Economics and Financial Management for Nurses and Nurse Leaders (eBook)

CONTENTS

Contributors

Preface

Acknowledgments

PART I: OVERVIEW OF ECONOMICS AND HEALTH CARE

1 Economics of Health Care

Historical Context of Health Care and Nursing Economics

Health Care Costs

Health Care Economics Concepts

Economics and the Nursing Workforce

Crossword: Economics of Health Care

2 Health Insurance and Reimbursement

Health Care Coverage and the Uninsured

Health Insurance History and the ACA

ACA Timeline

Reimbursement Mechanisms

Principles of Health Insurance

Government Health Insurance Programs

Crossword: Health Insurance and Reimbursement

3 Managed Care and ACOs

Historic Foundations of Managed Care

Principles of Managed Care

Provider Reimbursement Mechanisms

Problems With Managed Care

ACOs Compared With MCOs

CMS and ACA Financing Innovations

Primary Care Utilization and Financial Measures

Performance Measures for Inpatient and Ambulatory Care

Comparing and Trending Indicators

Crossword: Managed Care and ACOs

PART II: BUDGETS AND BUDGETING

4 Measuring Nursing Care

Rules and Conventions for Reporting Indicators

Categories of Indicators

Measuring Nursing Care in a Nurse-Managed Health Center

Measuring Nursing Care in an Inpatient Nursing Unit

Crossword: Measuring Nursing Care

5 Reporting and Managing Budgets

Reporting Operating Budgets

Managing Operating Budgets

Health Center and Inpatient Unit Budgets

Crossword: Reporting and Managing Budgets

Appendix

6 Budget Planning

Budget Planning and the Nurse’s Role

Strategic Planning and Budget Linkage

Budget Forecasting

Planning the Operating Budget

Closing a Program

Crossword: Budget Planning

Appendix

7 Special Purpose, Capital, and Other Budgets

Special Purpose Budget

Product Line Budget

Evidence-Informed Case Rate

Capital Budget

Cash Flow Budget

Budget Relationships and Linkage

Crossword: Special Purpose, Capital, and Other Budgets

Appendix

PART III: FINANCIAL ANALYSIS AND MAKING A BUSINESS CASE

8 Cost Finding, Break Even, and Charges

Cost Finding

Cost Allocation

Break-Even Analysis

Contribution Margin

Prices and Pricing

Classification and Coding Systems

Crossword: Cost Finding, Break Even, and Charges

Appendix

9 Comparing Costs and Benefits

Cost–Benefit Analysis

Cost-Effectiveness Analysis

Cost–Utility Analysis

Program Evaluation

Limitations of CBA, CEA, and CUA

Comparative Effectiveness Research

Crossword: Comparing Costs and Benefits

Appendix 9A Worksheets

Appendix 9B A Cost–Benefit Analysis Evaluating Adult Outpatient Asthma Education

Appendix 9C A Cost-Effectiveness Analysis for Proposed Alternative Interventions to Postprocedure Surgical Pain Reduction

Appendix 9D A Cost–Utility Analysis Evaluating Adult Outpatient Asthma Education

10 Writing a Business Plan

Writing Skills for Business Plans

Business Plan Sections

Crossword: Writing a Business Plan and Health Program Grant Writing

Appendix 10A Business Plan Feasibility Checklist

Appendix 10B A Business Plan: To Initiate the Cleaning of Hospital Privacy Curtains to Reduce Nosocomial Infections at Bay General Hospital’s 4B Progressive Care Unit

Corinne M. Allen, Whitney E. Bralye, Madeira A. Macedo, Alysia D. Porter, and Heather N. Rothhammer

Appendix 10C Respiratory Project Committee, Fairfield County Hospital

Samanthika T. De Alwis, Jasmine B. Erguiza, Candace Fleming, and Jennifer N. Ma

Appendix 10D Increasing Patient Volume at the Bay General Hospital Cardiac Clinic

Yonatan G. Breiter, Seth M. Cloues, Caitlin O. Flanagan, Alex Guevarra, and Hector E. Solano

Appendix 10E Business Plan: Probiotic Use With Antibiotics

Natalie Bower, Gehrig Y. Ertle, Emily M. Finzen, Lindsey F. Reardon, and Cassen E. Uphold

11 Health Program Grant Writing

Business Plans and Grant Proposals

Grant Proposal Sections

After the Application Is Submitted

Crossword: Writing a Business Plan and Health Program Grant Writing

Appendix 11A Worksheets

Appendix 11B Dental Care Van Grant Proposal

Angelica Holguin, Christina M. Nardi, Diane Trinh, Paige M. Weisbrod, and Sara E. Moschetto

Appendix 11C Grant Proposal: Decreasing High Utilizers of the Emergency Department

Alexandra Carr, Caramia O. Perlas, Deborah B. Rosenberg, and Asja Serdarevic

Appendix 11D Incorporating Massage and Healing Touch Therapies on a Specialized Nursing Unit at Seaview Hospital: A Grant Application

Janet A. Giachello and Jennifer A. Schmid

PART IV: ADVANCED TOPICS

12 Assessing Financial Health

Hospital-Wide Indicators

Accounting Concepts

Financial Statements

Crossword: Assessing Financial Health, and Entrepreneurship and Practice Management

Appendix

13 Entrepreneurship and Practice Management

Starting a Nurse-Run Business

Principles for Practice Management

Nurse Entrepreneur Resources

Crossword: Assessing Financial Health, and Entrepreneurship and Practice Management

Appendix

14 Ethical Issues and International Health Care Systems

Bioethics and Health Economics

International Health Economics and Financing

Crossword: Ethical Issues and International Health Care Systems, and Health Policy and Future Trends

Appendix

15 Health Policy and Future Trends

Health Policy Questions

Future Trends

Keeping Up to Date

Crossword: Ethical Issues and International Health Care Systems, and Health Policy and Future Trends

Appendix

Glossary

Resources

Crossword Puzzle Answer Key

Index