michael rhook, health economics - casemix accounting - revenue the missing link
DESCRIPTION
Michael Rhook, Consultant, Health Economics delivered the presentation at the 2014 Hospital Patient Costing Conference. The Hospital Patient Costing Conference 2014 examines the development and implementation of patient costing methodologies to reflect Activity Based Funding allocations. For more information about the event, please visit: http://www.healthcareconferences.com.au/patientcostingconferenceTRANSCRIPT
![Page 1: Michael Rhook, Health Economics - Casemix Accounting - Revenue the Missing Link](https://reader034.vdocument.in/reader034/viewer/2022052619/5561b9e1d8b42a74208b4edb/html5/thumbnails/1.jpg)
Revenue - the missing link MARCH 2014
1
![Page 2: Michael Rhook, Health Economics - Casemix Accounting - Revenue the Missing Link](https://reader034.vdocument.in/reader034/viewer/2022052619/5561b9e1d8b42a74208b4edb/html5/thumbnails/2.jpg)
Clinical Costing 2
CLINICAL DATA
PRICING DATA
ü üü
ü ý ý
![Page 3: Michael Rhook, Health Economics - Casemix Accounting - Revenue the Missing Link](https://reader034.vdocument.in/reader034/viewer/2022052619/5561b9e1d8b42a74208b4edb/html5/thumbnails/3.jpg)
Simple Presentation 3
DEFINE THE PROBLEM
OUTLINE THE REASON
A SIMPLE SOLUTION
![Page 4: Michael Rhook, Health Economics - Casemix Accounting - Revenue the Missing Link](https://reader034.vdocument.in/reader034/viewer/2022052619/5561b9e1d8b42a74208b4edb/html5/thumbnails/4.jpg)
Not matching revenue with expenditure – the problems
u Understating expenditure for medical costs
u Allocating expenditure to the wrong patient groups
u Attributing expenditure for non-patient care purposes to patient care
u Not conceding that revenue does not come free
u Very poor pricing regimes, specifically differentiating public and private patients
4
![Page 5: Michael Rhook, Health Economics - Casemix Accounting - Revenue the Missing Link](https://reader034.vdocument.in/reader034/viewer/2022052619/5561b9e1d8b42a74208b4edb/html5/thumbnails/5.jpg)
Take a data set of $2B in Health Services 5
![Page 6: Michael Rhook, Health Economics - Casemix Accounting - Revenue the Missing Link](https://reader034.vdocument.in/reader034/viewer/2022052619/5561b9e1d8b42a74208b4edb/html5/thumbnails/6.jpg)
Revenue for the Same $2B 6
![Page 7: Michael Rhook, Health Economics - Casemix Accounting - Revenue the Missing Link](https://reader034.vdocument.in/reader034/viewer/2022052619/5561b9e1d8b42a74208b4edb/html5/thumbnails/7.jpg)
GL Revenue for Inpatients 7
![Page 8: Michael Rhook, Health Economics - Casemix Accounting - Revenue the Missing Link](https://reader034.vdocument.in/reader034/viewer/2022052619/5561b9e1d8b42a74208b4edb/html5/thumbnails/8.jpg)
What is all the income for? 8
Programs and Fixed Revenue -‐ How do we match expenses?Development programsTrainingResearchPilot ProgramsNon-Direct Care Public Health Matters
Q. Why are there profits in Special Purpose Funds?A. Because the matching expense is still in the Operating Fund.
![Page 9: Michael Rhook, Health Economics - Casemix Accounting - Revenue the Missing Link](https://reader034.vdocument.in/reader034/viewer/2022052619/5561b9e1d8b42a74208b4edb/html5/thumbnails/9.jpg)
11 ways for Medical Appointments and recognising Private Patient Fees
9
Medical/Surgical/Anaes/Intensivists
Private FeesRecovered Shared SPF's Off -‐ Books
Full time Sometimes Sometimes Often Occasionally 4 Fractional No No Sometimes Often 2 Sessional Sometimes Sometimes Often Often 4 FFS No No No Always 1
11
![Page 10: Michael Rhook, Health Economics - Casemix Accounting - Revenue the Missing Link](https://reader034.vdocument.in/reader034/viewer/2022052619/5561b9e1d8b42a74208b4edb/html5/thumbnails/10.jpg)
Private Patients – If I cannot see the fees, how can I know the cost?
10
Private FeesRecovered Shared SPF's Off -‐ Books
Prosthesis Mostly Occasionally
Diagnostic ServicesPrivate Fees
Operating SPF's Off -‐ BooksPathology - Outsourced FFS Public FFS no AlwaysImaging - Outsourced FFS Public FFS no AlwaysPathology - In House Public FFS PrivateImaging - In-house Public FFS Private
![Page 11: Michael Rhook, Health Economics - Casemix Accounting - Revenue the Missing Link](https://reader034.vdocument.in/reader034/viewer/2022052619/5561b9e1d8b42a74208b4edb/html5/thumbnails/11.jpg)
Costing hates a vacuum 11
Orthopeadics FFS/Sessional/Fractional
Cost Bucket Public Private RevenueMedical Y no revenue = no expenseWards Y YAllied Health Y YMedical Support Y YPathology Y no revenue = no expenseRadiology Y no revenue = no expensePharmacy Y YICU Y YTheatre Y YSpecialist Y no revenue = no expenseProsthesis Y no revenue = no expenseED Y YHotel Y YOheads Y Y
![Page 12: Michael Rhook, Health Economics - Casemix Accounting - Revenue the Missing Link](https://reader034.vdocument.in/reader034/viewer/2022052619/5561b9e1d8b42a74208b4edb/html5/thumbnails/12.jpg)
Solution – Revenue Buckets and Standards for Allocation
u A reconciliation of revenue as well as expenditure when submitting costing data.
u A matching of revenue and expenditure at episode level
u A concession that all revenue has a cost and it is not necessarily a patient cost.
u For private patients a “NO REVENUE = NO COST” Policy
12
![Page 13: Michael Rhook, Health Economics - Casemix Accounting - Revenue the Missing Link](https://reader034.vdocument.in/reader034/viewer/2022052619/5561b9e1d8b42a74208b4edb/html5/thumbnails/13.jpg)
Complete the process. It’s timely and relatively easy
13
![Page 14: Michael Rhook, Health Economics - Casemix Accounting - Revenue the Missing Link](https://reader034.vdocument.in/reader034/viewer/2022052619/5561b9e1d8b42a74208b4edb/html5/thumbnails/14.jpg)
Solution
u Revenue Buckets
u Revenue matching – it is a handy tool when analyzing expenditure
u Revenue allocation processes
u A completed process using the other 50% of the available data.
14
![Page 15: Michael Rhook, Health Economics - Casemix Accounting - Revenue the Missing Link](https://reader034.vdocument.in/reader034/viewer/2022052619/5561b9e1d8b42a74208b4edb/html5/thumbnails/15.jpg)
Benefits
u Better expenditure matching
u Better pricing
u Better Accountability for funders and providers
15