Health expenditure data for policy: Health accounts, national accounts or both?

Compatibility of statistical frameworks and comparability of data are aspects of statistical quality. This paper explores comparability of data from National Accounts (NA) and Care Accounts/health accounts (CA&HA) of the Netherlands. Although based on the same sources, differences result from specificities of each framework, making data adjustments necessary. Data comparison of major aggregates and household spending is a means for verification and for triangulation of sources. Monitoring household spending on health is one of the Sustainable Development Goals. The usability of NA data for household consumption estimates is key to judge plausibility of household spending levels. However, definitions, coverage and valuation in NA and CA&HA should be understood to benefit from the use of NA data for HA. More than in the concepts used the strength of NA is the way NA are usually produced compared with HA. Key is the integrated analysis including supply and demand to verify the comprehensiveness and consistency. It is concluded that SUT data of NA on consumption of human health and social care can be used for judging plausibility of HA household spending estimates, and, in the absence of the latter, NA data can directly be used. The case of the Netherlands shows that policy measures can have a large impact on the validity of using NA for the estimation of household spending.

[Data sources, the data used, and the modality for collection]. / Sources de données, données utilisées et modalité de recueil.

The hospital costing process implies access to various sources of data. Whether a micro-costing or a gross-costing approach is used, the choice of the methodology is based on a compromise between the cost of data collection, data accuracy, and data transferability. This work describes the data sources available in France and the access modalities that are used, as well as the main advantages and shortcomings of: (1) the local unit costs, (2) the hospital analytical accounting, (3) the Angers database, (4) the National Health Cost Studies, (5) the INTER CHR/U databases, (6) the Program for Medicalizing Information Systems, and (7) the public health insurance databases.

From Board to Bedside: How the Application of Financial Structures to Safety and Quality Can Drive Accountability in a Large Health Care System.

BACKGROUND: As the health care system in the United States places greater emphasis on the public reporting of quality and safety data and its use to determine payment, provider organizations must implement structures that ensure discipline and rigor regarding these data. An academic health system, as part of a performance management system, applied four key components of a financial reporting structure to support the goal of top-to-bottom accountability for improving quality and safety. FOUR KEY COMPONENTS OF A FINANCIAL REPORTING STRUCTURE: The four components implemented by Johns Hopkins Medicine were governance, accountability, reporting of consolidated quality performance statements, and auditing. Governance is provided by the health system's Patient Safety and Quality Board Committee, which reviews goals and strategy for patient safety and quality, reviews quarterly performance for each entity, and holds organizational leaders accountable for performance. An accountability plan includes escalating levels of review corresponding to the number of months an entity misses the defined performance target for a measure. A consolidated quality statement helps inform the Patient Safety and Quality Board Committee and leadership on key quality and safety issues. An audit evaluates the efficiency and effectiveness of processes for data collection, validation, and storage, as to ensure the accuracy and completeness of quality measure reporting. CONCLUSION: If hospitals and health systems truly want to prioritize improvements in safety and quality, they will need to create a performance management system that ensures data validity and supports performance accountability. Without valid data, it is difficult to know whether a performance gap is due to data quality or clinical quality.

Proposed reporting model update creates dialogue between FASB and not-for-profits.

Seeing a need to refresh the current guidelines, the Financial Accounting Standards Board (FASB) proposed an update to the financial accounting and reporting model for not-for-profit entities. In a response to solicited feedback, the board is now revisiting its proposed update and has set forth a plan to finalize its new guidelines. The FASB continues to solicit and respond to feedback as the process progresses.

Healthcare not-for-profits: FASB exposure draft highlights flexibility in financial statement presentation.

A new version of the FASB accounting standard covering not-for-profit healthcare organizations contains potentially significant changes to the statement of operations and changes in net assets, statement of cash flows, and notes to the financial statements. Healthcare organizations already have tremendous flexibility with disclosures around all aspects of their business. Although auditors prefer to see only information that can be effectively audited, this preference does not prevent organizations from expanding on certain activities or transactions covered by GAAP in their footnotes.

Implementing a trustworthy cost-accounting model.

Hospitals and health systems can develop an effective cost-accounting model and maximize the effectiveness of their cost-accounting teams by focusing on six key areas: Implementing an enhanced data model. Reconciling data efficiently. Accommodating multiple cost-modeling techniques. Improving transparency of cost allocations. Securing department manager participation. Providing essential education and training to staff members and stakeholders.

New FASB standard addresses revenue recognition considerations.

Healthcare organizations are expected to apply the following steps in revenue recognition under the new standard issued in May 2014 by the Financial Accounting Standards Board: Identify the customer contract. Identify the performance obligations in the contract. Determine the transaction price. Allocate the transaction price to the performance obligations in the contract. Recognize revenue when--or in some circumstances, as--the entity satisfies the performance obligation.

[Development and use of modern hardware-software complex for medical equipment accounting in military unit of the medical service in wartime].

Development and use of modem hardware-software complex for medical equipment accounting in military unit of the medical service in wartime. The authors presented characteristics of a modern hardware-software complex for medical equipment assessment in medical troops of the medical service, included into the complete set of medical equipment <, which is accepted by the Armed Forces of the Russian Federation. An algorithm of development and routine of special- purpose software for accounting of medical equipment in medical branches of formations and military units in wartime.

Empirical analysis of retirement pension and IFRS adoption effects on accounting information: glance at IT industry.

This study reviews new pension accounting with K-IFRS and provides empirical changes in liability for retirement allowances with adoption of K-IFRS. It will help to understand the effect of pension accounting on individual firm's financial report and the importance of public announcement of actuarial assumptions. Firms that adopted K-IFRS had various changes in retirement liability compared to the previous financial report not based on K-IFRS. Their actuarial assumptions for pension accounting should be announced, but only few of them were published. Data analysis shows that the small differences of the actuarial assumption may result in a big change of retirement related liability. Firms within IT industry also have similar behaviors, which means that additional financial regulations for pension accounting are recommended.

Improving outpatient charge capture.

Hospitals can identify opportunities to enhance revenue collection by closely analyzing outpatient charge-capture data. A hospital can bolster its charge-capture analysis by performing a charge-capture process walk-through and scrutinizing subsystem links, third-party payer contracts, and electronic health record structures. The hospital then can integrate charge-integrity functions into clinical departments as needed by developing charge-reconciliation tools and reports and monitoring their utilization, and incorporating charge-reconciliation responsibilities into clinical department managers' job descriptions and goals.

Perspectives on medical malpractice self-insurance financial reporting.

Financial reporting of medical malpractice self-insurance is evolving. The Financial Accounting Standards Board Accounting Standards Codification Section 954-450-25 provides guidance for accounting and financial reporting for medical malpractice. Discounting of medical malpractice liabilities has been reassessed in recent years. Malpractice litigation reform efforts continue in several states. Accountable care organizations could increase the frequency of medical malpractice claims because of patients' heightened expectations regarding quality of care.

Applying the ABCs in provider organizations.

Activity-based costing (ABC) is an accounting technique designed to guard against potentially serious financial problems that can arise when an organization's accounting costs deviate significantly from its actual costs. In general, an ABC analysis considers two factors: a cost element (a directly measurable unit of cost, such as the cost of an item) and a cost driver (a directly measurable feature of the service, such as how often the item is used). ABC is best applied to specific service areas, orservice packages, for which consumption of resources is largely predictable and atomic units of services can be accurately identified.

FASB's ASU 2011-7 changes financial statement reporting requirements.

FASB's new Accounting Standards Update 2011-07 will change how healthcare entities accumulate and report major portions of their financial statements, including patient revenues, net accounts receivables, and bad-debt expenses. Healthcare entities now must reclassify their provisions for bad debts associated with patient service revenue from an operating expense to a deduction from patient service revenue (net of contractual allowances and discounts). International Financial Reporting Standards do not require healthcare entities to comply with this new standard.

Mergers and acquisitions: what has changed.

The Healthcare Financial Management Association's Principles and Practices (P&P) Board prepares background papers to provide views on an issue from a variety of sources and is intended to produce a thorough understanding of the issue. The purpose of this background paper is to provide clarity around certain issues arising in business combinations of not-for-profit entities.