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Part I The Healthcare Environment

Chapter 1. Introduction to Healthcare Financial Management ………………….. 3

Learning Objectives ………………………………………… …………………… 3

Introduction …………………………………………. ……………………………… 3

How to Use this Book …………………………………………. ………………….. 4

The Role of Financial Management in the

Health Services Industry ……………………………………….. …………. 6

Current Challenges ………………………………………… …………………….. 8

Organizational Goals ………………………………………… ………………….. 9

Tax Laws ………………………………………… ………………………………… 13

Depreciation …………………………………………. …………………………… 21

Health Reform and Financial Management ……………………………. 25

Chapter Key Concepts ……………………………………….. ……………….. 29

Chapter Models, Problems, and Mini-Cases …………………………… 30

Selected Bibliography ………………………………………… ………………. 31

Selected Websites ………………………………………… …………………….. 32

Notes …………………………………………. …………………………………….. 32

Supplement. Forms of Business Organization,

Ownership, and Structure ………………………………………. ……….. 33

Supplement Learning Objectives ……………………………………….. … 33

Forms of Business Organization ………………………………………. ….. 33

Alternative Forms of Ownership ………………………………………. … 38

Organizational Structures ………………………………………… ………….. 42

Supplement Key Concepts ……………………………………….. …………. 46

Supplement Bibliography ………………………………………… ………….. 47

Supplement Websites ………………………………………… ……………….. 47

Supplement Notes ………………………………………… ……………………. 47

vii

VIII Detailed Contents

Chapter 2. Health Insurance ……………………………………… ………………………….. 49

Learning Objectives ………………………………………… …………………. 49

Introduction …………………………………………. ……………………………. 49

Insurance Concepts ………………………………………… ………………….. 50

Major Health Insurers (Third-Party Payers) …………………………… 57

Private Insurers ………………………………………… ……………………….. 57

Public Insurers ………………………………………… …………………………. 61

Development of Premium Rates ………………………………………. …..63

Consumer-Directed Health Plans ……………………………………… ….. 71

Value-Based Benefit and Insurance Design ……………………………. 75

Health Reform and Health Insurance …………………………………….. 76

Chapter Key Concepts ……………………………………….. ………………. 79

Selected Case ………………………………………… ………………………….. 81

Selected Bibliography ………………………………………… ………………. 81

Selected Websites ………………………………………… ……………………. 81

Notes …………………………………………. …………………………………….. 82



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