LEADERSHIP: CHAPTER 4: FINANCIAL MANAGEMENT IN HEALTH CARE:

LEADERSHIP: CHAPTER 4: FINANCIAL MANAGEMENT IN HEALTH CA cf cf cf cf cf cf cf



RE:
1.Accountable Care Organization:: One billing occurs across the transit cf cf cf cf cf cf cf cf

ion of care. Generally the better the quality of care, the better the rei
cf cf cf cf cf cf cf cf cf cf cf cf cf

mbursement
2.Bottom Line:: Income of an organization that is the result of revenu
cf cf cf cf cf cf cf cf cf cf cf

e (money earned) minus expenses
cf cf cf cf


3.Budget:: Detailed financial plan for carrying out the activities of an or
cf cf cf cf cf cf cf cf cf cf cf

ganization or unit cf cf

4.Budget Variance:: Difference between actual budget and actual spendin
cf cf cf cf cf cf cf cf

g
5.Capital Budget:: Financial plan that deals with purchases of capita
cf cf cf cf cf cf cf cf cf

l assets (equipment, land, etc.)
cf cf cf cf

6.Cash Budget:: Financial plan that tracks cash received and spent
cf cf cf cf cf cf cf cf cf

7.Cash On Hand:: Amount of cash readily available to the organization
cf cf cf cf cf cf cf cf cf cf

8.Centers For Medicare & Medicaid Services (CMS):: Formerly known as t
cf cf cf cf cf cf cf cf cf cf

he Healthcare Financing Administration, the federal agency that adminis
cf cf cf cf cf cf cf cf

ters Medicare, Medicaid, State Children's Health Insurance Program (SC
cf cf cf cf cf cf cf cf

HIP), and several other health-related programs
cf cf cf cf cf


9.Continuum Of Care:: Matching an individual's ongoing needs with the a
cf cf cf cf cf cf cf cf cf cf

ppropri-
ate level and type of medical, psychological, health, or social care or se
cf cf cf cf cf cf cf cf cf cf cf cf cf

rvice within an organization or across multiple organizations
cf cf cf cf cf cf cf


10.For Profit Organizations:: Organizations with stated financial structu
cf cf cf cf cf cf cf

res that include profit goals and tax liabilities
cf cf cf cf cf cf cf


11.Health Care System:: All of the structures, organizations, and servi
cf cf cf cf cf cf cf cf cf

ces de- cf

signed to deliver professional health and wellness services to consu
cf cf cf cf cf cf cf cf cf cf

mers
12.Health Maintenance Organization (HMO):: Geographically organized sy
cf cf cf cf cf cf

stem that provides an agreed-
cf cf cf cf

on package of health maintenance and treatment services
cf cf cf cf cf cf cf


13.Indirect Costs:: Generalized costs (housekeeping, information technolo
cf cf cf cf cf cf

gy, etc.) for support of the program and billed to the program; often call
cf cf cf cf cf cf cf cf cf cf cf cf cf

ed support costs
cf cf


14.Managed Care:: Linkage between the financing and delivery of service
cf cf cf cf cf cf cf cf cf

s in such a way as to permit payers to exercise control over the delivery
cf cf cf cf cf cf cf cf cf cf cf cf cf cf

of services
cf cf


15.Medicaid:: Joint federal and state assistance program designed to pa cf cf cf cf cf cf cf cf cf

y for medical long-
cf cf cf

term care assistance for individuals and families with low income and li
cf cf cf cf cf cf cf cf cf cf cf


1cf/
cf25

, LEADERSHIP: CHAPTER 4: FINANCIAL MANAGEMENT IN HEALTH CA cf cf cf cf cf cf cf



RE:
mited resources cf

16.Medicare:: Health insurance program for people age 65 and older or u
cf cf cf cf cf cf cf cf cf cf cf

nder age 65 with certain disabilities or any age with end-
cf cf cf cf cf cf cf cf cf cf

stage renal disease
cf cf


17.Not For Profit Organizations:: Organizations with financial structures t
cf cf cf cf cf cf cf cf

hat pro-
cf

ject financial goals with particular tax and legislative protection or shel
cf cf cf cf cf cf cf cf cf cf cf

ters
18.Operating (Expense) Budget:: Financial plan for the day-to-
cf cf cf cf cf cf cf

day activities of the organization
cf cf cf cf


19.Personnel Budget:: Part of the operating budget that deals with pe
cf cf cf cf cf cf cf cf cf cf

rsonnel needed to deliver care; composed of salary and benefit cost
cf cf cf cf cf cf cf cf cf cf

s




2cf/
cf25

, LEADERSHIP: CHAPTER 4: FINANCIAL MANAGEMENT IN HEALTH CA cf cf cf cf cf cf cf



RE:
20.Preferred Provider Organization (PPO):: Managed care company that cf cf cf cf cf cf cf cf

con-
tracts with health care providers (both physicians and hospitals) and
cf cf cf cf cf cf cf cf cf cf cf

payers
(self-
nsured employers, insurance companies, or managed care organizations
cf cf cf cf cf cf cf

to provide health care services to a defined population for predetermine
cf cf cf cf cf cf cf cf cf cf

fixed fees
cf cf

21.Revenues:: Income received for goods or services provided cf cf cf cf cf cf cf

22.Value Based Purchasing:: Reimbursement for health care services ba
cf cf cf cf cf cf cf cf

sed on quality of care
cf cf cf cf

23.Variable Costs:: Costs that vary in relation to volume and productivity
cf cf cf cf cf cf cf cf cf cf

24.Reimbursement For Health Care Services:: - cf cf cf cf cf

Health care delivery services organized under hospitals and care-
cf cf cf cf cf cf cf cf cf

giving facilities in the early nineteenth century
cf cf cf cf cf cf

- Early twentieth century, hospitals began pay-for-service financial plans
cf cf cf cf cf cf cf

- Explosion in health care costs led to federal and private insurance plan
cf cf cf cf cf cf cf cf cf cf cf




Medicare reimbursement now based on quality of care: cf cf cf cf cf cf cf

- Changes all aspects of health care delivery, including the way nursi
cf cf cf cf cf cf cf cf cf cf

ng care is provided
cf cf cf




- The Institute of Healthcare Improvement approaches health care opti
cf cf cf cf cf cf cf cf

mization with the "Triple Aim": improving the patient experience, impro
cf cf cf cf cf cf cf cf cf

ving the health of the population, and reducing the per capita cost of h
cf cf cf cf cf cf cf cf cf cf cf cf cf

ealth care. cf

25.Factors That Influence The Financial Burden Of Health Care In The U.S::
cf cf cf cf cf cf cf cf cf cf cf c

Demographic influences: cf

- Culturally diverse cf


- Steep population growth and an aging population
cf cf cf cf cf cf




Uninsured individuals: cf

- Uninsured and underinsured populations affect hospitals and their com
cf cf cf cf cf cf cf cf

munities.
- Cost of uninsured patients who receive care trickles down to other paye
cf cf cf cf cf cf cf cf cf cf cf

rs, govern- cf

ment, or private insurance companies, then to customers and taxpayer
cf cf cf cf cf cf cf cf cf cf

s.

3cf/
cf25