Health Care Environments

Both Medicare and Medicaid are administered through a division of Health and Human Services called the Centers for Medicare and Medicaid Services (CMS).

Examine the financial characteristics of health care delivery along with managing costs, revenues, and human resources.

The role of finance in Health Care Systems, Inc. as a regional not-for-profit hospital relates to both the accounting and financial management aspects of the business. Facets of both accounting and financial management are intertwined with maximizing productivity by way of managing and analyzing financial operations to ensure resources are being utilized properly (Gapensiki, 2013). The divulgence of financial reports to managers and investors will aid in the development of plans and budgets for future growth, assess acceptable levels of financial risk, manage contracts appropriately and make decisions related to capital investments allowing the organization to expand service offerings thereby demonstrating greater value in the community. Operating as a not-for-profit entity requires that the hospital operate exclusively in the interest of the public for a charitable purpose. Through understanding who the primary third party payers

Medicare was established by the federal government to provide healthcare insurance initially for the elderly and included the disabled a few years after the program’s inception. As of 2013, there were 52.3 million beneficiaries of Medicare, with an average of $11,910 spent on each individual for healthcare, with a total annual budget of $582.9 billion (NCPSSM, 2015). Medicare is funded through two trust fund accounts that are held by the U.S. Treasury: the Hospital Insurance (HI) and Supplementary Medical Insurance (SMI) Trust Funds (Medicare.gov, 2015). These trust funds are financed by payroll deductions, Social Security benefit taxes, premiums paid by Medicare beneficiaries, interest from investments, and funds furnished by Congress (Medicare.gov, 2015). All of these resources subsidize the Medicare Trust Fund in

Effective financial management is the basis of thriving health care organizations. Organizations must make good investment decisions based on objective analysis (Healthcare Financial Management Association [HFMA], 2005). Integration of financial management principles provides decision makers with guidance to make capital decisions maximize mission-based benefits at effective costs (HFMA, 2005). An operating budget is the statement of profit and loss for the entire organization. Various health care entities prepare operating budget for the following year for discussion and approval by top management (Academic Writing Tips, 2011). At the end of the year, departmental managers provide an account for the previous year’s

The organization I choose is Dignity Health Mercy Medical Center Redding (MMCR), located in Northern California. MMCR 2014 Community Health Needs Assessment Report is easy to read and understand. They provided the picture of the community they are serving and what are the problems that need priority. The hospital catered on communities in Shasta, Tehama and Trinity County. What I noticed is that the community they are serving is mostly Caucasian (79.6%), only 11% Hispanic. Out of the 209, 900 population, 17.3% were uninsured, 21.7% on Medi-cal with 10.9% unemployment rate. Most of the people seeking medical help go to the Emergency Department for non-acute medical services. MMCR priority is to have a community-based collaboration with other non-profit organization will address the existing problem the community is facing and to provide a long-term plan that will benefit the community in the future.

Managers who are managing health care organizations must be attentive to the accounting practices and must obey and practice the financial management procedures to be able to solve any issues if any should arise. With the continuation of the high costs of health care managers as well as consumers must know how to budget carefully. According to All Business. (2010), the cost of providing health care services, patients way of payment for these services and the environment in which those patients reside and receive those services are important elements that affect the care this is or may not be

In Healthcare System the role of finance is an important aspect in healthcare. In the financial role of healthcare it involves handling operations such as negotiating contracts, making cash available for expenses such as payroll and cover cost for unexpected expenses. The role of finances also makes it capable for leadership to better make plans for the future, when finances are in order organizations can better equipped to make decisions such as is the organization financial able to expand test or treatments and are they able to buy new medical equipment.

This course is designed as an introduction to the terminology, processes, functions, and financial reports commonly encountered in health care operations. This course introduces the concepts of basic managerial financial functions, such as budgeting, reimbursement methods, and the responsibilities of health care financial

Medicare is administrated by the Centers for Medicare and Medicaid Services (CMS). It is divided by subdivisions which is the Center for Medicare Management who overseas development of payment policy and management of fee-for-service contractors. The Center for Beneficiary provides beneficences with information on Medicare programs, and research grievance and appeal functions. The Center for Medicaid and State Operations focuses on federal and state programs like Children’s Health Insurance Program and the Clinical Laboratory Improvement and CMS who enforces insurance portability and transaction and code set requirements of HIPAA.

Controlling is ensuring the validity and accuracy of all financial information within the firm. Controlling will become very profound as the industry overall undergoes fundamental change in regards to operations. Legislation imposed by the federal government regulates, to a certain extent, how health care organizations operate. As such, management must be able to control costs and assess the validity of the financially information presented to them. If the organization fails to do so, the results could be devastating. First, loses will occur due to the excessive lack of control. The organization may be forced to lower spending in some areas of compensate for the aggressive spending in others. In addition, the reputation of the firm could be harmed. Patients and other vendors may be unlikely do business with the firm for fear of the company's lack of financial security. Therefore, in order to ensure the continuity of the business, the firm must have adequate methods by which to check the validity of its financial information. Third party audits, independent audits, check and balances and management oversight all will help ensure that the overall financial position of the firm is sound and credible.

In the health care world finances play a significant role in the quality of care rendered to the consumer. There is no health care facility that is the same when it comes to their financial management because it is needed both internally and externally to ensure that it runs properly. Today’s health care field consist of either not-for-profit organizations, for-profit organizations and governmental, (Gapenski, 2008).

The Centers for Medicare and Medicaid Services is the government body in charge of managing Medicare and Medicaid programs. CMS likewise runs the State Children's Health Insurance Program (SCHIP), which is mutually financed by the Federal and State governments and managed by individual States. ACA created major change in CMS's implementation responsibilities.

In addition to delivering health care of the highest quality, another main goal of a health care organization is to remain profitable and viable through effective financial management. In an effort to do so, members of administration along with the Chief Financial Officer (CFO) work diligently in attempting to maintain and sustain a successful health care organization by monitoring the flow of cash (in and out) in accordance to GAAP (Generally Accepted Accounting Principles), while ensuring the needs and wants of the consumers are met. With this being the case, health care accounting skills are equally important in

Healthcare managers participate in various important roles that allow them to form and maintain flourishing organizations. Managers ought to be aware of the decisive elements of management and the generally accepted accounting principles. At the same time, they must realize, stick to, and put into effect the general financial ethical standards. Successful management of finances of healthcare is one of countless tests that mug the organization. Revenues and expenses of the organization are essential because they establish the external and internal finances of the company. The