What is ROI of RTLS in Healthcare
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Sustainability of water supply and sanitation services
Sustainability of water and sanitation services refers to continuous services that meet agreed upon levels over time. There are six key building blocks for sustainability: institutional capacity, financing, affordability, asset management, water resource management, and monitoring/regulation. For services to be sustained, enabling conditions like legal, organizational and cultural factors must support partners' effective engagement. However, many projects still fail to maintain benefits for 15-20 years due to lack of follow-up, inappropriate technology, unskilled operators, and slow/absent maintenance. Strong institutions with clear roles and adequate training/resources are needed for successful, sustainable service delivery.
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Assignment Exercise 10–1 Components of Balance Sheet and Statemen.docx
Assignment Exercise 10–1
: Components of Balance Sheet and Statement of Net Income Refer to the Metropolis Health System (MHS) financial statements contained in Appendix 28-A. Use the MHS comparative balance sheet, statement of revenue and expenses, and statement of fund balance for this assignment. Required Identify the following MHS balance sheet components. List the name of each component and its amount(s) from the appropriate MHS financial statement. Current Liabilities Total Assets Income from Operations Accumulated Depreciation Total Operating Revenue Current Portion of Long-Term Debt Interest Income Inventories
Assignment Exercise 10–2
: Components of Balance Sheet and Income Statement Refer to the Metropolis Health System (MHS) balance sheet and statement of revenue and expense in Chapter 28’s MHS Case Study. Patient accounts receivable of $7,400,000 is shown as net of $1,300,000 allowance for bad debts (8,700,000 − 1,300,000 = 7,400,000). (1) What percentage of gross accounts receivable is the allowance for bad debts? (2) If the allowance for bad debts is raised to $1,500,000, where does the extra $200,000 go?
Assignment Exercise 10–2
: Components of Balance Sheet and Income Statement Refer to the Metropolis Health System (MHS) balance sheet and statement of revenue and expense in Chapter 28’s MHS Case Study. Patient accounts receivable of $7,400,000 is shown as net of $1,300,000 allowance for bad debts (8,700,000 − 1,300,000 = 7,400,000). (1) What percentage of gross accounts receivable is the allowance for bad debts? (2) If the allowance for bad debts is raised to $1,500,000, where does the extra $200,000 go?
of the people whom MHS serves. • Rehabilitation and Wellness Center—for outpatient physical therapy and return-to-work services, plus cardiac and pulmonary rehabilitation, to get people back to a normal way of living. • Home Health Services—bringing skilled care, therapy, and medical social services into the home; a comfortable and affordable alternative in longer-term care. • Same-Day Surgery (SDS)—eliminating the need for an overnight stay. Since 1998, same-day surgery procedures have doubled at MHS. • Skilled Nursing Facility—inpatient service to assist patients in returning more fully to an independent lifestyle. • Community Health and Wellness—community health outreach programs that provide educational seminars on a variety of health issues, a diabetes education center, support services for patients with cancer, health awareness events, and a women’s health resource center. • Occupational Health Services—helping to reduce workplace injury costs at over 100 area businesses through consultation on injury avoidance and work-specific
rehabilitation services. • Recovery Services—offering mental health services, including substance abuse programs and support groups, along with individual and family counseling. 4. MHS’s Plant The central building for the hospital is in the center of a two-square-block area. A physicians’ offic.
American Recovery and Reinvestment Act of 2009 HIT
The American Recovery and Reinvestment Act of 2009 allocates approximately $22 billion to promote health information technology. It provides incentives for healthcare providers to adopt electronic health records through Medicare and Medicaid incentive payments. It also establishes standards for interoperability and sets deadlines for implementing electronic health records with penalties for non-compliance. The funding supports various programs and organizations to achieve goals of improved healthcare quality, safety and efficiency through health information technology.
171PART VIICase Study26605_CH18_BAKER.qxd 11300.docx
171
PART VII
Case Study
26605_CH18_BAKER.qxd 11/30/05 4:27 PM Page 171
26605_CH18_BAKER.qxd 11/30/05 4:27 PM Page 172
BACKGROUND
1. The Hospital System
Metropolis Health System (MHS) offers
comprehensive health care services. It is
a midsize taxing district hospital. Al-
though MHS has the power to raise rev-
enues through taxes, it has not done so
for the past seven years.
2. The Area
MHS is located in the town of Metropo-
lis, which has a population of 50,000.
The town has a small college and a mod-
est number of environmentally clean in-
dustries.
3. MHS Services
MHS has taken significant steps to re-
duce hospital stays. It has developed a
comprehensive array of services that
are accessible, cost-effective, and re-
sponsive to the community’s needs.
These services are wellness oriented in
that they strive for prevention rather
than treatment. As a result of these
steps, inpatient visits have increased
overall by only 1,000 per year since
1998, whereas outpatient/same-day sur-
gery visits have had an increase of over
50,000 per year.
A number of programmatic, service,
and facility enhancements support this
major transition in the community’s in-
stitutional health care. They are geared
to provide the quality, convenience, af-
fordability, and personal care that best
suit the health needs of the people
whom MHS serves.
• Rehabilitation and Wellness Center—for
outpatient physical therapy and re-
turn-to-work services plus cardiac and
pulmonary rehabilitation to get peo-
ple back to a normal way of living.
• Home Health Services—bringing skilled
care, therapy, and medical social serv-
ices into the home; a comfortable and
affordable alternative in longer term
care.
• Same-Day Surgery (SDS)—eliminating
the need for an overnight stay. Since
1998, same-day surgery procedures
have doubled at MHS.
• Skilled Nursing Facility—inpatient serv-
ice to assist patients in returning more
fully to an independent lifestyle.
• Community Health and Wellness—com-
munity health outreach programs that
173
CHAPTER 18
Case Study:
Metropolis Health System
26605_CH18_BAKER.qxd 11/30/05 4:27 PM Page 173
174 CHAPTER 18 CASE STUDY: METROPOLIS HEALTH SYSTEM
provide educational seminars on a vari-
ety of health issues, a diabetes education
center, support services for patients with
cancer, health awareness events, and a
women’s health resource center.
• Occupational Health Services—helping
to reduce workplace injury costs at
over 100 area businesses through con-
sultation on injury avoidance and
work-specific rehabilitation services.
• Recovery Services—offering mental
health services, including substance
abuse programs and support groups
along with individual and family coun-
seling.
4. MHS’s Plant
The central building for the hospital is
in the center of a two–square block area.
A physicians’ office building is to the
west. Two administrative offices, con-
verted from former residences, are on
one corner. The new ambulatory ce.
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The document discusses the evolving rural healthcare environment, including increased affiliations between rural and urban providers, changes to payment models under the Affordable Care Act, and a transition to value-based and managed care. It notes pressures on state budgets, the growth of high-deductible health plans, reduced readmissions, and declining inpatient volumes. The document also summarizes the expansion of Medicaid, Medicare payment reductions, quality reporting programs, accountable care organizations, and the financial challenges rural hospitals may face in this changing environment if they maintain a fee-for-service model.
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Assignment Exercise 10–1 Components of Balance Sheet and Statemen.docx
Assignment Exercise 10–1
: Components of Balance Sheet and Statement of Net Income Refer to the Metropolis Health System (MHS) financial statements contained in Appendix 28-A. Use the MHS comparative balance sheet, statement of revenue and expenses, and statement of fund balance for this assignment. Required Identify the following MHS balance sheet components. List the name of each component and its amount(s) from the appropriate MHS financial statement. Current Liabilities Total Assets Income from Operations Accumulated Depreciation Total Operating Revenue Current Portion of Long-Term Debt Interest Income Inventories
Assignment Exercise 10–2
: Components of Balance Sheet and Income Statement Refer to the Metropolis Health System (MHS) balance sheet and statement of revenue and expense in Chapter 28’s MHS Case Study. Patient accounts receivable of $7,400,000 is shown as net of $1,300,000 allowance for bad debts (8,700,000 − 1,300,000 = 7,400,000). (1) What percentage of gross accounts receivable is the allowance for bad debts? (2) If the allowance for bad debts is raised to $1,500,000, where does the extra $200,000 go?
Assignment Exercise 10–2
: Components of Balance Sheet and Income Statement Refer to the Metropolis Health System (MHS) balance sheet and statement of revenue and expense in Chapter 28’s MHS Case Study. Patient accounts receivable of $7,400,000 is shown as net of $1,300,000 allowance for bad debts (8,700,000 − 1,300,000 = 7,400,000). (1) What percentage of gross accounts receivable is the allowance for bad debts? (2) If the allowance for bad debts is raised to $1,500,000, where does the extra $200,000 go?
of the people whom MHS serves. • Rehabilitation and Wellness Center—for outpatient physical therapy and return-to-work services, plus cardiac and pulmonary rehabilitation, to get people back to a normal way of living. • Home Health Services—bringing skilled care, therapy, and medical social services into the home; a comfortable and affordable alternative in longer-term care. • Same-Day Surgery (SDS)—eliminating the need for an overnight stay. Since 1998, same-day surgery procedures have doubled at MHS. • Skilled Nursing Facility—inpatient service to assist patients in returning more fully to an independent lifestyle. • Community Health and Wellness—community health outreach programs that provide educational seminars on a variety of health issues, a diabetes education center, support services for patients with cancer, health awareness events, and a women’s health resource center. • Occupational Health Services—helping to reduce workplace injury costs at over 100 area businesses through consultation on injury avoidance and work-specific
rehabilitation services. • Recovery Services—offering mental health services, including substance abuse programs and support groups, along with individual and family counseling. 4. MHS’s Plant The central building for the hospital is in the center of a two-square-block area. A physicians’ offic.
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171PART VIICase Study26605_CH18_BAKER.qxd 11300.docx
171
PART VII
Case Study
26605_CH18_BAKER.qxd 11/30/05 4:27 PM Page 171
26605_CH18_BAKER.qxd 11/30/05 4:27 PM Page 172
BACKGROUND
1. The Hospital System
Metropolis Health System (MHS) offers
comprehensive health care services. It is
a midsize taxing district hospital. Al-
though MHS has the power to raise rev-
enues through taxes, it has not done so
for the past seven years.
2. The Area
MHS is located in the town of Metropo-
lis, which has a population of 50,000.
The town has a small college and a mod-
est number of environmentally clean in-
dustries.
3. MHS Services
MHS has taken significant steps to re-
duce hospital stays. It has developed a
comprehensive array of services that
are accessible, cost-effective, and re-
sponsive to the community’s needs.
These services are wellness oriented in
that they strive for prevention rather
than treatment. As a result of these
steps, inpatient visits have increased
overall by only 1,000 per year since
1998, whereas outpatient/same-day sur-
gery visits have had an increase of over
50,000 per year.
A number of programmatic, service,
and facility enhancements support this
major transition in the community’s in-
stitutional health care. They are geared
to provide the quality, convenience, af-
fordability, and personal care that best
suit the health needs of the people
whom MHS serves.
• Rehabilitation and Wellness Center—for
outpatient physical therapy and re-
turn-to-work services plus cardiac and
pulmonary rehabilitation to get peo-
ple back to a normal way of living.
• Home Health Services—bringing skilled
care, therapy, and medical social serv-
ices into the home; a comfortable and
affordable alternative in longer term
care.
• Same-Day Surgery (SDS)—eliminating
the need for an overnight stay. Since
1998, same-day surgery procedures
have doubled at MHS.
• Skilled Nursing Facility—inpatient serv-
ice to assist patients in returning more
fully to an independent lifestyle.
• Community Health and Wellness—com-
munity health outreach programs that
173
CHAPTER 18
Case Study:
Metropolis Health System
26605_CH18_BAKER.qxd 11/30/05 4:27 PM Page 173
174 CHAPTER 18 CASE STUDY: METROPOLIS HEALTH SYSTEM
provide educational seminars on a vari-
ety of health issues, a diabetes education
center, support services for patients with
cancer, health awareness events, and a
women’s health resource center.
• Occupational Health Services—helping
to reduce workplace injury costs at
over 100 area businesses through con-
sultation on injury avoidance and
work-specific rehabilitation services.
• Recovery Services—offering mental
health services, including substance
abuse programs and support groups
along with individual and family coun-
seling.
4. MHS’s Plant
The central building for the hospital is
in the center of a two–square block area.
A physicians’ office building is to the
west. Two administrative offices, con-
verted from former residences, are on
one corner. The new ambulatory ce.
LiteKnights
India's healthcare system faces challenges including a shortage of medical professionals, inadequate infrastructure, and lagging health indicators compared to other developing countries. The document outlines a vision for universalizing access to quality primary healthcare in India through strengthening the primary care system, establishing community health workers, expanding health insurance coverage, and improving sanitation. It proposes strategies and estimated costs to achieve this vision over a 5 year period.
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The document discusses the evolving rural healthcare environment, including increased affiliations between rural and urban providers, changes to payment models under the Affordable Care Act, and a transition to value-based and managed care. It notes pressures on state budgets, the growth of high-deductible health plans, reduced readmissions, and declining inpatient volumes. The document also summarizes the expansion of Medicaid, Medicare payment reductions, quality reporting programs, accountable care organizations, and the financial challenges rural hospitals may face in this changing environment if they maintain a fee-for-service model.
Hospital Readmissions Reduction Program: Keys to Success
Avoidable readmissions are a major financial major problem for the healthcare industry, especially for government payers. To tackle this problem, CMS launched the Hospital Readmissions Reduction Program (HRRP). While some hospitals may be able to absorb the financial penalties under HRRP, they still need to track increasingly complex reporting metrics. Most tracking solutions are inadequate for today’s complicated reporting needs. A healthcare enterprise data warehouse and analytics applications, however, are designed to solve the numerous reporting burdens. When used together, they also deliver a robust solution that enables hospitals to track and drive real cost and quality improvement initiatives, all without the need for users to be technical experts.
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Overview
This activity focuses on Quality Measures for Hospitals. The activity uses online resources from
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Value Based Purchasing (VBP) Program
Background
The National Quality Strategy (NQS) was first published in March 2011 as the National Strategy
for Quality Improvement in Health Care, and is led by the Agency for Healthcare Research and
Quality on behalf of the U.S. Department of Health and Human Services (HHS). Today, the NQS
serves as a guide for identifying and prioritizing quality improvement efforts, sharing lessons
learned, and measuring the collective success of Federal, State, and public‐ and private‐sector
healthcare stakeholders across the country.
The Aims of the NQS are threefold:
Better Care: Improve the overall quality by making health care more patient‐centered,
reliable, accessible, and safe.
Healthy People/Healthy Communities: Improve the health of the U.S. population by
supporting proven interventions to address behavioral, social, and environmental
determinants of health in addition to delivering higher‐quality care.
Affordable Care: Reduce the cost of quality health care for individuals, families,
employers, and government.
To align with this, CMS has set goals for their Quality Strategy. These include:
• Make care safer by reducing harm caused in the delivery of care
– Improve support for a culture of safety
– Reduce inappropriate and unnecessary care
– Prevent or minimize harm in all settings
• Strengthen person and family engagement as partners in their care
• Promote effective communication and coordination of care
• Promote effective prevention and treatment of chronic disease
• Work with communities to promote best practices of healthy living
• Make care affordable
CMS’s vision states that if we can find better ways to pay providers, deliver care, and distribute
information than patients can receive better care, health dollars are spent more wisely, and
there are healthier communities, a healthier economy, and a healthier county. It is with this in
mind that they have created multiple quality payment programs.
In January 2015, the Department of Health and Human Services made an announcement that
set in place measurable goals and a timeline to move the Medicare program towards paying
providers based on the quality of care rather than the quantity. This was the first time in the
history of the program that explicit goals were set. They invited private sector payers to match
or exceed these goals as well. These goals included:
1. Alternative Payment Models
a. 30% of Medicare payments tied to quality or value through Alternative Payment
models by the end of 2016 and 50% by the end of 2018
2. Linking Fee‐For‐Service payments to Quality/Value
a. 85% of all Medi ...
4508 Final Quality Project Part 2 Clinical Quality Measur
4508 Final Quality Project
Part 2: Clinical Quality Measures for Hospitals
Overview
This activity focuses on Quality Measures for Hospitals. The activity uses online resources from
the CMS website. The Clinical Quality Measures for Hospitals activity focuses on the Hospital
Value Based Purchasing (VBP) Program
Background
The National Quality Strategy (NQS) was first published in March 2011 as the National Strategy
for Quality Improvement in Health Care, and is led by the Agency for Healthcare Research and
Quality on behalf of the U.S. Department of Health and Human Services (HHS). Today, the NQS
serves as a guide for identifying and prioritizing quality improvement efforts, sharing lessons
learned, and measuring the collective success of Federal, State, and public‐ and private‐sector
healthcare stakeholders across the country.
The Aims of the NQS are threefold:
Better Care: Improve the overall quality by making health care more patient‐centered,
reliable, accessible, and safe.
Healthy People/Healthy Communities: Improve the health of the U.S. population by
supporting proven interventions to address behavioral, social, and environmental
determinants of health in addition to delivering higher‐quality care.
Affordable Care: Reduce the cost of quality health care for individuals, families,
employers, and government.
To align with this, CMS has set goals for their Quality Strategy. These include:
• Make care safer by reducing harm caused in the delivery of care
– Improve support for a culture of safety
– Reduce inappropriate and unnecessary care
– Prevent or minimize harm in all settings
• Strengthen person and family engagement as partners in their care
• Promote effective communication and coordination of care
• Promote effective prevention and treatment of chronic disease
• Work with communities to promote best practices of healthy living
• Make care affordable
CMS’s vision states that if we can find better ways to pay providers, deliver care, and distribute
information than patients can receive better care, health dollars are spent more wisely, and
there are healthier communities, a healthier economy, and a healthier county. It is with this in
mind that they have created multiple quality payment programs.
In January 2015, the Department of Health and Human Services made an announcement that
set in place measurable goals and a timeline to move the Medicare program towards paying
providers based on the quality of care rather than the quantity. This was the first time in the
history of the program that explicit goals were set. They invited private sector payers to match
or exceed these goals as well. These goals included:
1. Alternative Payment Models
a. 30% of Medicare payments tied to quality or value through Alternative Payment
models by the end of 2016 and 50% by the end of 2018
2. Linking Fee‐For‐Service payments to Quality/Value
a. 85% of all Medi ...
The Changing Landscape: Value-Based Purchasing, Reimbursement and its Impact ...
The Changing Landscape: Value-Based Purchasing, Reimbursement and its Impact ...marcus evans Network
Troy Trosclair, HCA MidAmerica Division - Speaker at the marcus evans National Healthcare CNO Summit, held in Hollywood, FL, April 26-28, 2012, delivered his presentation entitled The Changing Landscape: Value-Based Purchasing, Reimbursement and its Impact on NursingHealthshare 2000+ presentation
This document describes a proposed health care delivery program called HealthShare 2000+. The key points are:
1. HealthShare 2000+ aims to provide affordable, equitable, and accessible health care to members, especially the poor, through a group trust model without insurance, premiums, deductibles, or other limitations.
2. It would organize health care providers and facilities into categories and grades of service. Members would select service units that would be directly paid to providers through electronic funds transfer from the group trusts.
3. The program claims to eliminate wasteful administrative and billing costs compared to insurance, ensuring 100% of member contributions go directly to health care. It also aims to reduce costs and improve care through preventative
PRIMARY CARE ScenarioType of care providedScenario.docx
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.
Forensic and Valuation Issues in Healthcare
PYA Principal Carol Carden co-presented “Forensic and Valuation Issues in Healthcare” at the AICPA Forensic & Valuation Services Conference in New Orleans, LA, November 10, 2014.
How to improve operating margins ● What.docx
How to improve operating margins
● What does operating margin tell you about the organization, and how would
you calculate this ratio?
● Select a local medical service organization and describe how it has
specifically improved its operating margins.
HFMA
Financial Reporting Function
Financial Reporting Function
Financial Accounting Standards Board
(FASB)
FASB standards rest on certain
assumptions:
Ø Monetary unit
Ø Economic entity
Ø Time period
Ø Going concern
Financial Reporting Function
FASB
Two key principles
Ø Cost principle
Ø Full disclosure principle
Financial Reporting Function
Generally Accepted Accounting Principles
(GAAP)
Ø Consistency
Ø Relevance
Ø Reliability
Ø Comparability
Financial Reporting Function
Financial Statements
For Profit Not-for-Profit
Balance Sheet Statement of Financial
Position
Income Statement Statement of Operations
Statement of Cash Flows Statement of Cash Flows
Financial Reporting Function
Accepted Accounting Methods
Ø Accrual
Ø Cash
Ø Fund
Financial Reporting Function
Financial Statement Presentation
Ø Two years are displayed
- Prior year to the right of the current year
Ø Statement of Operations or Income Statement are for a period of
time—typically a month
Ø Statement of Cash Flows reflects a period of time consistent with the
Statement of Operations or Income Statement—typically a month
Ø Statement of Financial Position or Balance Sheet reflect the status
of Assets, Liabilities, and Net Assets/Shareholders’ Equity as of a
day.
Financial Reporting Function
Ratio Analysis
Ø Liquidity Ratios
Ø Profitability Ratios
Ø Asset Efficiency Ratios
Ø Capital Structure Ratios
Ø Operating Indicators
Financial Reporting Function
Ratio Analysis
Ø Liquidity
- Current ratio
- Quick ratio
Current ratio = Current Assets/Current Liabilities
Quick ratio = (Cash + Marketable Securities + Net
Accounts Receivable)/Current Liabilities
Financial Reporting Function
Ratio Analysis
Ø Profitability
- Operating margin
- Return on assets
Operating Margin = [(Operating Revenue-Operating
Expenses)/Total Operating Revenues] x 100
Return on Assets = Excess of revenues over expenses/
Total Assets
Financial Reporting Function
Ratio Analysis
Ø Asset efficiency
- Total asset turnover
- Inventory turnover
Total Asset Turnover = Total Operating Revenue/ Total
Assets
Inventory Turnover = Total Operating Revenue/ Inventory
Financial Reporting Function
Ratio Analysis
Ø Capital structure
- Debt to Capitalization
- Debt service coverage
Debt to Capitalization = [Long-term Debt/ (Long-term Debt
+ Unrestricted Net Assets)] x 100
Debt Service Coverage = (Excess of revenues over
expenses + Depre.
Part II Record Financial Operations CHAPTER 5 EXPE
Part II: Record Financial
Operations
CHAPTER 5: EXPENSES: (OUTFLOW)
Overview: The Distinction Between
Expense and Cost
• Expenses are expired costs that have been
used up, or consumed, while carrying on
business.
• Expense in the broadest sense includes every
expired (used up) cost that is deductible from
revenue.
Overview: The Distinction Between
Expense and Cost
• “Cost” is the amount of cash expended* in
consideration of goods or services received (or
to be received).
*(or property transferred, services performed,
or liability incurred)
• Costs can either be expired or unexpired.
• Expired costs are used up in the current
period and are matched against current
revenues.
• Unexpired costs are not yet used up and will
be matched against future revenues.
Overview: The Distinction Between
Expense and Cost
• Confusion also exists over the term “cost”
versus the term “charges”.
• Charges are revenue, or inflow
• Costs are expenses, or outflows
• Charges add; costs take away.
Overview: Confusion Over Other
Terminology
Disbursements for Services
• Disbursements for services represent an
expense stream (an outflow)
• Disbursements for services can trigger
payment either:
– when the expense is incurred; or
– after the expense is incurred.
Disbursements for Services
• Payment when the expense is incurred does
not require the expense to enter the Accounts
Payable account.
• Payment after the expense is incurred requires
the expense to be recorded in the Accounts
Payable account.
• It is then cleared from Accounts Payable when
payment is made.
Grouping Expenses for Planning and
Control
• Grouping by Cost Center
• One form of responsibility center.
• Study examples in Exhibits 5-1 and 5-2.
Exhibit 5–2
General
Services and
Support
Services Cost
Centers
Grouping by Diagnoses and Procedure
• Beneficial because is matched costs and
common classifications of revenues
• Study examples in Exhibits 5-3, 5-4, 5-5 &
Table 5-1
Exhibit 5–5 Example of Hospital
Departmental Costs Classified by
Diagnoses, MDC, and DRG
Table 5–1 Example of Radiology Department
Costs Classified by Procedure Code
• By care settings recognizes different sites
where service is delivered
• Care settings were discussed in the previous
chapter.
Grouping by Care Settings
• By service lines would be used for grouping
costs if revenues were divided by service line.
• Service lines were discussed in the previous
chapter.
Grouping by Service Lines
• Distinguishes projects that posses their own
objectives, funding, and indicators.
• Study the example in Exhibit 5-6.
Grouping by Programs
Exhibit 5–6 Program Cost Center:
Southside Homeless Intake Center
Cost Reports As Influencers Of
Expense Formats
• Since the mid-1960s Annual Cost Reports are
required by the Medicare Program and the
Medicaid Program.
Cost Reports As Influencers Of
Expense Formats
• The arrangement of c ...
The True Impact of Unplanned Extubation
Every year, unplanned extubation (UE) occurs in more than 200,000 patients in the U.S. alone, resulting in 50,000 deaths. This is a pervasive and preventable patient safety issue and it can be prevented. This presentation explores the impact of UE and who can take action.
Part IDescribe the following 4 types of costsFixedVariableS.docx
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,.
MBQIP 2011 Missouri
The Flex Program provides cost-based reimbursement for critical access hospitals (CAHs) through two components: state rural health plans and CAH certification. Originally, the program aimed to develop rural health networks and improve quality of care. Over time, more hospitals were certified as CAHs. Currently, CAHs make up 26% of community hospitals and 66% of rural hospitals. Quality reporting through measures like pneumonia and heart failure processes of care is increasing for CAHs.
CHAPTER 28 Case Study Metropolis Health SystemBACKGROUND· 1.The H.docx
CHAPTER 28 Case Study: Metropolis Health SystemBACKGROUND
· 1.The Hospital System
Metropolis Health System (MHS) offers comprehensive healthcare services. It is a midsize taxing district hospital. Although MHS has the power to raise revenues through taxes, it has not done so for the past seven years.
· 2.The Area
MHS is located in the town of Metropolis, which has a population of 50,000. The town has a small college and a modest number of environmentally clean industries.
· 3.MHS Services
MHS has taken significant steps to reduce hospital stays. It has developed a comprehensive array of services that are accessible, cost-effective, and responsive to the community’s needs. These services are wellness oriented in that they strive for prevention rather than treatment. As a result of these steps, inpatient visits have increased overall by only 1,000 per year since 2008, whereas outpatient/same-day surgery visits have had an increase of over 50,000 per year.
A number of programmatic, service, and facility enhancements support this major transition in the community’s institutional health care. They are geared to provide the quality, convenience, affordability, and personal care that best suit the health needs of the people whom MHS serves.
· • Rehabilitation and Wellness Center—for outpatient physical therapy and return-to-work services, plus cardiac and pulmonary rehabilitation, to get people back to a normal way of living.
· • Home Health Services—bringing skilled care, therapy, and medical social services into the home; a comfortable and affordable alternative in longer-term care.
· • Same-Day Surgery (SDS)—eliminating the need for an overnight stay. Since 1998, same-day surgery procedures have doubled at MHS.
· • Skilled Nursing Facility—inpatient service to assist patients in returning more fully to an independent lifestyle.
· • Community Health and Wellness—community health outreach programs that provide educational seminars on a variety of health issues, a diabetes education center, support services for patients with cancer, health awareness events, and a women’s health resource center.
· • Occupational Health Services—helping to reduce workplace injury costs at over 100 area businesses through consultation on injury avoidance and work-specific rehabilitation services.
· • Recovery Services—offering mental health services, including substance abuse programs and support groups, along with individual and family counseling.
· 4.MHS’s Plant
The central building for the hospital is in the center of a two-square-block area. A physicians’ office building is to the west. Two administrative offices, converted from former residences, are on one corner. The new ambulatory center, completed two years ago, has an L shape and sits on one corner of the western block. A laundry and maintenance building sits on the extreme back of the property. A four-story parking garage is located on the eastern back corner. An employee parking lot sits beside the laundry .
Why You Need to Understand Value-Based Reimbursement and How to Survive It
There are clear signs the healthcare industry is in the midst of a shift to value-based reimbursement. The most noticeable signs are the recent and proposed 2015 rulings from CMS. There are four areas in value-based reimbursement that will be impacted by the end of 2015: the physician payment structure, bundled payments, Inpatient Prospective Payment Systems regulations, and commercial payers. To survive the shift to value-based reimbursement, it’s important for providers and payers to take three steps: provide access to rich data, share knowledge and learn from each other, develop strategies by doing assessments.
ARRA March 2010
The document discusses incentives for hospitals to adopt electronic health records (EHRs) under the American Recovery and Reinvestment Act (ARRA). Hospitals can receive up to $15.9 million in incentive payments over 4 years if they demonstrate meaningful use of certified EHR technology. They must meet requirements like using EHRs to exchange health information and submit clinical quality measures. Hospitals that do not show meaningful use by 2015 will face Medicare payment reductions. States can also receive grants to help hospitals finance EHR purchases through loan programs.
Healthcare Reform and Lean Leadership
This document discusses healthcare reform in the United States. It provides background on rising healthcare costs driven largely by chronic conditions. It outlines key provisions and timelines of the Affordable Care Act, including expanding insurance coverage, new taxes and fees, and delivery system reforms focused on value over volume. It also presents data on the impact of reforms in Massachusetts as well as lessons learned around rising costs, physician compensation, and hospital operating margins.
Stewart Altman
This document discusses whether it is possible for the United States to control rising health care costs. It notes that health care spending has been growing at 2% above inflation for 40 years, and past attempts to control costs have had limited success and lasted only for short periods. The author argues that truly reducing costs will require changing the health care delivery system to improve productivity and eliminate unnecessary services, which will need reimbursement systems that support these goals rather than the current fee-for-service model. Options discussed include bundled payments, pay-for-performance programs, and gainsharing between hospitals and doctors.
Nature and effects of multiple funding flows to public healthcare facilities:...
This presentation was given at the 'Health Financing and Governance Knowledge Synthesis Workshop' held on 22-23 March in Abuja, Nigeria.
It includes findings from a strand of RESYST's financing research which aims to examine how healthcare providers respond to multiple funding flows and the implications of such flows for achieving the health systems goals of equity, efficiency and quality.
10 04 28_whitepaper_hospital_costs_final
Labor is the largest component of hospital costs, representing nearly two-thirds of total expenses. Between 2004-2008, hospitals in Massachusetts hired over 11,000 additional full-time employees, with wages for registered nurses increasing by 50% over that period. Patient care supplies and other expenses, which make up 25% of total costs, grew 35% during those years. Capital-related expenses, including depreciation and interest, increased 23% as hospitals faced difficulties accessing capital. Payment shortfalls from government programs like Medicare and Medicaid, which account for over half of hospital revenues, increased significantly and hospitals relied more on payments from private insurers to make up the difference.
Scenario 3 Urgent Care CenterImplement and plan steps necessary f.pdf
Scenario 3: Urgent Care Center
Implement and plan steps necessary for opening a new health care facility on the west side of the
city.There are only one centralized hospital and one urgent care center, and they are all in the
center of town.Many residents on the west side of town have close to a 40-minute drive to either
of these facilities. Theexisting urgent care facility closes at 7:00 P.M., leaving the emergency
department at the hospital as theonly option for those seeking treatment later in the
evening.Location is one of the most important deciding factors when opening an urgent care
center. The west side ofthe city includes a Wal-Mart, Sams Club, CVS, and Walgreens. These
stores create high traffic volume andhouse an ideal strategic location for an urgent care center.
There are no medical centers of any kind on thisside of town, and there is a large community of
about 81,000 residents.
Objectives
To improve public health and provide basic clinical care for families and patients on the west
side of the city.The objectives of the new urgent care center are to:
1. Provide added primary care options - We aim to provide accessible and convenient primary
healthcare services for the residents the west side of the city. The opening of this new urgent care
center will reduce travel time for patients who need immediate medical attention to improve
patient outcomes.
2. Provide x-ray and lab options for patients - This new urgent care center involves making
diagnostic services more accessible to our patients. Implementing diagnostic healthcare services
to a wider range in our community will ensure that our patients receive collaborative,
comprehensive, and high quality care.
3. Add affordable options for care and referrals to local physicians and facilities - Affordable
options for care focuses on improving access to healthcare by offering cost-effective healthcare
services to our patients. We will implement programsadd networks that will connect patients to
healthcare in their local area that is convenient and affordable to them.
4. Extend operating hours - Residents of the west side of the city currently have a 40 minute
commute to the hospital, which is the only option for medical attention after 7:00pm. Our new
urgent care center will offer extended hours of operation to ensure accessible and convenient
care to patients later in the evening. Having access to a closer healthcare facility will improve
patients outcomes who need immediate medical care in the case of an emergency.
5. Accredit the new facility as an urgent care center - We will obtain the necessary legal and
official certifications and licenses for our healthcare facility to ensure compliance with legal,
safety, and regulatory requirements to successfully operate as an urgent care center. This will
also include assessing and improving facilities safety procedures and precautions and providing
annual trainings to staff.
Financial Review
Personnel - $300,000.00
Contractual Services $.
Get Covid Testing at Fit to Fly PCR Test
A Fit-to-Fly PCR Test is a crucial service for travelers needing to meet the entry requirements of various countries or airlines. This test involves a polymerase chain reaction (PCR) test for COVID-19, which is considered the gold standard for detecting active infections. At our travel clinic in Leeds, we offer fast and reliable Fit to Fly PCR testing, providing you with an official certificate verifying your negative COVID-19 status. Our process is designed for convenience and accuracy, with quick turnaround times to ensure you receive your results and certificate in time for your departure. Trust our professional and experienced medical team to help you travel safely and compliantly, giving you peace of mind for your journey.
Letter to MREC - application to conduct study
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The Alliance for Healthcare Transformation provides a wide range of services to help healthcare organizations address the changing healthcare landscape and requirements under the Affordable Care Act. These services include population health assessments and best practices, electronic health records evaluations and clinical systems, patient safety programs, financial and revenue cycle management, monetizing healthcare assets, and international healthcare consulting. The goal is to help providers improve quality of care, health outcomes, and cost efficiency through evidence-based programs and recommendations.
4508 Final Quality Project Part 2 Clinical Quality Measur.docx
4508 Final Quality Project
Part 2: Clinical Quality Measures for Hospitals
Overview
This activity focuses on Quality Measures for Hospitals. The activity uses online resources from
the CMS website. The Clinical Quality Measures for Hospitals activity focuses on the Hospital
Value Based Purchasing (VBP) Program
Background
The National Quality Strategy (NQS) was first published in March 2011 as the National Strategy
for Quality Improvement in Health Care, and is led by the Agency for Healthcare Research and
Quality on behalf of the U.S. Department of Health and Human Services (HHS). Today, the NQS
serves as a guide for identifying and prioritizing quality improvement efforts, sharing lessons
learned, and measuring the collective success of Federal, State, and public‐ and private‐sector
healthcare stakeholders across the country.
The Aims of the NQS are threefold:
Better Care: Improve the overall quality by making health care more patient‐centered,
reliable, accessible, and safe.
Healthy People/Healthy Communities: Improve the health of the U.S. population by
supporting proven interventions to address behavioral, social, and environmental
determinants of health in addition to delivering higher‐quality care.
Affordable Care: Reduce the cost of quality health care for individuals, families,
employers, and government.
To align with this, CMS has set goals for their Quality Strategy. These include:
• Make care safer by reducing harm caused in the delivery of care
– Improve support for a culture of safety
– Reduce inappropriate and unnecessary care
– Prevent or minimize harm in all settings
• Strengthen person and family engagement as partners in their care
• Promote effective communication and coordination of care
• Promote effective prevention and treatment of chronic disease
• Work with communities to promote best practices of healthy living
• Make care affordable
CMS’s vision states that if we can find better ways to pay providers, deliver care, and distribute
information than patients can receive better care, health dollars are spent more wisely, and
there are healthier communities, a healthier economy, and a healthier county. It is with this in
mind that they have created multiple quality payment programs.
In January 2015, the Department of Health and Human Services made an announcement that
set in place measurable goals and a timeline to move the Medicare program towards paying
providers based on the quality of care rather than the quantity. This was the first time in the
history of the program that explicit goals were set. They invited private sector payers to match
or exceed these goals as well. These goals included:
1. Alternative Payment Models
a. 30% of Medicare payments tied to quality or value through Alternative Payment
models by the end of 2016 and 50% by the end of 2018
2. Linking Fee‐For‐Service payments to Quality/Value
a. 85% of all Medi ...
4508 Final Quality Project Part 2 Clinical Quality Measur
4508 Final Quality Project
Part 2: Clinical Quality Measures for Hospitals
Overview
This activity focuses on Quality Measures for Hospitals. The activity uses online resources from
the CMS website. The Clinical Quality Measures for Hospitals activity focuses on the Hospital
Value Based Purchasing (VBP) Program
Background
The National Quality Strategy (NQS) was first published in March 2011 as the National Strategy
for Quality Improvement in Health Care, and is led by the Agency for Healthcare Research and
Quality on behalf of the U.S. Department of Health and Human Services (HHS). Today, the NQS
serves as a guide for identifying and prioritizing quality improvement efforts, sharing lessons
learned, and measuring the collective success of Federal, State, and public‐ and private‐sector
healthcare stakeholders across the country.
The Aims of the NQS are threefold:
Better Care: Improve the overall quality by making health care more patient‐centered,
reliable, accessible, and safe.
Healthy People/Healthy Communities: Improve the health of the U.S. population by
supporting proven interventions to address behavioral, social, and environmental
determinants of health in addition to delivering higher‐quality care.
Affordable Care: Reduce the cost of quality health care for individuals, families,
employers, and government.
To align with this, CMS has set goals for their Quality Strategy. These include:
• Make care safer by reducing harm caused in the delivery of care
– Improve support for a culture of safety
– Reduce inappropriate and unnecessary care
– Prevent or minimize harm in all settings
• Strengthen person and family engagement as partners in their care
• Promote effective communication and coordination of care
• Promote effective prevention and treatment of chronic disease
• Work with communities to promote best practices of healthy living
• Make care affordable
CMS’s vision states that if we can find better ways to pay providers, deliver care, and distribute
information than patients can receive better care, health dollars are spent more wisely, and
there are healthier communities, a healthier economy, and a healthier county. It is with this in
mind that they have created multiple quality payment programs.
In January 2015, the Department of Health and Human Services made an announcement that
set in place measurable goals and a timeline to move the Medicare program towards paying
providers based on the quality of care rather than the quantity. This was the first time in the
history of the program that explicit goals were set. They invited private sector payers to match
or exceed these goals as well. These goals included:
1. Alternative Payment Models
a. 30% of Medicare payments tied to quality or value through Alternative Payment
models by the end of 2016 and 50% by the end of 2018
2. Linking Fee‐For‐Service payments to Quality/Value
a. 85% of all Medi ...
The Changing Landscape: Value-Based Purchasing, Reimbursement and its Impact ...
The Changing Landscape: Value-Based Purchasing, Reimbursement and its Impact ...marcus evans Network
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This document describes a proposed health care delivery program called HealthShare 2000+. The key points are:
1. HealthShare 2000+ aims to provide affordable, equitable, and accessible health care to members, especially the poor, through a group trust model without insurance, premiums, deductibles, or other limitations.
2. It would organize health care providers and facilities into categories and grades of service. Members would select service units that would be directly paid to providers through electronic funds transfer from the group trusts.
3. The program claims to eliminate wasteful administrative and billing costs compared to insurance, ensuring 100% of member contributions go directly to health care. It also aims to reduce costs and improve care through preventative
PRIMARY CARE ScenarioType of care providedScenario.docx
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.
Forensic and Valuation Issues in Healthcare
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How to improve operating margins ● What.docx
How to improve operating margins
● What does operating margin tell you about the organization, and how would
you calculate this ratio?
● Select a local medical service organization and describe how it has
specifically improved its operating margins.
HFMA
Financial Reporting Function
Financial Reporting Function
Financial Accounting Standards Board
(FASB)
FASB standards rest on certain
assumptions:
Ø Monetary unit
Ø Economic entity
Ø Time period
Ø Going concern
Financial Reporting Function
FASB
Two key principles
Ø Cost principle
Ø Full disclosure principle
Financial Reporting Function
Generally Accepted Accounting Principles
(GAAP)
Ø Consistency
Ø Relevance
Ø Reliability
Ø Comparability
Financial Reporting Function
Financial Statements
For Profit Not-for-Profit
Balance Sheet Statement of Financial
Position
Income Statement Statement of Operations
Statement of Cash Flows Statement of Cash Flows
Financial Reporting Function
Accepted Accounting Methods
Ø Accrual
Ø Cash
Ø Fund
Financial Reporting Function
Financial Statement Presentation
Ø Two years are displayed
- Prior year to the right of the current year
Ø Statement of Operations or Income Statement are for a period of
time—typically a month
Ø Statement of Cash Flows reflects a period of time consistent with the
Statement of Operations or Income Statement—typically a month
Ø Statement of Financial Position or Balance Sheet reflect the status
of Assets, Liabilities, and Net Assets/Shareholders’ Equity as of a
day.
Financial Reporting Function
Ratio Analysis
Ø Liquidity Ratios
Ø Profitability Ratios
Ø Asset Efficiency Ratios
Ø Capital Structure Ratios
Ø Operating Indicators
Financial Reporting Function
Ratio Analysis
Ø Liquidity
- Current ratio
- Quick ratio
Current ratio = Current Assets/Current Liabilities
Quick ratio = (Cash + Marketable Securities + Net
Accounts Receivable)/Current Liabilities
Financial Reporting Function
Ratio Analysis
Ø Profitability
- Operating margin
- Return on assets
Operating Margin = [(Operating Revenue-Operating
Expenses)/Total Operating Revenues] x 100
Return on Assets = Excess of revenues over expenses/
Total Assets
Financial Reporting Function
Ratio Analysis
Ø Asset efficiency
- Total asset turnover
- Inventory turnover
Total Asset Turnover = Total Operating Revenue/ Total
Assets
Inventory Turnover = Total Operating Revenue/ Inventory
Financial Reporting Function
Ratio Analysis
Ø Capital structure
- Debt to Capitalization
- Debt service coverage
Debt to Capitalization = [Long-term Debt/ (Long-term Debt
+ Unrestricted Net Assets)] x 100
Debt Service Coverage = (Excess of revenues over
expenses + Depre.
Part II Record Financial Operations CHAPTER 5 EXPE
Part II: Record Financial
Operations
CHAPTER 5: EXPENSES: (OUTFLOW)
Overview: The Distinction Between
Expense and Cost
• Expenses are expired costs that have been
used up, or consumed, while carrying on
business.
• Expense in the broadest sense includes every
expired (used up) cost that is deductible from
revenue.
Overview: The Distinction Between
Expense and Cost
• “Cost” is the amount of cash expended* in
consideration of goods or services received (or
to be received).
*(or property transferred, services performed,
or liability incurred)
• Costs can either be expired or unexpired.
• Expired costs are used up in the current
period and are matched against current
revenues.
• Unexpired costs are not yet used up and will
be matched against future revenues.
Overview: The Distinction Between
Expense and Cost
• Confusion also exists over the term “cost”
versus the term “charges”.
• Charges are revenue, or inflow
• Costs are expenses, or outflows
• Charges add; costs take away.
Overview: Confusion Over Other
Terminology
Disbursements for Services
• Disbursements for services represent an
expense stream (an outflow)
• Disbursements for services can trigger
payment either:
– when the expense is incurred; or
– after the expense is incurred.
Disbursements for Services
• Payment when the expense is incurred does
not require the expense to enter the Accounts
Payable account.
• Payment after the expense is incurred requires
the expense to be recorded in the Accounts
Payable account.
• It is then cleared from Accounts Payable when
payment is made.
Grouping Expenses for Planning and
Control
• Grouping by Cost Center
• One form of responsibility center.
• Study examples in Exhibits 5-1 and 5-2.
Exhibit 5–2
General
Services and
Support
Services Cost
Centers
Grouping by Diagnoses and Procedure
• Beneficial because is matched costs and
common classifications of revenues
• Study examples in Exhibits 5-3, 5-4, 5-5 &
Table 5-1
Exhibit 5–5 Example of Hospital
Departmental Costs Classified by
Diagnoses, MDC, and DRG
Table 5–1 Example of Radiology Department
Costs Classified by Procedure Code
• By care settings recognizes different sites
where service is delivered
• Care settings were discussed in the previous
chapter.
Grouping by Care Settings
• By service lines would be used for grouping
costs if revenues were divided by service line.
• Service lines were discussed in the previous
chapter.
Grouping by Service Lines
• Distinguishes projects that posses their own
objectives, funding, and indicators.
• Study the example in Exhibit 5-6.
Grouping by Programs
Exhibit 5–6 Program Cost Center:
Southside Homeless Intake Center
Cost Reports As Influencers Of
Expense Formats
• Since the mid-1960s Annual Cost Reports are
required by the Medicare Program and the
Medicaid Program.
Cost Reports As Influencers Of
Expense Formats
• The arrangement of c ...
The True Impact of Unplanned Extubation
Every year, unplanned extubation (UE) occurs in more than 200,000 patients in the U.S. alone, resulting in 50,000 deaths. This is a pervasive and preventable patient safety issue and it can be prevented. This presentation explores the impact of UE and who can take action.
Part IDescribe the following 4 types of costsFixedVariableS.docx
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,.
MBQIP 2011 Missouri
The Flex Program provides cost-based reimbursement for critical access hospitals (CAHs) through two components: state rural health plans and CAH certification. Originally, the program aimed to develop rural health networks and improve quality of care. Over time, more hospitals were certified as CAHs. Currently, CAHs make up 26% of community hospitals and 66% of rural hospitals. Quality reporting through measures like pneumonia and heart failure processes of care is increasing for CAHs.
CHAPTER 28 Case Study Metropolis Health SystemBACKGROUND· 1.The H.docx
CHAPTER 28 Case Study: Metropolis Health SystemBACKGROUND
· 1.The Hospital System
Metropolis Health System (MHS) offers comprehensive healthcare services. It is a midsize taxing district hospital. Although MHS has the power to raise revenues through taxes, it has not done so for the past seven years.
· 2.The Area
MHS is located in the town of Metropolis, which has a population of 50,000. The town has a small college and a modest number of environmentally clean industries.
· 3.MHS Services
MHS has taken significant steps to reduce hospital stays. It has developed a comprehensive array of services that are accessible, cost-effective, and responsive to the community’s needs. These services are wellness oriented in that they strive for prevention rather than treatment. As a result of these steps, inpatient visits have increased overall by only 1,000 per year since 2008, whereas outpatient/same-day surgery visits have had an increase of over 50,000 per year.
A number of programmatic, service, and facility enhancements support this major transition in the community’s institutional health care. They are geared to provide the quality, convenience, affordability, and personal care that best suit the health needs of the people whom MHS serves.
· • Rehabilitation and Wellness Center—for outpatient physical therapy and return-to-work services, plus cardiac and pulmonary rehabilitation, to get people back to a normal way of living.
· • Home Health Services—bringing skilled care, therapy, and medical social services into the home; a comfortable and affordable alternative in longer-term care.
· • Same-Day Surgery (SDS)—eliminating the need for an overnight stay. Since 1998, same-day surgery procedures have doubled at MHS.
· • Skilled Nursing Facility—inpatient service to assist patients in returning more fully to an independent lifestyle.
· • Community Health and Wellness—community health outreach programs that provide educational seminars on a variety of health issues, a diabetes education center, support services for patients with cancer, health awareness events, and a women’s health resource center.
· • Occupational Health Services—helping to reduce workplace injury costs at over 100 area businesses through consultation on injury avoidance and work-specific rehabilitation services.
· • Recovery Services—offering mental health services, including substance abuse programs and support groups, along with individual and family counseling.
· 4.MHS’s Plant
The central building for the hospital is in the center of a two-square-block area. A physicians’ office building is to the west. Two administrative offices, converted from former residences, are on one corner. The new ambulatory center, completed two years ago, has an L shape and sits on one corner of the western block. A laundry and maintenance building sits on the extreme back of the property. A four-story parking garage is located on the eastern back corner. An employee parking lot sits beside the laundry .
Why You Need to Understand Value-Based Reimbursement and How to Survive It
There are clear signs the healthcare industry is in the midst of a shift to value-based reimbursement. The most noticeable signs are the recent and proposed 2015 rulings from CMS. There are four areas in value-based reimbursement that will be impacted by the end of 2015: the physician payment structure, bundled payments, Inpatient Prospective Payment Systems regulations, and commercial payers. To survive the shift to value-based reimbursement, it’s important for providers and payers to take three steps: provide access to rich data, share knowledge and learn from each other, develop strategies by doing assessments.
ARRA March 2010
The document discusses incentives for hospitals to adopt electronic health records (EHRs) under the American Recovery and Reinvestment Act (ARRA). Hospitals can receive up to $15.9 million in incentive payments over 4 years if they demonstrate meaningful use of certified EHR technology. They must meet requirements like using EHRs to exchange health information and submit clinical quality measures. Hospitals that do not show meaningful use by 2015 will face Medicare payment reductions. States can also receive grants to help hospitals finance EHR purchases through loan programs.
Healthcare Reform and Lean Leadership
This document discusses healthcare reform in the United States. It provides background on rising healthcare costs driven largely by chronic conditions. It outlines key provisions and timelines of the Affordable Care Act, including expanding insurance coverage, new taxes and fees, and delivery system reforms focused on value over volume. It also presents data on the impact of reforms in Massachusetts as well as lessons learned around rising costs, physician compensation, and hospital operating margins.
Stewart Altman
This document discusses whether it is possible for the United States to control rising health care costs. It notes that health care spending has been growing at 2% above inflation for 40 years, and past attempts to control costs have had limited success and lasted only for short periods. The author argues that truly reducing costs will require changing the health care delivery system to improve productivity and eliminate unnecessary services, which will need reimbursement systems that support these goals rather than the current fee-for-service model. Options discussed include bundled payments, pay-for-performance programs, and gainsharing between hospitals and doctors.
Nature and effects of multiple funding flows to public healthcare facilities:...
This presentation was given at the 'Health Financing and Governance Knowledge Synthesis Workshop' held on 22-23 March in Abuja, Nigeria.
It includes findings from a strand of RESYST's financing research which aims to examine how healthcare providers respond to multiple funding flows and the implications of such flows for achieving the health systems goals of equity, efficiency and quality.
10 04 28_whitepaper_hospital_costs_final
Labor is the largest component of hospital costs, representing nearly two-thirds of total expenses. Between 2004-2008, hospitals in Massachusetts hired over 11,000 additional full-time employees, with wages for registered nurses increasing by 50% over that period. Patient care supplies and other expenses, which make up 25% of total costs, grew 35% during those years. Capital-related expenses, including depreciation and interest, increased 23% as hospitals faced difficulties accessing capital. Payment shortfalls from government programs like Medicare and Medicaid, which account for over half of hospital revenues, increased significantly and hospitals relied more on payments from private insurers to make up the difference.
Scenario 3 Urgent Care CenterImplement and plan steps necessary f.pdf
Scenario 3: Urgent Care Center
Implement and plan steps necessary for opening a new health care facility on the west side of the
city.There are only one centralized hospital and one urgent care center, and they are all in the
center of town.Many residents on the west side of town have close to a 40-minute drive to either
of these facilities. Theexisting urgent care facility closes at 7:00 P.M., leaving the emergency
department at the hospital as theonly option for those seeking treatment later in the
evening.Location is one of the most important deciding factors when opening an urgent care
center. The west side ofthe city includes a Wal-Mart, Sams Club, CVS, and Walgreens. These
stores create high traffic volume andhouse an ideal strategic location for an urgent care center.
There are no medical centers of any kind on thisside of town, and there is a large community of
about 81,000 residents.
Objectives
To improve public health and provide basic clinical care for families and patients on the west
side of the city.The objectives of the new urgent care center are to:
1. Provide added primary care options - We aim to provide accessible and convenient primary
healthcare services for the residents the west side of the city. The opening of this new urgent care
center will reduce travel time for patients who need immediate medical attention to improve
patient outcomes.
2. Provide x-ray and lab options for patients - This new urgent care center involves making
diagnostic services more accessible to our patients. Implementing diagnostic healthcare services
to a wider range in our community will ensure that our patients receive collaborative,
comprehensive, and high quality care.
3. Add affordable options for care and referrals to local physicians and facilities - Affordable
options for care focuses on improving access to healthcare by offering cost-effective healthcare
services to our patients. We will implement programsadd networks that will connect patients to
healthcare in their local area that is convenient and affordable to them.
4. Extend operating hours - Residents of the west side of the city currently have a 40 minute
commute to the hospital, which is the only option for medical attention after 7:00pm. Our new
urgent care center will offer extended hours of operation to ensure accessible and convenient
care to patients later in the evening. Having access to a closer healthcare facility will improve
patients outcomes who need immediate medical care in the case of an emergency.
5. Accredit the new facility as an urgent care center - We will obtain the necessary legal and
official certifications and licenses for our healthcare facility to ensure compliance with legal,
safety, and regulatory requirements to successfully operate as an urgent care center. This will
also include assessing and improving facilities safety procedures and precautions and providing
annual trainings to staff.
Financial Review
Personnel - $300,000.00
Contractual Services $.
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What is ROI of RTLS in Healthcare
- 1. Let’s take a brief look at some numbers
- 2. U.S. Healthcare wastes more than
- 3. U.S. Healthcare wastes more than per year
- 4. U.S. Healthcare wastes more than per year out of total national health expenditure
- 9. Hospitals misplace or lose of medical equipment annually of mobile assets are stolen during their useful life
- 10. Hospitals misplace or lose of medical equipment annually of mobile assets are stolen during their useful life Medical employees spend up to
- 11. Hospitals misplace or lose of medical equipment annually of mobile assets are stolen during their useful life Medical employees spend up to of their time searching for equipment
- 14. Only 50% - 60% of their infusion pumps were being utilized.
- 16. After implementing RTLS: • The hospital reduced the number of pumps purchased from 300 to 250 which saved them $276,000 and an additional $27,000 in maintenance cost. • In total, $303,000 by improving the visibility of infusion pumps through
- 18. The RTLS system they implemented generated nearly $1 million in savings the first year.
- 19. This included:
- 20. This included: • $250,000 on rental equipment • $100,000 on budgeting for “shrinkage” (the common practice of intentionally purchasing more equipment than needed because of missing items) • more than $600,000 in procurement-related expenses because of better utilization of equipment.
- 21. Download RTLS ROI Report