NU 452 Test 2 Guide With
Complete Solution
PPACA's Payment Reform Provisions - The Patient Protection and Affordable
Care Act - ANSWER · Value-based purchasing -defined as a function of
quality, efficiency, safety, and cost
· Accountable care organizations (ACOs)
· Bundled payments
· The medical home
· The health insurance marketplace
Fiscal Planning - ANSWER - Not intuitive; a learned skill that improves with
practice
- An important but often neglected dimension of planning
- Should reflect the philosophy, goals, and objectives of the organization
--What you think is important is where you should be putting your money
--i.e. if organization has a philosophy is giving into the community -
something within budget should be going to the community
--budgeting for the unit needs to be congruent with the philosophy of the
organization ("important part of the budgeting process")
- A skill increasingly critical to nursing managers because of increased
emphasis on finance and "big business" of health care
,Balancing Cost and Quality - ANSWER · In order to have the revenue that we
need to be doing the greatest good for the greatest number of ppl - need to
look at balance between cost & quality
Balancing Cost and Quality: cost containment - ANSWER · Controlling the
expenses within preplanning budget constraints (you have your budget - and
controlling within it)
· Refers to effective and efficient delivery of services while generating
needed revenues for continued organizational productivity
· *The responsibility of every health-care provider*, and the viability of most
health-care organizations, today depends on its ability to use its fiscal
resources wisely
· Sometimes nurses at the bed side don't think about this; but what nurses
do every day makes a big difference
Balancing Cost and Quality: Cost Effective - ANSWER · Cost-effective means
producing *good* results for the amount of money spent
o Has the money spent produced good results; what it worth the cost
· Expensive items can be cost-effective and inexpensive items may not
o Just because something is low cost, does not equal cost effectiveness
o *Also, just bc spend a lot of money, won't always get better outcomes*
· Cost-effectiveness then must take into account factors such as anticipated
length of service, need for such a service, and availability of other
alternatives
o i.e. how frequently will that item or service be used; takes into account
,overall how much will be spending
o (in united states, we spend more per captia on health care but outcomes
are not the best)
Responsibility Accounting - ANSWER · Ultimately, who is responsible for
budgeting in the hospital
· Each of an organization's revenues, expenses, assets, and liabilities is
someone's responsibility
· As a corollary, the person with the most direct control or influence on any
of these financial elements should be held accountable for them, usually the
leader-manager
-When thinking about the unit - *the nurse manager would be responsible
for budgeting within the unit; they are the one that knows what
employees/personnel needed*
· The unit manager also can best monitor and evaluate all aspects of a unit's
budget control
· *Forecasting*
Forecasting - ANSWER involves making an educated budget estimate using
historical data
-It is the nurse mangers responsibility how best to forecast - making an
estimate on your budget
Budget - ANSWER -A plan that uses numerical data to predict the activities of
an organization over a period of time
-The desired outcome of budgeting is maximal use of resources to meet
, organizational short- and long-term needs
· goal of budget: to maximize our resources available (greatest good for the
most amount of people)
· also, to realize when resources are not adequate bc can jeopardize patient
safety
-A budget provides a mechanism contributions for planning and control, as
well as for promoting each unit's needs and contributions
budgeting process - ANSWER · can be related to nursing process
· Essential to get input from all levels of the organization is essential
How is budgeting process related to the nursing process? - ANSWER 1)
*Assess* what needs to be covered in the budget- input from all levels of the
organization
2) *Diagnosis* of the goals for the budget - what needs to be accomplished..
cost-effectiveness
3) *Plan* for the budget cycle- usually annual; could be perpetual so always
have 12 months of budget ahead
4) *Implementation* or ongoing management and analysis of the budget-
ongoing monitoring and analysis to assure meeting budget
5) *Evaluate* and periodic review of the budget for the fiscal year- reviewed
and modified as needed through the fiscal year
the manger needs to account for: - ANSWER -fixed expenses
Complete Solution
PPACA's Payment Reform Provisions - The Patient Protection and Affordable
Care Act - ANSWER · Value-based purchasing -defined as a function of
quality, efficiency, safety, and cost
· Accountable care organizations (ACOs)
· Bundled payments
· The medical home
· The health insurance marketplace
Fiscal Planning - ANSWER - Not intuitive; a learned skill that improves with
practice
- An important but often neglected dimension of planning
- Should reflect the philosophy, goals, and objectives of the organization
--What you think is important is where you should be putting your money
--i.e. if organization has a philosophy is giving into the community -
something within budget should be going to the community
--budgeting for the unit needs to be congruent with the philosophy of the
organization ("important part of the budgeting process")
- A skill increasingly critical to nursing managers because of increased
emphasis on finance and "big business" of health care
,Balancing Cost and Quality - ANSWER · In order to have the revenue that we
need to be doing the greatest good for the greatest number of ppl - need to
look at balance between cost & quality
Balancing Cost and Quality: cost containment - ANSWER · Controlling the
expenses within preplanning budget constraints (you have your budget - and
controlling within it)
· Refers to effective and efficient delivery of services while generating
needed revenues for continued organizational productivity
· *The responsibility of every health-care provider*, and the viability of most
health-care organizations, today depends on its ability to use its fiscal
resources wisely
· Sometimes nurses at the bed side don't think about this; but what nurses
do every day makes a big difference
Balancing Cost and Quality: Cost Effective - ANSWER · Cost-effective means
producing *good* results for the amount of money spent
o Has the money spent produced good results; what it worth the cost
· Expensive items can be cost-effective and inexpensive items may not
o Just because something is low cost, does not equal cost effectiveness
o *Also, just bc spend a lot of money, won't always get better outcomes*
· Cost-effectiveness then must take into account factors such as anticipated
length of service, need for such a service, and availability of other
alternatives
o i.e. how frequently will that item or service be used; takes into account
,overall how much will be spending
o (in united states, we spend more per captia on health care but outcomes
are not the best)
Responsibility Accounting - ANSWER · Ultimately, who is responsible for
budgeting in the hospital
· Each of an organization's revenues, expenses, assets, and liabilities is
someone's responsibility
· As a corollary, the person with the most direct control or influence on any
of these financial elements should be held accountable for them, usually the
leader-manager
-When thinking about the unit - *the nurse manager would be responsible
for budgeting within the unit; they are the one that knows what
employees/personnel needed*
· The unit manager also can best monitor and evaluate all aspects of a unit's
budget control
· *Forecasting*
Forecasting - ANSWER involves making an educated budget estimate using
historical data
-It is the nurse mangers responsibility how best to forecast - making an
estimate on your budget
Budget - ANSWER -A plan that uses numerical data to predict the activities of
an organization over a period of time
-The desired outcome of budgeting is maximal use of resources to meet
, organizational short- and long-term needs
· goal of budget: to maximize our resources available (greatest good for the
most amount of people)
· also, to realize when resources are not adequate bc can jeopardize patient
safety
-A budget provides a mechanism contributions for planning and control, as
well as for promoting each unit's needs and contributions
budgeting process - ANSWER · can be related to nursing process
· Essential to get input from all levels of the organization is essential
How is budgeting process related to the nursing process? - ANSWER 1)
*Assess* what needs to be covered in the budget- input from all levels of the
organization
2) *Diagnosis* of the goals for the budget - what needs to be accomplished..
cost-effectiveness
3) *Plan* for the budget cycle- usually annual; could be perpetual so always
have 12 months of budget ahead
4) *Implementation* or ongoing management and analysis of the budget-
ongoing monitoring and analysis to assure meeting budget
5) *Evaluate* and periodic review of the budget for the fiscal year- reviewed
and modified as needed through the fiscal year
the manger needs to account for: - ANSWER -fixed expenses
