How does legal and regulatory issues shape and define good financial management of a health care organization?

Provide a succinctly explanation of each of the following assessments and why it so importance to nurses within the context of your nursing practice:
November 30, 2020
Identify current programs that are out there and their effectiveness
November 30, 2020

How does legal and regulatory issues shape and define good financial management of a health care organization?

How does legal and regulatory issues shape and define good financial management of a health care organization?

week 1 Finance and the Regulatory Components (graded) a) Are there any other types of information besides financial that may be useful in making financial decisions? b) Identify the major components of a corporate compliance plan, including the establishment of internal controls relating to the finances of an organization. [http://www.bezern.com/] c) How does legal and regulatory issues shape and define good financial management of a health care organization? Reimbursement and Payment Determination (graded) a) Discuss the major reimbursement methods used in health care. [http://www.bezern.com/] b) Discuss the major aspects of Medicare benefits. [http://www.bezern.com/] c) List some of the important considerations when negotiating a health plan contract. [http://www.bezern.com/] wek 2 Accounting Conventions and Methods (graded) Discuss the accounting conventions that affect the application of accounting principles. [http://www.bezern.com/] Financial Performance (graded) Explain why it is important to know the scope of business being reviewed when using financial statements. [http://www.bezern.com/] week 3 Cost Categories (graded) Discuss the four types of costs that might be relevant when considering alternative projects. [http://www.bezern.com/] Cost Information (graded) Describe how cost information relates to the three key activities of management: planning, budgeting, and control. [http://www.bezern.com/] weeek 4 Financial Sources (graded) List the major nonhospital and nonphysician sectors of the healthcare industry Financial Theories and Concepts (graded) Describe the two major theories used for the detection of out-of-control costs. [http://www.bezern.com/] This section lists options that can be used to view responses. [http://www.bezern.com/] week 5 discussion Capital Investments (graded) List some of the kinds of information that is needed to evaluate a capital investment project. [http://www.bezern.com/] Future and Present Value (graded) List some of the pros and cons of retiring debt early. [http://www.bezern.com/] week 6 Cash and Assets (graded) List and describe where cash is generated by an organization and where an organization uses its cash. [http://www.bezern.com/] Cash Resources (graded) List and explain the criteria that should be used when investing an organization’s cash in the short term. [http://www.bezern.com/] week 7 HMO, MCO and Health Plans (graded) Discuss legal and regulatory issues that affect MCOs. [http://www.bezern.com/] Financial Policy (graded) Describe the relationship between financial planning and strategic planning. [http://www.bezern.com/] This section lists options that can be used to view responses. [http://www.bezern.com/] =”msonormal”> =”msonormal”> =”msonormal”> week 1 assignment 1. [http://www.bezern.com/] What are four general phases of the working capital cycle? 2. [http://www.bezern.com/] What are the three primary sources of short-term funds? 3. [http://www.bezern.com/] An organization’s short-term investment options for idle cash include what four areas? List and provide their characteristics. [http://www.bezern.com/] 4. [http://www.bezern.com/] Discuss the term float ourse Assignment CAPITAL BUDGETING PROCESS Complete an APA-formatted two-page paper (not including the title and reference pages) answering the following questions. [http://www.bezern.com/] > * Organizations that decide to issue bonds generally go through a > series of steps. [http://www.bezern.com/] Discuss the six steps. > [http://www.bezern.com/] > * An alternative to traditional equity and debt financing is > leasing. [http://www.bezern.com/] Leasing is undertaken primarily > for what purposes? > * Discuss the two major types of leases. [http://www.bezern.com/] > * Discuss the terms short-term borrowing and long-term financing. > [http://www.bezern.com/] > * What are the primary sources of equity financing for > not-for-profit healthcare organizations? > * The capital budgeting process occurs in several stages, but > generally includes what? > * Discuss and list the three discounted cash flow methods. > [http://www.bezern.com/] > > week 6 assignment > > COURSE ASSIGNMENT > > CASH AND WORKING CAPITAL > > Complete an APA-formatted two-page paper (not including the title > and reference pages) answering the following questions. > [http://www.bezern.com/] > >> * What are four general phases of the working capital cycle? >> * What are the three primary sources of short-term funds? >> * An organization’s short-term investment options for idle cash >> include what four areas? List and provide their characteristics. >> [http://www.bezern.com/] >> * Discuss the term float. [http://www.bezern.com/] > > Submit your assignment to the Dropbox located on the silver tab at > the top of this page > > quiz 2 > > TCO 2) A statement that reports inflows and outflows of cash during > the accounting period in the categories of operations, investing, > and financing, is called a(an): > > Income statement > > Statement of retained earnings > > Balance sheet > > Statement of cash flows > > Report of management > > Question 2. [http://www.bezern.com/] Question : > > (TCO 2) Two major methods of asset valuation are: > > : historical cost and future cost > > historical cost and acquisition cost > > historical cost and replacement cost > > acquisition cost and future cost > > Question 3. [http://www.bezern.com/] Question : > > (TCO 2) _____ is the most important financial metric to review to > determine long-term financial viability. [http://www.bezern.com/] > > Return on equity > > Total margin > > Days cash on hand > > Hospital cost index > > None of the above > > Comments: > > Question 4. [http://www.bezern.com/] Question : > > (TCO 2) What should be a firm’s primary long-term financial > objective? > > Profit growth > > Debt growth > > Asset growth > > Equity growth > > Question 5. [http://www.bezern.com/] Question : > > (TCO 2) Explain the difference between the accrual basis of > accounting and the cash basis of accounting. > [http://www.bezern.com/]? > > Question 6. [http://www.bezern.com/] Question : > > (TCO 2) What is an accounting entity? > > Question 7. [http://www.bezern.com/] Question : > > (TCO 2) The HC method, which uses unadjusted historical costs, does > not take into account depreciation expenses, purchasing power, and > unrealized gains in replacement value. [http://www.bezern.com/] > Despite these weaknesses as a financial reporting method, the HC > method is used more frequently for accounting purposes than other > methods, such as the HC-GPL, CV, and CV-GPL methods. > [http://www.bezern.com/] Why is this so? > > Question 8. [http://www.bezern.com/] Question : > > (TCO 2) Define and describe the purpose of fund accounting (now > called net assets). [http://www.bezern.com/] > > quiz 3 > > TCO 3) When considering how changes in volume affect total fixed > costs, it is important to consider: > > the relevant range > > the variable cost per unit > > price > > both A and B > > both B and C > > Question 2. [http://www.bezern.com/] Question : > > (TCO 3) To maximize the amount of profit realized from a rate > increase, charges should be increased most in departments with: > > High charge payer mix/high write-offs for bad debt, charity, & > discounts > > Low charge payer mix/low write-offs for bad debt, charity, & > discounts > > High charge payer mix/low write-offs for bad debt, charity, & > discounts > > Low charge payer mix/high write-offs for bad debt, charity, & > discounts > > Question 3. [http://www.bezern.com/] Question : > > (TCO 3) Your controller has told you that the marginal profit of DRG > 209 (major joint procedure) fo
r a Medicare patient exceeds the > marginal profit for an average charge patient. > [http://www.bezern.com/] Why might this occur? > > High fixed costs of treatment > > Low Medicare payment > > High prices > > Low prices > > Question 4. [http://www.bezern.com/] Question : > > (TCO 3) > > Your hospital has been approached by a major HMO to perform all > their DRG 225 cases (foot surgeries). [http://www.bezern.com/] They > have offered a flat payment of $8,000 per case. > [http://www.bezern.com/] You have reviewed your charges for DRG 225 > during the last year and found the following profile: > > Average Charge: $11,300 > > Average LOS: 4. [http://www.bezern.com/]5 Days > > data:image/png;base64,R0lGODlhWQACAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAEAAQBXAAEAgAAAAAAAAAIIjI+py+0PWwEAOw== > > Cost/Charge Variable Cost % > > data:image/png;base64,R0lGODlhFQACAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAEAAAAUAAEAgAAAAAAAAAIEjI+ZBQA7 > data:image/png;base64,R0lGODlhHgACAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAAAeAAEAgAAAAAAAAAIFjI+pawUAOw== > > Routine Charge $3,200 0. [http://www.bezern.com/]75 65 > > Operating Room 1,850 0. [http://www.bezern.com/]7 80 > > Anesthesiology 210 0. [http://www.bezern.com/]7 75 > > Lab 575 0. [http://www.bezern.com/]65 40 > > Radiology 275 0. [http://www.bezern.com/]65 50 > > Medical Supplies 3,220 0. [http://www.bezern.com/]6 85 > > Pharmacy 955 0. [http://www.bezern.com/]55 85 > > Other Ancillary 1,015 0. [http://www.bezern.com/]75 55 > > Total Ancillary $8,100 0. [http://www.bezern.com/]7 75 > > In the above data set, assume that the hospital’s cost-to-charge > ratio is 0. [http://www.bezern.com/]75 for routine services and 0. > [http://www.bezern.com/]70 for Total Ancillary services. > [http://www.bezern.com/] Using this information, what would the > average cost of DRG 225 be? (Your answer might be slightly different > due to rounding. [http://www.bezern.com/] Pick the closest. > [http://www.bezern.com/]) > > $7,613 > > $8,100 > > $7,613 > > $8,000 > > $8,070 > > Instructor Explanation: Chapter 15 > > Points Received: 0 of 5 > > Comments: > > Question 5. [http://www.bezern.com/] Question : > > (TCO 3) David Jones, the new administrator for a surgical clinic, > was trying to determine how to allocate his indirect expenses. > [http://www.bezern.com/] His staff was complaining that the current > method of taking a percentage of revenues was unfair. > [http://www.bezern.com/] He decided to try to allocate utilities > based on square footage of each department, administration based on > direct costs, and laboratory based on tests. > [http://www.bezern.com/] Use the information in the chart below to > answer the question. [http://www.bezern.com/] > > Square Footage Direct Expenses Lab Tests > > Utilities 200,000 > > Administration 2,000 500,000 > > Laboratory 2,000 625,000 > > Day-op Suite 3,000 1,400,000 4,000 > > Cystoscopy 1,500 350,000 500 > > Endoscopy 1,500 300,000 500 > > Total 10,000 3,375,000 5,000 > > Based on the scenario above, what are the Day Op Suite’s total > expenses? > > 2342769 > > Instructor Explanation: > > What are the Day Op Suite’s total expenses? > > What are the Cystoscopy Department’s total expenses? > > What are the Endoscopy Department’s total expenses? > > Question 6. [http://www.bezern.com/] Question : > > (TCO 3) Your hospital has been approached by a major HMO to perform > all their MS-DRG 470 cases (major joint procedures). > [http://www.bezern.com/] They have offered a flat price of $10,000 > per case. [http://www.bezern.com/] You have reviewed your charges > for MS-DRG 470 during the last year and found the following profile: > > Average Charge $15,000 > > Average LOS 5 Days > > Routine Charge $3,600 Cost/Charge 0. [http://www.bezern.com/]80 > Variable Cost % 60 > > Operating Room 2,657 0. [http://www.bezern.com/]80 80 > > Anesthesiology 293 0. [http://www.bezern.com/]80 80 > > Lab 1,035 0. [http://www.bezern.com/]70 30 > > Radiology 345 0. [http://www.bezern.com/]75 50 > > Medical Supplies 4,524 0. [http://www.bezern.com/]50 90 > > Pharmacy 1,230 0. [http://www.bezern.com/]50 90 > > Other Ancillary 1,316 0. [http://www.bezern.com/]80 60 > > Total Ancillary $11,400 0. [http://www.bezern.com/]75 50 > > The HMO in the above example has indicated that their doctors use > less expensive joint implants. [http://www.bezern.com/] If this less > expensive implant were used, your medical supply charges would be > reduced by $2,000. [http://www.bezern.com/] What is the estimated > reduction in variable cost? > > If medical supply charges would be reduced by $2,000, estimated > reduction in variable cost will be $900 > > Question 7. [http://www.bezern.com/] Question : > > (TCO 3) How are costs classified? > > quiz 7 > > Page 1 > > Question 1. [http://www.bezern.com/]1. [http://www.bezern.com/] (TCO > 7) Employee covered health plans are most likely to be? (Points : 5) > > High deductible health plans with a savings option. > [http://www.bezern.com/] > > HMOs. [http://www.bezern.com/] > > PPOs. [http://www.bezern.com/] > > Traditional indemnity plans > > Question 2. [http://www.bezern.com/]2. [http://www.bezern.com/] (TCO > 7) Capitation plans are more common for physician payment because: > (Points : 5) > > they can better control utilization. [http://www.bezern.com/] > > physicians want more risk in their payment plans. > [http://www.bezern.com/] > > they are concerned about adverse selection. [http://www.bezern.com/] > > physicians have larger reserves and can assume more risk. > [http://www.bezern.com/] > > Question 3. [http://www.bezern.com/]3. [http://www.bezern.com/] (TCO > 7) The James Clinic is an organization of 100 physicians in a > variety of specialties. [http://www.bezern.com/] They recently > contracted with Prudential Health Plan on a capitated basis to > provide all medical services to Prudential’s members for the next > three years. [http://www.bezern.com/] This HMO model would be > defined as a: (Points : 5) > > Staff Model > > Group Model > > Individual Practice Association Model > > Network Model > > Question 4. [http://www.bezern.com/]4. [http://www.bezern.com/] (TCO > 7) Suppose that AT&T had made an offer to acquire Merck > Pharmaceuticals. [http://www.bezern.com/] Ignoring potential > antitrust problems, this merger would be classified as a: (Points : > 5) > > Cross-border merger > > Horizontal merger > > Conglomerate merger > > Vertical merger > > Question 5. [http://www.bezern.com/] 5. [http://www.bezern.com/] > (TCO 7) An HMO has a Point of Service (POS) option for its members, > but will pay only 80 percent of approved charges. > [http://www.bezern.com/] If a member goes out of network for a > medical procedure with a charge of $2,000, of which $1,200 is > approved, how much must the member pay? (Points : 10) > > Question 6. [http://www.bezern.com/] 6. [http://www.bezern.com/] > (TCO 7) A hospital incurs $10 million of cost to treat Medicaid > patients and receives $7 million in payment. > [http://www.bezern.com/] Actual charges for these Medicaid patients > were $20 million. [http://www.bezern.com/] The net community benefit > expense that would be reported in Schedule H of IRS Form 990 would > be? (Points : 10) > > Question 7. [http://www.bezern.com/] 7. [http://www.bezern.com/] > (TCO 7) How is charity care usually defined? (Points : 10) > > midterm > > Devry HSM340 Midterm > > Midter
m Exam page 1 > > Question 1. [http://www.bezern.com/]1. [http://www.bezern.com/] (TCO > 4) Budgets normally cover a period of: (Points : 5) > > 5 years > > 2 years > > 3 years > > 1 year > > Question 2. [http://www.bezern.com/]2. [http://www.bezern.com/] (TCO > 4) Which budgetary issue causes the most strife in all areas of a > health care organization? (Points : 5) > > Setting volume levels > > Setting prices > > Allocation of indirect costs > > Deciding whether to use a fixed or flexible budget > > Question 3. [http://www.bezern.com/]3. [http://www.bezern.com/] (TCO > 4) Efficiency is a relationship between: (Points : 5) > > Outputs and organizational goals > > Inputs and outputs > > Inputs and organizational goals > > None of the above > > Question 4. [http://www.bezern.com/]4. [http://www.bezern.com/] (TCO > 3) Which of the following is the first step in any budgetary > process? (Points : 5) > > Define standard treatment protocols > > Define required departmental volumes > > Define standard cost profiles > > Define volumes of patients > > Question 5. [http://www.bezern.com/]5. [http://www.bezern.com/] (TCO > 3) Assume that the clinic used the price that they need to exactly > break even at 10,000 shots. [http://www.bezern.com/] Fewer people > than expected showed up and purchased the flu shot. > [http://www.bezern.com/] The clinic would: (Points : 5) > > earn a profit. [http://www.bezern.com/] > > have a loss. [http://www.bezern.com/] > > break-even. [http://www.bezern.com/] > > have a reduced unit contribution margin. [http://www.bezern.com/] > > none of the above. [http://www.bezern.com/] > > Question 6. [http://www.bezern.com/]6. [http://www.bezern.com/] (TCO > 2) A statement that reports inflows and outflows of cash during the > accounting period in the categories of operations, investing, and > financing, is called a(an): (Points : 5) > > Income statement > > Statement of retained earnings > > Balance sheet > > Statement of cash flows > > Report of management > > Question 7. [http://www.bezern.com/]7. [http://www.bezern.com/] (TCO > 2) _____ is the most important financial metric to review to > determine long-term financial viability. [http://www.bezern.com/] > (Points : 5) > > Return on equity > > Total margin > > Days cash on hand > > Hospital cost index > > None of the above > > Midterm Exam page 2 > > Question 1. [http://www.bezern.com/] 1. [http://www.bezern.com/] > (TCO 4) What is the amount of variance that can be attributed to the > difference between budgeted and actual volume? > > Use the following data to calculate the variances. > [http://www.bezern.com/] > > The following information has been prepared for a home health > agency. [http://www.bezern.com/] > > BudgetActual > > Wage Rate per Hour $16. [http://www.bezern.com/]00 $17. > [http://www.bezern.com/]00 > > Fixed Hours 320 320 > > Variable Hours per Relative > > Value Unit (RVU) 1. [http://www.bezern.com/]0 1. > [http://www.bezern.com/]1 > > Relative Value Units (RVUs) 1,000 1,200 > > Total Labor Hours 1,320 1,640 > > Labor Costs $21,120$27,880 > > Cost per RVU $21. [http://www.bezern.com/]12 $23. > [http://www.bezern.com/]23 > > Budgeted costs at actual volume would be $25,344 ($21. > [http://www.bezern.com/]12 × 1,200), and the total variance to be > explained is $2,536 Unfavorable ($27,880 – $25,344). > [http://www.bezern.com/] Be sure to specify whether the variance is > favorable or unfavorable. [http://www.bezern.com/] (Points : 5) > > Question 2. [http://www.bezern.com/] 2. [http://www.bezern.com/] > (TCO 2) Explain the difference between the accrual basis of > accounting and the cash basis of accounting. > [http://www.bezern.com/]? (Points : 10) > > Question 3. [http://www.bezern.com/] 3. [http://www.bezern.com/] > (TCO 2) What is an accounting entity? (Points : 10) > > Question 4. [http://www.bezern.com/] 4. [http://www.bezern.com/] > (TCO 1) What are social responsibility and ethics as they relate to > business-oriented organizations? How should social responsibility > and ethics affect the decisions of even for-profit companies? > (Points : 20) > > Question 5. [http://www.bezern.com/] 5. [http://www.bezern.com/] > (TCO 2) Define and describe the purpose of fund accounting (now > called net assets). [http://www.bezern.com/] (Points : 20) > > final > > 1. [http://www.bezern.com/](TCO 4) WHEN WOULD IT MAKE SENSE TO USE A > FLEXIBLE BUDGET AS COMPARED TO A FORECAST BUDGET? (POINTS : 30) > > QUESTION 2. [http://www.bezern.com/] 2. [http://www.bezern.com/] > (TCO 7) EXPLAIN THE DIFFERENCE BETWEEN A HORIZONTAL MERGER AND A > VERTICAL MERGER. [http://www.bezern.com/] (POINTS : 30) > > QUESTION 3. [http://www.bezern.com/] 3. [http://www.bezern.com/] > (TCO 1) DESCRIBE THE OUTPATIENT CODE EDITOR. > [http://www.bezern.com/] (POINTS : 30) > > QUESTION 4. [http://www.bezern.com/] 4. [http://www.bezern.com/] > (TCO 1) WHAT IS THE PRIMARY PROVISION OF THE EMTALA. > [http://www.bezern.com/] (POINTS : 3 > > QUESTION 5. [http://www.bezern.com/]5. [http://www.bezern.com/](TCO > 3) USE THE FOLLOWING DATA TO CALCULATE THE VARIANCES IN PROBLEM. > [http://www.bezern.com/] > > .PNG”> > > YOUR HOSPITAL HAS BEEN APPROACHED BY A MAJOR HMO TO PERFORM ALL > THEIR MS-DRG 470 CASES (MAJOR JOINT PROCEDURES). > [http://www.bezern.com/] THEY HAVE OFFERED A FLAT PRICE OF $10,000 > PER CASE. [http://www.bezern.com/] YOU HAVE REVIEWED YOUR CHARGES > FOR MS-DRG 470 DURING THE LAST YEAR AND FOUND THE FOLLOWING PROFILE: > > ESTIMATE THE VARIABLE COST PER MS-DRG 470 USING THE DEPARTMENTAL > COST/CHARGE RATIOS AND VARIABLE COST PERCENTAGES. > [http://www.bezern.com/] > > (POINTS : 10) > > QUESTION 6. [http://www.bezern.com/] 6. [http://www.bezern.com/] > (TCO 2) HOW ARE REVENUES AND EXPENSES DEFINED UNDER ACCRUAL > ACCOUNTING? (POINTS : 10) > > QUESTION 7. [http://www.bezern.com/] 7. [http://www.bezern.com/] > (TCO 2) WHAT IS AN ACCOUNTING ENTITY? (POINTS : 10) > > QUESTION 8. [http://www.bezern.com/] 8. [http://www.bezern.com/] > (TCO 5) DEFINE AN ANNUITY. [http://www.bezern.com/] (POINTS : 10) > > QUESTION 9. [http://www.bezern.com/] 9. [http://www.bezern.com/] > (TCO 5) WHAT AVENUES ARE AVAILABLE FOR FOR-PROFIT HEALTHCARE > PROVIDERS TO INCREASE THEIR EQUITY POSITION? (POINTS : 10) > > QUESTION 10. [http://www.bezern.com/] 10. [http://www.bezern.com/] > (TCO 6) WHAT IS THE WORKING CAPITAL CYCLE AND WHY MUST IT BE > MANAGED? (POINTS : 10) > > QUESTION 11. [http://www.bezern.com/] 11. [http://www.bezern.com/] > (TCO 6) DEFINE WORKING CAPITAL. [http://www.bezern.com/] WHAT IS THE > DIFFERENCE BETWEEN WORKING CAPITAL AND NET WORKING CAPITAL? (POINTS > : 10 > > QUESTION 12. [http://www.bezern.com/] 12. [http://www.bezern.com/] > (TCO 5) EXPLAIN FROM YOUR FINDINGS IN PROBLEM 6 WHY THE INVESTMENT > INCREASES IN VALUE WHEN THE NUMBER OF COMPOUNDING PERIODS INCREASES? > (POINTS : 10) =”msonormal”>

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