This article discusses the dissimilarities between revenue and expenditure in the health system, activity-based funding, and casemix in healthcare finance. It also provides a brief on the Australian DRG classification system. The article is useful for students pursuing healthcare finance courses.
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Running head: HEALTH FINANCIAL MANAGEMENT Health Financial Management Name of the Student: Name of the University: Author’s Note: Course ID:
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1HEALTH FINANCIAL MANAGEMENT Table of Contents Answer to Question 1:................................................................................................................2 Answer to Question 2:................................................................................................................3 Answer to Question 3:................................................................................................................3 References:.................................................................................................................................5
2HEALTH FINANCIAL MANAGEMENT Answer to Question 1: The major points of dissimilarities between revenue and expenditure in the health system are described briefly as follows: Points of dissimilaritiesRevenueExpenditure ConceptIt denotes the sum of money received for services within a specific timeframe. Expenditurecouldbe describedasthemonetary outflowfromthehealth system to another party used forpayingaparticular service (Cole, Chaudhary & Bang, 2014). Effect on equityRevenue takes into account interestandassets,which increasestheequityofthe healthcare system. Expenseisrealisedatthe time of incurring any liability or utilisation of asset, which minimises the equity of the particular health system. TypeInhealthsystem,revenue could be realised in the form ofservicerevenueornon- operatingrevenuesuchas rentrevenueandinterest revenue. Expensescouldbeboth direct and indirect. The direct expensesincludematerial andlabour,whileindirect expensescompriseofrent and insurance.
3HEALTH FINANCIAL MANAGEMENT Answer to Question 2: Activity-based funding (ABF) is a technique to fund hospitals, in which they are paid for the mix and number of patients treated. If more patients are treated, the hospitals receive additional funding (Donovan et al., 2014). ABF leads to related group codes, which provide meaningful techniques clinically to relate the kinds of patients that a hospital treats to the resources needed. IHPA carries out updates and reviews of current allocations and it is accountable to initiate new classifications for the service categories without a current classification. In other words, it ascertains the amount of cost and the price to be paid to the hospitals. For developing the budget, activity needed is ascertained and after this process, it is multiplied with the price to arrive at the budget. Two agencies are accountable to approve the budget, which include Common Wealth and State Government. These two agencies merge together to develop funding pools, which are then passed over to the state health agency. The state heath agency then passes the same to the district in-charge from which the hospitals receive their funding. Answer to Question 3: Casemix provides assistance to the healthcare sector with a consistent procedure of categorisingthetypesof patients;treatmentneeded andrelatedcosts(Finkleret al., 2016).These classifications are beneficial, as they depict to describe the relationship between healthcare costs and activity. The Australian DRG classification system is utilised for categorising acute admitted patients and other classifications are utilised for classifying other patient care. The patients admitted to the hospitals have diseases and the processes that are undertaken at the time of admissionhavebeencodedutilisingICD-10-AM/ACHI/ACS(Ihpa.gov.au,
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4HEALTH FINANCIAL MANAGEMENT 2018).Specialised clinical staffs undertake such coding and the coded information coupled with the demographic information of the patients like gender, age and duration of their stay areutilisedforallocatingacutepatientadmissionstoAustralianDRGclass.This classification is performed either on the part of the hospital or clinical coder or pertinent health authority of the state. Figure 1: Australian DRG system of classification (Source:Ihpa.gov.au, 2018)
5HEALTH FINANCIAL MANAGEMENT References: Cole, S. A., Chaudhary, R., & Bang, D. A. (2014). Sustainable risk management for an evolving healthcare arena.Healthcare Financial Management,68(6), 110-115. Donovan, C. J., Hopkins, M., Kimmel, B. M., Koberna, S., & Montie, C. A. (2014). How ClevelandClinicusedTDABCtoimprovevalue.HealthcareFinancial Management,68(6), 84-89. Finkler, S. A., Smith, D. L., Calabrese, T. D., & Purtell, R. M. (2016).Financial management for public, health, and not-for-profit organizations. CQ Press. Ihpa.gov.au. (2018).Retrieved 13 April 2018, from https://www.ihpa.gov.au/