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CALIFORNIA STATE UNIVERSITY, LONG BEACH
COLLEGE OF HEALTH AND HUMAN SERVICES
Department of Health Care Administration
HCA 515 Advanced Financial Management in Health Care
Fall 2011
Instructor: Terence Cunningham, MHAE-mail:
Classroom: ET-105
Office Hours: 6pm-7pm Wed
Office Location: ET-101
Phone: 562-430 6465 / Class Number: 12595
Class Meets: Aug 31-Dec 14
Class Time: 7 pm – 9:45pm
Additional Contact Information
HCA Dept. Administrative Coordinator: Deby McGill,
Tel: 562/985-5694. Fax: 562/985-5886
Catalog Description
Financial environment, payment systems, discounted cash flow analysis, risk, financial statements, capital investments, and capital budgeting. Emphasis on decision-making using accounting and finance theories, principles, concepts and techniques.
Learning Objectives
The Health Care Administration Department has adopted a competency-based curriculum, based on the American College of Health Care Executives (ACHE) Competency Assessment Tool and Healthcare Leadership Alliance (HLA) Competency Directory. This course is designed to develop competencies in the Knowledge of Healthcare Environment (KHE) and Business Skills and Knowledge (BSK). This course also enhances students’ writing and presentation skills that address the domain, Communication and Relationship Management (CRM).
Learning Objective / Domain / Competency / Activity (A1), Assignment (A2) or Assessment (A3) /Demonstrate analytical and decision-making skills using accounting and finance theories, principles, concepts and techniques most important to health care administrators. / BSK / A. Problem solving and decision making
D. Financial management / A1-In class problems and exercises; A2-Case Study and homework; A3- Case presentation, exams
Gain specific factual knowledge in health care finance including concepts, terminology, classifications, methods and trends / KHE - BSK / KHE-A. Healthcare issues and trends
BSK-D. Financial management / A1-Lecture and discussion
A2-Homework
A3-Exams
Analyze health care payment systems, financial statements, financial performance, financing and capital investments, and apply to a case study / KHE - BSK / KHE-A. Healthcare issues and trends
BSK-D. Financial management / A1-Lecture and discussion, in-class problems
A2-Assignments and case study
A3-Presentation, exams
Learn how to operate a financial calculator / BSK / D. Financial management / A1-Exercise with financial calculator in class
A2-Homework
A3-Exams
Demonstrate writing and oral communication skills / CRM / B. Communication skills / A2-Case study
A3 Presentation
Text(s) and other course materials
Gapenski, LC. & Pink, G. (2011). Understanding Health Care Financial Management. 6th Ed. Chicago, IL. AUPHA-HAP. ISBN: 1-56793-362-8.
Gapenski, LC. (2010). Cases in Health Care Finance. 4ht Ed. AUPHA-HAP.
ISBN: 1-56793-342-0
Business calculator-BA Models such as Texas Instruments BA-IIPLUS or SHARP EL-733A.
Course Format
This course will consist of lectures and discussions, assignments, group projects, written case analysis and presentations, and executive summaries. These are explained below:
Presentations: Each textbook chapter has a Power Point presentation that will be available on the course’s web site. Instructor will make a presentation as they are scheduled in the course outline. There may be guest lecturers for some presentations in order provide specific health care applications of financial concepts.
Written Case: Students will prepare a written case analysis from the assigned case workbook. This is a team work of 3 students which requires only one written case to be submitted. The written case analysis should be about 12-15 pages in length. A review of case facts should be limited to one page or less. The analysis should be single-spaced and in 11-12 point type. Below is a general outline of a typical case analysis (there is more information at the end of syllabus).
I. Introduction (1 to 2 pages)
A. General issue addressed in the case
B. Importance to the organization, to financial management
II. Body (5 to 7 pages)
A. Specific problems identified-cite examples
B. Analytical tools used to solve the problem, address the issue
i. key assumptions used in the analysis
ii. method of analysis
C. Specific findings derived from the analysis
D. Institutional implications, future development
E. Implementation issues
III. Conclusion (2-3)
A. Brief statement of findings (what was learned)
B. The importance of the findings (as a manager and to the organization)
C. Caveats, limitations and additional issues
IV. Appendices
Case Presentation: Each team will make a presentation from the assigned case. This presentation should be about 25-30 minutes and must follow the guidelines provided in the Case Presentation Evaluation Form. Case and group assignments will be made in the first class. These presentations will be scheduled during class time on Dec 7, 2011.
Executive Summaries: Each student must turn in a total of two executive summaries from other student presentations. The executive summaries are due electronically not later than Dec 7, 2011. They should be no longer than one page in length, single-spaced, 11-12 point type. Students should highlight the main sections of the presentation including findings and conclusion.
Short Assignments: To get the most out of this class, students should read the material assigned prior to each Wednesday class. There will be four short assignments (3-4 problems each) for each class. Students should complete the assignment and turn it in the following scheduled class. A financial calculator is needed for many of these assignments.
Exams: There will be a midterm and a final exam in this class. Midterm exam will be given in class with books and class notes open. But no laptops, cell phones, IPADs or other electronic equipment is allowed during the exam. The midterm exam is scheduled for Oct 19. The final exam will be comprehensive and held on Dec 14, 2011.
Course Evaluation:
Success in achieving the course objectives will be evaluated with the following instruments. Students can accumulate up to 500 points from all course requirements.
Points Weights Cutoff Points
Written Case Analysis 100 points 20.0% A = 500 - 450 points
Midterm I 100 Points 20.0% B = 449 - 400 points
Final 100 points 20% C = 399 - 350 points
Case Presentation 60 points 12% F = less than 350 points
Short Assignments 80 points 16.% (4x20 points)
Executive Summaries 40 points 8.0% (2 x 20 points)
Participation 20 points 4.0%
TOTAL 500 points 100%
TOPIC OUTLINE
CONTENT/ACTIVITY/READINGS
Course Syllabus/Outline
Case and Group Assignments
Aug 31 Part I The Healthcare Environment
- Introduction to healthcare financial management Chapter 1
Definition of health care finance
Goals of the course
The role of healthcare finance
The health services industry
Regulatory and legal issues
Alternative forms of business organization
Alternative forms of ownership
Taxes and financial decisions
Depreciation
Sept 7 - Third party payer system Chapter 2
Insurance concept
Basic characteristics of insurance
Generic reimbursement methods
Third part payers
Medicare payment systems
Managed care payment systems
Sept14 PART II Basic Financial Management Concepts Chapter 3
BRING YOUR FINANCIAL CALCULATOR
-Time value analysis
Future and present values
Lump sums
Annuities
Solving for I and N
Investment returns
Amortization
ASSIGNMENT 1 DISTRIBUTED (due Sept 28)
Sep 21 - Financial risk and required return Chapter 4
Financial risk basics
Stand-alone risk
Portfolio risk
Corporate risk
Market risk
ASSIGNMENT 1 COLLECTED
Sep 28 PART III Capital Acquisition
- Debt Financing Chapter 5 (read only)
Long term debt
Short term debt
Credit ratings
Interest rate components
The term structure of interest rates
- Equity Financing Chapter 6 (read only)
Preferred stock
Common stock
The Market for common stock
Regulation of securities markets
Equity in not-for-profit institutions
- Securities Valuation Chapter 7
The general valuation model
Debt valuation
Preferred and common stock valuation
Informal efficiency
ASSIGNMENT II DISTRIBUTED (due Oct 12 electronic submission)
Oct 5 Part IV Cost of Capital and Capital Structure
-Cost of Capital Chapter 9
Capital asset pricing model
Discounted cash flow approach
Cost of fund capital
Oct 12 Mid Term Exam
Oct 19 Part V Capital Allocation
-The basics of Capital Budgeting Chapter 11
Relevance to the health care
Cash flow estimation
Breakeven analysis
Profitability analysis
Internal rate of return
Net present value
ASSIGNMENT II due (electronically)
Oct 26 Project Risk Analysis Chapter 12
Types of project risks
Sensitivity analysis
Scenario analysis
Monte Carlo simulation analysis
Decision tree analysis
Nov 2 Part VI Financial condition Analysis and Forecasting
-Financial Condition Analysis Chapter 13
Ratio Analysis
DuPont Analysis
Percentage Change analysis
Common size analysis
Operating Analysis
ASSIGNMENT III DISTRIBUTED (due Nov16)
Nov 9 -Financial Forecasting Chapter 14
Strategic Planning
Operating plans
The financial plan
Forecasting
Sustainable growth
Cash budgeting
ASSIGNMENT III COLLECTED
Nov 16 Working Capital Management Chapter 15
Cash Management Techniques
Marketable securities management
Receivables management
Credit policy
Inventory management
ASSIGNMENT IV DISTRIBUTED (due Dec 7)
Nov 23 No class
Nov 30 Risk Sharing Chapter 17
Provider incentives under capitation
Financial risk under capitation
Developing Premium Rates
Risk Sharing Arrangements
Developing Premium Rates
Risk Sharing Arrangements
Withholds
Group Case Presentations (if needed)
Dec 7 Executive summaries (two) due electronically not later than Dec14
ASSIGNMENT IV COLLECTED
GROUP CASE PRESENTATIONS
GROUP WRITTEN CASES DUE
Individual Team Members rating form due on their team members contribution to the group’s case presentation
Dec 14 Final Exam
Executive summaries due electronically
BIBLIOGRAPHY (HFMA Articles)
January 2010:
1) Brocato, L., Hirschl, N., & Padfield, S. (2010, January 01). How to staff for racs. Healthcare Financial Management Association, 40-43.
2) Grube, M.E., Kaufman, K. (2010, January 01). Positioning you organization for success in the new era. Healthcare Financial Management Association, 54-62.
3) D'Cruz, M.J., & Welter, T.L. (2010, January 01). Is your organization ready for value-based payment?. Healthcare Financial Management Association, 64-72.
4) Woodson, W., & Jenkins, S. (2010, January 01). Payment reform: how should your organization prepare?. Healthcare Financial Management Association, 74-79.
5) DeVore, S.D. (2010, January 01). Results from the first 4 years of pay for performance. Healthcare Financial Management Association, 88-92.
6) Asset efficiency-why it matters and how to measure it. (2010, January 01). Healthcare Financial Management Association, 130-131.
February 2010:
1) Bigalke, J.T. (2010, February 01). Episode-based payment: bundling for better results. Healthcare Financial Management Association, 36-39.
2) Glaser, J., Markell, P., & Stone, J. (2010, February 01). The strategic importance of data. Healthcare Financial Management Association, 47-52.
3) Bradley, P., & Kaplan, J. (2010, February 01). Turning hospital data into dollars. Healthcare Financial Management Association, 88-92.
4) Hospitals continue financial recovery. (2010, February 01). Healthcare Financial Management Association, 104-105.
March 2010:
1) Cleverley, W.O., & Cleverley, J.O. (2010, March 01). Cost reduction: identifying the opportunities. Healthcare Financial Management Association, 53-59.
2) Rauh, S.S., Wadsworth, E., & Weeks, W.B. (2010, March 01). The fixed-cost dilemma: what counts when counting cost reduction efforts?. Healthcare Financial Management Association, 60-63.
3) Williams, J. (2010, March 01). Innovative approaches to cost containment. Healthcare Financial Management Association, 72-78
4) Casolari, C., & Womack, S. (2010, March 01). Prioritizing capital projects when cash is scarce. Healthcare Financial Management Association, 114-116.
5) National average costs by department for heart failure and shock. (2010, March 01). Healthcare Financial Management Association, 122-123.
April 2010:
1) Nugent, M.E. (2010, April 01). Payment change: 3 ways to set your course for success. Healthcare Financial Management Association, 40-44.
2) Gordon, D.C. (2010, April 01). Squeezing the funding you need from today's capital sources. Healthcare Financial Management Association, 47-55.
3) Beith, C., & Vaughan, J. (2010, April 01). Capitalizing hidden values from hospital assets. Healthcare Financial Management Association, 56-60.
4) Grauman, D.M., Harris, J.M., & Martin, C. (2010, April 01). Access to capital: implications for hospitals consolidation. Healthcare Financial Management Association, 62-70.
5) French, C.J., & Dodd, T.H. (2010, April 01). Are alternative investments the right approach for your organization?. Healthcare Financial Management Association, 72-77.
6) Zuckerman, A.M. (2010, April 01). What would you do? Primary care growth at any cost?. Healthcare Financial Management Association, 112-114.
May 2010:
1) Doody, D. (2010, May 01). Alternative strategies a better alternative. Healthcare Financial Management Association, 42-45.
2) Johnson, T.K. (2010, May 01). Ambulatory care stands out under reform. Healthcare Financial Management Association, 57-63.
3) Scott, M., & Stephen, R. (2010, May 01). Effective cost modeling for service line planning. Healthcare Financial Management Association, 64-72.
4) Schuhmann, T.M. (2010 , May 01). Can net income from non-patient-care activities continue to save hospitals?. Healthcare Financial Management Association, 74-84.
June 2010:
1) Henciak, B., Fontaine, C., Fields, K., & Parks, S. (2010, June 01). ‘Virtual’ central business office: how umms improved revenue cycle performance. Healthcare Financial Management Association, 34-38.
2) Gottlieb, J., Khawaja, A., Teitelbaum, K., & Channing, A. (2010, June 01). Achieving operational efficiencies using a drg-based tracer approach. Healthcare Financial Management Association, 69-79
3) McDowell, J. (2010, June 01). Achieving strategic cost advantages by focusing on back-office efficiency. Healthcare Financial Management Association, 98-104.
July 2010:
1) Blake, J.W., & Jordahl, E.A. (2010, July 01). Managing risk through a global capital strategy. Healthcare Financial Management Association, 36-39.
2) Daniels, G.L., & Tisdell, S. (2010, July 01). Your hospital's strategy for managing total cost of risk. Healthcare Financial Management Association, 82-86.
3) Funding a hospitalist program: which approach will you take. (2010, July 01). Healthcare Financial Management Association, 76-80.
September 2010:
1) Boggs, S.L. (2010, September 01). Physician practice and hospital revenue cycle drivers: what's the difference?. Healthcare Financial Management Association, 40-46.
2) Franklin, D., Ingram, C., & Levin, S. (2010, September 01). A closer look at self-pay segmentation. Healthcare Financial Management Association, 73-78.
3) Langford, A., Dye, L., Moresco, J., & Riefner, D.C. (2010, September 01). Improving the revenue cycle by taking the patient's perspective. Healthcare Financial Management Association, 80-88.