The report provides a financial and operational plan for a new health care facility in Princes Highway, Kirrawee, Australia. It includes objectives, benefits, risks, process, resources, and financial information.
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Running head: HEALTH FINANCIAL MANAGEMENT Health Financial Management Name of the Student Name of the University Authors Note Course ID
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1HEALTH FINANCIAL MANAGEMENT Executive Summary The report relates to provide a financial and operational plan for proposing a new health care facility which will be situated in Princes Highway, Kirrawee, at Australia. Some of the main information in the report will include the objectives to be achieved, contribution to the local health District and new services which are to be introduced. The overall outcomes have shown the essential form of value to the Local Health District in this proposal will involve encouragement of the people to actively take part in taking care of their health, promotion of liaising with other health agencies and service providers, encouragement of individuals and community groups at district level for activelyparticipating in the Centre’sactivities including different types of fundraising. The discussions have also identified that the processes for delivering such services will involve X-Ray, ultrasonography and general health check-up. Some of the equipment needed to proceed with such a plan will involve X- Ray Film processor table top is, Ultrasound (3 probes), Gastroscope (With halogen light source), Colonoscope (With halogen light source). In addition to this, the utilities required are seeninformofOperatingTable(Trauma/Multifunction,electric/hydraulicdriven) Anaesthesia trolley and Syringe pump. The overall depiction of the annual cost health centre facility is computed as $26,85,477.60, while the total profit is seen as $ 520322522.4.
2HEALTH FINANCIAL MANAGEMENT Table of Contents Introduction................................................................................................................................2 Background................................................................................................................................3 The Proposal...............................................................................................................................4 Aims.......................................................................................................................................4 Benefits..................................................................................................................................4 Efficiency Gains.................................................................................................................4 Potential Savings/increased costs.......................................................................................4 Expected benefits of the proposal......................................................................................4 Risks...........................................................................................................................................5 Process........................................................................................................................................8 Resources...................................................................................................................................8 Reporting of outcomes...............................................................................................................8 Financial Information.................................................................................................................8 Conclusion..................................................................................................................................8 References................................................................................................................................10 Attachment 1............................................................................................................................11 Attachment 2............................................................................................................................12
3HEALTH FINANCIAL MANAGEMENT Introduction The present business case relates to provide a financial and operational plan for proposing a new health care facility which will be situated in Princes Highway, Kirrawee, at Australia. Some of the main information in the report will include the objectives to be achieved,contributionto thelocalhealthDistrictand newserviceswhichare tobe introduced. In addition to this, the next section is involved with providing a discourse on the background, which can suggest why the hell services will be beneficial for this particular area. This information will justify the necessity of such a service. Thirdly, the proposal will highlight the main aims, benefits and factors associated with the new healthcare setup. This section will be followed by identifying the risks associated to the business. This will classify the risks in form of civility, in fact, mitigation plan along with other notes. The next important part of the study will highlight the action process, nomination of staff members and the responsibilities assigned to them. The discussions of the report will also include the monitoring plan along with outcomes, savings and the main areas of decreasing costs associated with the project. Outline The various types of objectives which are to be achieved by the new health care facility will include Promotion of health check-up activities, providing medical and nursing service, Providing different types of support and counselling services. In addition to this, there will be objectives associated to the facility which will include encouraging dental health check-ups on a regular basis and Providing occupational therapy, audiology, dietetics, physiotherapy and speech therapy. The essential form of value to the Local Health District in this proposal will involve encouragement of the people to actively take part in taking care of theirhealth,promotionofliaisingwithotherhealthagenciesandserviceproviders,
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4HEALTH FINANCIAL MANAGEMENT encouragementofindividualsandcommunitygroupsatdistrictlevelforactively participating in the Centre’s activities including different types of fundraising. Moreover, service planning and volunteer work will be also included under the district level duties of the healthcare facility. The district level activities will also include partnering with primary health care providers like General practitioners (GPs) for delivering a coordinated service. Some of the important form of new services to be introduced will include aged care services, disability services, mental health programs and rehabilitation programs. Background The necessity of the health service is to mainly encourage people in actively taking part in their own health check-ups. In addition to this, at the LHD level, the health care plan will look forward to work together with a greater number of primary health care providers which will introduce innovative health check-up solutions at a cheaper cost. Furthermore, the individuals and the communities will be able to actively involved in the lifestyle -related diseases which is a major concern in any area. It needs to be also understood that the development of health care program will not only include the programs to improve the social well-being but also physical environment in a community. The processes for delivering such services will involve X-Ray, ultrasonography and general health check-up. Some of the equipment needed to proceed with such a plan will involve X-Ray Film processor table top is, Ultrasound (3 probes), Gastroscope (With halogen light source), Colonoscope (With halogen light source). In addition to this, the utilities required are seen in form of Operating Table (Trauma/Multifunction, electric/hydraulic driven) Anaesthesia trolley and Syringe pump. The overall depiction of the annual cost health centre facility is computed as $26,85,477.60, while the total profit is seen as $ 520322522.4.
5HEALTH FINANCIAL MANAGEMENT The Proposal Aims The main aim of the proposed business case is associated to suggest a financial and operational plan for a new health centre facility which will be able to provide full range of services at a minimised cost. Benefits Efficiency Gains The important nature of efficiency gains from the business case is aimed at showing the best use of asset utilisationsuch as machinery,property, rent,building rent and equipment. Potential Savings/increased costs The potential areas of cost savings will involve early detection and treatment of the patients. Expected benefits of the proposal FactorBenefits PatientsThe various types of expected benefits to the patients will involve better self-service of their own health, preventing lifestyle -related diseases and conditions,encouragingtoactivelytakepartinserviceplanning, volunteering work and fundraising. In addition to this, the project will be beneficial for providing counselling and support services to old age people anddisabledpeople.Thepatientslookingforwardtorehabilitation programs will be also benefited in a significant manner(Taylor et al., 2014). FacilityThe benefits to the facility will include specialised equipment’s at the earliest disposal. Moreover, the partnering with other health agencies will
6HEALTH FINANCIAL MANAGEMENT be conducive in filling the service gaps. Furthermore, the facility will be benefited with additional finance provided by different types of community services (Hood & Price, 2014). CliniciansThe clinicians with the benefited with reduced variation in quality of care, introduction of automatic provision for expert advice and recommendations sourced from up to date services and improving consistency of care. The introduction of highly innovative equipment will help the clinicians in streamlining the workflow with integrated EMR which will allow tracking, diagnosisandtreatmentwithefficientgatheringofdata.Therefore, clinicians will be able to maintain and improve the overall consistency of healthcare services(Frøen et al., 2016). OtherA significant nature of other benefits will be measured in form of attitude of targeted users in form of depth of commitment. There will be ample amount ofsupportandmaintenancefacilitiesbasedonemergencyservice requirement.Furthermore,thebusinesscasewillaimateasingthe integration of organisational context with routine workflow which will entail the redesigning of clinical processes. Lastly, the overall program will ensure adequate quality, reliability and knowledge base program they are by maintaining an up to date information on healthcare methods(Mittal & Griskevicius, 2016). Risks The risk associated to the proposal is listed as follows:
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7HEALTH FINANCIAL MANAGEMENT Risk IssueSeverityImpactMitigation PlanNotes Financial risk ModerateThe increasing cost of new technology,healthcare practitioners and equipment mayleadtoinflatedcost therebyincreasingthe dependencyonlong-term debt borrowings. Thehealthcare facilityshould incorporate advanced alternative payment model for tracking the present rates of equipment is using latesttechnology (Ginteretal., 2018). The introduction of differenttypes ofservices suchas Medicare sharedservice program, ACO programand advanced alternative payment model will be conducivein addressingthe financial risks. PatientsHighThe risks related to patient safety are seen with unable to follow up on missing test results, Tracking of missed appointments,unableto fulfil expired prescriptions, inadequaterecords retention, prevention of falls Theimportant natureofmeeting suchrisksinclude havingaproper communication withpatientsand improvingthe overall MIS of the Maintenance ofa comprehensive risk management planwillnot onlyfoster safetyofthe
8HEALTH FINANCIAL MANAGEMENT Risk IssueSeverityImpactMitigation PlanNotes and immobility (Wager, Lee & Glaser, 2017). facilitypatientsbut alsoreduce readmissions forasimilar reason. InsurancesLowThisismainlyinvolved withtheconcernsofrisk financingwhichincludes risktransferbyinsurance policies and risk retention Thehealthcare facilityshould establishan ongoingrisk managementplan forstrategically identifying, mitigatingand managingofrisk (Weinsteinetal., 2014). Therisk mitigationon insurances should bear in mindthe fundingloss reasonsother than insurances Other- Cyber risk HighIncreased exposure to cyber threatandlosingof confidential information of the patients Protectionofdata with the use of best inclassindustry firewall which will notifythepatients and parties in case there is any breach Thegreater relianceon technologyis the main cause ofincreased exposureto such a risk.
9HEALTH FINANCIAL MANAGEMENT Risk IssueSeverityImpactMitigation PlanNotes ofconfidential information(Islam et al., 2015). Process Refer to attachment 1 Resources Someoftheadditionalresourcesidentifiedareseenintermsofinvestment perspectives and support of the Australian government. As a healthcare facility there may be a requirement of long-term debt borrowings and in such situations the government must provide adequate financing options to the healthcare Centre. Reporting of outcomes The monitoring process of outcomes related to savings and increased costs for the proposal will be done by the board of directors of the company. In addition to this, the reporting duration will be done on an annual basis. Financial Information Refer to attachment 2 Conclusion The different aspects of the reporting have shown that the main purpose of proceeding with the business case is to not only provide a healthcare facility but also encourage people in actively taking part in their own health check-ups. In addition to this, at the LHD level, the
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10HEALTH FINANCIAL MANAGEMENT health care plan will look forward to work together with a greater number of primary health care providers which will introduce innovative health check-up solutions at a cheaper cost. Some of the main equipment needed for proceeding with the business is depicted with X-Ray Film processor table top is, Ultrasound (3 probes), Gastroscope (With halogen light source), Colonoscope (With halogen light source). In addition to this, the utilities required are seen in formofOperatingTable(Trauma/Multifunction,electric/hydraulicdriven)Anaesthesia trolley and Syringe pump.
11HEALTH FINANCIAL MANAGEMENT References Frøen, J. F., Friberg, I. K., Lawn, J. E., Bhutta, Z. A., Pattinson, R. C., Allanson, E. R., ... & Kinney,M.V.(2016).Stillbirths:progressandunfinishedbusiness.The Lancet,387(10018), 574-586. Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018).The strategic management of health care organizations. John Wiley & Sons. Hood, L., & Price, N. D. (2014). Demystifying disease, democratizing health care. Islam, S. R., Kwak, D., Kabir, M. H., Hossain, M., & Kwak, K. S. (2015). The internet of things for health care: a comprehensive survey.IEEE Access,3, 678-708. Mittal, C., & Griskevicius, V. (2016). Silver spoons and platinum plans: How childhood environmentaffectsadulthealthcaredecisions.JournalofConsumer Research,43(4), 636-656. Taylor, M. J., McNicholas, C., Nicolay, C., Darzi, A., Bell, D., & Reed, J. E. (2014). Systematic review of the application of the plan–do–study–act method to improve quality in healthcare.BMJ Qual Saf,23(4), 290-298. Wager, K. A., Lee, F. W., & Glaser, J. P. (2017).Health care information systems: a practical approach for health care management. John Wiley & Sons. Weinstein, R. S., Lopez, A. M., Joseph, B. A., Erps, K. A., Holcomb, M., Barker, G. P., & Krupinski, E. A. (2014). Telemedicine, telehealth, and mobile health applications that work: opportunities and barriers.The American journal of medicine,127(3), 183-187.
12HEALTH FINANCIAL MANAGEMENT Attachment 1 Sequential Activities/ PeriodWeek 1Week 2Week 3 &4Week 5 & 6Week 7Week 8 and 9Week 10 Undergoingreviewfor personnel selection Action Plan of the Process Identificationofthetoolsand resources required Definingthevarioustypesof problemandopportunityfor improvement  Ideation of the Project Creation of a change team Defining of aims DesigningofTeamsteps intervention Developmentof implementation plan Developmentof communication plan  
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13HEALTH FINANCIAL MANAGEMENT Attachment 2 (1) SALES FORECAST Year012345 Projected Sales17,65,00019,41,50021,35,65023,49,21525,84,137 (b) Cost of goods10,23,00010,67,82511,74,60812,92,06814,21,275 (2) CASHFLOW FORECAST Preop Year012345 CASH INFLOWS Cash from Sales17,65,00019,41,50021,35,65023,49,21525,84,137 Directors loans040,00040,00040,00040,00040,000 Capital Employed01,50,0001,50,0001,50,0001,50,0001,50,000 Other cash inflows TOTAL CASH INFLOW019,55,00021,31,50023,25,65025,39,21527,74,137 CASH OUTFLOWS Payments for materials10,23,00010,67,82511,74,60812,92,06814,21,275 operating expenses ()0 Premises (rent, rates)023,00023,00023,00023,00023,000 Salaries075,00080,25085,86891,87898,310 General expenses03,5003,7103,9334,1694,419 Interest and bank charges payable04,0004,0004,0004,0004,000 Lease payments012,00014,50016,50018,5005000 Corporation Tax1,64,7082,05,1522,28,3392,54,1982,82,720 Market survey costs01,6251,7501,8251,9002,000 Other preliminary expenses02,0002,1502,3002,5502,750 capital expenditure Plant and other capital expenditure012,50012,75013,00513,26513,530 financing repayments Loan repayments10,00010,00010,00010,000 TOTAL CASH OUTFLOWS013,21,33314,25,08715,63,37717,15,52818,67,004 Cash flow summary NET CASHFLOW FOR PERIOD06,33,6687,06,4137,62,2738,23,6879,07,133 OPENING CASH BALANCE006,33,66813,40,08121,02,35429,26,040 CLOSING CASH BALANCE06,33,66813,40,08121,02,35429,26,04038,33,173 (3) DEPRECIATION SCHEDULE Year012345 Fixed Assets Equipments1500013,50012,00010,5009,0007,500 Ambulances3200025,60020,48016,38413,10710,486 Utensils1250010,0008,0006,4005,1204,096 Total book values (i.e. net fixed assets)049,10040,48033,28427,22722,082 Annual Depreciation Furniture-10% straight line1,5001,5001,5001,5001,500 Vehicles - 20% reducing balance6,4005,1204,0963,2772,621 Plant & machinery-20% reducing balance2,5002,0001,6001,2801,024 total annual depreciation10,4008,6207,1966,0575,145 (4) PROFIT AND LOSS FORECAST Preop Year012345 Revenue017,65,00019,41,50021,35,65023,49,21525,84,137 Cost of sales010,23,00010,67,82511,74,60812,92,06814,21,275 Gross profit07,42,0008,73,6759,61,04310,57,14711,62,861 Gross Margin13,80,68314,62,81216,02,85917,56,08619,24,456 Expenses/overheads Premises (rent, rates)23,00023,00023,00023,00023,000 Wages and salaries75,00080,25085,86891,87898,310 General expenses3,5003,7103,9334,1694,419 Accountant Fees35,00035,00035,00035,00035,000 Payroll Tax1,5001,5001,5451,5911,639 Utilities25,00026,25027,56328,94130,388 Sales and Marketing12,50014,25016,75018,50020,500 Postage & Telephone1,4751,6251,7501,8752,025 Repairs and Maintainance2,0002,1002,2052,3152,431 Preliminary expenses2,0002,1502,3002,5502,750 Lease Payments12,00014,50016,50018,50020,500 Total expenses/overheads1,92,9751,89,8351,99,9132,09,8192,20,461 Profit before tax5,49,0256,83,8407,61,1308,47,3289,42,400 Tax @ 30%1,64,7082,05,1522,28,3392,54,1982,82,720 Before tax net margin31%35%36%36%36% Profit after tax3,84,3184,78,6885,32,7915,93,1296,59,680 Transfer to reserves5,49,0256,83,8407,61,1308,47,3289,42,400
14HEALTH FINANCIAL MANAGEMENT Start-up Requirements Start-up Expenses Fixed CostsParticularsAmount ($) Premises (RENT & RATES)$23,000 Salaries$75,000 Interest on loan 8%$4,000 Accountant Fees$35,000 Payroll Tax$1,500 Retainer contracts$25,000 Sales and Marketing$12,500 Postage & Telephone$1,475 Brouchers$2,000 Logo Designs$3,500 Market survey$1,625 Preliminary expenses$2,000 Lease payments$12,000 Total Fixed Costs$1,98,600 Average Monthly Costs Rent$1,917 Lease payments$1,000 Interest on loan 3%$333 Postage & Telephone$123 Repairs and Maintainance$167 Salaries / Wages$6,250 Total Average Monthly Costs$9,790 x Number of Months:12 Total Monthly Costs$1,17,475 Total Startup Expenses$3,16,075 Start-up Assets Owner Funding Owners Fund$1,50,000 Total Owner Funding$1,50,000 Loans Bank Loan$40,000 Other Total Loans$40,000 Total Start up Funds$1,90,000 Assets Equipments$15,000 Ambulances$32,000 Utensils$12,500 Total Fixed Assets$59,500 Total Start-up Assets$2,49,500
15HEALTH FINANCIAL MANAGEMENT AssetsFY-1FY-2FY-3FY-4FY-5 Current Assets Cash$11,550$45,000$49,870$50,398$56,904 Accounts receivable$17,65,000$19,41,500$21,35,650$23,49,215$25,84,137 Total current assets$17,76,550$19,86,500$21,85,520$23,99,613$26,41,041 Fixed (Long-Term) Assets Ambulances$32,000$12,000$10,500$9,000$7,500 Equipments$15,000$20,480$16,384$13,107$10,486 Utensils$12,500$8,000$6,400$5,120$4,096 (Less accumulated depreciation)$10,400$8,620$7,196$6,057$5,145 Total fixed assets$49,100$31,860$26,088$21,170$16,936 Total Assets$18,25,650$20,18,360$22,11,608$24,20,783$26,57,977 Liabilities and Owner's Equity Current Liabilities Accounts payable$35,000$25,000$27,000$25,000$27,000 Accrued Rent$23,000$23,000$23,000$23,000$23,000 Bank Charges Payable$3,000$3,000$3,000$3,000$3,000 Short-term loans$10,000$10,000$10,000$10,000$10,000 Income taxes payable$1,64,708$2,05,152$2,28,339$2,54,198$2,82,720 Deferred income Tax$12,49,443$14,28,748$16,03,969$17,96,038$20,09,028 Accrued salaries and wages$75,000$80,250$85,868$91,878$98,310 General Expenses$3,500$3,710$3,933$4,169$4,419 Lease Payment$12,000$14,500$16,500$18,500$20,500 Current portion of long-term debt$50,000$45,000$40,000$35,000$30,000 Total current liabilities$16,25,650$18,38,360$20,41,608$22,60,783$25,07,977 Long-Term Liabilities Long-term debt$2,00,000$1,90,000$1,80,000$1,70,000$1,60,000 Less: Loan Repayment$10,000$10,000$10,000$10,000 Total long-term liabilities$2,00,000$1,80,000$1,70,000$1,60,000$1,50,000 Total Liabilities$18,25,650$20,18,360$22,11,608$24,20,783$26,57,977 Owner's Equity Owner's investment$1,50,000$1,50,000$1,50,000$1,50,000$1,50,000 Net Profits$3,84,318$4,78,688$5,32,791$5,93,129$6,59,680 Reserve and Surplus$5,49,025$6,83,840$7,61,130$8,47,328$9,42,400 Total owner's equity$10,83,343$13,12,528$14,43,921$15,90,457$17,52,081 Total Liabilities and Owner's Equity$29,08,993$33,30,888$36,55,529$40,11,241$44,10,057 {42} Common Financial RatiosYear 1Year 2Year 3Year 4Year 5 Debt Ratio(Total Liabilities / Total Assets)1.001.001.001.001.00 Current Ratio(Current Assets / Current Liabilities)1.091.081.071.061.05 Working Capital(Current Assets - Current Liabilities)1,50,9001,48,1401,43,9121,38,8301,33,064 Assets-to-Equity Ratio(Total Assets / Owner's Equity)1.691.541.531.521.52 Debt-to-Equity Ratio(Total Liabilities / Owner's Equity)1.691.541.531.521.52 Balance Sheet
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16HEALTH FINANCIAL MANAGEMENT YEAR 1YEAR 2YEAR 3YEAR 4YEAR 5 Doctors30000321003434736751.339323.9 Nurses120001284013738.814700.515729.6 Occupational therapistsand physiotherapists 10000107001144912250.413108 Paramedics120001284013738.814700.515729.6 Pharmacists600064206869.47350.267864.78 Volunteers500053505724.56125.226553.98 TOTAL PEOPLE 714202025 Total Payroll75,00080,25085,86891,87898,310 PERSONNEL PLAN Income FormulaCalculationExplanatory NotesCategoryProduct/ServiceFormulaCalculationExplanatory Notes number of staff x hourly rate x hours x days of work x 523,36,336.00$ The pay of the Dotors is depicted to be $ 154 per hourIncome Income from Patients Number of product/services x number of patients x days of operation x weeks of operation x cost per service48,38,40,000.00$The income from service for patients is seen as $ 35 per unit number of staff x hourly rate x hours x days of work x 521,85,640.00$ The pay of the Nurses is depicted to be $ 84 per hour Income from Ambulance Services Number of product/services x number of patients x days of operation x weeks of operation x cost per service3,91,68,000.00$The income from service for patients is seen as $ 5per unit number of staff x hourly rate x hours x days of work x 521,96,560.00$ The pay of the occupational therapists and physiotherapists is seen to be $90 number of staff x hourly rate x hours x days of work x 522,62,080.00$ The pay of the Paramedics is seen to be $120 number of staff x hourly rate x hours x days of work x 522,44,608.00$ The pay of the Pharmacists is seen to be $112 number of staff x hourly rate x hours x days of work x 521,63,800.00$ The pay of the Volunteers is seen to be $75 total cost of staff above x 15%2,08,353.60$TOTAL INCOMEInsert total amount here ->52,30,08,000.00$ Insert total amount here ->15,97,377.60$ (number of item x frequency of use x number of patients x days of operation (per week) x weeks of operation) x cost per item1,63,800.00$ The pay of the X-Ray Film processor tabletop is seen to be $75Break Even Calculation (number of item x frequency of use x number of patients x days of operation (per week) x weeks of operation) x cost per item2,83,920.00$ The pay of the Ultrasound (3 probes) is seen to be $ 130TOTAL INCOME52,30,08,000.00$ (number of item x frequency of use x number of patients x days of operation (per week) x weeks of operation) x cost per item1,31,040.00$ The pay of the Gastroscope is seen to be $60minus TOTAL COSTS PER YEAR26,85,477.60$ (number of item x frequency of use x number of patients x days of operation (per week) x weeks of operation) x cost per item3,71,280.00$ The pay of the Colonoscope is seen to be $ 170Profit / Loss520322522.4 Insert total amount here ->9,50,040.00$ (Cost of utility per week)x 52 weeks - Note: You may also use quarterly calculations in this section6,240.00$ The pay of the Operating Table is seen to be $ 170If the Profit/Loss row is NEGATIVE, your service is LOSING MONEY. Increase your income. (Cost of utility per week) x 52 weeks7,280.00$ The pay of the Anesthesia trolley is seen to be $ 140 (Cost of utility per week)x 52 weeks9,100.00$ The pay of the Anesthesia trolley is seen to be $ 175 Insert total amount here ->22,620.00$ Cost of administration item per week x weeks of operation39,000.00$ The pay of the Machinery and Equipments is seen to be $ 750 Cost of administration item per week x weeks of operation31,200.00$ The pay of the Property is seen to be $ 600 Cost of administration item per week x weeks of operation27,300.00$ The pay of the Rent is seen to be $ 525 Cost of building rent per week x 5246,800.00$ The pay of the Building Rent is seen to be $ 900 Insert total amount here ->1,44,300.00$ Total value of equipment x 20%28,860.00$ Insert total amount here ->1,15,440.00$ Total of each of the five section totals26,85,477.60$