HFMA's CSAF 2021, Certified Specialist
Accounting and Finance, Latest
Updated 2025/2026. 356Q&A. 100%.
Difference between marginal revenue and marginal cost.
Contribution Margin
Level of sales volume of a product producing the exact amount of contribution margin needed to
cover fixed costs.
Break-even point
Indirect Costs
Overhead
Method of determining product costs using cost drivers or activity measures, which cause indirect
costs to be incurred.
Activity-based costing (ABC)
Predetermined (Synthetic), Negotiated (Historical), and Customized (Engineered)
Three main types of Cost standards.
Variable, Fixed Cost Pattern, Semi-Variable Cost Pattern, Semi-Fixed or Stepped Variable
Four Types of Individual Cost behaviors
Price, Volume, and Efficiency
Three Principal Types of expense variances
Fee-for-Service, Per Diem Rate, Case Rate, Capitation
The 4 Primary payment methods used in managed care
the reimbursement method proposed in the contract
Healthcare providers should develop different modeling tools depending on
per-person, aggregate, and carve-out.
The general categories of provider excess loss insurance are
have a clear plan as to why they are in business and how they can stay in business in the future.
A Strategic Plan allows organizations to
operating, capital, and cash.
The main types of control budgets include
,Admissions, ALOS, Expense per visit, Inflation on expense, FTE per visit, Productivity on FTE per visit,
Labor cost per FTE, Net Rev per visit
A budgeting process develops assumptions for the following:
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
Operating budget's statistical factors include
for management to determine if resources are being used efficiently
The primary purpose of measuring productivity is
fixed and flexible
Budget types include
Volume, rate (charged), price (of a supply), and efficiency (cost per procedure).
The four budget variances used to explain by cause are
Payback, Net Present Value Method, Return on Investment
Three common Capital Evaluation techniques
Board of Directors, Management, Health Systems Agencies, Creditors, Employee Unions, Rate
Regulators
Users of ratio analysis
Profitability Ratios, Liquidity Ratios, Activity Ratios, Capital Structure Ratios
The categories of ratios used
Revenue bonds and General Obligation Bonds
Two common types of long-term debt
Take advantage of lower interest rates, change collateral restrictions, allow acquisition of other
assets, better fit debt service requriements
Undertake debt restructuring by either retiring or reacquiring existing debt for 4 reasons
the borrower intended to protect the lender against default by the borrower.
Healthcare bond issues place legal obligations on
you need to know the payment flow or payment pattern and the interest rate
In order to use the discounted cash flow method
Cash Outflow, Cash Inflow, Economic Life, Opportunity Cost of funds
Every capital investment proposal requires 4 quantifiable factors
Discounted cash flow method, Replacement cost method, Market comparison
,Three significant Investment valuation methods
Internal and External
Two types of equity financing
get transferred to the lessee. The lessor recovers full price and interest during the lease.
In a capital lease, all of the benefits and risks of owner except title or ending (salvage value)
when the hospital is liable for the leasing cost; renewal options are determined by the fair market
value
An operating lease is
working capital is conserved, budgetary control, tax benefits may be realized, project may be
financed 100%, lessee has greater flexibility in replacing equipment
Advantages of leasing
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
Disadvantages of leasing
Provisions or structure of the financing, competitive environment and market position, medical staff
characteristics, management capability, financial
When issuing a rating on a specific organization, a rating agency will commonly consider the
following
Cash receipts and disbursements Method, Adjusted Net Income Method, Working Capital
Differential Method
Methods of a Cash budget:
Identify cash requirements and sources for a certain period of time, control the flow of cash funds
Primary purposes of a cash budget:
Controlled Disbursement Account, Depository Account, Concentration Account and Zero Balance
Account, Sweep Account
Healthcare organizations use commercial banking services for:
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
The components incorporated in a cash budget:
Establishes a framework to make investment decisions and evaluate results
An investment policy
asset allocation models
, The returns, risks, and correlation are the primary inputs for
maturity (liquidity) risk, interest rate risk, credit risk, political (legal) risk, market (price) risk
Different types of asset allocation risks are as follows:
Effectiveness and efficiency of operations, Reliability of financial reporting (external and internal),
compliance with applicable laws and regulations
Three Internal control objectives:
Enhanced standards for accountability and penalties for wrongdoing.
Sarbanes-Oxley established:
Disclosure controls, ensuring specified information (controls) is made known to them, regular
evaluations of controls with quarterly certifications
Sarbanes-Oxley makes it so that CEOs and CFOs are responsible for:
Register public accounting firms, establish audit standards, inspect accounting firms, disciplinary
proceedings and appropriate sanctions, PCAOB budget.
PCAOB does:
Objective, Date, Evaluation
Components of auditor's attestation report:
management to ensure objectives and organizational policies are effectively carried out.
Operational auditing is one technique available to
are satisfied within a year of the balance sheet date
Current liabilities
Notes payable to banks, current portions of long-term debt, accounts payable, advances from and
accounts payable to third-party payers for reimbursement settlements, refunds, deferred revenue,
accrued salaries, current portion of malpractice costs
Examples of current liabilities:
No inures to private shareholder, no influencing legislation, no political campaign
Exemption requirements for nongovernmental not-for-profit healthcare:
form for income tax under IRS section 501(a) and for non-exempt charitable trusts
IRS form 990 - Return of Organization Exempt from Income Tax
on financing long-term debt
Most healthcare organizations are dependent
to restructure their long-term liabilities, reduce interest rates, or terminate restrictive bond
covenants
Advance refunding enables providers:
Accounting and Finance, Latest
Updated 2025/2026. 356Q&A. 100%.
Difference between marginal revenue and marginal cost.
Contribution Margin
Level of sales volume of a product producing the exact amount of contribution margin needed to
cover fixed costs.
Break-even point
Indirect Costs
Overhead
Method of determining product costs using cost drivers or activity measures, which cause indirect
costs to be incurred.
Activity-based costing (ABC)
Predetermined (Synthetic), Negotiated (Historical), and Customized (Engineered)
Three main types of Cost standards.
Variable, Fixed Cost Pattern, Semi-Variable Cost Pattern, Semi-Fixed or Stepped Variable
Four Types of Individual Cost behaviors
Price, Volume, and Efficiency
Three Principal Types of expense variances
Fee-for-Service, Per Diem Rate, Case Rate, Capitation
The 4 Primary payment methods used in managed care
the reimbursement method proposed in the contract
Healthcare providers should develop different modeling tools depending on
per-person, aggregate, and carve-out.
The general categories of provider excess loss insurance are
have a clear plan as to why they are in business and how they can stay in business in the future.
A Strategic Plan allows organizations to
operating, capital, and cash.
The main types of control budgets include
,Admissions, ALOS, Expense per visit, Inflation on expense, FTE per visit, Productivity on FTE per visit,
Labor cost per FTE, Net Rev per visit
A budgeting process develops assumptions for the following:
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
Operating budget's statistical factors include
for management to determine if resources are being used efficiently
The primary purpose of measuring productivity is
fixed and flexible
Budget types include
Volume, rate (charged), price (of a supply), and efficiency (cost per procedure).
The four budget variances used to explain by cause are
Payback, Net Present Value Method, Return on Investment
Three common Capital Evaluation techniques
Board of Directors, Management, Health Systems Agencies, Creditors, Employee Unions, Rate
Regulators
Users of ratio analysis
Profitability Ratios, Liquidity Ratios, Activity Ratios, Capital Structure Ratios
The categories of ratios used
Revenue bonds and General Obligation Bonds
Two common types of long-term debt
Take advantage of lower interest rates, change collateral restrictions, allow acquisition of other
assets, better fit debt service requriements
Undertake debt restructuring by either retiring or reacquiring existing debt for 4 reasons
the borrower intended to protect the lender against default by the borrower.
Healthcare bond issues place legal obligations on
you need to know the payment flow or payment pattern and the interest rate
In order to use the discounted cash flow method
Cash Outflow, Cash Inflow, Economic Life, Opportunity Cost of funds
Every capital investment proposal requires 4 quantifiable factors
Discounted cash flow method, Replacement cost method, Market comparison
,Three significant Investment valuation methods
Internal and External
Two types of equity financing
get transferred to the lessee. The lessor recovers full price and interest during the lease.
In a capital lease, all of the benefits and risks of owner except title or ending (salvage value)
when the hospital is liable for the leasing cost; renewal options are determined by the fair market
value
An operating lease is
working capital is conserved, budgetary control, tax benefits may be realized, project may be
financed 100%, lessee has greater flexibility in replacing equipment
Advantages of leasing
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
Disadvantages of leasing
Provisions or structure of the financing, competitive environment and market position, medical staff
characteristics, management capability, financial
When issuing a rating on a specific organization, a rating agency will commonly consider the
following
Cash receipts and disbursements Method, Adjusted Net Income Method, Working Capital
Differential Method
Methods of a Cash budget:
Identify cash requirements and sources for a certain period of time, control the flow of cash funds
Primary purposes of a cash budget:
Controlled Disbursement Account, Depository Account, Concentration Account and Zero Balance
Account, Sweep Account
Healthcare organizations use commercial banking services for:
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
The components incorporated in a cash budget:
Establishes a framework to make investment decisions and evaluate results
An investment policy
asset allocation models
, The returns, risks, and correlation are the primary inputs for
maturity (liquidity) risk, interest rate risk, credit risk, political (legal) risk, market (price) risk
Different types of asset allocation risks are as follows:
Effectiveness and efficiency of operations, Reliability of financial reporting (external and internal),
compliance with applicable laws and regulations
Three Internal control objectives:
Enhanced standards for accountability and penalties for wrongdoing.
Sarbanes-Oxley established:
Disclosure controls, ensuring specified information (controls) is made known to them, regular
evaluations of controls with quarterly certifications
Sarbanes-Oxley makes it so that CEOs and CFOs are responsible for:
Register public accounting firms, establish audit standards, inspect accounting firms, disciplinary
proceedings and appropriate sanctions, PCAOB budget.
PCAOB does:
Objective, Date, Evaluation
Components of auditor's attestation report:
management to ensure objectives and organizational policies are effectively carried out.
Operational auditing is one technique available to
are satisfied within a year of the balance sheet date
Current liabilities
Notes payable to banks, current portions of long-term debt, accounts payable, advances from and
accounts payable to third-party payers for reimbursement settlements, refunds, deferred revenue,
accrued salaries, current portion of malpractice costs
Examples of current liabilities:
No inures to private shareholder, no influencing legislation, no political campaign
Exemption requirements for nongovernmental not-for-profit healthcare:
form for income tax under IRS section 501(a) and for non-exempt charitable trusts
IRS form 990 - Return of Organization Exempt from Income Tax
on financing long-term debt
Most healthcare organizations are dependent
to restructure their long-term liabilities, reduce interest rates, or terminate restrictive bond
covenants
Advance refunding enables providers:
