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At least 541 records · Page 30Linked to original sources
PubMed1987

Capital expenditure planning: the value of information to hospitals.

This article examines some of the costs caused by the uncertainty created by competition among hospitals, especially those costs reflected in capital expenditure planning. A proposal is developed for a computer-based capital budgeting system that would allow hospitals to share enough information about their future capital expenditure plans to reduce the major costs of competition-induced uncertainty without publicly disclosing their future intentions. The benefits of such a system can be measured as the expected value of complete information. An illustrative example is provided.

Capital Expenditures↗
PubMedDate not supplied

Coping with 1989's unfavorable capital-budgeting climate.

Lower inpatient revenues, higher costs, and dramatic changes in the health care environment are, combined, creating an unfavorable climate for new capital acquisitions. Yet techniques exist to aid CEOs in prioritizing their capital budgets; hospital associations could help, in other ways, to minimize costly technology-acquisition mistakes. Managing the 1989 capital budgeting process wisely will prepare hospitals for stiff competition in the 1990s.

Budgets↗
PubMed1989

Allocating capital in a multi-hospital system.

Healthcare systems must have an efficient and equitable way of allocating limited capital resources to their operating units. An effective capital allocation method has two key components: a formula that addresses the quantitative challenge of distributing capital, and scrutiny by corporate, regional, and local management to ensure that the formula works fairly.

Capital Expenditures↗
PubMed1986

Rate adjusters for Medicare under capitation.

This article addresses three issues related to capitation. First, the average adjusted per capita cost (AAPCC) fluctuates with the mix of risks in the fee-for-service system. More sensitive adjusters in the AAPCC are needed. Second, the AAPCC, as now estimated, exhibits large geographic variance; so-called shrinkage estimators may help. Third, the AAPCC requires new adjusters to yield more homogeneous risk classes. Otherwise, the portion of the Medicare population under capitation may experience access problems at alternative delivery systems. Until such adjusters are developed, it seems better to rely upon a blend of capitation and fee-for-service than the present AAPCC.

Aged↗
PubMed1987

Capitation in IPA-HMOs. Dealing with financial risks and ethical dilemmas.

Capitation, a relatively new method of payment, is being used increasingly for primary care physicians in independent practice association (IPA) model HMOs. The author explains the actual payment method, including the various amounts withheld, and the financial risks and rewards inherent in this system. He then confronts the sensitive ethical issues posed by capitation. Finally, he offers five sound suggestions for physicians who contemplate joining an HMO that employs capitation.

Actuarial Analysis↗
PubMed1999

Placing the incentive on quality through contact capitation.

Contact capitation is emerging as a reimbursement method of choice among capitated physician networks. It allows for a more equitable allocation of dollars and permits physicians to benefit financially from the savings they individually create through more effective, efficient care practices. However, in order to operate at peak efficiency, the contact capitation system should be designed with thorough and ongoing input from the participating physicians.

Capitation Fee↗
PubMedDate not supplied

Capitation and insurance protection: how to protect against unpredictability.

Capitation contracting has created new challenges in the world of health care. The payment emphasis in a capitated environment concentrates on prepayment of services. Opportunities are created to control health care dollars by the physician or hospital group, but the potential downside must also be recognized. This article introduces the Provider Excess Loss (or "stop loss") insurance product and some of the main features of coverage. This insurance is specifically designed to protect providers in a capitated environment and is purchased by Physician Hospital Organizations (PHO), Independent Physician Associations (IPA), and physician-owned HMOs, among others. The emphasis is on collective purchasing. Focus on the main policy features-deductible options, allowable charges, and premium factors-should ensure a basic understanding of how coverage works and how to design coverage to make it fit the unique needs of each provider's risk.

Capitation Fee↗
PubMed1999

Realizing the financial benefits of capitation arbitrage.

By anticipating the arbitrage potential of cash flow under budgeted capitation, healthcare organizations can make the best use of cash flow as a revenue-generating resource. Factors that determine the magnitude of the benefits for providers and insurers include settlement interval, withhold amount, which party controls the withhold, and incurred-but-not-reported expenses. In choosing how to structure these factors in their contract negotiations, providers and insurers should carefully assess whether capitation surpluses or deficits can be expected from the provider. In both instances, the recipient and magnitude of capitation arbitrage benefits are dictated largely by the performance of the provider.

Accounts Payable and Receivable↗
PubMed2000

Objective risk adjustment improves calculated ROI for capital projects.

Most healthcare organizations can ill afford to assume risk for which they are inadequately compensated. When capital projects are being considered, factoring risk with an adjustment to the projected cost of capital can increase the calculated return on investment and improve the net present value of anticipated cash flow. This adjustment factor, however, should reflect the capital structure of the organization, historical average returns, and variance in the context of the market, the specific industry, and similar projects being considered.

Capital Financing↗
PubMed2002

Report shows declines in HMO enrollment, capitation slowing.

Capitation losses appear to be leveling off. The decline in total HMO enrollment slowed in 2001 while Medicaid HMO enrollment grew for the 10th consecutive year. And despite a declining percentage of HMOs reimbursing primary care physicians and hospitals under capitation, the percentage of HMOs reimbursing some specialty physicians under capitation rose slightly, mirroring several other recent reports showing an increase in specialty cap.

Capitation Fee↗
PubMed1992

Chicano return migration to the Southwest: an integrated human capital approach.

"This study uses an integrated human capital framework to examine the relationship between human capital, employment and ethnic factors and return migration to the Southwest [United States] among Chicanos. The sample used in the study is derived from the 1980 Public Use Microdata Samples and contains 1,926 Chicano householders between the ages of 25 and 64 who were born in one of five southwest states, lived outside of this region in 1975, and worked in the civilian labor force at any time between 1975 and 1980. The results suggest that various human capital, employment and ethnic composition variables are important predictors of Chicano return migration."

Americas↗
PubMed1996

Household composition and expenditures on human capital formation in Kenya.

"Expenditures on human capital determinants in Kenya are analyzed using microdata. Specific expenditures on food, schooling, and medical care provide evidence of human capital formation activities of households. The analysis is focused on expenditure and distributional effects of household composition dimensions. To determine empirical magnitudes of the effects, a flexible form of a household expenditure function is estimated. The results of the analysis show that gender and age composition are important determinants of the level and distribution of human capital investments in a household. In addition, household budget allocation favors boys over girls for secondary school education. The policies implied by the findings are discussed."

Africa↗
PubMed2002

Measuring human capital cost through benchmarking in health care environment.

Each organization should seek to maximize its human capital investments, which ultimately lead to increased profits and asset efficiency. Service companies utilize less capital equipment and more human productivity, customer service, and/or delivery of service as the product. With the measurement of human capital, one can understand what is happening, exercise some degree of control, and make positive changes. Senior management lives or dies by the numbers and if Human Resources (HR) really wants to be a strategic business partner, HR must be judged by the same standards as everyone else in the health care organization.

Accounting↗
PubMed2002

Evaluating capital investment opportunities: capturing the value of flexibility.

The risks inherent in today's healthcare environment make it difficult to predict financial returns from large capital investments or strategic initiatives. Discounted cash-flow financial models are an inadequate means of valuing capital investment opportunities. Real-option analysis includes in the value of a capital investment the ability of management to alter a strategic course or react to marketplace changes. The value of managerial flexibility is higher in an investment opportunity with considerable risk.

Capital Expenditures↗
PubMedDate not supplied

Getting a return on investment from spending capital dollars on new beds.

In assessing this bed-purchase process and the resulting return on investment, I identified the following critical success factors related to capital investments: Evaluation of capital equipment for return on investment from the expense side, particularly when looking at use of manpower for critical positions in the organization Evaluation of capital equipment for increasing nursing satisfaction, a factor in addressing the healthcare worker shortage in today's environment Involvement of a representative team to create personal ownership through individuals wanting to take care of something they are involved in purchasing Spin-off timesaving that can be realized through the adage "form follows function" The last factor was found not only in savings of nurse staff time but also in pharmacy time because the weight function on the new beds saved approximately one hour, allowing for speedier calculation of creatinine clearance in antibiotic dosing. Changing my position and perspective was rewarding. The persistence of the CNO and the involvement of the employees made the experience gratifying on a personal level as well.

Beds↗
PubMed2004

Hospitalists may spur return to global capitation.

The steady increase in the use of hospitalists by health plans, hospitals, and physician groups will spur a return to global capitation contracts, predicts one expert. Find out how capitated groups are using inpatient physicians to cut utilization and boost efficiency for client hospitals, making capitation a much more attractive proposition.

Ambulatory Care↗
PubMed2005

Capitated organizations should reassess their risk coverage, say experts.

Capitated organizations should reassess their risk coverage, say experts. With all signs pointing to a growth spurt in capitation during 2005, Charles Crispin, president of Evergreen Re, a Stuart, FL-based reinsurance brokerage and consulting company, says capitated physician organizations need to reassess their carve-out strategy and make sure they have enough reinsurance to avoid catastrophic loss.

Capitation Fee↗
PubMed1992

Capitation: a service by another name.

Fee for service and capitation systems are usually regarded as different methods of medical remuneration, however, they can be seen to differ mainly in the degree to which they 'bundle' or 'package' medical services. A capitation system for general practice services in Australia could be established by the creation of a Medicare item and benefit for a year's general practice care. This would allow doctors to assess the benefits of capitation without a total and potentially traumatic commitment, and may encourage innovation in the efficient delivery of primary health care.

Australia↗