Issues in Cost Accounting for Health Care Organizations / Edition 1

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This new second edition is based on a thorough literature review of all cost accounting articles published in the last five years. It is an excellent resource for readings on the topic of health care cost measurement and analysis, this text provides the insights of leading authorities in the area of health care costs. Each article is linked with the conceptual discussion in the companion volume, Essentials of Cost Accounting for Health Care Organizations.


  • A combination of classic articles and the most recent published applications of cost accounting to the health care setting (it is the most complete compilation of articles on the topic of health care cost accounting)
  • Has a new focus on not only hospitals, but also other types of health care providers including managed care, nursing homes, home health, clinics, and physician practices
  • Each article provides insight about a specific potential problem area in the management of health care organizations.

The book contains black-and-white illustrations.

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Editorial Reviews

Offers a collection of articles focusing on critical issues in health care cost accounting. Each article provides insight about a specific potential problem area in the management of health care organizations. Many articles incorporate the latest costing techniques, such as the application of Activity Based Costing to health care. Some articles are classics that lay the foundations for health care costing. Material is presented in four sections to parallel the text, . Finkler is a professor at New York University's Robert F. Wagner Graduate School of Public Service. Ward is an assistant professor at the Medical University of South Carolina. Annotation c. Book News, Inc., Portland, OR (
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Product Details

  • ISBN-13: 9780834205291
  • Publisher: Wolters Kluwer Law & Business
  • Publication date: 1/28/1994
  • Edition description: Older Edition
  • Edition number: 1
  • Pages: 287

Table of Contents

Pt. I Cost Accounting Foundations 1
Ch. 1 Introduction to Cost Accounting 5
Reading 1-1 Reader's Forum: The Value of a Cost Accounting System 5
Reading 1-2 Understanding the Hospital Cost Accounting Process 8
Reading 1-3 The Human Element in Cost Accounting 14
Ch. 2 Cost Definitions 19
Reading 2-1 The Identification of Surgical Services Costs 19
Reading 2-2 Cost Finding for High-Technology, High-Cost Services: Current Practice and a Possible Alternative 24
Reading 2-3 Horizontal Accounting Considered for the Hospital Setting 37
Reading 2-4 Costing Out Nursing Services 44
Reading 2-5 Cost Accounting for Emergency Services 49
Ch. 3 Product Costing 56
Reading 3-1 Job-Order Costing in Physician Practice 56
Reading 3-2 Product Cost Analysis in the Clinical Laboratory 62
Reading 3-3 Product Costing for Health Care Firms 71
Reading 3-4 A Microcosting Approach 81
Ch. 4 Cost Allocation 85
Reading 4-1 The Distinction between Cost and Charges 85
Reading 4-2 Using Reciprocal Allocation of Service Department Costs for Decision Making 98
Reading 4-3 RVUs: Relative Value Units or Really Very Useful? 104
Reading 4-4 Alternative Costing Methods in Health Care 111
Reading 4-5 Accounting for the Move to Ambulatory Patient Groups 116
Reading 4-6 Cost Allocation in the Emergency Department 128
Ch. 5 Costing for Nonroutine Decisions 134
Reading 5-1 HMO Negotiations and Hospital Costs 134
Reading 5-2 Capitated Hospital Contracts: The Empty Beds versus Filled Beds Controversy 138
Reading 5-3 Privatization in Health Care Institutions 142
Reading 5-4 Considering Cost Effectiveness in the Hospital Setting 152
Reading 5-5 Cost-Effectiveness Analysis in Health Care 156
Ch. 6 Cost-Volume-Profit Analysis 165
Reading 6-1 Breakeven Analysis for Capitated Arrangements 165
Reading 6-2 Managed Care and Breakeven Analysis: A Clarification 167
Reading 6-3 Using Breakeven Analysis with Step-Fixed Costs 171
Reading 6-4 Alternative Contribution Margin Measures 176
Pt. II Cost Accounting Information for Planning and Control 181
Ch. 7 Predicting Future Costs 183
Reading 7-1 Regression-Based Cost Estimation and Variance Analysis: Resolving the Impact of Outliers 183
Reading 7-2 The Learning Curve and the Health Care Industry 189
Ch. 8 Budgeting 197
Reading 8-1 The Financial Evolution of Hospitals and the Zero-Base Budget Approach 197
Reading 8-2 Zero-Based Budgeting for a Radiology Service: A Case Study in Outsourcing 205
Reading 8-3 Developing and Using a Budget Manual 211
Reading 8-4 Outcome Budgeting Shifts Focus to Meeting Objectives 215
Reading 8-5 Flexible Budgeting Allows for Better Management of Resources As Needs Change 224
Ch. 9 Flexible Budgeting and Variance Analysis 229
Reading 9-1 Physician Cost Variance Analysis under DRGs 229
Reading 9-2 A Contemporary Approach to Budget Variance Analysis: A Pharmacy Application 233
Reading 9-3 Rolling Budgets and Variance Reports 241
Reading 9-4 Statistical Cost Control: A Tool for Financial Managers 245
Ch. 10 Management Control 250
Reading 10-1 Developing a Planning and Control System for a Responsibility Unit 250
Reading 10-2 Cost Control Systems 253
Reading 10-3 Competitive Pricing Models for Intra-Hospital Services 259
Reading 10-4 Transfer Pricing in the Hospital-HMO Corporation 262
Pt. III Additional Cost Accounting Tools to Aid in Decision Making 267
Ch. 11 Cost Accounting Ratios 269
Reading 11-1 Ratio Analysis: Use with Caution 269
Reading 11-2 Hospital Industry Cash Flow Ratio Analysis: A Sufficiency and Efficiency Perspective 278
Reading 11-3 Ratio Analysis for the Development Office of Health Care Institutions 283
Ch. 12 Measuring Productivity 289
Reading 12-1 Productivity Management: A Model for Participative Management in Health Care Organizations 289
Ch. 13 Inventory 300
Reading 13-1 Inventory Management System Reaps Savings for Department 300
Ch. 14 Dealing with Uncertainty 307
Reading 14-1 Decision Analysis and Capital Budgeting: Application to the Delivery of Critical Care Services 307
Reading 14-2 Expected Value Technique Useful in HMO Negotiations: Tool Helps Managers Consider Potential Outcomes of Bidding Process 315
Reading 14-3 Decision Making under Uncertainty: A Linear Programming Approach 324
Ch. 15 Information Systems for Costing 329
Reading 15-1 Saving Money throughout the Cost Accounting Installation Cycle 329
Reading 15-2 Cost Accounting Software Design 337
Reading 15-3 An Integrated Planning and Management Control System for Hospitals 342
Ch. 16 Performance Evaluation and Incentive Compensation 347
Reading 16-1 Measuring Segment Performance: New Ventures of Today's Innovative Hospital System Pose Evaluation Challenges 347
Reading 16-2 The Impact of Motivation and Incentive Programs on Financial Budgets 354
Pt. IV Cost Accounting for the Year 2000 and Beyond 363
Ch. 17 New Approaches to Cost Accounting 365
Reading 17-1 Activity-Based Costing in the Operating Room at Valley View Hospital 365
Reading 17-2 Activity-Based Costing for Hospitals 371
Reading 17-3 ABC Estimation of Unit Costs for Emergency Department Services 385
Ch. 18 Total Cost Management: Measuring the Costs of Quality 393
Reading 18-1 Measuring the Costs of Quality 393
Reading 18-2 Total Quality Management: An Application in a Biomedical Laboratory 399
Index 405
About the Authors 421
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