1. As an administrator, you need to assess this situation: How would you determine if there was a true need for another receptionist? Do you need to reinstate the position or can you retrain the current number of employees? Why?
2. As an administrator, describe the effects that labor shortages of key personnel and rising costs of labor have on profitability. How would you determine how to allocate your money? Be sure to think critically about the impact that quality outcomes and patient outcomes have on financial resources.
3. Based on what you have learned so far in this course, what would be your plan of action for the next 30 days? What types of reports would you use to help support your decisions?
Type of care provided
Care in this type of setting is delivered by physicians, physician assistants, nurse practitioners, and advanced practice professionals. This area of health care is the most widely used, and it is a major focus of the Affordable Care Act of 2010, focusing on primary care providers and decreasing the focus on the utilization of specialty providers.
Scenario
A primary care clinic can be an individual-physician practice or a multiple-physician practice organized as a nonprofit or a for-profit facility. Multiple-physician practices generally specialize in cardiac, women’s health, pediatrics, or related services. You are the administrator of a local for-profit, multiple-physician community clinic owned by five local physicians, specializing in internal medicine, women’s health, pediatrics, orthopedics, and oncology. The clinic sees an average of 50 patients per day. Scheduling is centralized with two receptionists, and each specialty has four staff members to assist the physicians. All the physicians have visiting privileges at the area hospitals and frequently speak at local and national conferences on numerous preventative health care topics. The clinic is noted for its use of technology and has agreements in place with the local hospitals for web-based exchanges of health information on shared patients.
Action Required:
Your office just underwent an organizational change and one office receptionist was eliminated, saving the office $40,000 per year in labor costs. However, there have been a number of complaints that all patients cannot be processed due to the increased flow of patients. Two weeks later you begin to hear that wait times for appointments have increased, and one specific patient was not able to be seen. That patient now has developed an infection and requires surgery
Budget Considerations
Operational Budget – This budget focuses on a broader view of the total operations of the organization in which all departments are reviewed for both their income potential and the costs associated with the work activities used to generate projected revenues. Each department will have its own budget for the managers to follow and on which to base the activities of the department in order to meet its contribution to the total revenues and the associated costs of the organization.
Dietary Services – This is a departmental budget focused on the costs and potential reimbursement for the organization. The operation is overseen by a dietitian or nutritionist who is responsible for supplying the nutritional needs of the patients within their care. This department may utilize the services of several consultants or contract this service to an outside organization.
Medical Supplies – This budget is focused specifically on the requirement-based services being delivered by the hospital professional, which are often referred to as nondurable disposable items. This budget includes specific items for the surgeon or professional performing the services. These may include such things as oxygen supplies, diabetic supplies, ostomy supplies, bandages, and related supportive items. These items are generally manufactured for one-time use. They are not reused due the inability to sterilize them. The items that are reusable are classified under capital assets and have a use-time identified with the specific piece of equipment.
Human Resources – This budget indicates the finances needed to support the organization’s objectives, from a personnel perspective. Full-time equivalent (FTE) calculations are used to project the personnel budget. These individuals could include nonskilled labors to professional licensed physicians and various job descriptions within the categories. In addition to listing the FTEs, the associated benefits of the FTEs would be projected within this department for each FTE within the organization. This will generally include line items for consultants and temporary positions based on the needs of the organization.
Maintenance/Facility Operations – This departmental budget focuses on the overall upkeep of the building and the related equipment and machines to provide a safe and comfortable environment for both the patients and workers. This budget includes all FTEs and may also include line items for consultants and outside sources based on needs of the facility.
Vendor/External Suppliers – Health service organizations have special needs and may require certain external items and/or services. Most organizations have projected budgets to include the purchase of supplies and services for outside contractors (vendors) who specialize in installation, monitoring, and the repair of specialized equipment or technology being utilized by the specific health care delivery system.
Departmental Costs – This budget focuses on the specific department and its overall needs, costs, and potential revenue in relation to the overall goals of the organization’s strategic plan. The manager’s primary responsibility is to monitor the operational efficiency of the department, including all areas that directly impact and support the generating of revenue for the organization. Managers may be required to present an analysis of the weekly or monthly operational analysis to the Chief Financial Officer of the organization or a lead manag
