Health Care Finance

Health Care Finance

• How the organization and delivery of health care services are paid for.

• Those who work for a Health Care Organization (HCO) know this can be a difficult challenge.

• For this reason, HCOs hire and charge CFOs to plan and monitor this process.

• This has become practically impossible without financially savvy managers

The financially challenge in health care

• Providers

• Trustees serving on Governing Boards of Health Care Organizations (HCO)

• Government Regulators

• Health Insurers and other Third Party Payers

Financial Information and Decision Making

• Information

• Decision Making

• Implementation of decision

• Results

• How does a good information system help financial managers deal with uncertainty?

Uses of Financial Information

• Evaluating the condition of an HCO

• Evaluating the stewardship in an HCO

• Assessing the efficiency of an HCO

• Assessing the efficacy of an HCO

• Determining whether the HCO complies with external or internal directives.

Users of Financial Information

• External Users (in PA)– PHC4– Unions Capital Blue Cross– Aetna – US-Healthcare

• Internal Users (within the Pinnacle Health System)– Governing Board– Management

Financial Organization

• CFO answers to

• Controller (internal) versus Treasurer (external) functions