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At least 19 recordsLinked to original sources
PubMed1993

Accurate charge capture and cost allocation: cost justification for bedside computing.

This paper shows that cost justification for bedside clinical computing can be made by recouping charges with accurate charge capture. Twelve months worth of professional charges for a sixteen bed surgical intensive care unit are computed from charted data in a bedside clinical database and are compared to the professional charges actually billed by the unit. A substantial difference in predicted charges and billed charges was found. This paper also discusses the concept of appropriate cost allocation in the inpatient environment and the feasibility of appropriate allocation as a by-product of bedside computing.

Cost Allocation↗
PubMed1984

A Markov sensitivity model for examining the impact of cost allocations in hospitals.

The cost allocation process in hospitals typically entails an accounting step-down procedure whereby costs are allocated from non-revenue producing service centres to revenue centres. The resulting revenue centre costs are then compared with the third party (Blue Cross, Medicare, Medicaid) allowable costs. Any costs in excess of the allowable costs are not reimbursable. This procedure has been conceptualized using a Markov chain in a recent journal article. The purpose of this paper is to demonstrate how the Markov model may be used to assess the impact of various changes in the original data without having to recalculate the entire step-down process via a Markov model or any other procedure. The changes include an alternate step-down model, a different cost allocation basis for one or more service centres, and the expansion or contraction of one or more service centres.

Cost Allocation↗
PubMed1988

Issues in nursing labor costs allocation.

Prospective payment has created a desire for improved internal operating efficiency by nurse executives and hospital administrators. Identifying nursing costs is one step in obtaining those efficiencies. Improved nursing cost allocation methods have been developed but these systems are costly to implement. Finding a low cost alternative to such systems would be valuable. The authors present direct comparisons of conventional daily and acuity based nursing labor costs allocation systems. Consistent with the findings of others, they demonstrate substantial differences between these methods. There is a high correlation of nursing labor costs with the patient's ancillary costs. However, the correlation is not sufficiently strong to use as a proxy for nursing costs. Consequently, nurse executives should strive to implement nursing cost allocation systems.

Ancillary Services, Hospital↗
PubMed1982

Cost allocation plans for public assistance programs--Health and Human Services Department. Interim final rule with comment period.

This rule revises existing regulations concerning the preparation, submission and approval of State agency cost allocation plans used in computing claims for Federal Financial Participation under public assistance programs. It also reflects the transfer of responsibility for review and approval of the plans to the Division of Cost Allocation (DCA) in the Department's regional offices. This responsibility was previously assigned to the Social and Rehabilitation Service which was abolished by Secretarial Order published on March 9, 1977 (42 FR 13262). The current rule has been rewritten so that it is clearer, easier to understand and more specific. The Department's Informal Grant Appeals regulation relative to cost allocation plans and indirect cost rates (45 CFR Part 75) is also being updated and revised to make it consistent with Supart E, Cost allocation plans, of 45 CFR Part 95, General administration--grant programs (public assistance and medical assistance). Although these regulations are final, the Department has decided to invite public comments for the reasons described in the Supplementary Information below. Comments may be submitted in the manner described below. If changes are needed as a result of the comments received, those changes will be published in the Federal Register along with the comments received and the Department's responses to those comments.

Cost Allocation↗
PubMed1994

Cost allocation patterns between hospital inpatient and outpatient departments.

OBJECTIVE: This study examines changes in hospitals' cost allocation patterns between inpatient and outpatient departments in response to the implementation of the prospective payment system. DATA SOURCES AND STUDY SETTINGS: The analysis was carried out using data for 3,961 hospitals obtained from the Medicare Cost Reports and from the American Hospital Association for the years 1984 through 1988. STUDY DESIGN: A total operating cost function was estimated on the two outputs of discharges and outpatient visits. The estimation results were instrumental in disaggregating costs into inpatient and outpatient components. This was done cross-sectionally for each of the five years. PRINCIPAL FINDINGS: Comparison of this cost breakdown with that of hospital revenue provides evidence of distinct patterns in which nonteaching, rural, and small hospitals increasingly allocated greater costs to outpatient departments than did large, urban, and teaching hospitals. CONCLUSIONS: The results suggest that small rural hospitals turned to the outpatient side in the face of tough economic challenges over the period of study. Because differences in cost allocation patterns occur by particular hospital category, analyses that rely on accounting cost or revenue data in order to identify cost differences among those same categories may come to erroneous conclusions. In particular, because teaching hospitals apportion costs more heavily on the inpatient side, cost allocation differences cause upward bias in the PPS medical education adjustment.

Cost Allocation↗
PubMed1982

Improved cost allocation in case-mix accounting.

Traditionally, many hospital costs have been allocated to patients using indirect measures that do not always reflect the value of the resources used to provide care. When, for example, costs are allocated by multiplying the patient's charges by the hospital's ratio of costs to charges, the allocated cost does not reflect actual cost because the hospital does not uniformly charge for services in proportion to their cost. The choice of method for cost allocation will be as important for the newly developed case-mix cost-accounting systems as it has been for traditional cost-accounting systems. To illustrate how the use of an indirect cost-allocation method might affect the output of a case-mix cost-accounting system, operating room, radiology and clinical laboratory costs were assigned to 106 hospitalized inguinal hernia patients in two diagnosis-related groups (DRGs) using both the hospital's existing cost-allocation method and a method that measures costs directly. Total costs and the costs in each department were significantly lower in each DRG using the direct method. It was concluded that patients in these two DRGs were being assigned more than the actual cost of their care with the existing cost-allocation method and, therefore, that the existing method prevented the case-mix accounting system from providing accurate management information.

Accounting↗
PubMed1990

[Pricing system for costly equipment. Cost allocation adapted to technical operating costs].

1. Our study consists on analysing annual technical operating costs (excluding professional fees) of computed tomography and extracorporeal lithotripsy in order to define a pricing system able to provide proper reimbursements of technical costs for costly equipment. 2. Economic and utilization data have been collected from physicians responsible for facilities and from equipment current manufacturers. Annual charges are assessed in function of annual volume of procedures. 3. Definition of mean costs (total mean cost, mean cost of one more procedure) and mean cost distribution analysis according to annual volume of procedures lead to propose a method for financing costly technical medical activities based on a two-price rate: until a defined number of procedures is reached, a full-rate reimbursement is applied and then, it is replaced by a reduced-rate reimbursement. 4. Such a pricing system is easy to manage and allows to fit annual technical receipts to annual technical expenditure on a wide range of patient procedure volume.

Equipment and Supplies, Hospital↗
PubMed1993

A cost allocation model for hospice.

Increasingly, nurses are becoming involved in the financial aspects of healthcare delivery to determine cost-effectiveness of nursing product lines. A model allocating costs for 15 service components was developed using data from 52 patients receiving Medicare hospice benefits in a home care environment. The model may be adapted for any service line with multiple components and providers to allocate patient care costs.

Cost Allocation↗
PubMed2000

Hospital and unit cost allocation methods.

The quest for an efficient healthcare system has resulted in the publication of many assessments relating to health facilities. Some use a methodological approach that, at first glance, appears questionable in terms of allocation of overhead or support costs among the facilities' centres of activity. The objective of this article is to verify, using hospital utilization data, whether the choice of an allocation method significantly affects the unit cost of such resources. The results obtained from our sample suggest that no statistically significant relationship exists between the methods used and the unit costs produced.

Accounting↗
PubMed1991

Prospective cost allocations for the chronic schizophrenic patient.

Schizophrenia affects from 0.5 percent to 1.0 percent of the population and is often a chronic relapsing illness with high morbidity. Because it strikes young adults, the lifetime direct and indirect costs are considerable. One method of budgeting the costs of treatment is through a prospective method with the development of "risk-adjusted" capitation rates that take into account a patient's past use of services, perceived health status, and level of disability. Such a system may provide opportunities to improve the quality of mental health services by increasing service flexibility, particularly in the development and differentiation of outpatient services. The essence of the approach is to encourage early intervention by reducing financial barriers for patients, especially barriers to alternatives to expensive inpatient services. One method currently employed in Rochester, New York, which creates a capitation payment system for the chronically mentally ill, will be described. The implications of this system for public policy will be discussed as we struggle to treat and care for chronic schizophrenic patients in humane and compassionate ways.

Capitation Fee↗