Essentials of health care finance

Cover
Essentials of Health Care Finance
Copyright
Contents
Preface
Content of the Book
About the Authors
Contributor
Chapter 1 Financial Information and the Decision-Making Process
	Information and Decision Making
	Uses and Users of Financial Information
	Financial Organization
	Forms of Business Organization
	Summary
Chapter 2 Billing and Coding for Health Services
	Generating Healthcare Claims
	Scheduling and Registration
	Provide Services
	Medical Documentation and him/Medical Records
	Charge Entry and Charge Master
	Billing and Claims Preparation
	Claims Editing
	Claim Payment
	Summary
	Appendix 2-A Sample UB-04 Form and Sample CMS-1500 Form
Chapter 3 Financial Environment of Healthcare Organizations
	Financial Viability
	Sources of Operating Revenue
	Healthcare Payment Systems
	Medicare Benefits
	Medicare Payments
	Summary
Chapter 4 Legal and Regulatory Environment
	Part I. Knowledge of the Law and Regulations Is an Essential Part of Healthcare Financial Management
	Part II. Primary Regulatory Issues Confronting Healthcare Organizations Today
	Legal Audits and Investigations
	Summary
	Acknowledgments
Chapter 5 Measuring Community Benefit
	Tax Exemption Status
	Community Benefit Areas
	The Community Value Index®
	Estimating Financial Benefits in Not-for-Profit Healthcare Firms
	Estimating Financial Benefits Provided by Not-for-Profit Healthcare Firms
	Summary
	Appendix 5-A Schedule H Form
Chapter 6 Revenue Determination
	Payment Methods and Their Relationship to Price Setting
	Methods for Controlling Revenue
	Generic Principles of Pricing
	Price Setting for Healthcare Services
	Justifying Healthcare Firm Prices
	Health Plan Contract Negotiation
	Health Plan Payment Schedules
	Summary
Chapter 7 Health Insurance and Managed Care
	HMO and Managed-Care Development
	Integrated Delivery Systems
	Paying Providers in a Managed-Care Environment
	Setting Prices in Capitated Contracts
	Medicare and Medicaid Risk Contracts
	Legal and Regulatory Issues
	Summary
Chapter 8 General Principles of Accounting
	Financial Versus Managerial Accounting
	Principles of Accounting
	Accrual Versus Cash Accounting
	Fund Accounting
	Conventions of Accounting
	Summary
Chapter 9 Financial Statements
	Organizational Structure
	Balance Sheet
	Statement of Operations (Revenues and Expenses)
	Statement of Changes in Net Assets
	Statement of Cash Flows
	Summary
	Appendix 9-A Case Example Audited Financial Statement
Chapter 10 Accounting for Inflation
	Reporting Alternatives
	Uses of Financial Report Information
	Case Example: Williams Convalescent Center
	Summary
Chapter 11 Analyzing Financial Position
	Developing an Effective Financial Reporting System
	Case Example: Harris Memorial Hospital
	Summary: Harris Case
Chapter 12 Financial Analysis of Alternative Healthcare Firms
	Long-Term Care Facilities and Nursing Homes
	Medical Groups
	Health Plans
	Summary
Chapter 13 Strategic Financial Planning
	Strategic Planning Process
	Developing the Financial Plan
	Integration of the Financial Plan with Management Control
	Summary
Chapter 14 Cost Concepts and Decision Making
	Concepts of Cost
	Cost Measurement
	Break-Even Analysis
	Summary
Chapter 15 Product Costing
	Healthcare Cost Accounting
	Relationship to Planning, Budgeting, and Control
	The Costing Process
	Two Required Systems for Healthcare Costing
	Relative Value Costing
	Summary
Chapter 16 The Management Control Process
	Essential Elements
	The Budgeting Process
	Zero-Base Budgeting
	Benchmarking at the Departmental Level
	Summary
Chapter 17 Cost Variance Analysis
	Cost Control
	Investigation of Variances
	Variance Analysis Calculations
	Variance Analysis in Budgetary Settings
	Variance Analysis in Managed-Care or Bundled Payment Settings
	Summary
Chapter 18 Financial Mathematics
	Single-Sum Problems
	Annuity Problems
	Summary
Chapter 19 Capital Project Analysis
	Participants in the Analytical Process
	Classification of Capital Expenditures
	The Capital Project Decision-Making Process
	Justification of Capital Expenditures
	Discounted Cash-Flow Methods
	Selection of the Discount Rate
	Valuation
	Summary
Chapter 20 Consolidations and Mergers
	Defining the Terms
	M&A Activity
	Overview of Theories of M&A Activity
	Factors Affecting M&A Activity
	Why Do Mergers Succeed or Fail?
	Valuations
	Summary
Chapter 21 Capital Formation
	Equity Financing
	Long-Term Debt Financing
	Alternative Debt Financing Sources
	More Recent Developments
	Early Retirement of Debt
	Summary
Chapter 22 Working Capital and Cash Management
	Cash and Investment Management Structure
	Management of Working Capital
	Short-Term Bank Financing
	Investment of Cash Surpluses
	Summary
Chapter 23 Developing the Cash Budget
	Determining Required Cash and Investment Reserves
	Sources and Uses of Cash
	Preparing the Cash Budget
	Summary
Glossary
Index