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Fiscal fitness. Ten principles for evaluating financial health.

Such factors as declining utilization, aging plant, and competition may contribute to a hospital's closing, but the ultimate cause of hospital failure can usually be found in the institution's financial books. Perhaps as many as 20 percent of the nation's hospitals will close in the next decade, usually because of insolvency. Ten specific principles of financial performance can help hospitals survive. Among these are the principles that operating profits should cover replacement cost of assets, that nonoperating sources of income are critical to product-line enhancement, and that growth of equity capital is the bottom line of survival. Careful attention should be given to Catholic hospitals' performance relative to the national norms. Financial Analysis Service data indicate a mixed showing in this regard, and in several areas both Catholic hospitals and hospitals in general need to improve.

Accounting↗

HMOs: looking behind the facade to establish true value.

Increasingly, healthcare providers are being given the opportunity to acquire an HMO. However, before the provider can make such an investment decision, it must determine if the HMO is worth the asking price. In other words, what is the true value of the HMO? In the model presented here, the potential acquirer of the HMO is led through three steps that require analysis--internal assessment, external assessment, and financial valuation. Together these steps help the potential acquirer determine what the HMO is truly worth.

Decision Making↗

The risks and opportunities of acquiring a distressed facility.

Often, distressed healthcare institutions have salvaged their deteriorating situations by merging or consolidating with or selling their assets and operations to a neighboring institution. This article reviews the analysis that should be undertaken by a financially sound institution when it considers acquiring a distressed institution. Acquiring a failing institution provides many good opportunities as well as many great risks. A healthy institution must depend upon good planning and execution to ensure a successful venture.

Decision Making↗

Product-line performance reporting: a key to cost management.

For many hospitals, performance reporting is the most important and valuable function of a cost management system. Performance reporting provides hospitals--or any organization, for that matter--with an enhanced ability to reduce and control costs and monitor profitability. By periodically comparing strategic and operational plans with actual results, managers are provided with measurements of their performance for the aspects of the organization they control. The following is an excerpt from the book, Cost Management for Hospitals. This section deals with product-line performance reporting and the variances that measure the effects different factors have on performance.

Accounting↗

An analytical review of hospital financial performance measures.

Hospital administrators must have timely, valid, and interpretable financial information that allows them to make operational decisions in response to the threats of the changing health care environment. Aggregate indexes that reflect dimensions of hospital financial performance and simplify the information in financial ratios are needed to aid in decision making. This article reviews the development and use of hospital financial performance measures and lays the groundwork for research into deriving a multidimensional measure.

Decision Support Systems, Management↗

Special report on taxation and reimbursement. Recovering excess funds from a defined-benefit pension plan: don't forget the hidden costs!

In light of the pitfalls and hidden costs associated with recovering excess pension plan funds, providers may consider examining more conventional sources of raising capital before proceeding. In any event, the process should always be initiated by a careful cost-benefit analysis conducted by the employer, with the help of pension consultants and counsel.

Centers for Medicare and Medicaid Services, U.S.↗