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At least 127 records · Page 7Linked to original sources
PubMed1996

Medical savings accounts. American College of Physicians.

This position paper examines medical savings accounts (MSAs) as a supplemental mechanism for financing health care services. Although federal legislation to encourage MSAs did not pass in 1995 and is not likely to pass in 1996, MSAs will continue to be seriously considered by public policymakers. Individual retirement accounts accumulate funds for retirement; MSAs could be used to accumulate funds for health care expenditures. Changes in the federal tax code would be required to permit tax-deductible contributions and tax-free earnings to individual MSAs. To be withdrawn without penalty, funds from an MSA could only be used to pay for approved medical or health insurance expenses. Each person would own and control his or her account, regardless of changes in employment. Coupled with high-deductible health insurance, MSAs could empower cost-conscious patients in health care decision making, increasing competitive pressure to reduce health care costs. Administrative costs and paperwork associated with health insurance might also be reduced, and some people who currently do not have health insurance might be able to obtain some financial protection. Medical savings accounts may not help unemployed persons or low- and middle-income persons who cannot afford to contribute to such accounts. These accounts may result in reduced health insurance protection and greater out-of-pocket expenses for those most in need of health care. Problems of adverse risk selection could arise if healthy persons choose insurance options involving MSAs; this choice would cause premiums to increase for persons who desire traditional health insurance.

Deductibles and Coinsurance↗
PubMed1988

Patient accounts managers: the reality behind the myth.

Rising receivables and slowed cash flow have put a greater emphasis on the position of patient accounts manager. As the patient accounts manager becomes increasingly important to the long-term viability of hospitals, the person filling that role is placed in the spotlight. In the first survey of its kind, HFMA and the American Guild of Patient Accounts Management profile today's patient accounts manager. The average patient accounts manager is a male in large institutions and female in smaller facilities, has a college degree, is between 31 and 50 years of age, and has been in the healthcare field for almost 10 years. In addition, they earn $33,600 a year and aspire to higher positions including consultant and chief financial officer.

Accounting↗
PubMed2005

Enhancement of CLAIM (clinical accounting information) for a localized Chinese version.

CLinical Accounting InforMation (CLAIM) is a standard for the exchange of data between patient accounting systems and electronic medical record (EMR) systems. It uses eXtensible Markup Language (XML) as a meta-language and was developed in Japan. CLAIM is subordinate to the Medical Markup Language (MML) standard, which allows the exchange of medical data between different medical institutions. It has inherited the basic structure of MML 2.x and the current version, version 2.1, contains two modules and nine data definition tables. In China, no data exchange standard yet exists that links EMR systems to accounting systems. Taking advantage of CLAIM's flexibility, we created a localized Chinese version based on CLAIM 2.1. Since Chinese receipt systems differ from those of Japan, some information such as prescription formats, etc. are also different from those in Japan. Two CLAIM modules were re-engineered and six data definition tables were either added or redefined. The Chinese version of CLAIM takes local needs into account, and consequently it is now possible to transfer data between the patient accounting systems and EMR systems of Chinese medical institutions effectively.

Accounting↗
PubMed2005

What do health savings accounts mean for the emergency department?

The insurance market is evolving, with increased emphasis on plans with high deductibles and a large degree of coinsurance. This article serves as an introduction to the defining characteristics of consumer-driven health care plans and their associated health savings accounts. We discuss the most recent evidence on the adoption of these plans and their effects on use and reimbursement. Compared to many specialties, the emergency department (ED) may be insulated from extensive shopping and price negotiation, because visits to the ED are often for urgent and time-sensitive conditions. However, ED utilization patterns may change if cost-conscious health savings account holders forgo other necessary medical care, or if they seek out substitutes to the ED for less urgent problems. In the long run, the ED may feel the impact of changes that stem from 2 areas: the ability of health savings accounts to control the increase in health care costs, and the potential of health savings accounts to replace or undermine more comprehensive health insurance plans. We note areas that emergency physicians should monitor as health savings accounts become more prominent.

Emergency Service, Hospital↗
PubMed1996

Shift in power to hospital accountants.

With the introduction of the Prospective Payment System, hospital accountants' role changed from reimbursement maximizers to an important role in decision making. Faced with increased competition, many hospitals are installing financial controls. Many hospitals are engaging in promotion and health awareness campaigns and expanding their services to stabilize income and reduce the effects of a changing environment. Thus, hospitals operate in a more competitive environment with much uncertainty. When faced with uncertainty, organizations often believe that they must convince society that their existence is legitimate. Increasing specialization and organizational complexity in healthcare professions have made the expert important. Experts, such as the role assumed by hospital accountants, maintain power because the organization depends on them for their special skills and information. Scarce resources coupled with uncertainty move hospital accountants as experts into the power equation in the changing control of the U.S. healthcare system. Since accountants often serve as monitors of scarce resources, information about the resource allocation directly affects the distribution of power. This places hospital accountants in a critical role of assisting their institutions in adapting to a new environment.

Accounting↗
PubMed1996

The role of employee flexible spending accounts in health care financing.

Employee flexible spending accounts for health care represent one component of the current health care financing system that merits serious reform. These accounts create a system of undesirable incentives, force employees and employers to take complicated gambles, reduce tax revenues, and fail to meet their purported policy objectives. This paper describes shortcomings in these accounts from both a theoretical and an empirical perspective. Some proposed alternatives; including medical spending accounts and zero balance accounts, resolve many of these concerns but not all of them.

Accounting↗
PubMed1991

Reporting method can meet new AICPA (American Institute of Certified Public Accountants) guidelines.

Guidelines contained in the American Institute of Certified Public Accountant's (AICPA's) new healthcare audit guide require some hospitals to revise systems for compiling financial statements on accounts receivable and revenue. An accounting method can be devised to identify financial responsibility as soon as possible after discharge, record amounts to be written off, and, through an analysis of closed accounts, estimate the collection process on accounts for which insufficient information is available.

Academies and Institutes↗
PubMed1993

Measuring accounts receivable performance: a comprehensive method.

Nonperforming assets, such as accounts receivable, are frequently cited as sources of financial difficulty for hospitals. Yet, many hospitals, relying on the traditional measure of accounts receivable--days revenue outstanding--may not have a true grasp of the real cost of their accounts receivable. The author discusses the costs imposed on a hospital by accounts receivable and describes three cost components that must be calculated if the true cost of accounts receivable is to be determined and controlled.

Accounts Payable and Receivable↗
PubMed1993

Achieving excellence in the management of accounts receivable.

Recent changes in healthcare reimbursement rules and practices have made the task of accounts receivable management a particularly demanding one for most financial managers. One multihospital system, after pursuing numerous strategies to reduce its accounts receivable with only marginal levels of success, launched a systemwide initiative to share both the positive and the negative accounts receivable management experiences of each department at each hospital in the system with all patient accounting staff. The objective of the initiative was to use the lessons learned from those experiences to attain excellence in accounts receivable management throughout the system. The ultimate success of the initiative is detailed in the following article.

Accounts Payable and Receivable↗
PubMed1998

Applying new AICPA accounting rules on special reports.

Two new standards on agreed-upon procedures, issued by the American Institute of Certified Public Accountants, provide healthcare organizations and associated decision makers with new flexibility in acquiring professional accounting services. Effective January 1, 1996, these procedures allow organizations to target the type and volume of services performed by accountants and potentially avoid the time and expense involved in completing a full financial statement audit. As with any other accounting engagement, both the healthcare organization and the accounting firm need to establish what procedures will be conducted, who will be allowed to use the resulting report, and how the procedures will be conducted.

Accounting↗
PubMedDate not supplied

Advantages of fund accounting in 'nonprofits'.

Motivated by the financial difficulties that have beset city governments and some private nonprofit organizations, the accounting profession and other circles are urging these organizations to conform to business accounting practices. (See Robert N. Anthony's article on p. 83 of this issue.) Fund accounting, these reformers claim, is too complex, too segmented to permit intelligent analysis. The authors of this article demur; not only is it legally and logically necessary to maintain separately the restricted and unrestricted monies received from various sources and spent for designated purposes; also close examination of the financial statements of nonprofit enterprises can provide a very good idea of how well they are doing financially. Furthermore, the authors advocate adoption of certain fund accounting principles for businesses, and they show why they could be helpful. This article is much more than a defense of how nonprofit organizations account for their operations; it is a comprehensive but brief introduction to the subject.

Accounting↗
PubMed2001

The FASB explores accounting for future cash flows.

The FASB's Statement of Financial Accounting Concepts No. 7, Using Cash Flow Information and Present Value in Accounting Measurements (Statement No. 7), presents the board's views regarding how cash-flow information and present values should be used in accounting for future cash flows when information on fair values is not available. Statement No. 7 presents new concepts regarding how an asset's present value should be calculated and when the interest method of allocation should be used. The FASB proposes a present-value method that takes into account the degree of uncertainty associated with future cash flows among different assets and liabilities. The FASB also suggests that rather than use estimated cash flows (in which a single set of cash flows and a single interest rate is used to reflect the risk associated with an asset or liability), accountants should use expected cash flows (in which all expectations about possible cash flows are used) in calculating present values.

Accounts Payable and Receivable↗
PubMedDate not supplied

Tread lightly through these accounting minefields.

In the current economic climate, there is tremendous pressure--and personal incentive for managers--to report sales growth and meet investors' revenue expectations. As a result, more companies have been issuing misleading financial reports, according to the SEC, especially involving game playing around earnings. But it's shareholders who suffer from aggressive accounting strategies; they don't get a true sense of the financial health of the company, and when problems come to light, the shares they're holding can plummet in value. How can investors and their representatives on corporate boards spot trouble before it blows up in their faces? According to the authors, they should keep their eyes peeled for common abuses in six areas: revenue measurement and recognition, provisions and reserves for uncertain future costs, asset valuation, derivatives, related party transactions, and information used for bench-marking performance. If a disaster strikes, it will most likely be in one of these accounting minefields. This article examines the hazards of each minefield in turn, using examples like Metallgesellschaft, Xerox, MicroStrategy, and Lernout & Hauspie. It also provides a set of questions to ask in order to determine where a company's accounting practices might be overly aggressive. For those whose greatest interest is in fairly valuing the business--not presenting it in the best possible light--these questions are the first line of defense against creative accounting. Accounting game players are adroit, but it's both foolish and dangerous, contend the authors, to declare oneself ignorant and hence powerless against their machinations. They argue that members of corporate boards need to be financially literate.

Accounting↗
PubMed1979

A community mental health accountability scale.

An Accountability Questionnaire was administered to administrators, service providers, and board members of 50 community mental health centers. The results, using cluster analysis techniques, yielded an Accountability Scale of 22 items. Four clusters with satisfactory discriminative validity were extracted: (a) Importance of Program Evaluation; (b) Satisfaction with State Monitoring Procedures; (c) Traditional Clinical versus Community Psychology Concerns; (d) Agency Preservation versus External Accountability. Analyses of variance indicated that board members, staff, and administrators differed significantly in their scores on each cluster. The Accountability Scale is a potential tool for community mental health agencies in assessing intraorganizational attitudes concerning accountability and has implications for administrative planning and evaluation.

Analysis of Variance↗
PubMed1997

Groups and Solos in Context: The Effects of Accountability on Team Negotiation.

This study examines whether and how accountability to constituents affects the cognitions, performance, and outcomes of team and solo negotiators. Previous findings for solos were replicated here: solo negotiators respond competitively when they are accountable to constituents. For teams, however, accountability pressures were distributed across the members resulting in each team member experiencing little responsibility for outcomes. As a consequence, teams did not respond to accountability pressures by behaving contentiously as solos did. Analysis of negotiators' perceptions of advantage reveals that solos who negotiate under conditions of high accountability consider themselves to be at a disadvantage in the negotiation even before the negotiation begins. These perceptions may underlie the accountability/competitive relation that characterizes solo negotiation. Implications for negotiation research as well as the study of groups in organizations are discussed. Copyright 1997 Academic Press.

Journal Article↗
PubMed1994

Referential coding and attention-shifting accounts of the Simon effect.

Stoffer (1991) and Umiltà and Nicoletti (1992) have proposed an attention-shifting account of the Simon effect. However, Hommel (1993) has presented evidence suggesting that the effect can be explained in terms of referential coding, without invoking attentional shifts. Five experiments are reported here, whose primary purpose is to test implications of the referential-coding account. All of the experiments compared conditions in which a noise stimulus was presented in the position opposite the target stimulus with conditions in which it was not. Contrary to the referential-coding account, (a) the basic Simon effect was larger without a fixation point to serve as a referent than with one; (b) the noise stimulus increased the magnitude of the Simon effect when a fixation point was used, but not when there was no fixation point; and (c) the magnitude of the Simon effect obtained in the presence of a noise stimulus was reduced substantially when the noise and the target (and, if present, the fixation point) were in different colors. The results, although counter to predictions of the referential-coding account, can be accommodated by the attention-shifting account if it is assumed that a fixation point provides an anchor that minimizes attention shifts.

Adult↗
PubMed2005

Comparison of cost accounting methods from different DRG systems and their effect on health care quality.

BACKGROUND: Diagnosis related groups (DRGs) are a well-established provider payment system. Because of their imminent potential of cost reduction, they have been widely introduced. In addition to cost cutting, several social objectives - e.g., improving overall health care quality - feed into the DRG system. OBJECTIVES: The WHO compared different provider payment systems with regard to the following objectives: prevention of further health problems, providing services and solving health problems, and responsiveness to people's legitimate expectations. However, no study has been published which takes the impact of different cost accounting systems across the DRG systems into account. METHODS: We compared the impact of different cost accounting methods within DRG-like systems by developing six criteria: integration of patients' health risk into pricing practice, incentives for quality improvement and innovation, availability of high class evidence based therapy, prohibition of economically founded exclusions, reduction of fragmentation incentives, and improvement of patient oriented treatment. RESULTS: We set up a first overview of potential and actual impacts of the pricing practices within Yale-DRGs, AR-DRGs, G-DRGs, Swiss AP-DRGs adoption and Swiss MIPP. It could be demonstrated that DRGs are not only a 'homogenous' group of similar provider payment systems but quite different by fulfilling major health care objectives connected with the used cost accounting methods. CONCLUSIONS: If not only the possible cost reduction is used to put in a good word for DRG-based provider payment systems, maximum accurateness concerning the method of cost accounting should prevail when implementing a new DRG-based provider payment system.

Costs and Cost Analysis↗
PubMed2004

Understanding accountability in the Canadian health system.

As the public sector in general and the health sector in particular undergo reform throughout the Western world to find systems that work better and cost less, the phenomenon of accountability becomes increasingly important to policy makers. In Canada, the most recent healthcare commissions, conducted by Romanow and Kirby, point to the need for improved accountability within the Canadian health system. Yet, although accountability is an ancient concept embedded in public administration and health system governance, its meaning is confused and its implementation is fraught with issues. This article aims to summarize the findings of a doctoral dissertation that was undertaken to clarify the concept of accountability within the health field, and to examine the issues related to improving health system accountability in Canada.

Canada↗