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Financing maneuvers. Two opportunities to boost a hospital's working capital.

Two receivables financing approaches, factoring and asset-backed securitization, offer an initial cash flow boost and a predictable source for continual cash flow. In a typical receivables factoring program, a healthcare organization receives advance funding from its receivables and reduces collection and follow-up efforts required of its staff. In exchange, the organization: Sells receivables at a discount between 5 percent and 10 percent off face value; and Pays a factoring fee of up to 20 percent of sold receivables. In a typical asset-backed securitization: Proceeds generated from the sale of A1-rated commercial paper are used to purchase receivables from a hospital; Accounts receivable eligible for sale are advance-funded at a level between 80 and 90 percent, with the unfunded portion remaining an asset of the hospital; The hospital is responsible for collection and follow-up activities; and An asset manager maintains cash collections to retire commercial paper notes and pay administrative costs. A healthcare organization interested in receivables financing should review each option's structure and benefits to assess advance funding provided, costs, a seller's level of control, and program eligibility requirements.

Accounts Payable and Receivable↗

Project risk definition and measurement in a not-for-profit setting.

The health care finance literature on capital investment decisions generally applies conventional market risk concepts without distinguishing between proprietary and not-for-profit forms of organization. Since proprietary firms have shareholder wealth maximization as their primary goal, a project's relevant risk is its contribution to the riskiness of the equity investors' well diversified stock portfolios, or its market risk. However, not-for-profit organizations do not have shareholder wealth maximization as their primary goal, and thus market risk concepts are not applicable. Rather, the relevant risk in a not-for-profit setting is a project's corporate risk; that is, the project's contribution to the riskiness of the organization. The difference in risk definition and measurement between proprietary and not-for-profit firms has two implications for managerial decisions: (1) in making capital investment decisions, a manager must define and measure a project's riskiness on the basis of the firm's organizational form; and (2) although diversification for the sole purpose of risk reduction is not a valid rationale for proprietary firms because stockholders can achieve the same result at less cost, risk-reducing diversification does make sense for not-for-profit firms.

Capital Expenditures↗