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Managing financial risk with options on futures.

With the rise of managed care and capitation, more providers will be sharing in the financial risk of providing care. To help protect their organizations from the risk of unexpectedly high utilization under such a fixed-payment system, healthcare financial managers soon will be able to use options on futures contracts. These contracts provide wide profit potential but limited loss potential. Before investing in options on futures, however, healthcare financial managers should consider issues such as basis risk and trading costs.

Capitation Fee↗

Concepts in the financial management of hospital social work departments.

Concepts in the financial management of social work departments such as the utilization of cost-benefit as a way of thinking, the identification of funding sources for the department, and development of an understanding of budgetary practices are explored. Examples are offered of revenue production in in-patient and ambulatory care programs. Ideas about the contribution of social work to a hospital in an organized matrix structure are discussed. Social work can become a revenue rather than expense center by translating key functions into financial management terms.

Cost-Benefit Analysis↗

Financial management for nurse managers--the bottom line for renewal.

Cost-effective health care has become the hospital motto for the 1990s. A great majority of costs can be controlled on individual nursing units, but many clinically expert nurse managers lack skills in financial management. Our goal was to teach such skills in a framework in which cost was balanced with quality. The three-day course emphasized leadership skills and management styles, change and renewal, solutions to problems of nurse turnover, and specific financial strategies. Evaluations of the course were positive and demonstrated one way in which valuable nurse managers can learn new skills to keep up with current needs.

Cost-Benefit Analysis↗

A computer assisted tutorial for applications of computer spreadsheets in nursing financial management.

A computer-based tutorial for teaching nursing financial management concepts was developed using the macro function of a commercially available spreadsheet program. The goals of the tutorial were to provide students with an experience with spreadsheets as a computer tool and to teach selected financial management concepts. Preliminary results show the tutorial was well received by students. Suggestions are made for overcoming the general lack of computer sophistication among students.

Budgets↗

Pension funds warrant a financial manager's review.

A hospital's pension funds may be managed by its finance department, another internal department, or an outside investment adviser. Whatever the arrangement, healthcare financial managers should be involved in the decision between internal and external management of pension funds. A financial manager also can play a prominent role in developing a pension fund policy that balances a hospital's commitment to legal requirements, pension plan goals, and communication with investment advisers.

Communication↗

Financial management and job social skills training components in a summer business institute: a controlled evaluation in high achieving predominantly ethnic minority youth.

Ninety-two adolescents, predominantly ethnic minority high school students, participated in a structured Summer Business Institute (SBI). Participating youth were randomly assigned to receive either job social skills or financial management skills training components. Students who additionally received the job social skills training component were more likely to recommend their employment agency to others than were youth who received the financial management component, rated their overall on-the-job work experience more favorably, and demonstrated higher scores in areas that were relevant to the skills that were taught in the job social skills workshops. The financial management component also appeared to be relatively effective, as youth who received this intervention improved their knowledge of financial management issues more than youth who received job social skills, and rated their workshops as more helpful in financial management, as well as insurance management. Future directions are discussed in light of these results.

Achievement↗

Financial management and DRGs.

Healthcare providers face increasing financial risk as the federal government continues to refine the DRG-based prospective payment system. Healthcare providers that survive must establish systems that provide information in resource need, consumption and cost. The process illustrated in this article will help healthcare providers identify and establish the necessary systems.

Accounting↗

The use of fund accounting and the need for single fund reporting by institutional healthcare providers. Principles and Practices Board Statement No. 8. Healthcare Financial Management Association.

For many years, hospitals and other institutional healthcare providers used fund accounting as a basis for presenting their financial statements. Recently, authoritative literature has placed less emphasis on separate fund reporting. This is evidenced by the reduction of fund classifications specified in the literature. This trend seems to follow the recognition that institutional healthcare activities should be reported in a manner comparable to other businesses. The Principles and Practices Board (P&P Board) of the Healthcare Financial management Association believes that general purpose financial statements of institutional healthcare providers should be comparable to reporting by other businesses. That is, all assets, liabilities, and equity are presented in a single aggregated balance sheet without differentiation by fund. This form of presentation, referred to in this statement as single fund reporting, should be used by all institutional healthcare providers including those that are part of HMOs, universities, municipalities, and other larger entities when separate reports of the provider are issued. The P&P Board is studying other significant issues concerning the reporting of revenues and components of equity and changes therein. The conclusion in this statement can be implemented even though conclusions on these related subjects are not yet complete. The P&P Board recognizes that certain circumstances may require detailed records and reports for special purposes. This statement deals only with those general purpose financial statements on which an independent accountant's opinion is expressed.

Accounting↗

Can MHA graduates tackle financial management? Lessons from American corporate industry.

American industry, the major purchaser of medical services, is beginning to use its buying power to intervene in the healthcare system. Management committees hav been established to develop cost analysis and containment approaches to the utilization of medical services. With innovations by corporate industry, does the hospital CEO see an advocate or yet another adversary in addition to government regulation? Specifically, what preparation do master's degree graduates have, prior to their subsequent job experience, to make an informed contribution in financial decision making? Research was conducted to obtain data from health administration graduate programs in the United States and Canada to help find answers to these questions. This study addresses the strengths and weaknesses of the two major inputs to health financial management education--the proper mix and delivery of course presentations, and the student's motivation, maturity, and academic background. In some respects, both have been found wanting--not only from the findings of this investigation, but also by the AUPHA Task Force on Financial Management in the curriculum. About one-fourth of the entrants to master's degree programs have a business school background which includes courses in accounting, economics, and finance. However, the remaining 75% have other academic backgrounds, which suggests that teaching financially oriented courses to these graduate students is a major problem. The question of whether a health administration graduate with some finance training or a pure finance graduate is more desirable remains unanswered. This is especially true in meshing the immediate needs of the healthcare marketplace for financial management personnel and the long-range career goals of the graduate. This article presents the survey results and seven recommendations for action.

Commerce↗

Ethical misconduct in healthcare financial management.

Serious violations of ethical conduct by healthcare financial managers have made headlines over the past few years. Leaders in both the healthcare financial industry and the academic community believe these violations reflect the influence of the ambiguous ethical atmosphere of the 1980s, a breakdown in external and internal controls, and a failure of personal character on the part of a few individuals.

Ethics, Institutional↗

Study suggests PPS creates job tension for the financial manager.

The implementation of PPS is an attempt to create an economic incentive that will reward efficiency and penalize inefficiency. As a result, the healthcare industry is in the middle of a major transition. To determine the effect PPS has had upon the role and behavior of financial managers, a survey was conducted. One of its conclusions was financial managers in the healthcare industry will experience an increase in job tension and will feel less satisfaction in their jobs.

Age Factors↗

Managing financial pressures with subacute care.

Many healthcare organizations have found that converting acute care beds to subacute care beds has enabled them to control costs, enhance payments, and better serve patients along the full continuum of care. Conversion to subacute care, however, requires careful planning and sufficient resources. Healthcare executives contemplating converting an acute care unit to a subacute care unit must determine the cost of conversion, the types of services to be offered, licensing requirements, the types of patients to be served, and reimbursement implications.

Bed Conversion↗