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PubMed1991

The WAMI Rural Hospital Project. Part 4: Improving the financial health of rural hospitals.

Sound financial management has been identified as a critical component of effective hospital administration. Inadequate financial practices are a leading factor in the failure of hospitals. As part of the Rural Hospital Project (RHP), which operated in six rural Northwest communities from 1985 to 1988, detailed and extensive analyses of financial practices were conducted to identify strengths and weaknesses of the hospitals' financial management. In addition, 15 hours of formal education covering a variety of financial topics were presented to project participants. Results of the evaluation demonstrated that the greatest degree of change occurred in the financial management leadership capacity of the hospitals. All five hospitals, which either had no chief financial officer initially or subsequently experienced a turnover in the position, recruited individuals with strong qualifications. Vacancies in the administrator position in three of the four hospitals were filled by individuals with stronger financial management qualifications than their predecessors. Hospital board finance committees were formed in three of the four communities which previously did not have them. The biggest changes in financial practices occurred in the budgeting processes, which by 1989 better reflected the goals and strategies of the hospital's strategic plans. The financial performance of the six hospitals varied considerably over the study period. As a group, the RHP hospitals continued to require substantial nonoperating subsidies to remain solvent, despite improved financial practices. Despite the methodological limitations of this evaluation, we conclude that the intervention improved the capacity of the hospital administrations' financial leadership, as well as that of the governing boards, and led to substantial improvement in selected financial practices at all sites. Rural hospitals continue to operate in a hostile and precarious financial environment that limits their ability to sustain themselves on the basis of operating revenue alone.

Alaska↗
PubMed1987

The materiel manager-chief financial officer alliance.

There is a gold mine of potential inventory reductions, expense reductions, and revenue increases in most hospitals that can be tapped by more intensive materiel management. The first step is incorporating the necessary ingredients for a strong materiel management effort--the right people and a state-of-the-art computer program. Reorganization may be necessary to establish a more unified, consolidated approach to materiel management. Second, conduct an audit of the entire hospital to identify opportunities for improvement and to establish baseline management data. Finally, push forward the process of system changes (which also establishes necessary controls) until results are accomplished--a process that usually requires one to three years. The alliance between the materiel manager and the CFO is definitely beneficial to the hospital and to the individuals involved.

Data Collection↗
PubMed1990

He's savvy beyond his years.

Joseph A. Ruffolo, 33, chief financial officer of Millard Fillmore Hospitals, Buffalo, N.Y., is the winner of the 1990 Cain Brothers, Shattuck & Co. award for hospital CFOs. He'll go to Harvard this summer for an intensive course on corporate financial management.

Financial Management↗
PubMed1991

Are managers compensated for hospital financial performance?

Management compensation in a sample of 213 nonprofit hospitals in Ontario, Canada, is examined. Management compensation is determined first and foremost by hospital size and teaching status. Results indicate only a weak relationship between management compensation and hospital financial performance.

Chief Executive Officers, Hospital↗
PubMed1986

Working well: a healthy employee means a wealthy organization.

The financial manager as "manager" of the organization's resources, manages both financial and human resources. In this interview, Mark J. Tager, MD, discusses how a manager can affect an employee's wellness on the job, or promote "working well". Wellness means both physical health and mental stamina. Employees at a high level of wellness are more creative, positive, and productive. According to Tager, there are five characteristics that can create wellness and help the employee to perform better on the job. These five characteristics--participation, environment, recognition, knowledge, and style or PERKS--are a set of practical management guide-lines that can help managers cultivate and protect their human resources.

Administrative Personnel↗
PubMed1992

Guidelines help managers deal with ethical issues.

While a great effort has been devoted to improving financial management techniques in the healthcare field, little attention has been paid to addressing the ethical issues facing financial managers. In the years ahead, the ability to evaluate the ethical aspects of alternative courses of action may be as important as technical and managerial skills. Because of the importance of this issue, this article is being reprinted, with some modification, from the July 1989 issue of Healthcare Financial Management.

Commerce↗
PubMed1987

Measuring and monitoring quality in accounts receivable.

Traditionally, billing activities and accounts receivable have been monitored using days in accounts receivable, an accepted measure of performance. Unfortunately, days in accounts receivables does not measure the quality of the receivable cycle--important to receivables performance and turnaround. By developing a system of quality measurement for the receivable cycle, the financial manager is able to identify financial risk, submit an accurate claim, and reduce the need for costly follow-up activity, improving receivables performance for the hospital.

Accounting↗
PubMed2002

What CFOs should know--and do--about corporate responsibility.

Not-for-profit healthcare organizations are not immune to the scrutiny arising from corporate accounting scandals and legislation. Financial managers will play a critical role in satisfying corporate-responsibility concerns. Financial managers need to understand the public-policy concerns fueling the corporate-responsibility movement and the effects. Financial managers should take steps related to certifying financial statements, establishing audit committees, and ensuring independence of audits, among other actions.

Financial Audit↗
PubMed1989

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↗
PubMed1987

In pursuit of survival: managing revenues.

The changing nature of funding for mental health services has necessitated an increased command of financial management by providers of those services. When services were largely funded by government units, financial management could focus mainly on stewardship concerns. However, in the current environment of competition and mixed governmental and nongovernmental financing, financial management must encompass not only stewardship and the management of costs, but it must also increasingly focus on the management of revenues. This article presents a paradigm for approaching the management of revenues which includes both operating and nonoperating sources of funds. Building on this paradigm, a number of ratios are presented which are designed to aid decision makers in revenue planning as well as in determining the sources of problems when revenue goals are not met.

Accounting↗
PubMed2003

Usefulness and effects on costs and staff management of a nursing resource management information system.

While administrative information systems can assist nurse managers to improve cost containment and resource management of their units, such effects cannot be known without rigorous evaluations. This article presents evaluation results of CLASSICA, an information system designed to provide decision support for nurse managers in financial management, resource allocation, and activity planning. CLASSICA demonstrated a 41% reduction in expenditures for overtime and extra hours during the evaluation period as compared with a 1.8% reduction in control units that did not use the system. Nurse managers reported a substantial improvement in management information and stated that they had gained control over costs. The system helped them analyse the relationships between patient activity, staffing and costs of nursing care. Nurse managers also reported high satisfaction with the system, the information and decision support provided, and its ease of use. These results suggest that CLASSICA is a decision support system that can successfully assist nurse managers in effectively managing their units.

Decision Support Systems, Management↗
PubMed1995

Integrating technology into dental practices.

The use of computers in dentistry has expanded considerably in the last 15 years. Computer software can facilitate practice activities ranging from patient data management and financial management to treatment planning and electronic scheduling. This article addresses strategies for using technology to simplify and improve practice management.

Appointments and Schedules↗
PubMedDate not supplied

Value-based health care, Part 2. The physician imperative: define, measure, and improve health care quality.

Health care is the only major industry that lacks agreed-upon metrics to objectively define the quality of its products and services. The fundamental deficiency has led to the use of price as the de facto metric for patient contracting. Provider selection defaults to price because quality is assumed to be equal across all physicians and hospitals. This assumption is erroneous and now obsolete. Health care quality can be accurately measured using sophisticated illness modeling techniques that objectively risk-adjust patients level data. Providers' clinical data can be correlated with patient self-assessed outcomes for all episodes of inpatient and outpatient care. Physicians and their hospitals currently managing financial risks and those positioning themselves for these opportunities find such tools and techniques to be invaluable. Credible information creates a power shift away from price-based contracting to a true competitive marketplace that rewards quality of care. Purchasers and patients seek providers who objectively demonstrate their value on both quality and price. Part I of this article appeared in the January/February issue of The Physician Executive.

Cohort Studies↗
PubMed2003

[Veterinarian: a healthy profession?].

Data of the insurance company Movir reveals that veterinarians are more often occupationally disabled compared to other occupations. The causes for this disability are: problems with the locomotion apparatus, accidents and psychological problems. Regarding the complaints of the locomotion apparatus is found that proportionally between 51 and 65 years there are more vets disabled. In absolute numbers the majority of the problems at Movir involves the farm animal vet. About the relative importance or indemnities of other insurance companies no statements can be made. The localisation of the affections are: lower back, knees, shoulders, neck and wrist/hand. Regarding the accidents is found that a lot of problems happen in the private situation, but that the high percentage of disability caused by accidents compared with other professions is probably caused by the profession related accidents. From the numbers of Movir comes forth that especially working with horses is dangerous, but there is no specific veterinarian skill very risky. Regarding the psychological problems comes forth that there are no differences between men and women. Proportionally from 46 years until 65 years there is a higher incidence of burnout then at younger ages. In absolute numbers more companion animal vets are burnout, but no statements can be made about the relative importance. There is no difference at Movir between the solopractice and the partnership regarding burnout. The professional circumstances playing a role in developing burnout are: a too high workload, problems with colleagues within the partnership, irregular shifts, organisation and management and financial management. The personal aspects of these veterinarians that play a role in burnout are: high expectations and demands, perfectionism and insecurity about the own abilities. In many of the files there were also problems within the private situation.

Accidents↗
PubMed1985

A comparison of career-entry administrative competencies with skills required in practice: implications for continuing education.

Dietitians, advancing in practice, are often required to fill expanding administrative roles without the benefit of additional formal preparation. A study was conducted to compare career-entry administrative competence with competence needed for current practice. The survey instrument contained 59 generic administrative competency statements categorized under the headings of organization and administration; leadership and supervision; personnel management; space, equipment, and materials management; communications; financial management; and quality assurance of services. The questionnaire was sent to the 138 administrative dietitians practicing in Nebraska. Completed questionnaires were returned from 50 dietitians, a 35% response rate. Results of a Student t-test analysis indicated a statistically significant difference between the two competency levels for each major category of administrative skills. The data support the need for multiple continuing education opportunities for dietitians to develop skills needed for their expanding managerial responsibilities.

Dietetics↗