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Introduction

Cost accounting is the system of accounting has the responsibility of...of course! Measuring Costs. Cost accounting is something that requires good measuring systems. A cost accounting system should be tightly integrated with the healthcare system.  Many of the indicators used in the Healthcare Data Analysis are shared and are derived from accounting.

Accounting Package Requirements

A good accounting package has the following features:

  • Capability to handle and process detailed resource utilization studies for every natural classification of expense for all departments, direct and/or indirect (overhead)

  • Reconciliation of identified expenses to actual financial statements

  • Internal indirect cost allocations to both the departmental and service levels. This is very important, since the indirect expenses allocated to the departments often exceed their direct expenses. The allocation of these expenses to the departments and to the services is a critical point in monitoring full costing and is often not given the detailed review it deserves.

  • Ability to maintain a very large number of statistical bases for allocating costs

  • Updating of information quickly. The cost accounting system should interface with the other financial systems software operating on the same hardware, thus eliminating a second manual entry of current financial information.

  • Interface with the case-mix system. The cost accounting system should be able to pass cost information to the case-mix system (which ideally would accept five cost fields per service: direct, indirect, fixed, variable and total) and accept information from the case-mix system to review profitability of service and cost variances from standard.

  • Budget system interface – preferable flexible project line budgeting.

  • Support of multi-unit users on the same system

  • Ability to support both standard and allocated costing methodologies for all services.

  • Variance reporting –reports comparing standard and actual costs and corresponding variances

  • Base data file – a file that contains resource utilization study information from national averages or standards, to be used to allocate costs to those services not directly studied.

  • Grouping or “roll-up” feature – allows for easy comparison of departments and administrative responsibility areas as well as inter-unit comparisons, etc.

  • Extensive security features – identifying and limiting users as desired.

  • Data entry ease. A data entry person should be able to enter the information directly from input forms.

  • General ledger reclassifications – should allow reclassifications inter- and intra-departmentally

  • Support of fixed, variable, and semi-variable classification of expenses by department

  • Rapid recalculation response time. You should be able to recalculate entire organization information or each department individually within a very short time period

  • Maintenance of the organization wide cost accounting information base within the singular system. The cost accounting system should support the whole organization’s cost information base. Avoid systems that have only the capability to maintain departments as separate entities.

  • Updating of information in real time.

  • Ability to report detailed resource utilization studies for every classification of expense for all organizational units, including:

    • direct and indirect costs

    • restricted and non-restricted costs

    • fixed, variable, and semi-variable costs

    • “what if costs.”

  • Ability to allocate all costs to the very smallest service level.

  • Ability to have the flexibility to draw on different methods for allocating costs and to be able to develop what-if scenarios.

  • Ability to adjust budgets manually by each period as well produce variance reports –reports comparing standard and actual costs and corresponding variances

  • Ability to perform comparison analysis not only within the same classifications of units within the organization but also outside the organization such as industry averages

  • Ability to “drill down” through multiple dimensions (departments, units, employees, service costs, etc) as well as the time dimension

Integration with other operating systems

  • All applications should have to ability to interface with all other operating systems. These interfaces should included at least the following

    • Financial

    • Decision support

    • Budget systems

    • Quality control

    • Human Resource controls

    • Research

    • Cost-benefit applications

    • Agency Reporting 

  • Ability to “customize” input forms on demand 

  • Ability to “customize” reports on demand

  • Ability to add/delete fields of information easily

  • Ability to change any part of the system without affecting the other parts

  • Elimination of redundant information (duplication of data or aggregate totals)

Technology

  • Based on relational database technology (SQL) with decision support features. Flat file and proprietary systems are OUT.

  • Ability to perform distributed transactions across multiple sites

  • Security features that includes not only user password protection but also the newest data encryption features. 

  • Easily to performance backups and data replications across multiple sites

  • Ability to manage system from remote sites

  • An easy programmable front-end interface that allows flexibility in the design and use of data input.

Operations

Each cost center should be measured on
1.        Its efficiency
2.        Its effectiveness

This implies two different indicators of measurement

Classifications:

Restricted Funds:

  • Specific-purpose fund 

  • Research fund   

  • Endowment fund

  • Plant replacement and renovation fund

Notes:

If  comparison data is not available it may be possible to break up “a dept” into sub-departments and measure the variability between these two sub units. 

Ratio data is available from “Healthcare Financial Management Asst Financial Advisory Services for a price.     

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