Financial Management for Healthcare Organizations

Healthcare Organizations: Financial Management Strategies

This is a Summary Table of Contents. Each chapter is preceded by a detailed Table of Contents.

VOLUME I

Dedication Foreword Preface Mission Statement Acknowledgements Disclaimer About the Authors

Acronyms Glossary of Finance and Investing Terms Glossary of Managed Care Terms

TAB I -- COMPETITIVE STRATEGY

Chapter 1 --Market Competition in Healthcare

Introduction............................................................................................................................1

A. Barriers to Free Market Competition in Healthcare Delivery...............................................................3 B. Examples of Growing Tension in Healthcare Services Markets ..........................................................4 C. Competitive Analysis..........................................................................................................................12 D. Implementing Successful Approaches from Other Industries ............................................................18 E. Lessons for Emerging Healthcare Organizations................................................................................23 F. Case Study: Competition in the St. Louis, Missouri, Healthcare Delivery Systems ..........................28 Additional Readings on Healthcare Competition......................................................................................34 Case Model Checklists

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Chapter 2 -- Improving Operations Management to Achieve Strategic Objectives

Introduction .................................................................................................................................................1 A. Competitive Trends...............................................................................................................................2 B. Information and Analysis......................................................................................................................7 C. Process Management ............................................................................................................................9 D. Human Resources Development.........................................................................................................12 E. Strategic Planning ...............................................................................................................................14 F. Leadership Development ....................................................................................................................16 G. Conclusion ..........................................................................................................................................17 Case Model Checklists

TAB II -- ASSET MANAGEMENT

Chapter 1 -- Cash Flow Analysis

Introduction .................................................................................................................................................1 A. About Cash Flow Analysis ...................................................................................................................2 B. Financial Statements .............................................................................................................................4 C. The Healthcare Cash Conversion Cycle .............................................................................................16 D. Cash Flow Management Issues...........................................................................................................17 E. Business Risks ....................................................................................................................................24 F. Cost of Capital and Capital Structure .................................................................................................29 G. Major Methods of Capital Budgeting .................................................................................................31 H. Conclusion ..........................................................................................................................................37 References and Readings...........................................................................................................................38 Case Model Checklists

Chapter 2 -- Managing and Enhancing Hospital Revenue Cycles

Introduction .................................................................................................................................................1 A. Organizational Structure .......................................................................................................................3 B. Benchmarking.......................................................................................................................................4 C. Technology Adoption ...........................................................................................................................5 D. Denial Management..............................................................................................................................7 E. Conclusion ............................................................................................................................................8 Case Model Checklists Appendix

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Chapter 3 -- Capital Formation Strategies for Hospitals

Introduction: Strategic Importance of Capital Investing .............................................................................1 A. Strategic Considerations in Capital Formation .....................................................................................3 B. Analysis of Hospital Credits .................................................................................................................9 C. Capital Formation Process ..................................................................................................................19 D. Capital Strategy ..................................................................................................................................23 Case Model Checklist

TAB III -- COST MANAGEMENT

Chapter 1 -- Managerial Cost Accounting Behavior

Introduction .................................................................................................................................................1 A. Cost Accounting ...................................................................................................................................2 B. Cost Behavior and Structure .................................................................................................................3 C. Marginal Costs and Marginal Revenue...............................................................................................15 D. Break-Even Analysis and Profits........................................................................................................17 E. Ambulatory Payment Classes and Physician Fiscal Credentialing.....................................................19 References .................................................................................................................................................27 Case Model Checklist Appendices

Chapter 2 -- Hybrid Cost Analysis and Activity-Based Medical Cost Management

Introduction .................................................................................................................................................1 A. Hybrid Cost Analysis............................................................................................................................2 B. Medical Activity-Based Cost Management ..........................................................................................7 C. Conclusion ..........................................................................................................................................23 References .................................................................................................................................................24 Case Models Checklists

Chapter 3 -- Economic Order Quantity Inventory Management

Introduction .................................................................................................................................................1 A. Healthcare Inventory Management.......................................................................................................2 B. Economic Order Quantity Process........................................................................................................5 C. Assessment of EOQ ..............................................................................................................................9 D. Conclusion ..........................................................................................................................................11 References .................................................................................................................................................11 Case Models Checklists Appendix

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Chapter 4 -- Analyzing and Negotiating Cost-Volume-Profit Contracts

Introduction .................................................................................................................................................1 A. Hospitalists and Physicians...................................................................................................................2 B. Medical Office Profits ..........................................................................................................................3 C. Cost-Volume-Profit Analysis ...............................................................................................................6 D. Capitation..............................................................................................................................................9 E. Break-even Analysis for Capitated Contracts.....................................................................................14 F. Negotiation and Managed Care Contracting.......................................................................................17 G. The Negotiation Process .....................................................................................................................25 H. Medical Contract Standards................................................................................................................32 I. Conclusion ..........................................................................................................................................34 References .................................................................................................................................................36 Case Models Checklists Appendix

TAB IV -- CLAIMS MANAGEMENT

Chapter 1 -- Incurred But Not Reported Healthcare Claim Strategies

Introduction .................................................................................................................................................1 A. Historical Review .................................................................................................................................2 B. What Is an IBNR Claim? ......................................................................................................................3 C. IBNR Problems for Healthcare Organizations......................................................................................4 D. Managed Care Organization Exacerbation of IBNR Claims ................................................................5 E. IBNR from a Net Present Value Perspective ........................................................................................6 F. Tax Strategies for IBNRs......................................................................................................................7 G. IBNR Challenges and Solutions ...........................................................................................................9 H. Potential Solutions to the IBNR Challenge ........................................................................................12 I. IBNR Calculations Methodology .......................................................................................................12 References ................................................................................................................................................14 Case Models Checklists Appendices

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Chapter 2 -- Asset Protection Strategies for Accounts Receivable

Introduction .................................................................................................................................................1 A. Rationale and Formulae ........................................................................................................................2 B. The Need to Protect Accounts Receivable............................................................................................3 C. Proactive Accounts Receivable Monitoring .........................................................................................4 D. Financial Ratio Liquidity Analysis for Accounts Receivable...............................................................5 E. Accounts Receivable Protection Strategies ..........................................................................................6 F. Conclusion ..........................................................................................................................................12 References .................................................................................................................................................13 Case Model Checklists Appendices

VOLUME II

TAB V -- RISK MANAGEMENT AND COMPLIANCE

Chapter 1 -- Workplace Violence in Healthcare

Introduction .................................................................................................................................................1 A. Assessment of Workplace Violence in Healthcare ...............................................................................2 B. Understanding the Risks .......................................................................................................................5 C. Dealing with Medical Workplace Violence........................................................................................14 References .................................................................................................................................................22 Case Model Checklists Appendix

Chapter 2 -- Healthcare Organization Compliance Tactics

Introduction .................................................................................................................................................1 A. Why Consider a Healthcare Organization Compliance Program?........................................................3 B. Benefits of a Healthcare Compliance Program...................................................................................12 C. Basic Components of a Healthcare Compliance Program ..................................................................14 D. Implementing a Compliance Program ................................................................................................27 E. Management Accountability...............................................................................................................29 F. Billing and Reimbursement Risk Areas..............................................................................................34 G. Corporate Compliance Program .........................................................................................................38 H. Conclusion ..........................................................................................................................................43 References .................................................................................................................................................44 Case Model Checklists Appendix

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