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PubMed1999

A framework for strategic information systems implementation in the United Kingdom health sector.

The implementation of information technologies in the United Kingdom health sector is a relatively recent phenomenon. Many of the developments have followed the patterns in the United States. One such example is that of Case Mix, introduced strategically as part of the Resource Management Initiative and aimed at the facilitation of both clinical and financial audit. Moreover, Case Mix was implemented alongside significant changes in hospital structure and culture, requiring clinicians to get involved in management tasks and decision making within the structure of the hospital, supported by a new information infrastructure. The success of such systems has varied significantly. A number of lessons can be learned from the way that the implementation was approached. This article stems from a research project focusing longitudinally on the implementation of Case Mix in four UK hospitals. It draws a number of findings from the cases, and importantly, explicates a framework for strategic information systems implementation, as generated from the cases and supported by the extant literature. Such a framework has implications for both theory and practice, and assists in the understanding of what is often a dynamic and poorly understood situation.

Capital Financing↗
PubMed1999

SOP 98-5 brings uniformity to reporting start-up costs.

The American Institute of Certified Public Accountants (AICPA) issued Statement of Position (SOP) No. 98-5, Reporting on the Costs of Start-Up Activities, in April 1998 to provide organizations with guidance on how to report start-up and organization costs. Because some companies were expensing start-up costs while other companies were capitalizing start-up costs with a variety of periods over which to amortize costs, it was difficult to compare companies' financial statements. SOP No. 98-5 will bring uniformity to the treatment of start-up and organization costs by dictating that these costs be expensed as incurred. AICPA's Accounting Standards Executive Committee adopted an intentionally broad definition of start-up costs to capture the vast majority of costs associated with starting up an organization. SOP No. 98-5 takes effect for financial statements for fiscal years beginning after December 15, 1998, but can be applied earlier for fiscal years for which financial statements have not been issued.

Accounting↗
PubMedDate not supplied

Turnaround distressed physician practices. 20 tips for success.

Physician practices are restructuring through merger and acquisition, and sale to practice management companies and to hospital systems. Many also are expanding internally by recruiting new physicians and opening additional offices. For many these strategies are working, but many others are experiencing operational and financial distress and failure that arise from rapid organizational growth without concomitant infrastructural change. Further, in the last several months, many national and regional practice management companies have decided to withdraw from the business, and others have declared bankruptcy. The number of physician practices that are in financial and operational distress is unprecedented. These groups require a solution, as proposed in this article.

Bankruptcy↗
PubMed2000

"Best-in-class": an interview with John T. Bigalke.

John T. Bigalke, FHFMA, MBA, CPA, is national director, healthcare assurance & advisory services, Deloitte & Touche LLP. Bigalke began his career in health care in 1977 as a staff auditor and consultant with a Big Five accounting firm. In 1983, he moved to another Big Five firm, where he spent 15 years in leadership positions, including vice chairman of the healthcare practice, before moving to Deloitte & Touche in 1998. A member of HFMA since 1980, he served on HFMA's National Board of Directors from 1997 to 2000.

Consultants↗
PubMed1999

Healthcare transition managers make market exits easier for insurers.

Insurers have been struggling to meet and maintain their profit margins on the health insurance business they underwrite. As a result, many have exited or are contemplating exiting from the health insurance market. At the same time, managed care organizations are seeking ways to augment their enrollment base and satisfy investor expectations. Insurers that wish to transfer their health insurance business to other carriers and managed care organizations that are interested in accepting this business have turned to a new type of healthcare financing company--the healthcare transition manager--to facilitate the transaction. Part broker, part matchmaker, and part administrative coordinator, these companies make it possible for commercial insurers to exit the health insurance market without undue hardship to enrollees or the managed care plans that assume risk for their care.

Consultants↗
PubMed1999

For-profit chains seek to acquire successful not-for-profit hospitals.

Over the last decade, investor-owned hospital corporations have grown primarily by acquiring other for-profit hospital chains or stand-alone for-profit institutions. Between 1990 and 1995, however, these corporations also acquired nearly 50 not-for-profit hospitals and converted them to for-profit status. An examination of the long-term financial condition of 39 not-for-profit hospitals acquired by various investor-owned hospital corporations between 1992 and 1996 was conducted using free-cash-flow accounting valuation. The results suggest that, initially, only not-for-profit hospitals in dire financial straits were candidates for acquisition and conversion to for-profit status. More recent acquisitions increasingly have involved more successful not-for-profit hospitals.

Accounts Payable and Receivable↗