Paul Lang

  1. A flat fee payment system instituted by the government to control the payment for outpatient services provided to Medicare recipients.
  2. The method of payment in which the provider is paid a fixed amount for each person served no matter what the actual number or nature of services delivered over a set period of time, usually a month or a year.
  3. A patient classification scheme used by Medicare that clusters patients into categories on the basis of patients' illnesses, diseases and medical problems.
  4. What are discounts relative to the provision of healthcare?
    A reduction in the charge for services.
  5. How are Medicare and Medicaid financed?
    Medicare: Federal Income Tax. Medicaid: Federal and State Income Tax.
  6. A system to pay providers whereby the fees for all providers (i.e. hospitals, physicians, home health care agencies) are included in a single negotiated amount. This is sometimes called “bundling” of services.
    Global Payments
  7. A recent alternative payment arrangement that bases partial reimbursement and/or creates additional reimbursement incentives for providers based upon adherence to pre-defined standards for quality of care. Indicators include various patient outcomes and frequency and type of tests ordered and services performed.
    Pay for Performance (P4P)
  8. Federal legislation designed to tighten accounting standards in financial reporting, and which holds top executives personally liable as to the accuracy and fairness of their financial statements.
    Sarbanes-Oxley Act
  9. Legislation enacted by CMS in 2005 to guard against providers’ ordering self-referrals for Medicare or Medicaid patients directly to any settings in which they have a vested financial interest. Also referred to as “anti-kickback” legislation.
    Issues addressed in Stark Law
  10. List four (4) efforts attempted by providers to control costs.
    Shifting to outpatient services; implementing more sophisticated cost-accounting systems and information services technologies; mergers and acquisitions; and reengineering/redesign.
  11. comparing 2 organizations of materially different sizes
    Common Sizing
  12. What % is one line item to another?
    Vertical Analysis
  13. ability to meet short term obligations
    Liquidity Ratios
  14. financial viability of the organization
    profitability ratios
  15. how efficient is organization using assets to produce revenue
    Activity ratios
  16. how are assets financed, can organization take on new debt
    Capital Structure ratios
  17. measures efficiency of the organization’s assets to produce revenue
    Total Asset turnover
  18. to what extent do fixed assets assist in the generation of revenue
    Fixed Asset Turnover
  19. indicates how old your equipment is – indicator of future capital investment needs
    Age of Plant
  20. used by investment bankers and bond rating agencies-measures ability to meet total loan requirements (interest & principal)
    Debt Service Coverage
  21. demonstrates the ability to earn enough to pay interest expense requirements
    Times Interest earned
  22. reflects proportion of assets financed by equity
    Net Assets to Total Assets
  23. measures proportion of debt to net assets
    Long-term debt to net assets
  24. measures how much profit per dollar invested in assets
    Return on Assets
  25. measures rate of return on each dollar of owner’s assets or net assets
    Return on Net Assets
  26. profits earned from primary business
    Operating Margin
  27. % change in line item from one year to next. (subsequent yr-previous yr)/previous yr X 100
    Horizantal Analysis
  28. Can be used to view changes over several years (subsequent yr-base yr)/base yr X 100
    Trend analysis
Card Set
Paul Lang
Financial (hospital)