Budgeting & Problem Solving

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Week4DQ_Budgeting.docx

Week 4: DQ 4.3

Budgeting & Problem Solving

After reading Chapter 19: Managing Costs and Budgets and the following online articles, watch this interview with a nurse manager about budgets and budgeting.

InterviewBudget_KellyEdmondson

Christman, E. & Ernstmeyer (Eds) (n.d.).  Nursing management and professional concepts. Chippewa Valley Technical College. Creative Commons Attribution 4.0.  https://wtcs.pressbooks.pub/nursingmpc/Links to an external site. 

Clipboard Health. (2020, June 1). How to develop a nursing unit budget.   https://nursingcecentral.com/how-to-formulate-a-nursing-budget/Links to an external site. 

Approved Resources to Use in Writing Discussion Posts:

· The course textbook,

· any published peer-reviewed full-text article from the CINAHL database 

Prepare a minimum of a 200-word response using the instructions and the scoring rubric. 

Make sure you review the information from the rubric and grading information. Write your post in your own words and do NOT use direct quotations.  APA Format is required to support citations and references. 

· Case Study B

In Table 1 is a 20-bed nursing unit expense budget for June 2013.  The average census in June 2013 was the same as budgeted (18 patients/day average).  The columns show the budget for June, the actual expenses for June and the variance (the difference between the expected and actual budget expenses).  In the last two columns, you see the expenses YTD (year to date; Jan - June) for the current year and the final column shows the YTD expenses (Jan - Jun) for the prior year. 

Please note that the numbers provided are in the "thousands".  Example:  Productive budget or June is actually $200,000 (not $200).

1. Study the columns and rows in this budget report.

2. Identify where the unit is over budget or under budget.

3. As the nurse manager, brainstorm how to explain this budget variance and write your answer as you would present to the Chief Nursing Officer.

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Chapter_019ManagingCostandBudget.pptx

Chapter 19

Managing Costs and Budgets

1

Learning Outcomes (1 of 2)

Evaluate significant factors escalating the costs of healthcare.

Compare and contrast different reimbursement methods and their incentives to control costs.

Differentiate costs, charges, and revenue concerning a specified unit of service, such as a visit, hospital stay, or procedure.

Value why all healthcare organizations must make a profit.

2

2

Learning Outcomes (2 of 2)

Give examples of cost considerations for nurses.

Differentiate between the operating, cash, and capital budgets in terms of purpose and relationships.

Explain the budgeting process.

Identify variances on monthly expense reports.

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3

Introduction

Gross domestic product (GDP) is the broadest measure of the health of the U.S. economy.

Real GDP: output of goods and services produced by labor and property located in the United States

4

4

What Escalates Healthcare Costs

Cost are a function of price and utilization rates

Price inflation

Inefficiency

Multi-payer systems

5

5

Factors Increase Cost

Unnecessary care

Healthcare financing

Pharmaceutical usage

Population demographics

Consumer attitudes

6

6

How Healthcare is Financed

Four sources

Government

Private insurance companies

Individuals

Other

7

7

Medicare

Medicare

Part A (hospital, hospice, home health, skilled nursing)

Part B (provider, medical equipment, diagnostics)

Part D (drug benefit plans)

8

8

Medicaid

Medicaid

State level program

Medically indigent, blind, or disabled

Children with disabilities

Majority paid by federal government

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9

Healthcare Reimbursement

Major methods

Cost-based reimbursement

Prospective payment system (PPS)

Diagnosis-related groups (DRGs)

Value-based purchasing

Hospital value-based purchasing program (HVBPP)

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10

The Changing Healthcare Economic Environment

Major public concern

Need to reduce costs

Improve outcomes

Improve wellness

11

Healthcare Delivery Reform Strategies

Managed Care

Organized Delivery Systems (ODSs)

Competition based systems

12

The Healthcare Economic Environment and Nursing Practice

Practice within a context of organizational viability and quality of care.

“Financial Thinking”

Nursing services considered value added for patients

Use cost-conscious nursing practices

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13

Understanding What is Required to Remain Financially Sound

Understand finances of department

Fee-for-service environment

Understand healthcare payment systems

Know reimbursement practices

Capture all charges

Mange time efficiently

Discuss cost with patients

Use of evidence based practice

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14

Budgets

Theoretical Frameworks for Budgeting

Nursing Budgets

Types of Budgets

Operating budget

Capital expenditure budget

Cash budget

The Budgeting Process

Managing the Unit-Level Budget

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15

Operating Budget

Cost center required organizational unit

Includes

Personnel

Unit of service measures

Supply

16

Personal Budget Considerations

Full-time equivalents (FTEs)

Productive hours

Nonproductive hours

17

The Budgeting Process

Gathering information and planning

Developing unit and departmental budgets

Developing cash budgets

Negotiating and revising

Evaluating

Reporting variance

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18

Conclusion

Managing cost is a must

Understanding budgets is important

Cost-effective nursing care required

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RNtoBSNDiscussionRubric.docx

BSN Discussion Rubric

Criteria

Ratings

Pts

Initial Post

· Discussion postings are responsive to the requirements of the discussion instructions and demonstrate the student has read the assigned materials. Minimum of 200 words for the initial post unless otherwise specified in the discussion question instructions (10 points).

· Post is primarily written in own words and does not include more than one direct quote and is not more than 10% of the total word count (10 points).

· Discussion postings significantly contribute to the quality of interaction by providing rich and relevant examples, applicable research support, discerning ideas, and/or stimulating thoughts/probes, and are respectful when offering suggestions, constructive feedback, or opposing viewpoints (10 points).

· The Initial Discussion Posts requires 2 credible sources published in the last 5 years; one of the sources must be the course textbook (5 points).

· Discussion posts use in-text citations and references in proper APA format; one of the sources must be the course textbook (5 points).

· Post is submitted before the submission deadline (defined as 11:59 p.m. on the due date) (10 points). All posts must be completed by Sunday 11:59 pm at the end of the Week when the discussion closes.

50 pts

Meets all Criteria

0 pts

No Marks

50 pts

First Response Post

· Discussion postings significantly contribute to the quality of interaction by providing rich and relevant examples, applicable research support, discerning ideas, and/or stimulating thoughts/probes, and are respectful when offering suggestions, constructive feedback, or opposing viewpoints with a minimum of 75 words excluding the reference (5 points).

· Post is primarily written in own words and does not include more than one direct quote and is not more than 10% of the total word count (5 points).

· Response posts require a minimum of one credible source published in the last 5 years (5 points).

· Discussion posts use in-text citations and references in proper APA format (5 points).

· Students are to post the first response post to at least one classmate on a different day than they posted their initial post (5 points).

If the instructor replies to your post with a question, it is expected that the student replies to the instructor’s question.

All posts must be completed by Sunday 11:59 pm at the end of the week when the discussion closes.

25 pts

Full Marks

0 pts

No Marks

25 pts

Second Response

· Discussion postings significantly contribute to the quality of interaction by providing rich and relevant examples, applicable research support, discerning ideas, and/or stimulating thoughts/probes, and are respectful when offering suggestions, constructive feedback, or opposing viewpoints with a minimum of 75 words excluding the reference (5 points).

· Post is primarily written in own words and does not include more than one direct quote and is not more than 10% of the total word count (5 points).

· Response posts require a minimum of one credible source published in the last 5 years (5 points).

· Discussion posts use in-text citations and references in proper APA format (5 points).

· Students are to post their second response post on a different day than they posted their initial post (5 points).

If the instructor replies to your post with a question, it is expected that the student replies to the instructor’s question.

All posts must be completed by Sunday 11:59 pm at the end of the Week when the discussion closes.

25 pts

Full Marks

0 pts

No Marks

25 pts

Total Points: 100

Icon Description automatically generated

The criterion in this rubric is linked to a Learning Outcome. Last updated 2021

Icon Description automatically generated

The criterion in this rubric is linked to a Learning Outcome. Last updated 2021

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