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Explore revenue sources, financial management, funding strategies, and competition dynamics in hospital settings for optimal financial performance. Learn about philanthropy, managed care, budgeting, and more.
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Hospitals HAS 4320
Revenue • Philanthropy and grants • Global budgets • Charges • Per diem
Revenue • Cost reimbursement • Per Case • Capitation • Managed care contracts
Funds Out • Payroll = 54% • Professional fees = 4% • Supplies and other = 33% • Capital depreciation and interest = 9%
Financial Management • Cost shifting • Losing proposition • Medicare and Medicaid • Services and patient groups
Financial Management • Medicare changes • Cream skimming • …Managed care systems
Capital Financing • Hill-Burton Act (1946) • Borrowed funds • Three factors • Guaranteed revenues • Tax exemption • Cost reimbursement
Capital Financing • Borrowing loses steam • Hospital systems
Who gets the profits? • Hospitals are doctors’ workshops • Hospitals are managed for managers • Little difference between for-profit and not-for-profit
Competition Among Hospitals • Pros and cons • Why is it good and why is it useless • Think about… • One hospital versus 10 hospitals • 10 hospitals agreed not to compete on price • 1975 versus today
Some findings… • Stanford • 1980s competition is bad • 1990s competition is good • Technology Advantages
Centers of Excellence • DHHS Office on Women’s Health • 15 centers • $12 million in funding • $129 million more • Enhanced research • Increased opportunities • Expanded resources
Centers of Excellence • Increased capacity • Increased women’s involvement • Closest to us • UCLA • UCSF • Univ of Washington
Regulation • Some hospitals cost more than others • Short-run versus long-run
Uncertainty and budgeting • Foreseeable and unknown • How do managers deal with change?
Theory and Accounting Measures • Deviation raises costs • Unobvious charges • Average over many days
Economies of scale • 400-bed hospital is good • Too few beds is bad • Too large is bad • Contracting out
Quality and cost • New cures are cheaper • No price competition
Measuring competition • Survivor analysis • Community care • Monopolies • Market share