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Mathematics & Economics
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Coursework
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English (U.S.)
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Topic:
Part 3-99
Coursework Instructions:
Please use template and complete part 3
Part 3: Program Finances
Factors that determine the financial feasibility of a health care program include the cost of the facility, equipment, staff salaries, patient out-of-pocket expenses, and insurance reimbursement. Referring to the concepts practiced so far, work on the following:
1. Determine how many physicians and supporting staff are needed to operate the clinic, applying the appropriate ratio of clinical and support staff per physician.
2. Determine the direct costs of the program. Direct costs in this case are patient expenses, and they increase as the number of patients increase. These include:
a. Physician and procedural support staff costs per patient/procedure
b. Gloves, sutures, gowns, equipment, lab supplies, other supplies
3. Determine the indirect costs of the program. Indirect costs are overhead costs that include but are not limited to:
a. General support staff and related costs
b. Electronic medical records
c. Insurance and taxes
d. Facility and administration
e. Employee benefits such as health and life insurance, retirement plans, and fringe benefits
4. Determine the equipment costs of the program. This includes items for the physician clinic that will be used for more than one year. This is in contrast to variable costs which occur per patient and include such items as gloves, syringes, needles, and gauze, and would include items such as:
a. Examination tables
b. Workstations
c. Desks and chairs in the waiting room
d. Other equipment of this nature
5. Determine reimbursement for clinic services based on HCPCS/CPT codes with geographical adjustment.
6. Determine net reimbursement after variable costs per patient.
7. Determine how many patients the clinic will need to see (a) on average per day and (b) annually to break even on expenses.
Note: Refer to the health financial instructions and sample calculations document to help you with this part of the project.
Table 1. Staffing and Salaries
Complete Table 1 by adding the staff positions including physician specialty, nurses and support staff, and the number of positions in your clinic. Multiply the number of positions by average salary for those positions to obtain total salaries.
Staff Position Number of Positions Average Salary Total Salaries
Primary Care Physician
Nurse
Support Staff
Total Salary:
Table 2. Fringe Benefits Expense and Total Salary Expense
These expenses have been established by the hospital system at 25% of salaries and added to salaries for Total Salary Expense.
Factors Dollar Amount
Total Salaries
Fringe Benefit Expense 25% of Salaries
Total Salary Expense w/ Fringe Benefits:
Table 3. Overhead (Indirect) Costs and Total Fixed Practice Costs
Begin with total salaries including fringe benefits. Multiply that amount by 40% (0.40) and combine the 2 numbers for total fixed practice costs. These costs do not vary based on the number of patients.
Cost Factors Dollar Amount
Total Salaries Expense
Overhead Costs 40% of Total Salary Expense
Total Overhead and Fixed Costs:
Table 4. Equipment Costs
These items will be used by the clinic for 5 years so the costs will be divided equally over 5 years (depreciation).
Cost Factors Dollar Amount
Total Equipment Cost
Depreciated Equipment Cost (cost for year one)
Total Clinic Costs (for year one including salaries, overhead, and equipment costs):
Table 5. RVU and Reimbursement Calculation
The cost of physician care varies in different locations, as do the cost of operating a practice and the rates of physician malpractice claims. In addition, each year Medicare adjusts the conversion rate either up or down.
Category RVU GCI Total RVU
Totals
· RVU:
· GCI:
· Total RVU:
Table 6. Variable Costs and Net Reimbursement
To complete Table 6, multiply reimbursement per visit by 10% (0.10) and subtract this number from reimbursement to obtain net reimbursement per patient.
Cost Factors Dollar Amount
Reimbursement per visit
Variable cost per patient 10%
Net Reimbursement per patient:
7. Breakeven Analysis
To calculate the number of patients needed to break even, divide total practice costs by net reimbursement. To calculate the number of patients per day, divide the total number of patients for an annual breakeven number by the number of days the practice is open. Enter text below.
Coursework Sample Content Preview:
MHACB/599 Capstone Project
This course is centered around a Capstone Project that requires you to synthesize the information you have learned in the Master of Health Administration Program. There are 5 progressive parts to the project, and you will complete and submit part 1 to part 5 as mentioned in competency 1 to competency 3.
Note: This document serves as your project guide and template, and you will submit the majority of the project deliverables on this document.
For each item that requires a response, enter your response on a new line.
Scenario
Assume you work in health administration in a hospital system in a metropolitan area in the United States. The board of directors and CEO of the hospital system have established a goal for the year to better address the health care needs of the community. You have been tasked with establishing a physician outpatient clinic focused on treating an endemic health concern in your county.
Objective
You are to examine county health data to determine a health problem of prevalent need and to design a program that can help alleviate these concerns in the community. Integral to program design are factors and considerations such as cost, staffing, facility, policies, and its potential impact on vulnerable populations. The executives also want to ensure that the physicians, staff, and administrators are held to ethical and leadership standards that align with the practices to promote a supportive work environment governed by transformational leadership. You are to research, design, and create a proposal for a program that meets the stated expectations of the board and CEO.
Overview
* Part 1: Defining the Health Problem and Identifying the Affected Population
* Part 2: Program Design
* Part 3: Program Finances
* Part 4: Organizational Structure
* Part 5: Program Proposal and Presentation
Part 1: Defining the Health Problem
Your task in this part of the project is to identify a public health issue in a locale of your choice based on an analysis of public health data for the demographic area. Based on your research, you will conceive of a program at the local hospital, health system, or clinic to improve health outcomes for the population.
Instructions
Use this project template to complete the requirements for Part 1 of your Capstone Project, detailed as follows:
1 Use the data to identify 2 endemic health issues among populations in the county. Your project will focus on only 1 of the issues, but you will need to identify a second issue if your first choice is determined to be unfeasible for this project. Your instructor will assist you in making that determination. Since county-level health data in most states is more detailed than city-level data, it is recommended that you choose a county, rather than a city. You can locate health data from the following sources:
* County Health Rankings
* National Center for Health Statistics
* County Health Department websites
* State health dept
2 Describe the conditions and the extent of these health problems and why you feel they warrant a program or service to address their impact on the population. Support the results of your analysis using charts or graphs that include demographic, morbidity, and mortality data.
3 Provide and analyze demographic information on the county population including age, gender, income, employment and other relevant information for your program.
4 Summarize the health issue you want to work on and explain your idea for a program to accomplish this objective.
Sources of Data
Cite using APA guidelines. Enter text below.
County and Health Profile
County and Hospital / Health System / Clinic
Select a county for the location of your project. County level data is kept by most states and is usually more detailed than city-level data. Include a rationale of why you selected the city, including if you have any prior experience or knowledge about the existing health care system in that city. (175-250 words) Enter text below.
Health Issue 1
Description and Analysis of Data
Explain the source(s) of your data and the types of analyses you conducted to reach your findings. For example, how does this data compare with other counties, states, or at the national level? (250-350 words) Enter text below.
Description of Condition(s) (primary interest)
Describe the condition(s) you have identified in your data analysis. Describe the extent of these health problems and why you feel they warrant a program or service to address their impact on the population. Provide demographic information on the county population including age, gender, income, employment and other relevant information for your program. (250-350 words) Enter text below.
Health Issue 2
Description and Analysis of Data
Explain the source(s) of your data and the types of analyses you conducted to reach your findings. For example, how does this data compare with other counties, states, or at the national level? (250-350 words) Enter text below.
Description of Condition(s)
Describe the condition(s) you have identified in your data analysis. Describe the extent of these health problems and why you feel they warrant a program or service to address their impact on the population. Provide demographic information on the county population including age, gender, income, employment and othe...
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