Main description:

This textbook is designed for students preparing as advanced practice clinicians, including APRNs, DNPs, DPTs, DOTs, and physician assistants. The book covers both health policy issues and practice financial management issues and is organized into two main parts. The first focuses on macro issues in healthcare finance. The second concentrates on healthcare financing management and new to the second edition, includes coverage of the role of the consumer as a payer and as a participant in ambulatory care. Case studies included with each section have been updated in the new edition. This book is suitable for healthcare finance courses in the curriculum for MSN and DNP programs and also for schools of social work, medicine, occupational, and physical therapy.

Contents:

Preface
Acknowledgments
SECTION ONE: PAYING FOR HEALTHCARE: OVERVIEW AND MODELS
CHAPTER 1. Introduction to Healthcare Finance
1.1. Chapter Objectives
1.2. What Do Healthcare Providers Need to Know about Finance and Financial Policy?
1.3. Characteristics of Financial Systems in Healthcare-The Social Compact
1.4. Health or Healthcare-The Social Goal and the Financial Objective
1.5. The Social Compact and Information Technologies
1.6. Concept Checkout
1.7. Discussion Questions
1.8. References
CHAPTER 2. Models of Healthcare Finance
2.1. Chapter Objectives
2.2. The Household as a Central Stakeholder in Healthcare
2.3. The Stakeholders in All Health-Financing Models
2.4. Essential Approaches to Healthcare Financing
2.5. Financial Flows in Healthcare Systems
2.6. Concept Checkout
2.7. Discussion Questions
2.8. References
SECTION ONE CASE STUDY: The Island Nation of Tekram
SECTION TWO: PAYING FOR HEALTHCARE: GOALS AND STRATEGIES
CHAPTER 3. Health Insurance in Public and Private Markets
3.1. Chapter Objectives
3.2. The Nature of Risk
3.3. Estimating Risk in Health Insurance
3.4. Managing Costs as a Risk-Control Strategy
3.5. The Budget Approach to Health Insurance
3.6. Risk Control Strategies in Health Insurance
3.7. Information Systems in Risk Management
3.8. Concept Checkout
3.9. Discussion Questions
3.10. References
CHAPTER 4. Healthcare System Strategy and Finance
4.1. Chapter Objectives
4.2. Goal Setting in the U.S. Healthcare System
4.3. The Relationship between Goals and Financial Strategy
4.4. Goals, Strategy, and Finance in the U.S. Healthcare System
4.5. Strategic Dilemmas in U.S. Healthcare
4.6. Concept Checkout
4.7. Discussion Questions
4.8. References
SECTION TWO CASE STUDY: The Prisoner's Dilemma
SECTION THREE: MANAGING HEALTHCARE: INCENTIVES AND COSTS
CHAPTER 5. Financial Management in Healthcare Markets
5.1. Chapter Objectives
5.2. Financial Incentives in the U.S. Healthcare Market
5.3. Healthcare Financial Management Strategies as a Response to Market Incentives
5.4. The Linkage between Healthcare Financial Management and Operations Management
5.5. The Organizational Financial Plan
5.6. Concept Checkout
5.7. Discussion Questions
5.8. References
CHAPTER 6. Practice Costs and Cost-Finding
6.1. Chapter Objectives
6.2. Cost Behavior in Ambulatory Care Practices
6.3. Two Types of Cost Analysis
6.4. Costing Systems Useful to Ambulatory Care Practices
6.5. The Organizational and Policy Uses of Cost Data
6.6. Concept Checkout
6.7. Discussion Questions
6.8. References
SECTION THREE CASE STUDY: Homegrown Healthcare Inc. A Rural Accountable Care Organization
SECTION FOUR: MANAGING HEALTHCARE: REVENUE AND BUDGETING
CHAPTER 7. Revenue Planning and Management
7.1. Chapter Objectives
7.2. Managing Revenue
7.3. Managing the Payer-to-Provider Process
7.4. Revenue Optimization and Account Evaluation
7.5. Account Negotiation Strategies
7.6. Concept Checkout
7.7. Discussion Questions
7.8. References
CHAPTER 8. Budgeting For Ambulatory Care Practices
8.1. Chapter Objectives
8.2. Strategic Planning, Budgeting, and Budget Evaluation
8.3. Constructing Budgets: A Focus on Revenue and Expense
8.4. Expense Budgets and Categories
8.5. Building a Chart of Accounts
8.6. Evaluating Budget Performance: Goal Achievement
8.7. Concept Checkout
8.8. Discussion Questions
8.9. Reference
SECTION FOUR CASE STUDY: New Day Health and Associates
SECTION FIVE: MANAGING HEALTHCARE: FINANCIAL STRATEGY AND REPORTING
CHAPTER 9. Capitalization Structure and Investment Planning
9.1. Chapter Objectives
9.2. Planning Capital Structure for the Practice
9.3. The Effect of Capitalization Structure on Performance
9.4. The World of Taxation and Its Effects on Capital
9.5. Risk and Capitalization
9.6. Capital Structure Planning for the Primary Care Provider
9.7. Concept Checkout
9.8. Discussion Questions
9.9. References
CHAPTER 10. Basic Financial Statements
10.1. Chapter Objectives
10.2. The Four Basic Financial Reports
10.3. Putting the Financial Picture Together: The Interaction of the Income and Expense Statement and the Balance Sheet
10.4. Understanding Cash Flow and Its Effect on the Balance Sheet
10.5. The Financial Position of a Practice: Financial Statements and Ratios
10.6. Financial Reports Required by Public Payers
10.7. Concept Checkout
10.8. Discussion Questions
10.9. References
SECTION SIX: PROJECTING AND EVALUATING FINANCIAL PERFORMANCE
CHAPTER 11. Financial Performance Evaluation
11.1. Chapter Objectives
11.2. Financial Ratios as an Analytical and Comparative Tool
11.3. Ratio Categories and Their Purposes in Financial Analysis
11.4. Basic Ratio Relationships and Financial Performance Diagnosis
11.5. Concept Checkout
11.6. Discussion Questions
11.7. References
CHAPTER 12. Projecting Financial Performance
12.1. Chapter Objectives
12.2. The Pro Forma Financial Analysis: Purpose and Use
12.3. Using Evidence to Build the Pro Forma Analysis
12.4. Building the Pro Forma Financial Plan
12.5. Financial Barriers and Supports: SWOT Analysis
12.6. Financial Interrelationships and Financial Strategy
12.7. Concept Checkout
12.8. Discussion Questions
12.9. References
SECTION SIX CASE STUDY: Provider Financial Goals and Management
SECTION SEVEN: HEALTHCARE PROJECTS-FINANCIAL PLANNING AND MANAGEMENT
CHAPTER 13. Project Planning and Budgeting
13.1. Chapter Objectives
13.2. Project Financial Planning and Budgeting
13.3. Accounting for Project Expenses
13.4. Integrated Project Management Plan and Team
13.5. Project Financial Management
13.6. Concept Checkout
13.7. Discussion Questions
13.8. References
CHAPTER 14. Project Financing and Valuation
14.1. Chapter Objectives
14.2. Constructing Project Financial Flows
14.3. Project Valuation Methods
14.4. Impact of the Financial Environment on Projects
14.5. Project Financial Evaluation
14.6. Concept Checkout
14.7. Discussion Questions
14.8. References
SECTION SEVEN CASE STUDY: General Practice Affiliates EMR Project
SECTION EIGHT: AMBULATORY HEALTHCARE FINANCING AND THE CONSUMER
CHAPTER 15. The Consumer's Role in Ambulatory Healthcare Financing
15.1. Introduction
15.2. Planning and Facilitating Consumer Engagement with Primary Health Costs
15.3. Implementing Effective Practice Engagement with Consumer's Financial Concerns
15.4. Evaluating the Workflow Process and Institutionalizing Consumer Cost Education in the Practice
15.5. Concept Checkout
15.6. Discussion Questions
15.7. References
CHAPTER 16. Financial Aspects of Ambulatory Care For Aging and Chronically Ill Individuals
16.1. Chapter Objectives
16.2. Financial Dimensions of Providing Primary Care for Aging and Chronically Ill Individuals
16.3. Strategic Financial Planning for Primary Care of the Older Adult
16.4. Informal Caregivers
16.5. Financial Concerns for Palliative Care in the Primary Care Practice
16.6. Concept Checkout
16.7. Discussion Questions
16.8. References
SECTION EIGHT CASE STUDY: General Practice Affiliates Patient and Caregiver Financial Challenges
CHAPTER 17. Concluding Thoughts on Financing Primary Healthcare
17.1. Chapter Objectives
17.2. Emerging Trends Affecting Healthcare Financing
17.3. The Roles of Macro and Micro Financing in Responding to These Trends
17.4. Discussion Questions
17.5. References
Index