Healthcare Finance- Week 1 Discussion

Healthcare Finance

Utilizing a Medicare Cost Report to Uncover Departmental Value

A Medicare Cost Report (MCR) collects descriptive data, both financial and statistical in nature, to identify if a facility has been overpaid or underpaid for Medicare patients. The data is also utilized to set prospective payments. MCRs are in place for institutional providers not physicians and remain the only national data available for all types of providers: profit, not-for-profit, and governmental.

Typical providers are hospitals, SNFs, HHA, hospice, renal dialysis centers, FQHC, and CAH (critical access hospitals).

For this Discussion, your task is to explore the role the MCR plays in a value-based healthcare system. Specifically, you will address issues included in the report like facility characteristics, utilization data, cost, and charges by cost center. Furthermore, choose two utilization metrics (data) and address how it has impacted the facility of your choice.

For this Discussion, you will select a hospital setting. You must reference an actual MCR and identify the facility you have chosen.

You will find all Indiana facilities (you can also use a state of your choice) and their MCRs listed on the  2022 Hospital Medicare Cost Reports Links to an external site.  page of the Indiana Department of Health website.

Post a cohesive response to the following:

· Describe the specific institution you identified.

· Utilizing the institution’s published MCR, analyzing costs and revenue of at least three specific departments.

· Evaluate implications of the volume of at least one of your specific departments to the facility’s future income stream.

Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.

Read a selection of your colleagues’ postings. Consider how your colleagues’ postings relate to the information presented in the Learning Resources and to your own posting.

Healthcare Finance

Week 1 Learning Resources

Required Reading

· Getzen, T. E., & Kobernick, M. S. (2022).  Health economics & financing (6th ed.). Wiley.

· Chapter 1, “Choices: Money, Medicine, and Health” (pp. 1–19)

· Pink, G. H., & Song, P. H. (2020).  Gapinski’s understanding healthcare financial management (8th ed.). Health Administration Press.

· Chapter 1, “Introduction to Healthcare Financial Management” (pp. 3–33)

· Chapter 2, “Health Insurance” (pp. 35–68)

· Beck da Silva Etges, A. P., Brasil Ruschel, K., Polanczyk, C. A., & Urman, R. A. (2020).  Advances in value-based healthcare by the application of time-driven activity-based costing for inpatient management: A systematic reviewLinks to an external site. .  Value in Health,  23(6). https://doi.org/10.1016/j.jval.2020.02.004

· Patrício, L., Sangiorgi, D., Mahr, D., Čaić, M., Kalantari, S., & Sundar, S. (2020).  Leveraging service design for healthcare transformation: Toward people-centered, integrated, and technology-enabled healthcare systemsLinks to an external site. .  Journal of Service Management,  31(5), 889–909. https://doi.org/10.1108/JOSM-11-2019-0332

Required Media

· Indiana Department of Health. (n.d.).  2022 hospital Medicare cost reports Links to an external site. . https://www.in.gov/health/cshcr/reports-on-health-care-facilities/hospital-reports/2022-hospital-medicare-cost-reports/

· Walden University, LLC. (2024).  Economic principles and value in healthcare [Video]. Walden University Canvas. https://waldenu.instructure.com

Optional Resources

· OASIS. (n.d.).  Statistics skills in Microsoft ExcelLinks to an external site. . Walden University. https://academicguides.waldenu.edu/academic-skills-center/microsoft-office/excel