Average Amount
of Occurances
per Month
Total Benefit
for Month
Phone Service
The Company Managing
Self-Insured Group
50.00$ per person employed 2 100.00$
Electicity Usage
The Company Managing
Self-Insured Group
87.85$ per person employed 2 175.70$
Water/Sewer
The Company Managing
Self-Insured Group
11.62$ per person employed 2 23.24$
Staff Wages
The Company Managing
Self-Insured Group
2,716.67$ per person employed 2 5,433.34$
Staff Insurance
Package
The Company Managing
Self-Insured Group
750.00$ per person employed 2 1,500.00$
Payroll Taxes
The Company Managing
Self-Insured Group
163.00$ per person employed 2 326.00$
Training Costs
The Company Managing
Self-Insured Group
38.00$ per person employed 2 76.00$
Extra Computers
The Company Managing
Self-Insured Group
91.67$ per person employed 2 183.34$
Extra Phones
The Company Managing
Self-Insured Group
11.67$ per person employed 2 23.34$
Extra Desks
The Company Managing
Self-Insured Group
41.67$ per person employed 2 83.34$
Supplies
The Company Managing
Self-Insured Group
9.03$ per person employed 2 18.06$
Setup of Work Area
The Company Managing
Self-Insured Group
$ 16.88 per hour 3 $ 50.64
Setup of Computer
The Company Managing
Self-Insured Group
$ 8.33 per hour 12 $ 99.96
Setup of Phone
System
The Company Managing
Self-Insured Group
$ 12.50 per phone 2 $ 25.00
Setup of Account
The Company Managing
Self-Insured Group
$ 16.67 per hour 2 $ 33.34
Computer/Misc
Support
The Company Managing
Self-Insured Group
16.67$ per hour 6 100.02$
Customer Support
Managers
The Self-Insured Group 0.64$ per minute 4,050 2,592.00$
Translation
Services
The individual Injured
Employee
-$ per item - -$
Self Treatments
Received from
Nurse-Triag Claims
The Self-Insured Group 962.76$ average per claim 67 64,504.92$
Total Cost per
Month
75,348.24$
Present Value of
Benefits (PVB)
904,178.88$
Benefit of Current Nurse Triage Services
AdditionalSupportCostsnot
Needed
AdditionalSupport
forInjured
Employees
AdditionalServices
NotNeeded
AdditionalStaffCosts
Saved
AdditionalMaterialsNot
Needed
5. 3 | P a g e
According to the table, the PVB is $904,178.88. The majority of time the individuals that benefited the
most is the self-insured group due to the self-treatment costs for the year. This amount that the self-
insured group saves by employing the nurse triage group is $774,059.04.
The Break Down of these Benefits
Managing Company Savings
Why Only Two?
According to this document, there would only be two additional hires added to the staff for the
managing company to take the extra call volume. This value may change depending on the needs of the
self-insured groups. Currently, a nurse-triage call is approximately 18 minutes in length; with a Spanish
translation call at approximately 21 minutes and an English call approximately 15 minutes in length. The
number of additional employees needed was decided on after calculating that the average number of
calls added per hour would be three and the average time spent on these calls would on average total
54 minutes. Therefore, the members currently with the managing company and two additional
employees are based on the self-insured nurse triage bill analysis. Additional employees may be needed
as the managing company grows and adds new self-insured groups.
Additional Services Not Needed
Phone Services
At present, the bill for land-line phones is $1,550.00 a month. There are thirty-one employees located in
the managing company’s building. On average, each employee’s phone line costs $50 each month. If
two extra employees are hired, this would be an additional $100 a month spent on this service; this does
not include additional charges for installation of a phone.
Electricity Usage
Currently, the bill for the electrical usage is $2,723.34 a month. Therefore, the average cost of each
employee at the managing company is $87.85 a month for energy. If the managing company adds two
new employees, it will cost an additional $175.70 a month.
Water and Sewer
Presently, the bill for water and sewer is $360 a month and on average the managing company’s
employee costs $11.62 a month. Once two members are added to the team, this would mean that an
additional $23.24 is spent a month on water and sewer.
Additional Staff Costs Saved
Staff Wages
At the moment, the average employee at the managing company gets paid $2,176.67 a month. If two
more employees were hired, the cost of wages rises to an additional $5,433.34 a month.
6. 4 | P a g e
Staff Insurance Package
At the moment, each employee at the managing company offers $750 to go to insurance and other
medical needs a month. Two more employees would cost an additional $1,500 a month.
Staff Payroll Taxes
Payroll taxes help to cover Social Security and Medicare. Currently, the managing company pays 6% of
this tax. Since the additional employees would have a salary of $2,716.67 a month; the additional payroll
tax would be $163.00 per person. This means each month there is an additional $326 that goes towards
payroll taxes.
Training
Training for the staff occurs twice a month on new best-practices, software updates, insurance
providers, medical language, insurance language, etc. These cost $38 per person on average each
session. Therefore, it costs the company an additional $76 for the new hires.
Additional Materials Not Needed
Extra materials such as computers, desks, phones and supplies are broken down into their monthly costs
over a 12 month period.
1. Computers typically will cost $1,100. If this is spread out over a 12 month period, the cost is
$91.67 a month. For two, this is $183.34 a month.
2. A single multi-line phone costs $140.00, spread over 12 months; this comes to $11.67 a month.
For two new hires, this is $23.34 a month.
3. Additional desks cost $500 each; split up over 12 months, this comes to $41.67 each month. For
two new employees this is an additional $83.34 a month.
4. Supply orders each month are approximately $280, with thirty-one employees, this cost comes
to $9.03 a month per employee. This means there would be an additional $18.06 for two new
hires.
Additional Support Costs Not Needed
Setup of Work Space
To set up each additional work space (cubical setup), it costs the company $135 an hour. Each setup
takes 1.5 hours. Spread this cost of a 12 month period, the company would spend an additional $33.76
for two cubical setups.
Computer Setup Time
To set up each computer takes the consultant approximately six hours. This costs $100 an hour.
Therefore, if this cost is spread out for 12 months, then the additional cost would be $99.96 for two
computers per month.
Setup of Phone System
To set up each phone takes the phone provider approximately half an hour. This costs the company
$150 for each set up. If this cost is spread out over 12 months, the additional costs would be $25 a
month for additional employees.
7. 5 | P a g e
Setup of Account and Support
The setup of an account needs to be provided by the IT staff; which is part of a sister company. The IT
company charges approximately $200 an hour for software support and setup. Therefore, if it takes 2
hours for setup, the additional costs would be $33.34 for two additional employees per month. If each
employee on average needs 3 additional support from the IT company a month, then the cost would be
another $100.02 for two additional hires. This would total $133.36 a month.
Self-Insured Group and Employee Savings
Additional Support for Injured Employees
Customer Support Managers Additional Costs
At this time, it takes approximately 15 minutes to enter a claim into the software system that did not go
through the nurse-triage service. These are entered by the managing company’s support management.
Their approximate billing value is $38 an hour. Each minute is worth $0.64 and there are approximately
270 claims each month that need to be entered into the software system. Therefore, this additional cost
would be $2,592 a month
Translation Services
There would be no cost of having a translation service at this time.
Self-Treatments Received from Nurse Triage
On average the nurse triage receives 67 self-treatment incidences a month. During these calls, the
nurses assess whether a person needs to go in to the hospital or just use first aid. Self-treatments are
just first aid directions and the call remains an incident instead of a claim on the insurance. If the nurse-
triage did not provide this service, these 67 incidences would become claims, which each medical claim
costs on average $962.76. This includes urgent care/emergency room, doctor and other medical need
costs. Therefore, without the service, the cost to the self-insured group would be approximately
$64, 504.92 a month or $774,059.04 a year.
Costs of Current Nurse Triage
“Cost” is a term used for the total expenditures that affect all parties involved in a project. When
running these values, it is important to see all the values that are necessary; regardless of how little the
monetary value is. Most of the values that are used in this section are called “activity based values.”
These values can mean the billing rates of employees that are going to directly work on the project in
study.
Costs of Having a Nurse Triage
There are many costs of having a nurse triage service available to the self-insured group. The following
table represents the costs by who incurs the cost, the cost per unit, the unit used, the average
occurrences for a month and the total value for a single month.
8. 6 | P a g e
Finally, it provides the Present Value of Costs or PVC. This value informs a business of how much the
program costs per year.
Break Down of Costs
Calls to Nurse Triage
A single call to the nurse triage service, over the years of 2005 through 2011, cost on average $72.67.
There are approximately 382 calls made a month. Therefore, the cost is $22,891.05 a month on
average.
Translation Fees
Of an employee needs to have their call translated, this service costs the group $1.69 per minute. On
average there are 2,988 minutes used for translations a month. Therefore, the cost for translation fees is
$5,049.72 per month.
Name of Cost Who Incurs Cost Cost/Unit Unit
Average Amount
of Occurances
per Month
Total Cost for
Month
Call to Medcor (All Calls) Self-Insured Group $ 72.67 per person employed 315 $ 22,891.05
Translation Fee Self-Insured Group $ 1.69 per person employed 2,988 $ 5,049.72
Customer Support
Follow Up Calls
Self-Insured Group $ 5.00 per follow-up call 764 $ 3,820.00
Customer Support
Managers
Self-Insured Group $ 6.34 per claim 382 $ 2,421.88
New Location Fee Member $ 5.00 per person employed 81 $ 405.00
Cost to Client Member $ 2.89 per person employed 382 $ 1,103.98
Follow up Calls Member $ 1.20 per person employed 764 $ 916.80
Company's
Management
Managing Company $ 50.00 per minute 12 $ 600.00
IT Consultant Firm Managing Company $ 189.00 per hour 16 $ 3,024.00
Implementation Team Managing Company $ 300.00 per hour 8 $ 2,400.00
Total Cost per
Month
$ 42,632.43
Present Value of
Costs (PVC)
$ 511,589.16
Cost of Current Nurse Triage Services
9. 7 | P a g e
New Locations
Every new location that is added to the group is also added to the nurse-triage. Each of these new
locations cost $5 to add. On average there are 81 new locations added each month. Thus, this costs the
group $405 a month on average.
Cost of Client and Company Follow Up Calls
The table, “Average Hourly Wages of Self-Insured Employees,” identifies the average amount of hourly
wages an employee in the group receives. This value includes all part-time and full-time employees.
The table, “Cost to Client for a Nurse-Triage Phone Call,” calculates out the cost of the initial call to the
nurse-triage service. Each call is on average 18 minutes. Each call needs to have the manager and the
injured employee. This takes up approximately 30% of each employee’s time, thus costing the
store/restaurant $2.89 per call. There are approximately 382 calls made each month, thus it costs the
members $1,103.98 each month to have the service.
The table, “Cost to Client for Managing Company’s Follow Up Call,” reveals the cost to the client for the
follow up call that is made by the managing company. This call is mandated by the self-insured group.
This call averages 15 minutes in length. On average, there are two follow-up calls per submission/claim.
Payroll for Self-
Insured Group
# of Employees
Average Salary for a
Year per Employee
Average Salary for
a Week per
Employee
Average Salary for
a Day per
Employee
Average Salary
for a Hour per
Employee
$ 1,500,000,000.00 150,000 $ 10,000.00 $ 192.31 $ 38.46 $ 4.81
Average Hourly Wages of Self-Insured Employees
Average Call Length to
Nurse-Triage (in
minutes)
Number of Minutes in
an Hour
Average Proportion of
an Hour that a Single
Employee will be on
Phone with Nurse-
Triage
Average Amount
of Salary not Used
by Client
Number of
Employees
Needed for Nurse
Triage Call
Amount of
Salary Lost to a
Call to Nurse
Triage
18 60 0.3 $ 1.44 2 $ 2.88
Cost to Client for a Nurse-Triage Phone Call
Average Length of Call
from Company to
Client (in minutes)
Number of Minutes in
an Hour
Average Proportion of
an Hour that a Single
Employee will be on
Phone with Nurse-
Triage
Average Amount
of Salary not Used
by Client
Number of
Employees
Needed for
Follow Up Call
Amount of
Salary Lost to a
Follow Up Call
15 60 0.3 $ 1.20 1 $ 1.20
Cost to Client for Managing Company's Follow Up Call
10. 8 | P a g e
If each call costs $1.20 and there are 382 claims/submissions to the service a month, this means it costs
the client $916.80 per month on average.
Therefore, the final cost to the clients each month is $2,020.78 on average.
Customer Support
The table, “Cost to Self-Insured Group for Follow Up Calls,” identifies the cost per call that is billed to the
self-insured group. This cost is $5 per follow up call. There is on average 382 claims per month and each
of these on average takes two follow up calls. This means that on average the self-insured group spends
$3,820 for this additional support.
The table, “Cost to Self-Insured Group for Support Manager’s Review,” calculates the cost per
claim/incident that is reported to the service. There are approximately 382 claims/incidences a month
and each claim costs $6.33 to review. Therefore this additional support costs the self-insured group an
extra $2,421.88 a month on average.
Therefore, the total additional charges that self-insured group pays on average are $6241.88 a month.
Company Upper Management
Upper Management at the managing company spends approximately 3 hours a week collaborating with
the support staff on nurse-triage issues. The hourly billing rate is $50. Thus the cost of these extra
meetings is $600 a month on average. This cost is absorbed by the managing company.
IT Department Charges
The IT Department is a sister company of the managing company. To use the IT’s services, the managing
company is charged for the assistance. This cost is on average $189 an hour. The managing company on
average has 16 times a month that they will need this assistance. This assistance might include
computer set-up, hardware issues, printer solutions, phone complications, network upkeep, etc.
Therefore, it costs an additional $3,024.00 a month on average.
Average Length of Call
from Company to
Client (in minutes)
Number of Minutes in
an Hour
Average Proportion of
an Hour that a Single
Employee will be on
Phone with Nurse-
Triage
Amount Billed per
Hour
Number of
Employees
Needed for
Follow Up Call
Amount Billed
per Call
15 60 0.3 $ 20.00 1 $ 5.00
Cost to Self-Insured Group for Follow Up Calls
Average Length of
Time for Review (in
minutes)
Number of Minutes in
an Hour
Average Proportion of
an Hour that a Single
Employee will be on
Phone with Nurse-
Triage
Amount Billed per
Hour
Number of
Employees
Needed for
Follow Up Call
Amount Billed
per Call
10 60 0.2 $ 38.00 1 $ 6.33
Cost to Self-Insured Group for Support Manager's Review
11. 9 | P a g e
Implementation Team Charges
The Implementation Team is a section of the IT Department. The IT Department is a sister company of
the managing company. This company works on any software programming issues, data analysis, server
upkeep, etc. This service costs $300 an hour. Therefore, it costs the managing company an additional
$2,400 a month for 8 hours of work.
Cost Benefit Analysis Results
The most important and difficult parts of a Cost-Benefits Analysis is finding the PVC and PVB. Once,
there are determined, the benefit cost ratio, payback time, net benefit and ROI% can be calculated. The
following table represents these values.
Benefit Cost Ratio
The benefit cost ratio is the comparison of PVB divided by PVC. This value is the dollar representation of
returns for every $1.00 invested in the project. For the nurse triage services, this dollar value is $1.77
per dollar invested. Each year this value would need to be recalculated, since the averages used in the
calculations are fluid depending on the month and year.
Payback Time
The payback time is a calculation made to discover how long, in years, it would take to break even if the
project is implemented. This is found by taking the PVC and dividing it by the PVB. The results of this
report showcase that it would take seven months to break even with the amount the nurse triage
service costs in 2011. Each year this value would need to be recalculated, since the averages used in the
calculations are fluid depending on the month and year.
Net Benefit
The net benefit demonstrates the benefit after considering the cost. This is found by finding the
difference between the PVB and PVC. In the case of the nurse-triage service, the service will yield
$392,589.72 in benefit after considering the cost. Each year this value would need to be recalculated,
since the averages used in the calculations are fluid depending on the month and year.
ROI%
ROI is an acronym that stands for Return on Investment Analysis. The ROI% demonstrates the
percentage of return for every dollar invested when considering cost. This is calculated by dividing the
For Year
Present Value of Cost (PVC) 511,589.16$
Present Value of Benefit (PVB) 904,178.88$
Benefit Cost Ratio (BCR) 1.77$
Payback Time 0.57
Net Benefit 392,589.72$
ROI% 76.7%
Cost Benefit Analysis
12. 10 | P a g e
net benefit by the PVC, then multiplying by 100 for a percent. In the nurse triage service implementation
project the ROI% equals 76.7%. This means that the service with yield $0.77 for every dollar invested
when considering cost. Each year this value would need to be recalculated, since the averages used in
the calculations are fluid depending on the month and year.
Conclusion
In conclusion, the present value of cost for the nurse triage service is $511,589.16; whereas the present
value of benefit is $904,178.88. The payback for the current expenses of the service will be seven
months. Each year a CBA should be conducted, since the averages used in the calculations are fluid
depending on the month and year.