HCS 577: Financial Management In Healthcare

In organizing and directing the financial manager decides how to use the resources of the health care agency to best carryout the

How do you see the various aspects of financial management as a whole for a healthcare organization? For example, how does one’s perspective influence decision making or how does the financial management relate to the organizational mission?

Austin, A., & Wetle, V. (2012). The United States health care system, combining business, health, and delivery. (2nd ed.). Upper Saddle River, NJ: Pearson Education.

(MCOs) operating. The hospital group is the state’s largest not-for-profit organization and boasts an impressive performance plan, serving the healthcare needs of approximately 8 million citizens in Virginia. Moreover, Chesapeake Health Plans was the first organization to successfully attempt to request and obtain the highest level of accreditation from the National Committee of Quality Assurance (NCQA). Furthermore, Chesapeake health plans are structured to provide medical plans that cover services under the HMO’s, PPO’s, POS, and Medicare HMO’s. Chesapeake health plans attributes a considerable portion of their net service revenue generated to their effective HMO health plans, which realized a 46% of total revenue, while their Medicare HMO produced an impressive 39% of total revenue. Furthermore, their Preferred Provider Plan (PPO) generated 10%, and the Point of Service Plan (POS) saw a 5% figure. This case study financial analysis will effectively assess Chesapeake Health Plans: HMO financial performance, focusing on a competitive analysis, a cash flow analysis, clear profitability ratios, liquidity ratios, debt management ratios, asset management ratios, operating indicator analysis, a comprehensive financial assessment of Chesapeake’s financial state, as well as effective fiscal recommendations for their organization.

When contemplating health care policy changes, several economic issues in health care must be considered. These include the financial issues affecting the health sector and have an impact on health policies. Policy makers face unending challenges due to the health sector revenues that are always rising. Another challenge is decreased funding and failure of the health insurance services.

Examine the financial characteristics of health care delivery along with managing costs, revenues, and human resources

There are many factors that have influenced the changes of health care economics. Money and technology has definitely been the reason for the change of health care economics over the years. Money is want makes the economy evolve. There will be advancement in technology and there needs to be people are managing these to keep up with the changes. The U.S. has definitely progressed as far as influencing factors to change in new advancement of technology and medical care. Having a good financial manager in your organization will prepare for these upcoming advancements and changes. Money drives these advancements in

This case is nondirected, in that it does not contain a specific list of questions that students must answer. Rather, the case contains general guidance or concerns expressed by various parties that students should consider when developing their solutions. If you, as the instructor, want to convert this case to a directed case, and hence provide your students with very specific guidance questions, you can make available the applicable questions for this case contained in the Case Questions section of the online material for instructors.

The debate over non-profit versus for-profit healthcare organization has been ongoing, does one provide better care than the other? Do the operations of for profit perform better than the non-profit organizations? Are the criticisms about for-profit organization validated and is there proof? The goal is to examine those questions as well as offer options to improve the financial and operational performance of non-profit and for-profit organizations criticisms.

A discussion regarding the health care reform or even health care in general can be somewhat controversial. The definition of health is drastically different depending on whom you speak to. Many would define health as " a person's absence of disease, others would describe good health based on the status of mind, body & social well-being" (GCU Lecture, module 2, 2012). According to The American Heritage® Dictionary of the English Language, health is defined as "The overall condition of an organism at a given time". An individual's overall health affects the nation, this is where stakeholders come into value. According to Keele, Buckner & Bushnell a stakeholder is either an individual or an organization that either invest time and

Health care stakeholders are individuals, groups, organizations or institutes that may affect or can be affected by the health-care providers in one way or another. Their effect on the healthcare depends on their views, interests, and contributions which differ from one stakeholder to the other. Therefore, this paper will dwell on analyzing about the stakeholders in the healthcare and their communication strategy. Some of the major stakeholders in Healthcare include; the public, the National Government, the healthcare professionals, the pharmaceutical industries among others (Hammer, 2016). To provide good, more efficient and better health-care services, these stakeholders must collaborate and communicate strategically to meet the set goals in the health sector.

The major difference between healthcare finance terminology and business finance terminology is that these terms focus on factors unique to the health services industry. For example, the provision of health services is dominated by not-for-profit or¬ganizations (such as ours), which are inherently different from investor-owned businesses. Also, the majority of payments made to health¬care providers for services are not made by patients—the consumers of the services—but rather by some third-party payer (e.g., a commercial insurance company or a government program). Even the purchase of health insurance is dominated by employers rather than by the individuals who receive the services. These terms emphasize ways in which the unique features of the health services industry affect financial decisions. The healthcare industry is a service industry. It is not in the business of manufacturing, say, widgets. Instead its essential business is the delivery of healthcare services. It may have inventories of medical supplies and drugs, but those inventories are necessary to service delivery, not to manufacturing functions. Because the business of healthcare is a service, this overview of key healthcare terminology will focus on the practice of financial management in the services industry.

The major objectives of healthcare financial management include: generating income (which is the most important) because it is the financial status of the organization. It is important to ensure that revenues are exceeding expenses. After assets are invested in, they are meant to be used. They must respond to regulations and be accredited to qualify for loans, reimbursements, etc. Facilitate relationships with third-party payers because they are the ones helping with the bills. The health organizations must also influence method and amount of payment to avoid overpaying, when faced with capitated prices or prospective payments. Monitoring physicians is important because they are at the forefront of everything, so management must make sure that physicians’ orders are consistent with patient needs. Lastly, protecting tax status involves for-profit organizations trying to reduce tax liabilities, while not-for-profit organizations try to protect their tax-exempt

Understanding the financial analysis of healthcare organizations is strategic to the organization by understanding their stand on the amount of revenue they gain, healthcare assets, and their financial goals. This paper will provide a comparison on the performance of financial analysis of several California Healthcare Organizations such as; Scripps Health, Palomar Health, Sharp Healthcare, and Tri-City Healthcare. The four healthcare organizations will be illustrated with an overview about what the organizations have been doing financially , where they have been growing financially, and what have they accomplished over the past year from examining their financial statement. As the nation’s healthcare model continues to evolve,

“Hospitals can be non-profit, for-profit, and government-owned and/or operated” (Baker & Baker, 2006). There are different terms for each classification in how to report and handle the finances but the basics are the same for any type of business. Business finances require the following basic fundamentals: creating “budgets, understanding capital expenditure, loan acquisition, and financial fees” (Baker & Baker, 2006). Government owned and operated hospitals offer unprofitable services; which