SOLUTIONS RATED A+
✔✔Cross training - ✔✔- increase the efficiency and proficiency of staff and to alleviate
inadequate staffing
- staff members are trained to perform more than one job.
✔✔job description - ✔✔- describe the duties, responsibilities, and skills required for a
position.
- usually begins with the job title, place of employment, and a brief description of the
position.
- list of job duties should be created and then prioritized and condensed into 10 to 15
bulleted items.
✔✔employee assistance program - ✔✔assist employees with personal or work-related
problems that interfere with their ability to carry out their jobs.
✔✔Performance management - ✔✔the process by which performance is assessed in
order to ensure that goals are met effectively.
✔✔hierarchical org chart - ✔✔position of power at the top and those below in
descending order.
✔✔matrix org chart - ✔✔management may be listed at the top but then each different
department or unit listed on an equal basis.
✔✔organizational chart - ✔✔diagram that shows the structure of an organization,
indicating the relationship of one unit or department to another and showing the chain of
command.
✔✔horizontal org chart - ✔✔similar to the matrix but the chain of command is very
limited and department managers are fairly autonomous.
✔✔Span of control - ✔✔the number of individuals a person supervises or receives
reports from within an organization.
✔✔policy - ✔✔formal guideline that aids in decision-making and promotes consistency
in actions.
✔✔Procedures, - ✔✔detailed step-by-step directions for carrying out a process.
✔✔Return on investment - ✔✔Net profit/ total cost of investment X 100
✔✔Productivity - ✔✔measure of output produced using a specific quantity of inputs.
,✔✔Health maintenance organization (HMO): - ✔✔Provides health care on capitation
basis with members paying set fees to receive all services.
✔✔Preferred provider organization (PPO): - ✔✔Healthcare services provided to a group
of individual based on a negotiated fee. Patients must usually choose physicians within
a network to avoid increased costs.
✔✔Point-of-service organization (PSO): - ✔✔Members can receive lower cost coverage
if using in-network providers or may pay more to use out-of-network providers.
✔✔Operating budget: - ✔✔used for daily operations and includes general expenses,
such as salaries, education, insurance, maintenance, depreciation, debts, and profit.
✔✔Capital budget: - ✔✔determines which capital projects (such as remodeling,
repairing, and purchasing of equipment or buildings) will be allocated funding for the
year.
✔✔Cash balance budget: - ✔✔projects cash balances for a specific future time period,
including all operating and capital budget items.
✔✔Master budget: - ✔✔combines operating, capital, and cash balance budgets as well
as any specialized or area-specific budgets.
✔✔Fixed/ forecast: - ✔✔Revenue and expenses are forecast for the entire budget
period and budget items are fixed.
✔✔Flexible budget - ✔✔Estimates are made regarding anticipated changes in revenue
and expenses and both fixed and variable costs are identified.
✔✔Zero-based budget - ✔✔All cost centers are re-evaluated each budget period to
determine if they should be funded or eliminated, partially or completely.
✔✔Responsibility center budget - ✔✔Budgeting is for a cost center (department) or
centers with one person holding overall responsibility.
✔✔Program budget - ✔✔Organizational programs are identified, and revenues and
costs for each program are budgeted.
✔✔Appropriations budget - ✔✔Government funds are requested and dispersed through
this process.
✔✔Continuous/ rolling budget - ✔✔Periodic updates to the budget, including revenues,
costs, volume, are done prior to the next budget cycle.
, ✔✔Capital budgets - ✔✔usually outlines goals for about a 5-year period,
✔✔Budget variance - ✔✔difference between the budgeted expense or revenue and
actual expense or revenue,
✔✔Net present value - ✔✔(difference between inflow and outflow):
Determines if the projected revenue exceeds projected costs.
✔✔Throughput analysis: - ✔✔Assesses the ability of a project to increase throughput
through bottlenecks in the organization.
✔✔Discounted cash flow - ✔✔Evaluates initial and ongoing costs as well as revenue.
✔✔Payback: - ✔✔Assesses how long it will take to recoup expenses
✔✔Internal rate of return: - ✔✔Assessment of the cash flow stream.
✔✔Staffing workload - ✔✔depend on the numbers of staff and patients, the nursing
hours per patient day, the type of unit, and the acuity level of the patients.
✔✔Fraud - ✔✔misrepresentation done for unauthorized self-benefit
✔✔abuse - ✔✔conduct that is below acceptable standards and results in fraudulent
reimbursement, such as for non-medically necessary services.
✔✔According to CMS, the types of healthcare fraud include: - ✔✔-Billing for
unauthorized or unnecessary materials or services:
-Billing for materials or services not actually provided:
-Upcoding:
-Unbundling:
-Kickbacks:
✔✔Upcoding: - ✔✔Intentional or unintentional coding for materials or services
reimbursed at a higher rate.
✔✔Unbundling: - ✔✔Billing separately for services/ materials that should be bundled in
order to gain increased reimbursement.
✔✔Kickbacks: - ✔✔Receiving payment for referring patients for healthcare services.
✔✔whistleblower - ✔✔an individual who exposes illegal or unethical practices of an
organization in order to facilitate change.