Discuss how you could develop a financial plan for the clinic using a management control process for the budget implementation.

Introduction: There are many factors to be considered when examining organizational finances and making decisions that have long-term effects on a medical practice. In healthcare organizations, there are multiple payers that influence reimbursement. There are external agencies such as the federal or state government, which may set rate limits that impact revenues, and there are outside forces such as marketing structure and competition that influence pricing of healthcare services. Managers who oversee budgets and help to make financial decisions need an overall understanding of the forces shaping this environment. Read the attached �Financial Resource Management and Healthcare Reimbursement.� For this task, you will act in the role of the manager as you consider how to develop a financial plan for the clinic for the upcoming fiscal year, including projections for the future. Task: A. Create an agenda to present to Dr. Ross in a preliminary meeting with him before meeting with the entire physician group. 1. Summarize the types of financial information the physician group would need to understand to have a clear picture of the clinic�s current financial status. a. Discuss what is influencing the pricing for the pediatric services. b. Discuss what is influencing revenue collection. c. Illustrate how this information should be analyzed to assist in the decisions to be made for the practice. B. Explain how issues presented in the scenario may impact the future revenue of the practice by doing the following: 1. Discuss the consideration to be given to the pediatric endocrinologist�s request. 2. Discuss the aspects that need to be considered in adding pediatric oncology. 3. Present the components that should appear in a managed care contract with Indian Health Service. C. Discuss how you could develop a financial plan for the clinic using a management control process for the budget implementation. For Task 4, please make sure that the four issues are covered in the Agenda for the informal meeting between you as the Practice Manager and Dr. Ross as the Managing Partner. No one else will be involved in this meeting, but you must cover the four problems from the scenario fully either in the Agenda form itself or under the Agenda as a key. 1. The informal Agenda Remember: � You need to list each of the four issues to be addressed � Give a limited description of each � List the financial documents that will be needed for the other four pediatricians � Explain the pricing formula and � Explain the Revenue Collection notes � Bring in the Information Analysis that you and Dr. Ross need to lead the other pediatricians through to help them make the right decisions. Tip: you will not be including financial statements that you would find in a business setting, but rather will need the financial statements you would only find in healthcare and need to put them in a manner the other pediatricians can understand. These would be documentations of payer mix reports, allowable fee schedules from Managed Care Payers, Contracts from those same Managed Care Payers, all the information you can get on the costs associated with a full day�s use of the practices exam rooms along with the expected revenue of those same exam rooms when the practice schedules are aligned to keep each day in the black, by limiting exposure to Medicaid Patients and other non-advantageous managed care situations. You will also need to be able to show the pediatricians how much you currently lose on the days when the pediatric endocrinologist is in the office and how much you might lose if you do not structure a contract with a possible pediatric oncologist so that he or she would cover their own expenses to a least a point. And most of all, you will need to show how much the practice would go in the red if they take on the Indian Health Services Managed Care contract without certain things being put into the contract. B. Explain how issues presented in the scenario may impact the future revenue of the practice by doing the following: 1. Discuss the consideration to be given to the pediatric endocrinologist�s request. 2. Discuss the aspects that need to be considered in adding pediatric oncology. 3. Present the components that should appear in a managed care contract with Indian Health Service. This is where you have to think about operating costs and fixed costs associated with each of these providers delivering services. What revenue is gained by their presence? What is lost? Do you have a market for his services? Considering your increase in SCHIP and Medicaid patients should you limit your Indian Health services patients? What would you write into this contract? How long will the new contract run, where patients can be seen, co-pays received up front vs after care, etc. c. Discuss how you could develop a financial plan for the clinic using a management control process for the budget implementation.

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