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Fundamentals of Health Care Financial Management : A Practical Guide to Fiscal Issues and Activities, 4th Edition.

Author/Creator:
Berger, Steven.
Publication:
Somerset : John Wiley & Sons, Incorporated, 2014.
Format/Description:
Book
1 online resource (443 pages)
Edition:
4th ed.
Series:
Jossey-Bass Public Health Ser.
Jossey-Bass Public Health Ser.
Status/Location:
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Other records:
Subjects:
Health Facility Administration -- United States.
Financial Management -- United States.
Form/Genre:
Electronic books.
Summary:
Learn the essentials of finance theory and practice with the tools needed in day-to-day practice In this thoroughly revised and updated fourth edition of Fundamentals of Health Care Financial Management, consultant and educator Steven Berger offers a practical step-by-step approach to understanding the fundamental theories and relationships guiding financial decisions in health care organization. Using cases set in a fictional mid-sized hospital, the book takes the reader into the inner workings of the finance executive's office. As in the previous editions, this book introduces students to key practical concepts in fundamental areas of financial management. This innovative introduction to the most-used tools and techniques includes health care accounting and financial statements; managing cash, billings and collections; making major capital investments; determining cost and using cost information in decision-making; budgeting and performance measurement; and pricing. Also covered in depth are the financial implications of Patient Protection and Affordable Care Act, which will increase patient volume, reduce bad debt, factor quality and patient satisfaction into the financial picture, and significantly affect how hospitals and physicians are paid for services. Students focusing on the business side of health care will find Fundamentals of Health Care Financial Management: A Practical Guide to Fiscal Issues and Activities, 4th Edition a valuable text for understanding the workings of the health care financial system.
Contents:
Fundamentals of Health Care Financial Management: A Practical Guide to Fiscal Issues and Activities
Contents
Figures, Tables, and Exhibits
Preface
Acknowledgments
The Author
Chapter 1: January
What Is Health Care?
What Is Management?
What Is Financial Management?
Why Is Financial Management Important?
Ridgeland Heights Medical Center: The Primary Statistics
Managed Care Inroads
RHMC's Actions to Counter Dwindling Inpatient Census
RHMC Decision Time
Financial Management Implications
Pro Forma Development
Net Present Value and Internal Rate of Return
Volume Assumptions
Revenue and Expense Assumptions
Living with the Finance Committee and Board of Directors' Calendar
Routine Matters
Periodic Review Matters
Year-End Closing
Chapter 2: February
Accounting Principles and Practices
Objectives of Financial Reporting
Basic Accounting Concepts
Basic Financial Statements of a Health Care Organization
Uses of Financial Information
The Financial Statements
Balance Sheet
Statement of Operations
Statement of Changes in Unrestricted Net Assets (or Equity)
Statement of Cash Flows
Notes to the Financial Statements
Preparing for the Auditors
Analysis of Sensitive Accounts
Contractual Adjustments
Accounts Receivable
Allowance for Doubtful Accounts
Provision for Bad Debts
Allowance for Contractual Adjustment
Third-Party Settlements
February Finance Committee Special Reports
Bond Debt Status
Health Insurance Annual Review
Chapter 3: March
Strategic Financial Planning: Five-Year Projections
Strategic Planning
Converting Vision (the Strategic Plan) into Financial Reality
RHMC Strategic Financial Planning
Volume Assumptions
Payer Mix
Rates and Reimbursements
Implications for Operating Expenses.
Ratio Analysis
Bonding-Related Ratios
Other Ratios
Operating Ratios
The Capital Plan and Its Relationship to the Strategic Plan
Routine Capital Items
Information Technology
Facility Improvements and Upgrades
Property Acquisition
Physician Recruitment
Physician Medical Offi ce Space
Capital Affordability
Chapter 4: April
Medicare and Medicaid Net Revenue Concepts
The History of Medicare and Medicaid
Impact of Medicare and Medicaid on Provider Net Revenues
Implications for Ridgeland Heights Medical Center
Calculation of Medicare and Medicaid Contractual Adjustments
Medicare Hospital Net Revenue Concepts
Medicaid Net Revenue Concepts
Implications of the Balanced Budget Act of 1997
Balanced Budget Refi nement Act of 1999
Benefits Improvement and Protection Act of 2000
Impact of the Balanced Budget Act on Medicaid
Implications of the Medicare Modernization Act of 2003
Implications of the Patient Protection and Aff ordable Care Act of 2010 (PPACA or ACA)
Reduction in the Annual Medicare Market Basket Payment Updates (APUs)
Penalties for High Readmission Rates
Establishment of ACO Contracts with Medicare
Bundled Payment Pilots
Value-Based Purchasing Program
Calculating Performance
CMS-TJC Core Measure Set
Reduced Payments for High Levels of Hospital-Acquired Infections
Individual and Business Mandates
Establishment of Health Insurance Exchanges and Affordability Credits
Medicaid Expansion
Medicare and Medicaid DSH cuts
Managed Care Net Revenue Concepts
Preparation of the Medicare and Medicaid Cost Report
Ratio of Costs to Charges
Implications and Sensitivity of Medicare Cost Reporting
Presentation of the Audited Financial Statements to the Finance Committee
Implications of Management Letter Comments Proposed by the Auditors.
Chapter 5: May
Fundamentals of Revenue Cycle Management (RCM)
Preregistration, Precertifi cation, and Insurance Verification
Charge Capture and Price Setting
Coding and Reimbursement: Documentation Capture and Review
Coding and Reimbursement: Coding 2013
Coding and Reimbursement: Coding 2014
Coding and Reimbursement: Timeliness
Denials Management
Denials Management: Fraud and Abuse Issues Related to Billing
Denials Management: Recovery Audit Contractors (RAC)
Follow-Up: Managed Care Arrangements and Negotiations
Performance Monitoring
Calculation of the Allowance for Doubtful Accounts and Bad-Debt Expense
Calculation of the Allowance for Contractual Adjustments
Chapter 6: June
Budget Preparation: The Beginning
Budget Calendar
Presentation of the Budget for Approval
Budget Calendar Time Frame
Detailed Budget Calendar Steps
Volume Issues
Historical Perspective
Demographic Changes
New Services
Impact from the New ACA Law
Physician Issues and Input
Wishful Thinking
June 1: Volume Kickoff Meeting
June 26: Approval of Projected 2013 and Budgeted 2014 Inpatient and Outpatient Volumes
Capital Budgeting: June
Accounting and Finance Department Responsibilities
June Finance Committee Special Agenda Items
Human Resources Report
Pension Status and Actuary Report Review
Chapter 7: July
Budget Preparation: The Middle Months
Which Is Better: Top-Down or Bottom-Up Budgeting?
July 1: Issuing the Budget Calendar
July 11: Computation of Gross Revenues and Contractual Adjustments
July 14: Review of Salary and Nonsalary Assumptions
July 15: Review of Gross Revenues and Contractual Adjustments and Validation of Payer Mix.
July 18: Review of the 2014 Budgeted Income Statement, Determination of Price Increase Targets, and Revision of Salary and Nonsalary Assumptions
July 25: Releasing 2013 Projected and 2014 Budgeted Worksheets to Department Managers
Capital Budgeting: July
Regulatory and Legal Environment
Medicare and Medicaid Fraud and Abuse
Other Regulatory and Business Compliance Issues
Corporate Compliance
Accreditation Issues
Patient Satisfaction Issues
Chapter 8: August
Capital Budget: August
August 12: Detailed Discussion for All Proposals over 100,000 and Training of All Proposal Evaluators
August 13: Discussion of All Pool Proposals with the Pool Evaluators
Funding Availability
Automatically Approved Capital Funding Items
August 13-16: Online Evaluation of Proposals
August 19-22: Consensus Meetings with Pool Evaluators
August 29: Consensus Meeting for All Proposals over 100,000
August 29-31: Online Revision of Ratings, If Necessary
Operating Budget
August 15: Return of Department Managers' Operating Budget Work to Their Vice Presidents
August 19-28: Review of the Proposed Operating Budget by the Divisional Vice Presidents and Its Return to Finance
Budget Variance Analysis
Budget Variance Parameters
Flexible Budgeting
Cost Accounting and Analysis
The Impossibility of Determining "True" Cost
August Finance Committee Special Agenda Items
Review of Next Year's Budget Assumptions
Review of Annual Materials Management and Inventory Level
Chapter 9: September
Operating Budget
September 9: Last Look at Budget Assumptions and Semifi nal Budget Approval
September 17: Final Review and Approval of the Operating Budget and Review of the Human Resources Committee Package
September 18-October 14: Preparation of the 2014 Budget for the Finance Committee.
Electronic Budgeting System for the Following Year
Capital Budget: September
Cash Budget
Physician Practice Management Issues
Physician Office Management
From PPMC to MSO
The Management Services Organization
Patient Throughput
The Hospital-Owned PPMC
Current Physician Practice Issues-2013
Additional Physician-Hospital Integration Issues
Monthly Physician Reporting
Chapter 10: October
Information Systems Implications for Health Care Financial Management
Information Technology Strategic Plan Initiatives
Systems to Support Enhanced Clinical Process Management and Data Access
Integrating Data and Reporting to Support Enhanced Decision Making
Maximizing the IT Infrastructure and Delivery Capabilities
HIPAA Implementation Issues
Selection of a New Health Care Information System
Features and Functions of the Selected IT System
Financial Implications for RHMC
How Improvements to Clinical Systems Benefi t RHMC's Financial Outcomes
Budget Presentation to the Board Finance Committee
October Finance Committee Special Agenda Items
Chapter 11: November
Preparation of the Budget Results and Delivery to the Department Managers
Budgeting and Spreading Contractual Adjustments by Department
Issues Involving RHMC's Cost Structure
How to Improve the Organization's Cost Structure
Enhancing Communication with Physicians
Standardizing the Organization's Supplies
Reducing Utilization of Services and Supplies
Obtaining the Best Pricing for Supplies and Products
Attaining Optimum Productivity and Staffi ng Levels
Supply Chain Management in Health Care
Obtaining the Best Pricing
Developing Close Relations with Distributors
Applying Just-in-Time Inventory Management
Establishing In-Service Training
Adopting a Consignment Policy
Implementing E-Commerce.
Benefits of Tax Status for Health Care Organizations.
Notes:
Description based on publisher supplied metadata and other sources.
Local notes:
Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, 2021. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries.
Other format:
Print version: Berger, Steven Fundamentals of Health Care Financial Management
ISBN:
9781118801710
9781118801680
OCLC:
881607234