HPI4007: Financial management of healthcare organizations
Summary of the module
Maastricht University
Faculty of Health, Medicine and Life Sciences (FHML)
MSc Healthcare Policy, Innovation and Management
,Table of contents
1. Financial management ........................................................................................................................................ 3
1.1 Calculating the unit costs ............................................................................................................................. 4
1.2 Breakeven analysis ....................................................................................................................................... 6
2. Budgeting & variance analysis............................................................................................................................. 8
2.1 Defining budgets .......................................................................................................................................... 8
2.2 Developing a master budget ...................................................................................................................... 19
2.3 Variance analysis ........................................................................................................................................ 23
3. Investment analysis ........................................................................................................................................... 28
3.1 Selecting an investment option .................................................................................................................. 33
3.2 Funding a capital investment ..................................................................................................................... 41
4. Hospital-based HTA ........................................................................................................................................... 44
4.1 Mini HTA ..................................................................................................................................................... 51
5. Budget Impact Analysis (BIA) ............................................................................................................................ 54
6. Financial statement ........................................................................................................................................... 58
6.1 Elements of a financial statement .............................................................................................................. 61
6.2 Principles behind a financial statement ..................................................................................................... 73
6.3 Preparation of a financial statement .......................................................................................................... 80
7. Financial statement analysis ............................................................................................................................. 82
7.1 Ratio analysis .............................................................................................................................................. 83
7.2 Groups/ types of financial ratios ................................................................................................................ 85
2
,1. Financial management
Financial management is the process of financial decision-making within an organization that aims to
meet the organization’s (financial) goals efficiently and effectively.
Elements of financial management:
- Planning (e.g., to estimate unit-cost price and financial results);
- Evaluation and control (e.g., to monitor financial performances);
- Decision-making (e.g., to set market prices, to decide on investments).
Why healthcare financial management?
Because of the complexity of healthcare management decisions:
- Population’s health (quality, accessibility, ethics);
- The business “health” (cost recovery, profitability);
- Rising health care costs – factors and solutions (reimbursement, technology, administration,
merger);
- Business orientation of the health care organizations vs. ethical standards.
Importance of costs
Costs = accounting costs (= monetary value of production inputs)
Costs as a multi-attributed concept
3
, 1.1 Calculating the unit costs
The management of a healthcare organization is often concerned with the expected costs, expenses
and revenues, as well as with the expected financial result of the organization. The discussion of
future unit cost-price and required tariff (or market price) is a typical task of healthcare manager.
Defining financial management terms:
- Unit cost-price is the monetary value of all inputs (resources) that are necessary for the
production/delivery of one unit (one service or one product).
- Market price is the amount of money that the organization receives for one product or one
service delivered. A manager will be interested in selling products/services at a market price
that is higher than the unit cost price.
- Tariff (also called fee) has the same meaning as market price but the key difference is that in
contrast to market prices, tariffs (fees) are usually set by the insurer/ government.
- Total costs are defined as the sum of all different types of costs that are necessary for the
production/delivery process.
- Total revenue is the total amount of money that the organization receives for selling a
certain number of products or for delivering a certain amount of services
Total costs can consist of many different cost components. For simplicity, we only make a distinction
between fixed and variable costs.
- The level of fixed costs is not affected by the production quantity. Even when there is no
production (no service delivery), there would still be fixed costs (e.g., costs of building,
wages, etc.)
- In contrast, variable costs directly depend on the production quantity.
Different costs for different purposes
- Full cost-price calculation → long-term pricing decisions and analysis
- Partial cost-price calculation → cost control and short-term pricing decisions
- Marginal cost-price calculation → investment decisions (e.g., expansion)
4
Summary of the module
Maastricht University
Faculty of Health, Medicine and Life Sciences (FHML)
MSc Healthcare Policy, Innovation and Management
,Table of contents
1. Financial management ........................................................................................................................................ 3
1.1 Calculating the unit costs ............................................................................................................................. 4
1.2 Breakeven analysis ....................................................................................................................................... 6
2. Budgeting & variance analysis............................................................................................................................. 8
2.1 Defining budgets .......................................................................................................................................... 8
2.2 Developing a master budget ...................................................................................................................... 19
2.3 Variance analysis ........................................................................................................................................ 23
3. Investment analysis ........................................................................................................................................... 28
3.1 Selecting an investment option .................................................................................................................. 33
3.2 Funding a capital investment ..................................................................................................................... 41
4. Hospital-based HTA ........................................................................................................................................... 44
4.1 Mini HTA ..................................................................................................................................................... 51
5. Budget Impact Analysis (BIA) ............................................................................................................................ 54
6. Financial statement ........................................................................................................................................... 58
6.1 Elements of a financial statement .............................................................................................................. 61
6.2 Principles behind a financial statement ..................................................................................................... 73
6.3 Preparation of a financial statement .......................................................................................................... 80
7. Financial statement analysis ............................................................................................................................. 82
7.1 Ratio analysis .............................................................................................................................................. 83
7.2 Groups/ types of financial ratios ................................................................................................................ 85
2
,1. Financial management
Financial management is the process of financial decision-making within an organization that aims to
meet the organization’s (financial) goals efficiently and effectively.
Elements of financial management:
- Planning (e.g., to estimate unit-cost price and financial results);
- Evaluation and control (e.g., to monitor financial performances);
- Decision-making (e.g., to set market prices, to decide on investments).
Why healthcare financial management?
Because of the complexity of healthcare management decisions:
- Population’s health (quality, accessibility, ethics);
- The business “health” (cost recovery, profitability);
- Rising health care costs – factors and solutions (reimbursement, technology, administration,
merger);
- Business orientation of the health care organizations vs. ethical standards.
Importance of costs
Costs = accounting costs (= monetary value of production inputs)
Costs as a multi-attributed concept
3
, 1.1 Calculating the unit costs
The management of a healthcare organization is often concerned with the expected costs, expenses
and revenues, as well as with the expected financial result of the organization. The discussion of
future unit cost-price and required tariff (or market price) is a typical task of healthcare manager.
Defining financial management terms:
- Unit cost-price is the monetary value of all inputs (resources) that are necessary for the
production/delivery of one unit (one service or one product).
- Market price is the amount of money that the organization receives for one product or one
service delivered. A manager will be interested in selling products/services at a market price
that is higher than the unit cost price.
- Tariff (also called fee) has the same meaning as market price but the key difference is that in
contrast to market prices, tariffs (fees) are usually set by the insurer/ government.
- Total costs are defined as the sum of all different types of costs that are necessary for the
production/delivery process.
- Total revenue is the total amount of money that the organization receives for selling a
certain number of products or for delivering a certain amount of services
Total costs can consist of many different cost components. For simplicity, we only make a distinction
between fixed and variable costs.
- The level of fixed costs is not affected by the production quantity. Even when there is no
production (no service delivery), there would still be fixed costs (e.g., costs of building,
wages, etc.)
- In contrast, variable costs directly depend on the production quantity.
Different costs for different purposes
- Full cost-price calculation → long-term pricing decisions and analysis
- Partial cost-price calculation → cost control and short-term pricing decisions
- Marginal cost-price calculation → investment decisions (e.g., expansion)
4
