Operating Budget Proposal in Health Care Finance and Reimbursement

Operating Budget Proposal in Health Care Finance and Reimbursement

Operating Budget Proposal Scoring Guide Criteria Describe the environmental forces that affect health care operating budgets. Propose an operating budget that includes organizational improvements. Explain how an operating budget aligns with an organizational target profit margin. Explain how financial performance will be measured. Write content clearly and logically with the correct use of grammar, punctuation, and mechanics. Format citations and references using the APA style. In 4–5 pages, describe the environmental forces that affect health care organization budgets. Propose a budget that includes organizational improvements. Explain how the budget aligns with the target profit margin and how financial performance will be measured. Note: The assessments in this course build upon each other, so you are strongly encouraged to complete them in sequence. By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria: • Competency 1: Develop financial strategies to address dynamic environmental forces. (L24.2, L24.5, L17.2) o Describe the environmental forces that affect health care operating budgets. o Explain how financial performance will be measured. • Competency 3: Develop a budget that integrates organizational improvements with sound financial analysis. (L8.4, L3.3) o Explain how an operating budget aligns with an organizational target profit margin. o Propose an operating budget that includes organizational improvements. • Competency 4: Communicate in a manner that is scholarly, professional, and consistent with expectations for professionals in health care administration. (L6.1, L6.2, L6.3, L6.4) o Write content clearly and logically with the correct use of grammar, punctuation, and mechanics. o Format citations and references using the APA style. Health care organizations must meet basic clinical and financial targets to remain viable. The Affordable Care Act and the advent of accountable care organizations require increased attention to and skills for meeting internal organizational targets. Reimbursement from government payers is increasingly linked to the effective management of meeting expected performance measures. To do this, you must understand the concepts of internal and external benchmarks, the necessity for performance measurement, and how to determine appropriate targets relative to the type and size of the organization. It is helpful to ensure that when comparing organizational outcomes data, the external benchmark is comparable. Effective management of health care requires competence in health care finance. Successful health care executives not only understand operating, capital, and revenue budgets, they also understand why each of these budgets is important to an organization and which groups of stakeholders need to remain apprised of the status. Questions to Consider To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. • How can internal benchmarks be used to help identify best practices within an organization? • How might an organization use external benchmarks to measure and monitor performance? • What is a scorecard, and how is it used to track financial performance? • Required Resources The following resources are required to complete the assessment. • Sample Operating Budget [XLSX]. This resource provides step-by-step guidelines for developing a budget, including a multiple-tab spreadsheet for a multi-year generic hospital budget. • Parkland Hospital. (n.d.). Developing a budget. Retrieved from https://www.parklandhospital.com/phhs/developing-a-budget.aspx Show Less Suggested Resources The resources provided here are optional and support the assessment. They provide helpful information about the topics. You may use other resources of your choice to prepare for this assessment; however, you will need to ensure that they are appropriate, credible, and valid. MHA-FP5006: Health Care Finance and Reimbursement Library Guide can help direct your research. The Supplemental Resources and Research Resources, both linked from the left navigation menu in your courseroom, provide additional resources to help support you. This article discusses opportunities for finding savings in the budget process and the need for a multi-year approach and contains helpful links to the American Hospital Association and other resources. • Becker’s Hospital CFO Report. (2014). CFO perspective: Finding savings in the annual operating budget. Retrieved from https://www.beckershospitalreview.com/finance/cfo-perspective-finding-savings-in-the-annual-operating-budget.html Additional Resources for Further Exploration This article discusses benchmarking and identifying costs. • Silber, J. H., Rosenbaum, P. R., Ross, R. N., Ludwig, J. M., Wang, W., Niknam, B. A., . . . Fleisher, L. A. (2014). A hospital-specific template for benchmarking its cost and quality. Health Services Research, 49(5), 1475–1497. This textbook chapter discusses budgets and the process of developing different types of budgets. • Harrison, C., & Harrison, W. P. (2013). Introduction to health care finance and accounting. Clifton Park, NY: Cengage Learning/Delmar. Available from the bookstore. o Chapter 8, “Budgets,” pages 127–152. These textbook chapters discuss the management control process, cost variance analysis, working capital, cash management, and developing a cash budget. • Cleverley, W. O., Cleverley, J. O., & Song, P. H. (2011). Essentials of health care finance (7th ed.). Sudbury, MA: Jones & Bartlett Learning. Available from the bookstore. o Chapter 16, “Management Control Process,” pages 355–378. o Chapter 17, “Cost Variance Analysis,” pages 379–395. o Chapter 22, “Working Capital and Cash Management,” pages 489–504. o Chapter 23, “Developing the Cash Budget,” pages 505–514. • Assessment Instructions Preparation Use the Sample Operating Budget located in the Required Resources section to help you complete this assessment. The information represents the clinic’s operating budget for 2015 and 2016. You have been asked to prepare a budget proposal for 2017 for the group of physicians who own the clinic. Because you know the clinic needs new billing software and there is a request for a new MRI machine, you will need to factor these expenses into your proposal. You will also need to explain environmental forces that may affect the budget and how your proposal addresses those forces. There is no specific format you must follow for this assessment. This is a budget proposal and should be organized in a clear and logical manner. Support your work with references to at least two professional resources, and follow the APA guidelines for in-text citations and references. Requirements Complete the sample operating budget by filling in the 2017 column. Include this information as a table inserted into your budget proposal, or attach separately in the assessment submission area. In your proposal, be sure you do the following: • Describe the environmental forces that will affect or are likely to affect the budget for the next year. (Consider things such as compliance changes, changes in how insurance claims are processed, changes in laws and regulations, and so on.) • Complete a 2017 operating budget that includes the purchase of new billing software and a new MRI machine. (This is where you use the sample operating budget.) Keep in mind that there will be costs beyond the purchase price, such as training for staff, the addition of more staff, and maintenance. You may want to refer to Assessment 3 and the cost-benefit analysis you completed. • Explain how this proposed budget aligns with the target profit margin. • Explain the measures you will implement to track financial performance over the next year. How will you evaluate financial performance? Additional Requirements • Include a title page and reference page. • Number of pages: 4–5 pages, not including the title page or reference page. • At least two current scholarly or professional resources. • APA format for in-text citations and references. • Times New Roman font, 12 point. • Double-spaced. Operating Budget Proposal Scoring Guide