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Using activity-based costing to guide strategic decision making.

Activity-based costing (ABC) is not widely used in the healthcare industry. Some healthcare provider organizations are considering ABC, however, because of its potential to improve resource management and thereby maximize efficiency. ABC supports better pricing practices through more accurate costing and can be used to identify underutilized resources as well as associated costs that can be reduced. ABC can be a useful tool for determining the cost of unused capacity and for making strategic management decisions that will reduce costs.

Accounting↗

Just get it right! Measure it and fix it: the only sure route to 98-percent inventory record integrity.

Call it what you want: Back to Basics, Do it Right the First Time, or simply Inventory Integrity. There is no escaping the fact that accurate inventory just may be the most important requisite for any successful business or any business improvement effort. Good decisions require good facts, not just a good imagination or high hopes. Inventory, which is often the largest asset on the books, forms the basis for major and far-reaching business decisions every single day. If it is not accurate, then just imagine how good the decisions will be.

Equipment and Supplies↗

Administrative benchmarks for Medicare, Medicaid HMOs.

Plus, check out benchmark data on Medicare and Medicaid administrative costs. Every provider knows that HMOs take a slice of the Medicare or Medicaid premium for their administrative costs before they determine provider capitation. But how much does administration really cost? Here's some PMPM data from a study by the Sherlock Company.

Benchmarking↗

Cost management information improves financial performance.

Cost management information creates flexible and effective solutions to a hospital's most pressing challenges. A cost management approach recognizes that all strategic, operational, and financial issues are interrelated. Thus, cost management information enables executives to improve strategic planning, cost controls, and financial performance.

Accounting↗

Use of performance standards in behavioral health carve-out contracts among Fortune 500 firms.

OBJECTIVE: To determine the prevalence and nature of performance standards in specialty managed behavioral healthcare contracts among Fortune 500 companies. STUDY DESIGN: This was a cross-sectional survey of all companies listed on the Fortune 500 during 1994, 1995, or both. METHODS: From April 1997 to May 1998 we conducted a mailed survey with phone follow-up. Of the 68% of firms that responded, over one third reported carve-out contracts. The survey focused on whether companies had behavioral health carve-out contracts with specialty vendors and characteristics of these contracts, including the use of performance standards. RESULTS: More than three quarters of the Fortune 500 companies reporting specialty behavioral healthcare contracts used at least one performance standard. Most common were administrative standards (70.2%) and customer service standards (69.4%). About half of the companies used quality standards, whereas only a third used provider-related standards. Most (58.8%) companies using performance standards also specified financial consequences. Larger Fortune 500 firms were significantly more likely to use performance standards. Risk contracts and contracts that included all covered employees were also more likely to include some categories of standards. CONCLUSIONS: Administrative and customer service standards may be most common because companies find it easier to specify those standards, especially compared with clinical quality measures. To the extent that employers want to obtain the most value from their behavioral healthcare purchasing, we expect that more will begin to adopt quality standards in their contracts, especially as performance measures become more refined. Reliance on accreditation, however, is an alternative approach for employers.

Behavioral Medicine↗

Collaborative planning, forecasting, and replenishment.

This article highlights Procter & Gamble's (P&G's) current success and future direction of creating consumer value and improving trading partner relationships through electronic data communication, including the future vision of the company's ultimate supply system and CPFR--Collaborative Planning, Forecasting, and Replenishment.

Commerce↗

Consumerism in the financial services industry: lessons for managed care.

Managed care today is being shaped by the emergence of a savvier, better informed health care consumer. Facing a strikingly similar consumer movement over the past two decades, the banking industry experienced a market transformation that holds important lessons for managed care. Nontraditional entrants in the financial services industry, offering focused "monoline" products and services closely analogous to "carve-out" providers in health care, targeted rising consumer demands and stronger preferences. Banks in time answered these formidable new competitive forces with innovative consolidation and globalization strategies. The most successful initiatives in healthcare, as in banking, will focus on satisfying the consumer's hunger for information, improved levels of service, and enhanced outcomes. Managed care plans may play a lead role in accelerating the impact of consumerism by bridging the disconnect between patients and their purchasing decisions.

Commerce↗

Bottom-feeding for blockbuster businesses.

Marketing experts tell companies to analyze their customer portfolios and weed out buyer segments that don't generate attractive returns. Loyalty experts stress the need to aim retention programs at "good" customers--profitable ones- and encourage the "bad" ones to buy from competitors. And customer-relationship-management software provides ever more sophisticated ways to identify and eliminate poorly performing customers. On the surface, the movement to banish unprofitable customers seems reasonable. But writing off a customer relationship simply because it is currently unprofitable is at best rash and at worst counterproductive. Executives shouldn't be asking themselves, How can we shun unprofitable customers? They need to ask, How can we make money off the customers that everyone else is shunning? When you look at apparently unattractive segments through this lens, you often see opportunities to serve those segments in ways that fundamentally change customer economics. Consider Paychex, a payroll-processing company that built a nearly billion-dollar business by serving small companies. Established players had ignored these customers on the assumption that small companies couldn't afford the service. When founder Tom Golisano couldn't convince his bosses at Electronic Accounting Systems that they were missing a major opportunity, he started a company that now serves 390,000 U.S. customers, each employing around 14 people. In this article, the authors look closely at bottom-feeders--companies that assessed the needs of supposedly unattractive customers and redesigned their business models to turn a profit by fulfilling those needs. And they offer lessons other executives can use to do the same.

Commerce↗

A financial argument for service-line management.

Service-line management is a management concept that focuses attention on specific segments of business within a hospital. Service-line management breaks down silos, fostering a team approach. Hospitals should use service-line management to grow strategically important services. Resources should be deployed appropriately. Hospitals should explore strategies for increasing volume of profitable services.

Diagnosis-Related Groups↗

New ventures require accurate risk analyses and adjustments.

For new business ventures to succeed, healthcare executives need to conduct robust risk analyses and develop new approaches to balance risk and return. Risk analysis involves examination of objective risks and harder-to-quantify subjective risks. Mathematical principles applied to investment portfolios also can be applied to a portfolio of departments or strategic business units within an organization. The ideal business investment would have a high expected return and a low standard deviation. Nonetheless, both conservative and speculative strategies should be considered in determining an organization's optimal service line and helping the organization manage risk.

Decision Making, Organizational↗

Marketing to maximize profitability.

An effective marketing strategy should focus on serving profitable customers, not just adding new ones. The author offers five steps that marketers can follow to ensure that their efforts provide the greatest boost to the bottom line.

Consumer Behavior↗

Breaking down silos and building teamwork.

The purpose of this article is to explain how successful companies break down old functional silos and build teamwork. It describes techniques that foster teamwork across functional departments within a company as well as methods that can be used to cut across company lines and break down barriers between organizations.

Consumer Behavior↗

The new health care paradigm: roles and competencies of leaders in the service line management approach.

PURPOSE: The purpose of this paper is to discuss the need for the service line management approach in health care. Service line management is increasingly utilized by US health care organizations as an innovative method for providing the needed stimulus to increase viability and profitability for the ailing health care sector. DESIGN/METHODOLOGY/APPROACH: Using current literature, this study describes a paradigm shift from traditional health care management approaches to focus on the importance of a service line management approach with its specific emphasis on competencies of leaders. RESEARCH LIMITATIONS/IMPLICATIONS: Four essential competencies--conceptual, participation, interpersonal, and leadership--must be gained by leaders to bring about organizational growth. PRACTICAL IMPLICATIONS: Health care managers must understand and practice these four key competencies to become effective health care leaders. ORIGINALITY/VALUE: This paper provides useful information on the need for the service line management approach in health care.

Delivery of Health Care↗