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HFMA's CSAF 2021, Certified Specialist
Accounting and Finance Exam Questions and
Answers 100% Pass
Contribution Margin - ANSWER ✔✔-Difference between marginal revenue and marginal cost.
Break-even point - ANSWER ✔✔-Level of sales volume of a product producing the exact amount of
contribution margin needed to cover fixed costs.
Overhead - ANSWER ✔✔-Indirect Costs
Activity-based costing (ABC) - ANSWER ✔✔-Method of determining product costs using cost drivers or
activity measures, which cause indirect costs to be incurred.
Three main types of Cost standards. - ANSWER ✔✔-Predetermined (Synthetic), Negotiated (Historical),
and Customized (Engineered)
Four Types of Individual Cost behaviors - ANSWER ✔✔-Variable, Fixed Cost Pattern, Semi-Variable Cost
Pattern, Semi-Fixed or Stepped Variable
Three Principal Types of expense variances - ANSWER ✔✔-Price, Volume, and Efficiency
The 4 Primary payment methods used in managed care - ANSWER ✔✔-Fee-for-Service, Per Diem Rate,
Case Rate, Capitation
Healthcare providers should develop different modeling tools depending on - ANSWER ✔✔-the
reimbursement method proposed in the contract
Created by Grace Amelia © 2025, All Rights Reserved.
,2|Page
The general categories of provider excess loss insurance are - ANSWER ✔✔-per-person, aggregate, and
carve-out.
A Strategic Plan allows organizations to - ANSWER ✔✔-have a clear plan as to why they are in business
and how they can stay in business in the future.
The main types of control budgets include - ANSWER ✔✔-operating, capital, and cash.
A budgeting process develops assumptions for the following: - ANSWER ✔✔-Admissions, ALOS,
Expense per visit, Inflation on expense, FTE per visit, Productivity on FTE per visit, Labor cost per FTE,
Net Rev per visit
Operating budget's statistical factors include - ANSWER ✔✔-Historical statistics, Historical relationship
of department volume, anticipated effects of new programs, clinical practice patters, covered lives in
global payment risk programs, changes in regulatory environment, technical developments, process
improvements, marketing efforts, demographic trends
The primary purpose of measuring productivity is - ANSWER ✔✔-for management to determine if
resources are being used efficiently
Budget types include - ANSWER ✔✔-fixed and flexible
The four budget variances used to explain by cause are - ANSWER ✔✔-Volume, rate (charged), price (of
a supply), and efficiency (cost per procedure).
Three common Capital Evaluation techniques - ANSWER ✔✔-Payback, Net Present Value Method,
Return on Investment
Users of ratio analysis - ANSWER ✔✔-Board of Directors, Management, Health Systems Agencies,
Creditors, Employee Unions, Rate Regulators
Created by Grace Amelia © 2025, All Rights Reserved.
,3|Page
The categories of ratios used - ANSWER ✔✔-Profitability Ratios, Liquidity Ratios, Activity Ratios, Capital
Structure Ratios
Two common types of long-term debt - ANSWER ✔✔-Revenue bonds and General Obligation Bonds
Undertake debt restructuring by either retiring or reacquiring existing debt for 4 reasons - ANSWER ✔✔-
Take advantage of lower interest rates, change collateral restrictions, allow acquisition of other assets,
better fit debt service requriements
Healthcare bond issues place legal obligations on - ANSWER ✔✔-the borrower intended to protect the
lender against default by the borrower.
In order to use the discounted cash flow method - ANSWER ✔✔-you need to know the payment flow or
payment pattern and the interest rate
Every capital investment proposal requires 4 quantifiable factors - ANSWER ✔✔-Cash Outflow, Cash
Inflow, Economic Life, Opportunity Cost of funds
Three significant Investment valuation methods - ANSWER ✔✔-Discounted cash flow method,
Replacement cost method, Market comparison
Two types of equity financing - ANSWER ✔✔-Internal and External
In a capital lease, all of the benefits and risks of owner except title or ending (salvage value) - ANSWER
✔✔-get transferred to the lessee. The lessor recovers full price and interest during the lease.
An operating lease is - ANSWER ✔✔-when the hospital is liable for the leasing cost; renewal options are
determined by the fair market value
Advantages of leasing - ANSWER ✔✔-working capital is conserved, budgetary control, tax benefits may
be realized, project may be financed 100%, lessee has greater flexibility in replacing equipment
Created by Grace Amelia © 2025, All Rights Reserved.
, 4|Page
Disadvantages of leasing - ANSWER ✔✔-Cost of extending the lease may be more than the actual
purchase price, Interest costs are higher than debt, third parties will recognize a full lease payment as
allowable only if a true operating lease, the leasing company frequently passes the cost of property tax to
the lessors
When issuing a rating on a specific organization, a rating agency will commonly consider the following -
ANSWER ✔✔-Provisions or structure of the financing, competitive environment and market position,
medical staff characteristics, management capability, financial
Methods of a Cash budget: - ANSWER ✔✔-Cash receipts and disbursements Method, Adjusted Net
Income Method, Working Capital Differential Method
Primary purposes of a cash budget: - ANSWER ✔✔-Identify cash requirements and sources for a certain
period of time, control the flow of cash funds
Healthcare organizations use commercial banking services for: - ANSWER ✔✔-Controlled Disbursement
Account, Depository Account, Concentration Account and Zero Balance Account, Sweep Account
The components incorporated in a cash budget: - ANSWER ✔✔-Ability of the organization to manage
overall revenue cycle, projection of costs, variability in activities that impact both revenues and expenses,
regularly recurring or periodic expenses, timing of capital purchases
An investment policy - ANSWER ✔✔-Establishes a framework to make investment decisions and
evaluate results
The returns, risks, and correlation are the primary inputs for - ANSWER ✔✔-asset allocation models
Different types of asset allocation risks are as follows: - ANSWER ✔✔-maturity (liquidity) risk, interest
rate risk, credit risk, political (legal) risk, market (price) risk
Created by Grace Amelia © 2025, All Rights Reserved.
HFMA's CSAF 2021, Certified Specialist
Accounting and Finance Exam Questions and
Answers 100% Pass
Contribution Margin - ANSWER ✔✔-Difference between marginal revenue and marginal cost.
Break-even point - ANSWER ✔✔-Level of sales volume of a product producing the exact amount of
contribution margin needed to cover fixed costs.
Overhead - ANSWER ✔✔-Indirect Costs
Activity-based costing (ABC) - ANSWER ✔✔-Method of determining product costs using cost drivers or
activity measures, which cause indirect costs to be incurred.
Three main types of Cost standards. - ANSWER ✔✔-Predetermined (Synthetic), Negotiated (Historical),
and Customized (Engineered)
Four Types of Individual Cost behaviors - ANSWER ✔✔-Variable, Fixed Cost Pattern, Semi-Variable Cost
Pattern, Semi-Fixed or Stepped Variable
Three Principal Types of expense variances - ANSWER ✔✔-Price, Volume, and Efficiency
The 4 Primary payment methods used in managed care - ANSWER ✔✔-Fee-for-Service, Per Diem Rate,
Case Rate, Capitation
Healthcare providers should develop different modeling tools depending on - ANSWER ✔✔-the
reimbursement method proposed in the contract
Created by Grace Amelia © 2025, All Rights Reserved.
,2|Page
The general categories of provider excess loss insurance are - ANSWER ✔✔-per-person, aggregate, and
carve-out.
A Strategic Plan allows organizations to - ANSWER ✔✔-have a clear plan as to why they are in business
and how they can stay in business in the future.
The main types of control budgets include - ANSWER ✔✔-operating, capital, and cash.
A budgeting process develops assumptions for the following: - ANSWER ✔✔-Admissions, ALOS,
Expense per visit, Inflation on expense, FTE per visit, Productivity on FTE per visit, Labor cost per FTE,
Net Rev per visit
Operating budget's statistical factors include - ANSWER ✔✔-Historical statistics, Historical relationship
of department volume, anticipated effects of new programs, clinical practice patters, covered lives in
global payment risk programs, changes in regulatory environment, technical developments, process
improvements, marketing efforts, demographic trends
The primary purpose of measuring productivity is - ANSWER ✔✔-for management to determine if
resources are being used efficiently
Budget types include - ANSWER ✔✔-fixed and flexible
The four budget variances used to explain by cause are - ANSWER ✔✔-Volume, rate (charged), price (of
a supply), and efficiency (cost per procedure).
Three common Capital Evaluation techniques - ANSWER ✔✔-Payback, Net Present Value Method,
Return on Investment
Users of ratio analysis - ANSWER ✔✔-Board of Directors, Management, Health Systems Agencies,
Creditors, Employee Unions, Rate Regulators
Created by Grace Amelia © 2025, All Rights Reserved.
,3|Page
The categories of ratios used - ANSWER ✔✔-Profitability Ratios, Liquidity Ratios, Activity Ratios, Capital
Structure Ratios
Two common types of long-term debt - ANSWER ✔✔-Revenue bonds and General Obligation Bonds
Undertake debt restructuring by either retiring or reacquiring existing debt for 4 reasons - ANSWER ✔✔-
Take advantage of lower interest rates, change collateral restrictions, allow acquisition of other assets,
better fit debt service requriements
Healthcare bond issues place legal obligations on - ANSWER ✔✔-the borrower intended to protect the
lender against default by the borrower.
In order to use the discounted cash flow method - ANSWER ✔✔-you need to know the payment flow or
payment pattern and the interest rate
Every capital investment proposal requires 4 quantifiable factors - ANSWER ✔✔-Cash Outflow, Cash
Inflow, Economic Life, Opportunity Cost of funds
Three significant Investment valuation methods - ANSWER ✔✔-Discounted cash flow method,
Replacement cost method, Market comparison
Two types of equity financing - ANSWER ✔✔-Internal and External
In a capital lease, all of the benefits and risks of owner except title or ending (salvage value) - ANSWER
✔✔-get transferred to the lessee. The lessor recovers full price and interest during the lease.
An operating lease is - ANSWER ✔✔-when the hospital is liable for the leasing cost; renewal options are
determined by the fair market value
Advantages of leasing - ANSWER ✔✔-working capital is conserved, budgetary control, tax benefits may
be realized, project may be financed 100%, lessee has greater flexibility in replacing equipment
Created by Grace Amelia © 2025, All Rights Reserved.
, 4|Page
Disadvantages of leasing - ANSWER ✔✔-Cost of extending the lease may be more than the actual
purchase price, Interest costs are higher than debt, third parties will recognize a full lease payment as
allowable only if a true operating lease, the leasing company frequently passes the cost of property tax to
the lessors
When issuing a rating on a specific organization, a rating agency will commonly consider the following -
ANSWER ✔✔-Provisions or structure of the financing, competitive environment and market position,
medical staff characteristics, management capability, financial
Methods of a Cash budget: - ANSWER ✔✔-Cash receipts and disbursements Method, Adjusted Net
Income Method, Working Capital Differential Method
Primary purposes of a cash budget: - ANSWER ✔✔-Identify cash requirements and sources for a certain
period of time, control the flow of cash funds
Healthcare organizations use commercial banking services for: - ANSWER ✔✔-Controlled Disbursement
Account, Depository Account, Concentration Account and Zero Balance Account, Sweep Account
The components incorporated in a cash budget: - ANSWER ✔✔-Ability of the organization to manage
overall revenue cycle, projection of costs, variability in activities that impact both revenues and expenses,
regularly recurring or periodic expenses, timing of capital purchases
An investment policy - ANSWER ✔✔-Establishes a framework to make investment decisions and
evaluate results
The returns, risks, and correlation are the primary inputs for - ANSWER ✔✔-asset allocation models
Different types of asset allocation risks are as follows: - ANSWER ✔✔-maturity (liquidity) risk, interest
rate risk, credit risk, political (legal) risk, market (price) risk
Created by Grace Amelia © 2025, All Rights Reserved.
