Health Care Financing Notes

Blending the topics of both accounting and finance, Essentials of Health Care Finance is a relevant, readable, and easily applied resource for health care management students and executives that explores finance theory and its practical application in health care across a full range of facilities, from hospitals, home health agencies, and skilled nursing facilities to surgical centers, physician practices, and integrated health systems. Carefully revised, the Ninth Edition of Essentials of Health Care Finance has been updated with additional reflection, examples, and application so that individuals with no healthcare experience can benefit from additional elaboration on key concepts such as physician practice management, flex budgeting, and strategic financial planning. The Ninth Edition also explores trends in national health expenditures and physician organizations and alignment; changes in health services financing and utilization since the enactment of the Affordable Care Act (ACA)

Essentials of Health Care Finance stands firmly in its place as the leading textbook on healthcare finance. No other text so completely blends the best of current finance theory with the tools needed in day-to-day practice. Useful for all course levels as well as a professional reference, this text offers a comprehensive introduction to the field. The Seventh Edition has been thoroughly revised to reflect the current economic environment in the healthcare industry, with thoughtful descriptions and ‘real-world’ examples. As the not-for-profit health care sector has increasingly come under attack by legislators seeking new sources of tax revenue, this edition also features a new chapter on assessing community benefits including an examination of the new Schedule H of the IRS 990 form. Ancillary instructor materials for the Seventh Edition have been significantly expanded and updated. PowerPoint lecture slides now include selected examples from the chapters. Electronic versions of many of the charts and tables in the chapters are provided to enable the instructor to re-create and modify existing examples. An expanded set of test questions with detailed answers will be provided for each chapter. New excel spreadsheets for selected chapters will be created to help both the students and the instructors perform a variety of financial analysis tasks with spreadsheet templates. The instructor’s manual has been revised to include key learning points, chapter overviews, and guidelines for class discussion.

Health Care Finance and the Mechanics of Insurance and Reimbursement stands apart from other texts on health care finance or health insurance, in that it combines financial principles unique to the health care setting with the methods and process for reimbursement (including coding, reimbursement strategies, compliance, financial reporting, case mix index, and external auditing). It explains the revenue cycle in detail, correlating it with regular management functions; and covers reimbursement from the initial point of care through claim submission and reconciliation. Thoroughly updated for its second edition, this text reflects changes to the Affordable Care Act, Managed Care Organizations, new coding initiatives, new components of the revenue cycle (from reimbursement to compliance), updates to regulations surrounding health care fraud and abuse, changes to the Recovery Audit Contractors (RAC) program, and more.

"This trusted resource explores finance theory and its practical application in health care across a full range of facilities, from hospitals and home health agencies to skilled nursing facilities, surgical centers and private physician practices. The vast, complex nature of the U.S. health care system renders traditional approaches to finance insufficient. Importantly, Essentials of Health Care Finance couches its discussion of economics, accounting and financial topics firmly within the unique context of the health care industry. Relevant and readable, this Eighth Edition of Essentials of Health Care Finance is fully revised and updated with current, real-world examples of financial problems and solutions as well as the latest financial ratio standards. This new edition also introduces ICD-10 coding and offers comprehensive coverage of the impact of the Affordable Care Act in all relevant chapters."--

The global movement toward universal health coverage (UHC) is accompanied by requests for large increases in government health spending in some countries. This combined with the global economic situation and stagnant economic growth across many low- and middle-income countries make it more critical than ever to place health financing discussions firmly in the context of macroeconomic and fiscal realities. Unfortunately, there is often a disconnect in decision making, with key fiscal decisions made in the absence of a clear understanding on the one hand of the potential consequences for the health sector, and on the other, the consequences for the country’s macroeconomic and fiscal position of increasing or reallocating government spending. Constructive health financing policy dialogue aims to reach a common understanding between health sector leaders and central budget authorities about policy objectives for the health sector and the resources needed to achieve those objectives, how much priority will be given to health in the government budget, and how the health sector will be held accountable for using funds effectively. This common understanding should be built on a realistic picture of the country’s macroeconomic and fiscal context, the constraints and competing priorities in the budget-setting process. When ministries of health and ministries of finance have a common understanding of macroeconomic and fiscal constraints, discussions can focus productively on using funds within the potential health resource envelope in the most effective way to achieve health system objectives. This guidance note outlines the key components of the macroeconomic, fiscal, and public financial management context that need to be considered for an informed health financing discussion at the country level. The guidance note is organized around four sets of questions that are key to placing the health financing dialogue in the context of a country’s macroeconomic and fiscal context. Each section points to measures, resources, and analytical tools that are available to assist in answering these questions for a specific country. The guidance note draws on case studies from 11 countries moving toward or sustaining universal health coverage conducted as part of the Japan†“World Bank Partnership Program on UHC as well as from other country examples.

This report discusses several different approaches that support reforming health care services in developing countries. For some time now, health care services have been supported by government funds. As demands for improving health care services continue to increase additional demands will be placed on governments to respond. This, however, will not be easy. Slow economic growth and record budget deficits in the 1980's have forced reductions in public spending. Alternative approaches to finance health care services are needed. Such possible changes could involve: decentralization of federal government involvement; the promotion of nongovernment involvement; the imposition of user fees; and, establishing health insurance. Finally, the role of the Bank in pursuing new financing strategies is discussed.

"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.

Health Care Finance: Basic Tools for Nonfinancial Managers, Fifth Edition is the most practical financial management text for those who need basic financial management knowledge and a better understanding of healthcare finance in particular. Using actual examples from hospitals, long-term care facilities, and home health agencies, this user-friendly text includes practical information for the nonfinancial manager charged with budgeting.

Sixth edition coming in November! Essentials of Health Care Finance, Fifth Edition stands firmly in its place as the leading textbook in its coverage of health care finance. No other text so completely blends the best of current finance theory with the tools needed in day-to-day practice. This timely revision includes 20 chapters that encompass virtually the entire spectrum of the health care industry--providing new and expanded information reflecting payment system changes in the industry and broadening content and examples to include hospitals as well as organizations in other sectors of the health care industry.