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Flashcards in Final Review! Deck (62):
0

What's the average number of days of revenue in accounts receivable for US hospitals?

46 days

1

What is the revenue cycle? What is revenue?

The revenue cycle is the process in which a company from a service gains revenue. Revenue is money derived from a company's core business.

2

What's a benchmark?

A benchmark is national average or standard against which a company can measure itself.

3

Who is the audience for the primary performance indicators?

The board

4

Who is the audience for secondary perormance indicators

The staff

5

What's the formula for profitability?

net income/net revenue = profit margin

6

What's the formula for productivity?

Units of service/FTE (full time equivilants)

FTE = 2080 hours (40 a week x 52 weeks)

7

How do you figure out net income?

Gross Revenue
* Deductions from Gross Revenue
1. Bad Debt
2. Charity Care
3. Contractual Allowance

Net Revenue = Gross Revenue - Deductions

Expenses
* SWB (most of the expenses)
* Supplies, depreciation, etc.

Net income = Net Revenue - Expenses

8

In healthcare, what does "ambulatory" mean?

Outpatient

9

When, by whom and in what state was the first ASC begun?

1970 by some anesthesiologists in Arizona.

10

What's the nosocomial rate in hospitals as opposed to ACSs?

4% in hospitals, .5% in ASCs

11

What are the 6 types of scope-based tech that are used in surgical procedures?

Arthroscopy
Endoscopy
Laparoscopy
Laryngoscopy
Colonoscopy
Sigmoidoscopy

12

What's a CASC admin?

A certified administrator of surgery centers

13

Who owns the highest percentage of freestanding ASCs?

Physicians...duh.

14

ASCs are not allowed to markup _____?

Inplants

15

How many inpatient beds do ASCs have?

None!

16

About how many acute care hospitals are there in the US?

About 5,500

17

What is acute care?

Medical care for the ill or injured. Short term care.

18

What advocacy organizations represent:
Non-for-profit hospitals?
For-profit hospitals?

AHA (American Hospital Association)
FAH (Federation of American Hospitals)

19

What does triage mean?

Triage means to separate cases into the 3/4 levels of care/acuity:
Primary
Secondary
Tertiary
Quaternary

20

What are the levels of care and where do they most commonly occur?

Primary = diagnosing and planning for treatment (physicians office, ER)
low acuity

Secondary = Anything for which you are admitted into a hospital. Admitted surgery with a medium acuity.

Tertiary = Level of care that requires at least one-on-one nursing. Generally takes place in an ICU. High acuity.

Quaternary = Experimental procedures and research not yet approved by FDA. Must be approved by IRB. Considered a kind of off-shoot of tertiary care

21

What does CMS stand for?

Centers for Medicare and Medicaid Services

22

What are the 4 parts to the Medicare program?

Part A - Inpatient Services
Part B - Outpatient and Physician Services
Part C - Medicare advantage. Contract with 3rd party insurance. A+B
Part D - Drugs!

23

A critical access hospital may not have more than ___ inpatient beds.

25

24

Disproportionate Share Hospitals care for more than the national average of _____ patients.

CMS

25

What is the OAA and when was it enacted?

The Older Americans Act in 1965.

26

Identify the 4 levels of long term care (from least to most intense)

Home Care
Assisted Living
Nursing Home
Skilled Nursing Facility (SNF)

27

What is an ADL and what 5 are there?

Activities of Daily Living

Ambulating
Toileting
Bathing
Eating
Medicating

28

What's the biggest source of payment for LTC?

Private pay

29

What percentage of LTC is paid by Medicare?

0%!

30

What's the biggest operational challenge in LTC?

HR, for sure. There's large turnover and issues of pay and benefits.

31

Why do we treat rehab facilities as different from LTC?

Rehab is more about the acute care side of LTC. They have their own conditions of participation and are focused specifically on rehab.

Think PT, OT, ST and RT

32

What are the 5 things physicians value?

Quality Care
Time (money)
Efficiency
Autonomy
Control

33

What percent of group practices are HOGs?

70%. Doh!

34

What are the 8 managerial challenges of medical group practice?

Business operations
Quality management
Financial management
Human Resources
Risk Management
Information Management
Organizational Governance
Patient Care

35

ABMS

American Board of Medical Specialties

36

ACHE

American College of Healthcare Executives

37

ACOG

American College of Obstetricians and Gynecologists

38

AHA

American Hospital Association

39

ALOS

Average Length of Stay

40

AMA

American Medical Association

41

ANA

American Nurses Association

42

ASCA

Ambulatory Surgical Center Association

43

CRNA

Certified Registered Nurse Anesthetist

44

DHHS

Department of Health and Human Services

45

DME

Durable Medical Equipment

46

DO

Doctor of Osteopathy

47

DPM

Doctor of Podiatric Medicine

48

FDA

Food and Drug Administration

49

HFMA

Hospital Financial Management Association

50

HIPAA

Health Insurance Portability and Accountability Act

51

HMO

Health Maintenance Organization

52

HOPD

Hospital Outpatient Department

53

HSCA

Healthcare Supply Chain Association

54

IRB

Institutional Review Board

55

ISO

International Organization of Standards

56

NICU

Neo-natal Intensive Care Unity

57

OPPS

Outpatient Prospective Payment System

58

PACU

Post anesthetic payment system

59

PCP

Primary Care Physician

60

PIP

Periodic Interim Payment

61

What's the definition of hospice and palliative care?

Hospice is pain management at the end of life.

Palliative care is addressing emotional, social, and spiritual care, for both those dying and those that are just recovering in an acute care setting.