HSM-340 Week 1 Discussion Question 1 – Finance and the Regulatory Components (graded)

You must always have a plan & a back up plan. Realize what you are staring with & what you may end up with. Always plan for emergencies & set backs. Never take all that you have & put it into one deci sion. The major function of information in general & financial information in particular is to oil the decision-making process. Decision making is basically34the selection of a course of action from a defined list of possible or feasible actions. In many cases the actual course of action followed may be essentially no action; decision makers may decide to make no change from their present policies. It should be recognized, however, that both action & inaction represent policy decisions. Generating information is the key to decisionmaking. The quality & effectiveness of decision making depend on accurate, timely, & relevat information. The difference between data & information is more than semantic: Data becme information only when they are useful & appropriate to the decision. Many financial ata never become information because they are not viewed as relevant or are unavailable in an intelligible form. Five financial information that may be important are evaluate the financial condition of an ntity, evaluate stewardship within an entity, assessing the efficacy of operation, assessing the ffectiveness of operations, determining the compliance of operation with directives. text book). nd response re there any other types of information besides financial that may be useful in aking financial decisions? think that have the credit to back your financial plan would help you a lot in making ecisions. Be prepared for any changes that may come up. If you are not ready for hem then you could be asking for a downfall. dentify the major components of a corporate compliance plan, including the stablishment of internal controls relating to the finances of an organization. Clear & unambiguous organizational commitment, Supportive corporate ulture, clear & comprehensive compliance policies, procedures, processes, & progras, Effective education, Managerial accountability systems, Effective investigation & aluation of complaints, Adequate documentation & record-keeping. How does legal & regulatory issues shape & define good financial management of a health care organization? This study source was downloaded by from CourseH on 10-03-2022 09:55:05 GMT -05:00 I think that when they work together with each other instead of fighting against each other then it will help make the organization grow. If they don’t work together there could be a bif financial downfall in the company. Week 1 Discussion Question 2 Cost reimbursement was the predominant form of payment for most hospitals & other institutional providers by Medicare until the early 1980s. In addition to Medicare, most state Medicaid plans & a large number of Blue Cross plans paid hospitals on the basis of “reasonable” historical They set fee schedules & handle disputes between PPO. Today, the major payers have abandoned historical cost reimbursement & substituted other payment systems. We provide some discussion of cost reimbursement for two reasons. First, it is used in some limited settings for payment. For example, Medicare still pays on a cost basis for services performed in comprehensive cancer centers & critical-access hospitals (CAHs). Second, some policy analysts have suggested that “regulated cost reimbursement” might be a legitimate way to maintain the quality of patient care. Two key elements in historical cost reimbursement are reasonable cost & apportionment. Reasonable cost is simply a qualification introduced by the payer to limit its total payment by excluding certain categories of cost or placing limits on costs that the payer 3839deems reasonable. Examples of costs often defined as unreasonable & therefore not reimbursable are costs for charity care, patient telephones, & nursing education. Apportionment refers to the manner in which costs are assigned or allocated to a specific payer such as Medicaid. (text book) They set fee schedules & handle disputes between PPOs.