...The Impact of Healthcare reforms on Hospital Costing Systems The costing systems implemented in hospitals has been the same for a while now. It’s worked and has been easily allocated based off of averages from previous years. Now as times change so will the costing systems for hospitals in order to get the most beneficial cost-reductions to them as well as improve on efficiency. This article looks into how accountants for hospitals can redesign, reposition, and re-implement costing ideas to allocate on a per-unit of care basis (Selivanoff, 2011). We’ll take a look at two ways for accountants to prepare for these reforms and five steps to adjusting the costing systems in place. In the hospital costing system accountants want to measure costs during a patients stay to determine how much resources are being used. The one way accounting departments are improving efficiency is deter away from the average costs for their resources. Rather than allocating a hundred dollars for this test and a hundred dollars for this procedure they want to implement an “on-the-fly” care plan. Which measures truly how much a patient is costing them to get the optimized cost-reduced methods. It allows them to take a deeper look into inventory and assign costs to each resource so that patients really pay for what they used and hospitals have a clear costing method that’s equal for every person. This method is effective but is highly stressful for the accounting department to record at first...
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...Ashley American InterContinental University Unit 3 Discussion Board Managerial Accounting ACCT310-1205B-06 January 27, 2013 Job order costing is used in situations where there are different products that are being produced each period. According to accounting for to management (2000), the costs are traced to the jobs and then the cost of the jobs that are divided by the number of the units in the job that are arrive at the cost per unit (para. 1). The type of industry that uses this type of system are places like the Hospitals, laws firms, movie studios, advertising and accounting firms. All of these industries deal with procedure and providing a type of service. The companies have to focus on more than one good and it can become a complex job when it comes to job order costing system. But it is also a way to the business organized and knows what area is helping them out in the long run. Manufacturing costs can be in three broad categories which are direct materials, direct labor and manufacturing overhead. Process costing methods are used for mass productions. It is a way to analyze the net cost of a manufacturing. Figuring out how much it would cost to fill the goods and how material is needed to keep them stocked. Soda, cereal, toilet paper, gasoline are some items where the process costing system occur. This system is mainly where homogenous items are being manufactured. According to Vitez (2003), It saves time and management money. But its how management accountants...
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...Due to the problem of inadequate nurse staffing levels it has lead hospitals to experience complications in their budgets. This problem all begins with hospitals not making any money because there aren’t enough patients to care for. In the article “How The Nursing Shortage Affects Patient Care and Healthcare Services” provided by Nurse Grid explains how new registered nurse graduates find it difficult to get a full time nursing job due to hospital's budget restrictions. These restrictions don’t allow hospitals to meet their full potential because it prevents them from expanding any type of research that is being done by physicians, considering medical research requires lots of money. Again in Jim Gogek’s article “Inadequate Staffing Harms Quality...
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...and his team failed to take seasonality into consideration. Two weeks in January are surely not representative of an entire year, especially in terms of patient volume; thus annualizing two weeks data is an obvious error. I would expect the patient volume to be lower than average in January as it is not a peak of cold/flu season and patients prefer to have their annual checkups during warmer seasons (mind you the hospital is in Massachusetts). This hunch is confirmed by analysis of the data in Exhibit 8: if we take values for Physician Visits/Year, combined NP – Patient & Employee Visits/Year and Intern/Resident Visits/Year and convert them to Visits/Day (taking into account that there are 8 Physicians, 1 Nurse Practitioner and 13 Interns/Residents at the clinic) we will get values of 5.3, 5.7 and 1.0 Visits/Provider/Day, which are very low (48 work weeks/year and 5 days/week work schedule assumed). Therefore, either PCU is overstaffed or more representative time span should be taken. Another factor that Oakley’s team overlooked is the fact that the teaching hospitals receive direct and indirect Graduate Medical Education payments from Medicare that partially compensate for residency education costs and for higher patient care costs due to presence of teaching programs. According to Donald A. Young et al, the authors of “Medicare and the American Health Care System: Report to the Congress” (June 1997, ISBN: 9780788146763), in fiscal year 1995, the average “per resident” Medicare...
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...My plan is to bring the hospital‘s AR Days back in line. This plan will need cooperation from the Medical Staff, the clinical departments, Health Information Management, Business Office and many others. Before I write my plan, I will need: a List of transactions with dates and maturity; information on our debtors as well as any information we collected on them. My writtenn report will be given to the board of directors. With approval we will have this implemented with four weeks. This plan will require everyone within the accounts receivable area in the hospital is responsible for making sure that all demographic and billing information is complete as possible. It starts in the registration area. The registration area is generally where every patient begins their journey through the hospitals computer system. It is very important for our employees to take the time to collect as much information as they can from the patient when the patient first presents for service. For the AR plan to work we will need to work with the Human resource and business office manager to implement a training session for all employees that work in admission especially the employees that work in the evenings. The training session should including education on what questions to ask. What documentation to ask patients for and more. How to make photocopies. After the original training, supplemental online training course should be implemented. Employees will be required to complete online tutorials...
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...Reading Assignment # 1 5/20/13 The problem in this case is the U.S. health care industry is the world’s most inefficient information enterprise. An electronic medical record system would save a lot of money in health care, and it would generally be easier on staff and doctor to access information. Electronic records would possibly reduce error and improve care, create less paperwork, and provide quicker service. The difficulties in building electronic medical record systems include it costing $30,000 to $50,000 per doctor. This would cause an issue for medical practices with fewer than four doctors. Also, training a doctor would take up to 20 hours of his or her time. There would be many obstacles that health providers, IT developers, and insurance companies would need to overcome before this system could be used nationally. Not digitalizing medical records would impact patients. Patients already using this system reduced their hospital admission by 25 percent and the length of their hospital stays by 20 percent. VistA improves patient quality of care. It insures that correct dosages are given and going to the correct patient. As mentioned before, this system would greatly reduce human error. One issue with electronic medical records is the sharing of records between different systems. Some systems may not be able to report the same data to one another. Another problem is there could be a conflict of interest for the insurance companies involved. There are both pros and cons...
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...Breached Rights at the Stafford hospital During the video I watched throughout people’s time at the Stafford hospital, it was clear certain rights had been breached in relation to service users’ care. In the case study one, I was a able to make a conclusion on a few rights that were breached; right to quality care, hygienic environment, respect, information, safety, dignity, socialisation etc… All of these rights should always be enforced throughout any setting to ensure service users feel positive within the environment. Keeping people safe helps people to feel comfortable in the setting and helps them to feel less insecure about the environment they’re in. It may also to help an aggressive attitude towards staff, if clients feel calm in their setting. However, in the Strafford hospital, this was the other way round. Staff was aggressive and spiteful towards members of the public who visited the hospital. The right to a clean environment, this right was breached when in the video, there was dirty left over sanitary equipment in the toilets, swabs, needles etc.. All leading to a very unhygienic environment for clients to be sat in – possibly leading to further problems within the hospital in relation to infection/disease. In the case study 2, what was seen, throughout the video, saw a number of things that lead to a disruption of the rights required where appropriate care to patients. Things I pointed out previously like; dressings on the floor, needles lying around, rejection...
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...At St. Mary’s Hospital there is a need for dedicated admission staff. Several reasons why are: 1. Improve Patient flow 2. Improve Patient satisfaction 3. Increase safety 4. Monitor Flow of visitors Patients currently enter hospital and are either registered at the business office, or directed to another area of the hospital and registered, depending on their business. The current system does not create a controlled environment and causes unnecessary steps for an efficient admission process. Unit Coordinators are currently the main admitters of Emergency Department and Inpatient admits, and because of the multiple interruptions of the Coordinator, mistakes are being made that are costly to the hospital. See problems: Problem: 1. Mistakes are being made on admissions due to not having a designated admit clerk. Mistakes on admissions that affects other departments include using two admit numbers, incorrect times on admits and discharges, incorrect insurance data collection, and missed Insurance verification, which could all be greatly reduced or eliminated with a regularly scheduled admission clerk. Nursing Staff admit patients after the front business office closes, Unit Coordinators are trained with this task; however coverage by the Unit Coordinator begins at 0630 and ends at 2300. After 2300 nurses admit patients but are not proficient at the process, because they have multiple other responsibilities. It has been stated...
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...answer. Many factors are presenting difficulties in building these electronic records. Some people factors include patients feel as though there will be no confidentiality in the online system, Organization factors include smaller medical practices not being able to afford the cost of the online database as well as the time commitment involved. Technological factors include not yet discovering a way to be able to share information from nurses to doctors as well as other care providers. 3. What is the business, political, and social impact of not digitizing medical records (for individual physicians, hospitals, insurers, patients, and the US Government)? Not digitizing medical records for physicians it makes their job harder because the now have to go through tons of paperwork to see if the patient had experienced these symptoms before and what was previously done to treat them. Hospitals are being faced with penalties for not updating their systems that can include the reduction of their Medicare and Medicade. Insurers are losing the option of immediate processing for claims, while patients are more at risk without the online medical records; they are being put through redundant testing that can be harmful for them. The U.S government is wasting $80 billion a year by not having these online records. 4. What are the business and...
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...Africa: Malaria Care Improves With Cash http://allafrica.com/stories/201304250118.html A question had been nagging at Ghanaian researcher Alexander Nartey. Since Ghana’s government had made health insurance available to the country’s poor to ease the burden of health care, why were so many people still paying cash, including those seeking basic treatment for malaria? The Ghanaian government in 2003 introduced its National Health Insurance Scheme (NHIS), which Nartey called a “pro-poor policy” to help those less likely to be able to pay for health care. The British charity Oxfam in a 2011 report found a number of problems with the scheme, calling it “severely flawed”, but Nartey was focusing on one key question: why weren’t more poor using it when the premium was less than U.S.$10 per year? With the support of the Dodowa Health Research Centre in Ghana, Nartey set out to find the answer. Because of his research, the American Society of Tropical Medicine and Hygiene (ASTMH) included him in its Young Investigator Awards last year, giving him international recognition by his peers and a $250 cash award. What Nartey discovered was what he said was a problem within Ghana’s health system - namely a delay in care. Those who used health insurance generally waited longer to receive treatment - standing in line or sitting on a bench until their turn came - but if they paid out of pocket they were treated much quicker. This, Nartey said, particularly made a difference when people were...
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...Duke University's Children's Hospital (DCH) is a pediatric hospital that is located on Duke University Hospital’s fifth floor. DCH is a 134-bed facility with 800 employees who care for patients in neonatal ICU, pediatric ICU, pediatric emergency room, intermediate care unit, bone-marrow transplant unit, subspecialty clinic, and outreach clinic (Meliones, 2000). The annual operating loss of DCH grew from a high $4 million in 1992 to a staggering $11 million in 1996, forcing hospital administrators to cut-down resources. This move made some caregivers feel that the clinical care quality at DCH had deteriorated. Complaints from parents were on the rise, dissatisfied doctors considered sending their patients to other hospitals, and some frustrated staff members eventually quit. As important as DCH’s institutional mission was to promote the community’s health, so important it was to not lose focus from the big picture during a difficult time. The specific goal of clinicians is to restore the health of their patients; however, cost is not something that they want on their minds. Hospital administrators on the other hand have their specific goal to control the rapidly growing healthcare costs. Cost-cutting in such testing conditions traumatized patients, frustrated clinicians, and crippled the mission of DCH. The decision to remove a respirator therapist who worked in the night shift, for instance, affected not only the patient and her parents, but also the insurance company,...
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...organization, and technology factors are responsible for the difficulties in building electronic medical record systems? Explain your answer. Influences of the group leads to the structure phase of problems within the electric medical record system that can possibly entail expenses. Doctors who are located locally as well as more micro hospitals might assume that it will become more costly over a short period. Because of the price range of thirty to fifty thousand dollars, smaller offices may not be able to implement this system. Viewing the technical aspect of the system might cause possible alignment difficulties when attempting to produce a single service. 3. What is the business, political, and social impact of not digitizing medical records (for individual physicians, hospitals, insurers, patients, and the U.S. government)? By keeping a hard copy or paper copy of medical records this may possibly limit information that may be required at another medical location. By not adhering to transferring over to the new system this opens a medical facility up to penalties rendered by the government. The cost of penalties may even result in costing more than it would to just upgrade to the new system. 4. What are the business and social benefits of digitizing medical recordkeeping? The most beneficial factor of the new system would be having the ability to look up information of a patient any time from any location. This could allow for more efficient and even faster diagnoses...
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...intervention strategies. In: Boltz M, Capezuti E, Fulmer T, Zwicker D, editor(s). Evidence-based geriatric nursing protocols for best practice. 4th ed. New York (NY): Springer Publishing Company; 2012. p. 268-97. Sterling, D. A, O’Connor, J. A., and Bonadies, J. Geriatric Falls: Injury Severity is High and Disproportionate to Mechanism. The Journal of TRAUMA Injury, Infection, and Critical Care. Volume 50 ² Number 1. Vu. M.Q, Weintraub.N, and Rubenstein. L.Z, (2004). Falls in the nursing home: are they preventable? Journal of PubMed J Am Med Dir Assoc, 2004 Nov-Dec; 5(6): 401-6. Wong, C.A., Recktenwald, A. J., Jones, M.L., Waterman, B. M., Bollini, M. L., Dunagan, C.(2014). The Cost of Serious Fall-Related Injuries at Three Midwestern Hospitals. The Joint Commission Journal on Quality and Patient Safety, Volume 37, Issue 2, pp...
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...or receive delayed diagnoses every year (Clark, 2015). According to Cerrato (2013) diagnostic errors account for 40,000 to 80,000 hospital deaths a year in the United States and each misdiagnosis claim averages around $386,849. Patient misdiagnosis lead to patient harm and higher costs. A misdiagnosis case may involve a wrong diagnosis, a missed diagnosis, a delayed diagnosis, or a failure to recognize complications that change or aggravate an existing condition. Sometimes a doctor diagnoses one condition correctly but misdiagnoses another condition or fails to realize that there is a second diagnosis that needs to be made this healthcare issue negatively affect hospitals and medical offices financially. The financial management staff in the health industry have to carefully monitor, analyze, and calculate the budgets and monetary claims for multiple departments. Whether the business is a nonprofit organization or a for profit organization, the impacts would still be the same. Giving out wrong diagnoses to patients lead to medical malpractice suits, affect the quality of care, increases the cost of care and affects Medicaid and Medicare. All of the above impacts can cause an organization to have a bad reputation and possibly lose their accessibility to Medicaid and Medicare patients. Every effect causes a financial problem. A doctor and hospital can be held liable when misdiagnosis lead to serious injuries or delays treatment for life threatening diseases. Proper diagnoses...
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...What cost cutting options were chosen? Explain why those were chosen. The cost cutting options chosen were reducing Agency staff and changing the skill mix. Reducing the agency staff will reduce cost, and save on premiums paid directly to contracted agencies. The cost for contracted staff is nearly double of the employees. Changing the Skill mix was also recommended by hiring unlicensed personnel such as nursing assistants and patient care technicians. Training time for unlicensed personnel is much less than licensed personnel. In addition unlicensed personnel such as nursing assistants will be able to assist nurses with easy tasks such as feeding, changing, bathing, and moving patients. This will enable the RN to utilize his or her time more effectively for direct patient care. Which cost cutting loan option was chosen? Explain why. Loan option two was initially chosen to repay the loan. This option was chosen because of the low interest rate at 9.0%, which would allow Elijah Heart Center (EHC) to have more funds initially. The only set back is the loan had a prepayment limitation of six months which would allow interest to accrue and add to the principle loan amount. After further investigation, it became clear that loan option one was the better choice because the funds could be paid sooner therefore accruing less interest. Which strategies for equipment acquisition were chosen? Explain why. The strategies chosen for equipment acquisitions...
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