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Risk contracting.

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Accounting↗

Toward a departmental bottom-line perspective.

In the absence of developing a relationship between price paid and cost expended, health care management has no basis for setting financial objectives much less subsequent evaluation. Departmental P&Ls bring the cost-price relationship into perspective.

Accounting↗

The effects of ownership and system affiliation on the economic performance of hospitals.

We investigated differences among five types of hospitals, defined by ownership (investor-owned or not-for-profit), system affiliation (system-affiliated or freestanding), and government sponsorship on 24 measures of economic performance. Using multivariate analysis of 1980 Medicare cost report and other data from a national sample of 561 hospitals, we found that investor-owned chain hospitals charged significantly more, and were more profitable, than all other types of hospitals except freestanding for-profits; there were no differences in productive efficiency that could be attributed to ownership or affiliation; the investor-owned hospitals had higher debt-to-asset ratios, less-capital-intensive plants, and greater capital costs as a percentage of operating costs than the not-for-profits; and there were no consistent case-mix differences among the hospitals.

Capital Expenditures↗

Financial characteristics of hospitals purchased by investor-owned chains.

This article focuses on the preacquisition financial condition of not-for-profit hospitals acquired by investor-owned hospital chains. Financial ratios are used to determine if not-for-profit hospitals acquired by investor-owned hospital systems have common financial characteristics which make them a likely target for a takeover. The results indicate that during the time period studied, investor-owned hospital systems did tend to purchase hospitals with common financial characteristics and that these characteristics provide a reasonable description of a financially distressed hospital. This finding has important consequences for our health care delivery system.

Economics, Hospital↗

Financial management of hospitals.

The effect of hospital reimbursement systems on the financial management of hospitals is briefly discussed, and the organization of hospital financial operations is reviewed. The implementation of Medicare prospective pricing will change the way in which hospital finances are managed. Health-care managers will be concerned with the profitability of product lines, or diagnosis-related groups, in future strategic planning efforts. The hospital's finance department consists of several traditional areas that exist in almost all financial organizations. The functions and interactions of these various areas are discussed in light of previous and current hospital reimbursement strategies. Staffing of the finance department and the duties of the hospital's chief financial officer are also described. The prospective pricing system of hospital reimbursement and increasing pressure from the business community to stem the rising costs of health care will produce changes in the medical and financial operations of the hospital industry over the next decade.

Accounting↗