HSM 340 Health Care Services Week 1 to 7

HSM
340 Health Care Services Week 1 to 7

Week
1 Assignment, Financial Laws and
Regulations

Complete an APA formatted 2 page
paper (not including the title and reference pages) answering the following
questions:

1.
What are five elements pertaining to
the establishment of a false claim under the False Claims Act?

2.
HIPAA privacy standards were
designed to accomplish what three broad objectives? Explain each.

3.
Stark II laws prohibit physician
referrals to entities in which the physician has a financial relationship. What
are 10 specific designated health services (DHS) for which referrals by
physicians who have financial relationships with the entity providing the DHS
are prohibited?

4.
Discuss the following:

a.
Qui tam

b.
HIPAA Privacy Rule

c.
EMTALA

d.
Compliance programs

Week 2 Quiz

1. (TCO 2)
A statement that reports inflows and outflows of cash during the accounting
period in the categories of operations, investing, and financing, is called
a(an):

2. (TCO 2)
Which method(s) of financial reporting does (do) not recognize the impact of
changes in purchasing power?

3. (TCO 2)
Which of the following is the BEST example of a financial metric?

4. (TCO 2)
What is/(are) the primary determinant(s) of firm value?

5. (TCO 2)
How are revenues and expenses defined under accrual accounting?

6. (TCO 2)
What is an audit (in the context of financial accounting)?

7. (TCO 2)
The HC method, which uses unadjusted historical costs, does not take into
account depreciation expenses, purchasing power, and unrealized gains in
replacement value. Despite these weaknesses as a financial reporting method,
the HC method is used more frequently for accounting purposes than other
methods, such as the HC-GPL, CV, and CV-GPL methods. Why is this so?

8. (TCO 2) Define and describe the purpose of fund
accounting (now called net assets).

Week 3 Quiz

1. (TCO 3)
From a hospital’s perspective, what is most likely to be the highest risk
arrangement with a payer?

2. (TCO 3)
SKF Primary Care Clinic is deciding whether to purchase MRI equipment that
would enable it to perform MRI imaging services in-house rather than sending
its patients to its competitor’s hospital three miles away. From a financial
position, if SKF were to make its decision without using net present value
analysis, the clinic would need to know (or at least reasonably estimate) which
of the following information?

3. (TCO 3)
Assume that the clinic used the price that they need to exactly break even at
10,000 shots. Fewer people than expected showed up and purchased the flu shot.
The clinic would:

4. (TCO 3)
Which of the following is the first step in any budgetary process?

5. (TCO 3)
David Jones, the new administrator for a surgical clinic, was trying to
determine how to allocate his indirect expenses. His staff was complaining that
the current method of taking a percentage of revenues was unfair. He decided to
try to allocate utilities based on square footage of each department,
administration based on direct costs, and laboratory based on tests. Use the
information in the chart below to answer the question.

6. (TCO 3)
Your hospital has been approached by a major HMO to perform all their MS-DRG
470 cases (major joint procedures). They have offered a flat price of $10,000
per case. You have reviewed your charges for MS-DRG 470 during the last year
and found the following profile:

7. (TCO 3)
How are costs classified?

Week 4 Midterm Exam

1. (TCO 4) Which
of the following is part of a statistics budget?

2. (TCO 4) The
following is an example of a _____________ budget: “The budget for the
radiology department is different at 90 percent occupancy than at 80 percent
occupancy.”

3. (TCO 4)
Effectiveness is a relationship between:

4. (TCO 3) What
is the main reason that relative value units (RVUs) often are used in health
care?

5. (TCO 3) Your
controller has told you that the marginal profit of DRG 209 (major joint
procedure) for a Medicare patient exceeds the marginal profit for an average
charge patient. Why might this occur?

6. (TCO 2) The
heading of every financial statement should contain the:

7. (TCO 2) Which
of the following is the BEST example of a financial metric?

Page 2

1. (TCO 4)
Formulate your answer based on the below information. Costs per case increased
to $4,900 from a budgeted value of $4,750. This increased actual total costs by
what amount?………….You have been asked by management to explain the
variances in costs under your inpatient capitated contract. The following data
is provided. Use the following data to calculate the variances. Budget Actual

2. (TCO 4) Based
on the information below, assume that the only change in the original example
data is that Blue Cross raises their discount to 20 percent. What price should
be set? You have been asked to establish a pricing structure for radiology on a
per-procedure basis. Present budgetary data is presented below:……………It is
estimated that Medicare patients comprise 40 percent of total radiology volume
and will pay on average $38.00 per procedure. Approximately 10 percent of the
patients are cost payers. The remaining charge payers are summarized below:

3. (TCO 4) What
is the amount of variance that can be attributed to the difference between
budgeted and actual volume? Use the following data to calculate the variances.
The following information has been prepared for a home health agency.

4. (TCO 2)
Explain the difference between the accrual basis of accounting and the cash
basis of accounting?

5. (TCO 2) What
is an audit (in the context of financial accounting)?

6. (TCO 1) What
are social responsibility and ethics as they relate to business-oriented
organizations? How should social responsibility and ethics affect the decisions
of even for-profit companies?

7.
(TCO 2) Define and describe the purpose of fund accounting (now called net
assets).

Week
5 Assignment, Capital Budgeting Process
Complete an APA-formatted two-page
paper (not including the title and reference pages) answering the following
questions.

1.
Organizations that decide to issue
bonds generally go through a series of steps. Discuss the six steps.

2.
An alternative to traditional equity
and debt financing is leasing. Leasing is undertaken primarily for what
purposes?

3.
Discuss the two major types of
leases.

4.
Discuss the terms short-term
borrowing and long-term financing.

5.
What are the primary sources of
equity financing for not-for-profit healthcare organizations?

6.
The capital budgeting process occurs
in several stages, but generally includes what?

7.
Discuss and list the three
discounted cash flow method

Week
6 Assignment, Cash and Working Capital
Complete an APA-formatted two-page
paper (not including the title and reference pages) answering the following
questions.

1.
What are four general phases of the
working capital cycle?

2.
What are the three primary sources
of short-term funds?

3.
An organization’s short-term
investment options for idle cash include what four areas? List and provide
their characteristics.

4.
Discuss the term float.

HSM 340 Week 7 Quiz

1. (TCO 7)
Coordination of benefits refers to:

2. (TCO 7)
A withhold is a feature for payment to health care provider that:

3. (TCO 7)
A medical group includes a provision in its contract with an HMO to receive
larger PMPM payments if the HMO members are chronically ill. This type of
provision is referred to as a:

4. (TCO 7)
Suppose that AT&T had made an offer to acquire Merck Pharmaceuticals.
Ignoring potential antitrust problems, this merger would be classified as a:

5. (TCO 7)
An HMO has a Point of Service (POS) option for its members, but will pay only
80 percent of approved charges. If a member goes out of network for a medical
procedure with a charge of $2,000, of which $1,200 is approved, how much must
the member pay?

6. (TCO 7)
An uninsured patient receives services with charges of $5,000 from a hospital.
The hospital staff bills the patient $1,000 and records $4,000 as charity care.
If the hospital’s ratio of cost to charges is 50%, what amount would the
hospital recognize as charity care in Schedule H of IRS Form 990?

7. (TCO 7)
Why is tax-exempt financing cited as a benefit received by not-for-profit
healthcare providers?

Explanation & Answer

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