FINANCE FOR HEALTHCARE

!0 question worksheet…

 

David Jones, the new administrator for a surgical clinic, was trying to determine how to allocate his indirect expenses. His staff was complaining that the current method of taking a percentage of revenues was unfair. He decided to try to allocate utilities based on square footage of each department, administration based on direct costs, and laboratory based on tests. Use the information in the chart below to answer problems 22, 23 and 24.

 

 

 

  Square Footage Direct

Expenses

Lab Tests
Utilities   $200,000  
Administration 2,000 500,000  
Laboratory 2,000 625,000  
Day-op Suite 3,000 1,400,000 4,000
Cystoscopy 1,500 300,000 500
Endoscopy 1,500 600,000 500
Total 10,000 $3,375,000 5,000

 

 

 

1.     What are the Day Op Suite’s total expenses?

 

 

 

2.     What are the Cystoscopy Department’s total expenses?

 

 

 

3.     What are the Endoscopy Department’s total expenses?

 

 

 

 

 

 

 

Use the following information for questions 4, 5, and 6.

 

 

 

Your hospital has been approached by a major HMO to perform all their MS-DRG 470 cases (major joint procedures). They have offered a flat price of $10,000 per case. You have reviewed your charges for MS-DRG 470 during the last year and found the following profile:

 

 

 

Average Charge      $15,000

 

Average LOS          5 Days

 

Cost/ChargeVariable Cost %

 

Routine Charge         $3,600              0.80                60

 

 

Operating Room       2,657              0.80                80

 

Anesthesiology            293              0.80                80

 

Lab                          1,035              0.70                30

 

Radiology                    345              0.75                50

 

Medical Supplies      4,524              0.50                90

 

Pharmacy                1,230              0.50                90

 

Other Ancillary         1,316              0.80                60

 

Total Ancillary          $11,400              0.75                50

 

 

 

4.     In the above data set, assume that the hospital’s cost to charge ratio is 0.80 for routine services and 0.75 for all other ancillary services. Using this information, what would the average cost of MS-DRG 470 be?

 

 

 

5.     Estimate the variable cost per MS-DRG 470 using the departmental cost/charge ratios and variable cost percentages.

 

 

 

6.     The HMO in the above example has indicated that their doctors use less expensive joint implants. If this less expensive implant is used, your medical supply charges would be reduced by $2,000. What is the estimated reduction in variable cost?

 

 

 

 

 

 

 

Use the following information for problems 7, 8, and 9.

 

 

 

You have been asked to establish a pricing structure for radiology on a per-procedure basis. Present budgetary data is presented below:

 

 

 

Budgeted Procedures   10,000

 

Budgeted Cost         $400,000

 

Desired Profit             $80,000

 

 

 

It is estimated that Medicare patients comprise 40 percent of total radiology volume and will pay on average $38.00 per procedure. Approximately 10 percent of the patients are cost payers. The remaining charge payers are summarized below:

 

 

 

                  Payer         Volume %     Discount %

 

Blue Cross          20                  4

 

Unity PPO           15                10

 

Kaiser                 10                10

 

Self Pay                5                40

 

50%

 

 

 

7.     What rate must be set to generate the required $80,000 in profit in the preceding example?

 

 

 

 

 

8.     If the forecasted volume increased to 12,000 procedures and budgeted costs increased to $440,000, while all other variables remained constant, what price should be established?

 

 

 

 

 

9.     Assume that the only change in the original example data is that Blue Cross raises their discount to 20 percent. What price should be set?

 

 

 

 

 

10.Calculate the breakeven price from the following information.

 

quantity of services = 3,000

 

fixed costs = $45,000

 

average cost per unit = $150.00

 

required profit = $30,000

 

 

 

 

 

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