`No margin—no mission` is a quote often attributed to the late Sister Irene Krause, a Healthcare Hall of Fame inductee and a missed colleague. She felt, as do I, that without effective financial management (margin), hospitals and other healthcare organizations cannot fulfill their mission of providing needed medical and healthcare services to their communities. Although healthcare organizations serve as community resources, they also are complex businesses, and like any business, their success depends on the leadership of managers and executives who understand and can apply key financial principles to fulfill their roles.
Healthcare is unique in the way it is financed. It is characterized by a pluralistic system of public and private financing, and public and private delivery of services, that is unmatched in other industries. Depending on their ownership (public or private), healthcare organizations adhere to accounting standards promulgated by either the Government Accounting Standards Board or by the Financial Accounting Standards Board. An understanding of the issues surrounding third-party payment and payment methodologies, government healthcare programs, complex receivables management, managed care requirements, corporate compliance programs, and so on requires special effort and special resources. This book is one of those resources.
Like so many who have worked in the field of hospital administration, my career was influenced by the predecessor to this book, The Financial Management of Hospitals. Since 1971, that text, first written by Howard Berman and Lewis Weeks, who were in later editions joined by Steve Kukla, has served as the primary finance textbook for students in hospital administration and as a key reference book on finance for practitioners. When I started in hospital finance in the early 1970s, it was known by most people in the field simply as `Berman and Weeks.` As the field of healthcare evolved, as health administration education broadened beyond hospitals, as payment methodologies grew more complex, and as the distinction among the various healthcare settings blurred, it became apparent that a new book was needed. This book, The Financial Management of Hospitals and Healthcare Organizations, now out in its second edition, reflects that natural evolution.
Michael Nowicki is well qualified to write this text. As a teacher and scholar, he has taught numerous courses on, and has written numerous papers about hospital and healthcare accounting and finance. During his career, he has worked for not-for-profit, investor-owned, and public healthcare facilities. As a Fellow in the Healthcare Financial Management Association (HFMA), Michael has and continues to serve HFMA in many volunteer capacities— most recently as a chapter president, a chapter liaison representative, and a member of both the National HFMA Board of Directors and the National HFMA Board of Examiners. In this latter role, Michael works with other volunteers nationally to oversee HFMA's certification program, which defines the body of knowledge for healthcare finance. Michael also is a Fellow in the American College of Healthcare Executives, which, along with his broad-based experiences, helps him take a view of financial management from the nonfinancial manager's perspective.
This book follows a rich tradition of providing an important instructional resource to students and practitioners alike. It is my hope that as the field continues to evolve and as healthcare managers and executives face new challenges, this book will continue to serve as that resource.
Richard L. Clarke, FHFMA
Healthcare Financial Management Association
The Financial Management of Hospitals and Healthcare Organizations is intended to be the primary textbook of choice in introductory courses in healthcare financial management at both the undergraduate and graduate levels, as well as a reference book for program graduates and other practicing healthcare managers. The purpose of this book is to introduce nonfinancial students and managers to the fundamental concepts and skills necessary to succeed as managers in an increasingly competitive employment environment.
For instance, program graduates find employment in a variety of healthcare settings. Therefore, the focus of this book—as well as the title of the book—extends beyond the hospital. Program graduates consistently report a deficiency in quantitative skills; this book includes problems representing key concepts, and a companion book of practice problems has been published. Traditional-age students report a need to apply the quantitative skills introduced in financial management, so a contemporary, comprehensive casebook with practice problems is also available in the companion book.
In this edition, Part I includes an overview of financial management, the organization of financial management, and the tax status of healthcare organizations. Part II includes third-party payers and payment methodologies, Medicare and Medicaid, cost accounting and analysis, and rate setting. Part III includes the management and financing of working capital, materials management, and accounts receivable management. Part IV includes resource allocation, budgeting, and capital budgeting. Part V includes management reporting and financial analysis. Finally, Part VI includes an analysis of trends that will affect healthcare organizations in the future.
This book is intended for students and managers with prerequisite knowledge in economics, accounting, and statistics; however, in the event that students and managers lack that prerequisite knowledge, the first chapter includes appendices that review the important concepts in those subjects.
Each part of the book includes its own recommended readings list and a glossary of important terms and list of abbreviations used are included at the end of the book. The chapters are modular to allow readers to either delete specific chapters or change the order of the chapters. For instance, many teachers structure their courses to cover the financial analysis chapter earlier. The plan is to publish a new edition of the book every three years. I hope you find The Financial Management of Hospitals and Healthcare Organizations relevant and current.