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A Central University

Department Of Management Studies

Assignment on Management Control System


in Non-Profit Organization

Management Control System

MBA 3rd Semester


2010-2011

Submitted To: Submitted By:

Dr.B.D.Mishra Akriti Gupta


Reader Iti Shrivastava
M.B.A.; Ph.D Shikha Sahu
Financial Management, Business Policy Shobhna Jha
Strategic Management

INDEX

Service Organization in General 01

1
Professional Service Organization 06

Financial Service Organization 12

Health care Organization 16

Non-profit Organization 18

Conclusion 24

SERVICE ORGANIZATIONS
In this Assignment, we describe the management control process in service organizations-
organizations that produce and market intangible services. We first discuss the characteristics
that distinguish service organizations in general from manufacturing organizations. We then
discuss the special problems that arise in professional, financial service, health care, and
nonprofit organizations.

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Service Organizations in General
In the 18th and the early part of the 19th century, the workforce in the United States was
predominantly in agriculture. After that, it was predominantly in manufacturing. Early in the
20th century, employment in the service sector overtook employment in the manufacturing
sector. By 2003, service sector employment had grown to more than twice that of
manufacturing. In this chapter we provide insights into management control systems for
service organizations.

Characteristics
For several reasons, management control in service industries is somewhat different from
management control in manufacturing companies. Some factors that have an impact on most
service industries are discussed in this section. (Others, which are characteristics of particular
service industries, are discussed later.) These factors apply also to the management control of
legal, research and development, and other service departments in companies generally.

1. Essence of Inventory Buffer


Goods can be held in inventory, which is a buffer that dampens the impact on production
activity of fluctuations in sales volume. Services cannot be stored. The airplane seat, hotel
room, hospital operating room, or the hours of lawyers, physicians, scientists, and other
professionals that are not used today are gone forever. Thus, although a manufacturing
company can earn revenue in the future from products that are on hand today, a service
company cannot do so. It must try to minimize its unused capacity.
Moreover, the costs of many service organizations are essentially fixed in the short run. In the
short run, a hotel cannot reduce its costs substantially by closing off some of its rooms.
Accounting firms, law firms, and other professional organizations are reluctant to lay off
professional personnel in times of low sales volume because of the effect on morale and the
costs of rehiring and training.
A key variable in most service organizations, therefore, is the extent to which current capacity
is matched with demand. Service organizations attempt this matching in two ways.. First, they
try to stimulate demand in off- peak periods by marketing efforts and price concessions.
Cruise lines and resort hotels offer low rates in off seasons; airlines and hotels offer low rates
on weekends; public utilities offer low rates on slack periods during the day. Second, if
feasible, service organizations adjust the size of the workforce to the anticipated demand by
such measures as scheduling training activities in slack periods and compensating for long

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hours in busy periods with time off later. The loss from unsold services is so important that
occupancy rates, “sold hours,” load factors, student enrollment, hospital admissions, and
similar indications of success in selling available services are normally key variables in
service organizations.

2. Difficulty in Controlling Quality


A manufacturing company can inspect its products before they are shipped to the consumer,
and their quality can be measured visually or with instruments (tolerances, purity, weight,
color, and so on). A service company cannot judge product quality until the moment the
service is rendered, and then the judgments are often subjective. Restaurant management can
examine the food in the kitchen, but customer satisfaction depends to a considerable extent on
the way it is served. The quality of education is so difficult to measure that few educational
organizations have a formal quality control system.

3. Labor Intensive
Manufacturing companies add equipment and automate production lines, thereby replacing
labor and reducing costs. Most service companies are labor intensive and cannot do this.
Hospitals do add expensive equipment, but mostly to provide better treatment, and this
increases costs. A law firm expands by adding partners and new support personnel.

4. Multi- Unit Organizations


Some service organizations operate many units in various locations, each unit relatively small.
These organizations are fast-food restaurant chains, auto rental companies, gasoline service
stations, and many others. Some of the units are owned; others operate under a franchise. The
similarity of the separate units provides a common basis for analyzing budgets and evaluating
performance not available to the manufacturing company. The information for each unit can
be compared with system wide or regional averages, and high performers and low performers
can be identified. However, because units differ in the Mix of services provide, in the
resources that they use, and in other ways, care must be taken in making such comparisons.

Historical Development

Cost accounting started in manufacturing companies because of the need to value work-in-
process and finished goods inventories for financial statement Purposes. These systems
provided raw data that were easily adapted for use in setting selling prices and for other

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management purposes. Standard cost systems, separation of fixed and variable costs, and
analysis of variances were built on the foundation of cost accounting systems. Until a few
decades ago, most texts on cost accounting dealt only with practices in manufacturing
companies.
Many service organizations (with the notable exception of railroads and other regulated
industries) did not have a similar impetus to develop cost data. Their use of product cost and
other management accounting data is fairly recent— mostly since World War II. Nowadays,
their management control systems are rapidly becoming as well developed as those in
manufacturing companies.

PROFESSIONAL SERVICE ORGANIZATIONS


Research and development organizations, law firms, accounting firms, health care
organizations, engineering firms, architectural firms, consulting firms, advertising agencies,
symphony and other arts organizations, and sports organizations (such as baseball teams) are
examples of organizations whose products are professional services.

Special Characteristics
1. Goals

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A dominant goal of a manufacturing company is to earn a satisfactory profit, specifically a
satisfactory return on assets employed. A professional organization has relatively few tangible
assets; its principal as set is the skill of its professional staff, which doesn’t appear on its
balance sheet. Return on assets employed, therefore, is essentially meaningless in such
organizations. Their financial goal is to provide adequate compensation to the professionals.
In many organizations, a related goal is to increase their size. In part, this reflects the natural
tendency to associate success with large size. In part, it reflects economies of scale in using
the efforts of a central personnel staff and units responsible for keeping the organization up-
to-date. Large public accounting firms need to have enough local offices to enable them to
audit clients who have facilities located throughout the world.

2. Professionals
Professional organizations are labor intensive, and the labor is of a special type. Many
professionals prefer to work independently, rather than as part of a team. Professionals who
are also managers tend. To work only part time on management activities; senior partners in
an accounting firm participate actively in audit engagements; senior partners in law firms have
clients. Education for most professions does not include education in management, but quite
naturally stresses the skills of the profession, rather than management; for this and other
reasons, professionals tend to look down on managers. Professionals tend to give inadequate
weight to the financial implications of their decisions; they want to do the best job they can,
regardless of its cost. This attitude affects the attitude of support staffs and nonprofessionals in
the organization; it leads to inadequate cost control.

3. Output and Input Measurement

The output of a professional organization cannot be measured in physical terms, such as units,
tons, or gallons. We can measure the number of hours a lawyer spends on a case, but this is a
measure of input, not output. Output is the effectiveness of the lawyer’s work, and this is not
measured by the number of pages in a brief or the number of hours in the courtroom. We can
measure the number of patients a physician treats in a day, and even classify these visits by
type of complaint; but this is by no means equivalent to measuring the amount or quality of
service the physician has provided. At most, what is measured is the physician’s efficiency in
treating patients, which is of some use in identify ing slackers and hard workers. Revenues

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earned is one measure of output in some professional organizations, but these monetary
amounts, at most, relate to the quantity of services rendered, not to their quality (although
poor quality is reflected in reduced revenues in the long run).
Example. There are more than 1,300 articles and books dealing with research on student
ratings of teachers. They describe as many as 22 dimensions of teaching performance (e.g.,
“explains clearly,” “uses class time well”) and 20 variables that affect the ratings (e.g., size of
course, time of day, gender, level of course).
The best of these rating systems can identify very good teachers and very poor teachers, but
none do a satisfactory job of ranking the 70 or 80 percent of teachers who are not at these
extremes.

Furthermore, the work done by many professionals is non repetitive. No two consulting jobs
or research and development projects are quite the same. This makes it difficult to plan the
time required for a task, to set reasonable standards for task performance, and to judge how
satisfactory the performance was. Some tasks are essentially repetitive: the drafting of simple
wills, deeds, sales contracts, and similar documents; the taking of a physical inventory by an
auditor; and certain medical and surgical procedures. The development of standards for such
tasks may be worthwhile, although in using these standards, unusual circumstances that affect
a specific job must be taken into account.

Some professionals, notably scientists, engineers, and professors, are reluctant to keep track of
how they spend their time, and this complicates the task of measuring performance. This
reluctance seems to have its roots in tradition; usually, it can be overcome if senior
management is willing to put appropriate emphasis on the necessity of accurate time
reporting. Nevertheless, difficult problems arise in deciding how time should be charged to
clients. If the normal Work week is 40 hours, should a job be charged for 1/40th of a week’s
compensation for each hour spent on it? If so, how should work done on evenings and
weekends be counted? (Professionals are “exempt” employees—that is, they are not subject to
government requirements for overtime payments.) How to ac count for time spent reading
literature, going to meetings, and otherwise keeping up to date?

4. Small Size

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With a few exceptions, such as some law firms and accounting firms, professional
organizations are relatively small and operate at a single location. Senior management in such
organizations can personally observe what is going on and personally motivate employees.
Thus, there is less need for a sophisticated management control system, with profit centers and
formal performance reports. Nevertheless, even a small organization needs a budget, a regular
comparison of performance against budget, and a way of relating compensation to
performance.

5. Marketing

In a manufacturing company there is a clear dividing line between marketing activities and
production activities; only senior management is concerned with both. Such a clean separation
does not exist in most professional organizations. In some, such as law, medicine, and
accounting, the profession’s ethical code limits the amount and character of overt marketing
efforts by professionals (al though these restrictions have been relaxed in recent years).
Marketing is an essential activity in almost all organizations, however. If it can’t be conducted
openly, it takes the form of personal contacts, speeches, articles, conversations on the golf
course, and so on. These marketing activities are conducted by professionals, usually by
professionals who spend much of their time in production work—that is, working for clients.

In this situation, it is difficult to assign appropriate credit to the person responsible for
“selling” a new customer. In a consulting firm, for example, a new engagement may result
from a conversation between a member of the firm and an acquaintance in a company, or from
the reputation of one of the firm’s professionals as an outgrowth of speeches or articles.
Moreover, the professional who is responsible for obtaining the engagement may not be
personally involved in carrying it out. Until fairly recently, these marketing contributions were
rewarded subjectively—that is, they were taken into account in promotion and compensation
decisions. Some organizations now give explicit credit, perhaps as a percentage of the
project’s revenue, if the person who “sold” the project can be identified.

MANAGEMENT CONTROL SYSTEMS


1. Pricing
The selling price of work is set in a traditional way in many professional firms. If the
profession is one in which members are accustomed to keeping track of their time, fees

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generally are related to professional time spent on the engagement. The hourly billing rate
typically is based on the compensation of the grade of the professional (rather than the
compensation of the specific person), plus a loading for overhead costs and profit. In other
professions, such as investment banking, the fee typically is based on the monetary size of the
security issue. In still others, there is a fixed price for the project. Prices vary widely among
professions; they are relatively low for research scientists and relatively high for accountants
and physicians.In manufacturing companies, the profit component of the selling price is
normally set so as to obtain, on average, a satisfactory return on assets employed. As noted
above, the principal “asset” of a professional organization is the skill of its professionals,
which is not measurable. Actually, the total value of the whole organization is greater than the
sum of what the value of the individuals would be if they worked separately. This is because
the firm already has incurred the cost of acquiring and training these individuals, has
organized them according to their personality “fit” and other considerations, and has
developed policies and procedures for assuring that the work is done efficiently and
effectively. In this manner, the firm accepts responsibility for producing a satisfactory
product, including the risk of loss if the work is not well done, and it absorbs the cost of
personnel who are not working on revenue-producing work. These considerations implicitly
affect the size of the “profit” component that is included in the fee.

2. Profit Centers and Transfer Pricing


Support units, such as maintenance, information processing, transportation,
telecommunication, printing, and procurement of material and services, charge consuming
units for their services.

3. Strategic Planning and Budgeting


In general, formal strategic planning systems are not as well developed in professional
organizations as in manufacturing companies of similar size. Part of the explanation is that
professional organizations have no great need for such systems. In manufacturing companies,
many program decisions involve commitments to procure plant and equipment; they have a
predictable effect on both capacity and costs for several future years, and, once made, they are
essentially irreversible. In a professional organization, the principal assets are people;
although the organization tries to avoid short-run fluctuations in personnel levels, changes in
the size and composition of the staff are easier to make and are more easily reversed than
changes in the capacity of a physical plant. The strategic plan of a professional organization

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typically consists primarily of a long-range staffing plan, rather than a full-blown plan for all
aspects of the firm’s operation.

4. Control of Operations
Much attention is, or should be, given to scheduling the time of professionals. The billed time
ratio, which is the ratio of hours billed to total professional hours available, is watched
closely. If, to use otherwise idle time or for marketing or public service reasons, some
engagements are billed at lower than normal rates, the resulting price variance warrants close
attention. The inability to set standards for task performance, the desirability of Carrying out
work by teams, the consequent problems of managing a matrix organization and the
behavioral characteristics of professionals all complicate the planning and control of the day-
to-day operations in a professional organization. When the work is done by project teams,
control is focused on projects. A written plan for each project is needed, and timely reports
should be prepared that compare actual performance with planned performance in terms of
cost, schedule, and quality.

5. Performance Measurement and Appraisal


As noted above in regard to teachers, at the extremes the performance of professionals is easy
to judge. Appraisal of the large percentage of professionals who are within the extremes is
much more difficult. For some professions, objective measures of performance are sometimes
available: The recommendations of an investment analyst can be compared with actual market
behavior of the securities; the accuracy of a surgeon’s diagnosis can be verified by an
examination of the tissue that was removed; and the doctors’ skill can be measured by the
success ratio of operations. These measures are, of course, subject to appropriate
qualifications, and in most circumstances the assessment of performance is finally a matter of
human judgment by superiors, peers, self, sub ordinates, and clients.
Judgments made by superiors are the most common. For these, professional organizations
increasingly use formal systems to collect performance appraisals as a basis for personnel
decisions and for discussion with the professional. Some systems require numerical ratings of
specified attributes of performance and provide for a weighted average of these ratings.
Compensation may be tied, in part, to these numerical ratings. In a matrix organization, both
the project leader and the head of the functional unit that is the professional’s organizational
“home” judge performance.
Appraisals by a professional’s peers, or by subordinates, are sometimes part of a formal
control system. In some organizations, individuals may be asked to make a self-appraisal.

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Expressions of satisfaction or dissatisfaction from clients are also an important basis for
judging performance, although such expressions may not always be readily forthcoming.
Example. One firm that sells investment advice to institutional clients keeps a record of letters
of commendation and criticism received from its clients, classifies these according to the
analysts who made the relevant criticisms or recommendations, and uses this information as
part of its performance evaluation System.
The budget can be used as the basis for measuring cost performance, and the actual time taken
can be compared with the planned time. Budgeting and control of discretionary expenses are
as important in a professional firm as in a manufacturing company. Such financial measures
are relatively unimportant in assessing a professional’s contribution to the firm’s profitability,
however. The professional’s major contribution is related to quantity and above all quality of
work, and its appraisal must be largely subjective. Furthermore, the appraisal must be made
currently; it cannot wait until one learns whether a new building is well designed, a new
control system—actually works well, or a bond indenture has a flaw.

In some professions, internal audit procedures are used to control quality. In many accounting
firms, the report of an audit is reviewed by a partner other than the one who is responsible for
it, and the work of the whole firm is “peer reviewed” by another firm. The proposed design of
a building may be reviewed by architects who are not actively involved in the project.

FINANCIAL SERVICE ORGANIZATIONS


Financial service organizations include commercial bank and thrift institutions, insurance
companies, and securities firms. These companies are in business primarily to manage money.
Some act as intermediaries; that is, they obtain money from depositors and lend it to
individuals or companies. Others act as risk shifters; they obtain money in the form of
premiums, invest these premiums, and accept the risk of the occurrence of specific events,
such as death or damages to property. Still others are traders; they buy and sell securities,
either for their own account or for customers.

The Financial Services Sector

Several general observations can be made about the financial services sector.

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First, in 2002, financial services firms accounted for over $400 billion, or about 5 percent, of
the gross domestic product, but their importance in the overall performance of the economy is
considerably greater than this percentage indicates. The financial services sector constitutes an
important backbone to the U.S. and world economies.

Second, 30 years ago, commercial banking, investment banking, retail brokerage, and
insurance existed as distinct separate industries; firms specialized in a single industry and
tended to compete in a single country. Nothing could be further from the truth today.
Deregulation (e.g., the weakening of the Glass-Steagall Act) has blurred industry and
geographic boundaries. Financial services firms not only operate in multiple segments
(investment banking, brokerage, etc.) but also are global in scope. In the 1990s several mega
mergers led to the consolidation of the financial services industry (examples: merger of
Citicorp and Travelers; UBS’s acquisition of Paine Webber; Morgan Stanley’s acquisition of
Dean Witter; Deutsche Bank’s acquisition of Bankers Trust). Blurring of industry boundaries,
globalization, and consolidation of financial services firms will accelerate in the 21st century.

Third, financial services firms have used the information technology revolution to innovate
new products and discover new methods of trading. For instance, the Charles Schwab
Corporation introduced TeleBroker (an automated telephone touchpad order entry system),
Voice Broker (an automated voice recognition quote system), and e.Schwab (Internet-based
brokerage service). New entrants such as E*Trade and Ameritrade were able to dramatically
lower brokerage commissions through Web-based trading. In 2002, over 35 percent of all
stock trades by individuals were done via the Internet; yet, six years earlier, this segment did
not exist.

Fourth, the need for controls in the financial services sector has become paramount. The
Asian financial crisis during the second half of the 1990s was, in part, the result of inadequate
controls in banks in Thailand, Indonesia, Japan, and other Asian countries which, in turn,
allowed the banks to make highly risky and bad loans. Most notable failure among financial
services firms was the collapse of Barings, Britain’s oldest merchant bank, in 1995. Deficient
Control partly contributed to Barings’ debacle.

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Fifth, during the 1990s, new forms of financial instruments (such as derivatives) designed by
financial service firms sometimes resulted in millions of dollars of losses for their clients. In
December 1994 Orange County in California lost $1.7 billion in leveraged interest-rate
products. In April 1994 Procter & Gamble sued Bankers Trust because of its loss of over $100
million on interest- rate swaps designed by Bankers Trust. In July 1994 Glaxo incurred losses
of $180 million on derivatives and asset-based bonds.

Finally, the corporate scandals during 2002 have created a huge push for in vestment banks to
spin off their research departments. It is argued that under the current system, the interests of
the investment bankers, not those of investors, drive the results of research. Research analysts
are tainted by the potential for a conflict of interest because the companies that they cover also
buy high-fee investment banking services from the analysts’ employers. The arguments for
spin off are many:
(1) This separation will ensure objective research data.
(2) At present, cost of research is being subsidized by investment banks; if investors
have to pay for it, they will demand higher-quality research.
(3) Investor confidence will improve if they are convinced that research is unbiased.
On the other hand, several arguments are offered against such a spin off:
(1) The cost of research will go up if they are set up as separate firms;
(2) the best research analysts will join investment banks due to the higher pay scales,
thereby leaving independent research firms with lower caliber employees; and
(3) To keep costs down, research departments may issue short reports instead of a rich,
detailed analysis of stocks as is the current practice.

Example. During 2002, there were investigations into the research work of Salomon Smith
Barney investment bank, a unit of Citigroup. On October 30, 2002, the Citigroup, on a
voluntary basis, spun off its research analysts from investment banking.

Special Characteristics
While the general principles and concepts of management control systems ap ply, they need to
be adapted to the following special characteristics of the financial services industry.

1. Monetary Assets
Most of the assets of financial service firms are monetary. The current value of monetary
assets is much more easily measured than the value of plant and other physical assets, or

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patents and other intangible assets. Currency is the extreme example of a fungible commodity.
At any time, dollars held by all companies have the same value; each dollar is worth a dollar,
valued at both its face amount and its purchasing power. Its purchasing power changes with
time, but at any given future time, all dollars have equal value. This means that one’s dollar
has the same quality at any given moment. In the financial services industry, quality refers to
the quality of services rendered and to the quality financial instruments other than money;
there is no need for quality control safeguards for money.

2. Financial assets
Financial assets also can be transferred from one owner to another easily and quickly. In an
electronic funds transfer, money moves almost instantaneously. In other transactions, it moves
in a few days at most. Its portability is tempting to thieves and forgers. For this reason, firms
that handle financial as sets, especially money, must take strong measures to protect them.
These involve not only physical measures to safeguard currency and documents, but also
measures designed to maintain the integrity of the system for transferring money from one
party to another.

3. Time Period for Transactions


The ultimate financial success or failure of a bond issue, a mortgage loan to an individual, or a
life insurance policy may not be known for 30 years or more. During this period, the
soundness of the loan or policy may change, and the purchasing power of money will
certainly change. This means that the ultimate performance of those involved in authorizing
and structuring the loan, or in selling and pricing the insurance policy, cannot be measured at
the time the initial decision is made. It also means that control requires that there be a means
of continued surveillance of the soundness of the transaction during its life, including periodic
audits of all outstanding loans. (Failure to identify “troubled loans” at an early stage is one
important reason for the rash of failures of banks and thrift institutions. At the other extreme,
some transactions are completed quickly. Many trades are made on the basis of information
that the trader has acquired in the previous few minutes, or even seconds. For currency
transactions and for listed securities, new information may become available almost
instantaneously in markets throughout the world. Traders either buy or sell securities on the
basis of the information they have. If they buy securities, future changes in prices will change
the value of the securities held. Therefore, there is a need for a system to report held and to
assess the risk to the organization if prices move against the trader’s securities. This means

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that the firm must have an accurate, prompt system for obtaining this information, for
summarizing it, for estimating the risk of the securities held (if applicable), and for making
this information available to traders; a computer model (“expert system”) evaluates the
information and in some cases acts with, human intervention.

4. Risk and Reward


Many financial services firms are in the business of accepting risks in return for rewards. Most
business decisions involve a trade-off between risks and re wards. The greater the risk, the
greater should be the anticipated reward. In financial services firms, this trade-off is more
explicit than in business investments such as those involving the purchase of a machine or the
introduction of a new product. Interest rates on loans and premiums on insurance policies are
based on assumptions about risk that may, or may not, turn out to be accurate.

5. Technology
Technology has revolutionized the financial services industry. Financial service firms have
used information technology as a way to offer innovative services. Automated teller machines
of banks are just one example. Insurance and mutual fluids have developed electronic
marketplaces. Financial service firms, via their website on the Internet, market their products
electronically to consumers. Investment banks, using concepts from quantum physics and
high- level mathematics formulas, have designed new forms of financial instruments. Banks
have become “virtual” by offering cyber-payment systems. Online brokerage services are a
fast-growing segment.

HEALTH CARE ORGANIZATIONS


Health care organizations consist of hospitals, clinics, and similar physicians’ organizations;
health maintenance organizations; retirement and nursing homes; home care organizations;
and medical laboratories, among others. They constitute the largest industry in the United
States: 14 percent of the gross national product, which are about the same percentage as the
total of all durable goods manufacturers. Although they have most of the characteristics of
non profit organizations, which are discussed in the next section, many of them are profit-
oriented companies.

Special Characteristics
1. Difficult Social Problem

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Society is gradually coming to grips with the fact that the present health care delivery system
is unworkable. Although physicians are bound by the Hippocratic oath to provide adequate
health care to their patients, the system can not do this. On the one hand, the cost per
treatment is inevitably increasing with the development of new equipment and new drugs;
hospital expenses in creased from $28 billion in 1970 to over $400 billion by 2003. (Contrast
this trend with the typical experience of manufacturing companies, in which new equipment
usually reduces unit costs). On the other hand, the number of ill persons is increasing because
medical advances prolong the lives of elderly people, who are the most likely to require
treatment. Society cannot pay for the predictable increases if the present rate of increase in
cost continues much longer. Health care providers are aware of this problem, but they don’t
know how society, especially the Congiess, will deal with it. It is clear, however, that health
care delivery will change drastically. Health care organizations must be alert to these changes.

2. Change in Mix of Providers


Within the overall increase in health care cost, significant changes have occurred in the way in
which health care is delivered and, hence, in the viability of certain types of providers. Many
services that traditionally were provided in hospitals on an inpatient basis are now provided in
outpatient clinics or in patients’ homes. Entrepreneurs have entered the industry to provide
these new services. There also has been a shift from small local hospitals to larger regional or
medical center hospitals. The number of hospital beds decreased by more than 30 percent
from 1970 to 2003. To remain viable, hospitals must have the flexibility to adapt to these
changes, either by providing more outpatient services themselves or by eliminating inpatient
services that are no longer profitable.

3. Third-Party Payers
Of the more than $900 billion total expenditures for health care in 2003, 43 per cent were
financed by the government, 35 percent by insurance companies, and only 22 percent by
individual patients. The largest government program is Medicare, a federal program that
provides support for persons age 65 and up and for younger persons with certain disabilities.
The Medicaid program pays for services provided to low-income people; it is financed by the
states within general guidelines set by the federal government.

Until 1983, Medicare reimbursed on the basis of “reasonable” costs incurred, which gave
health care providers little incentive to control costs. Currently, Medicare reimburses hospitals

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on the basis of Diagnostic Related Groups (DRGs). Medical and surgical procedures are
classified into one of about 500 DRGs, each DRG is priced annually at a set-dollar amount,
and hospitals are reimbursed for these amounts, regardless of the actual length of stay or the
actual costs incurred for individual patients. Other third-party payers have moved toward a
similar system of reimbursement.

The DRG system, and the increase in hospital costs per patient, has motivated hospitals to
install sophisticated cost accounting systems, usually systems that they purchase from an
outside computer software organization and then adapt to their own needs. Some hospitals
provide information processing services to other hospitals on a contract basis. These systems
provide information on individual patients (similar to job-cost systems in automobile repair
shops), and they report actual costs compared with standard costs for each DRG; costs are
classified by departments and even by attending physicians within departments.

This information is in addition to information traditionally collected in hospitals; it focuses on


outputs (patient care), as well as on inputs (cost per laboratory test).

Increasingly, health maintenance organizations (HMOs) reimburse physicians, hospitals, and


other providers. They contract with companies to provide medical services to employees at a
fixed cost per person covered. In turn, the HMO contracts with hospitals and other providers,
in some cases at a specified amount per DRG. The HMO therefore has the difficult task of
controlling its payments so that they do not exceed the fees earned, but nevertheless seeing to
it that adequate health care is provided.

4. Professionals
In 2003, the health care industry employed over 3 million professionals (physicians, dentists,
registered nurses, and therapists), which was more than any other industry except education.
The management control implications of professionals are the same as those discussed in the
preceding section. Their primary loyalty is to the profession, rather than to the organization.
Departmental managers typically are professionals whose management function is only part-
time; the chief of surgery does surgery. Historically, physicians have tended to give relatively
little emphasis to cost control. In particular, there has been an impression that they prescribe
more than the optimum number of tests, partly because of the danger of malpractice suits if
they don’t detect all the patient’s symptoms.

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5. Importance of Quality Control
The health care industry deals with human lives, so the quality of the service it provides is of
paramount importance. There are tissue reviews of surgical procedures, peer review of
individual physicians, and outside review agencies mandated by the federal government.

Management Control Process


Because of the shift in the product mix and because of the increase in the quantity and cost of
new equipment, the strategic planning process in hospitals is important. The annual budget
preparation process is conventional. Huge quantities of information are available quickly for
the control of operating activities. Financial performance is analyzed by comparing actual
revenues and expenses with budgets, identifying important variances, and taking appropriate
actions on them.

NONPROFIT ORGANIZATIONS
A nonprofit organization, as defined in law, is an organization that cannot distribute assets or
income to, or for the benefit of, its members, officers, or directors. The organization can, of
course, compensate its employees, including officers and members, for services rendered and
for goods supplied. This definition does not prohibit an organization from earning a profit; it
prohibits only the distribution of profits. A nonprofit organization needs to earn a modest
profit, on average, to provide funds for working capital and for possible “rainy days.”

Nonprofit organizations that meet the criteria of Section 501(c) of the Internal Revenue Code
are exempt from income taxes (except for their “unrelated business income”); over 1.2 million
organizations satisfy these criteria in the United States. If they are religious, charitable, or
educational organizations as defined in Section 501(c)(3) of the code, contributions made to

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them are tax deductible by the contributor; they are called “501(c)(3) organizations.” Many
such organizations are exempt from property taxes and from certain types of sales taxes.

In many industry groups, there are both nonprofit and profit-oriented (i.e., business)
organizations. There are nonprofit and for-profit hospitals, nonprofit and for-profit
(“proprietary schools and colleges, and even for-profit religious organizations. SRI
International is a nonprofit research organization that corn pete with Arthur D. Little, Inc., a
for-profit research organization.

Special Characteristics
1. Absence of the Profit Measure
A dominant goal of most businesses is to earn a satisfactory profit; net income measures
performance toward this goal. No such measure of performance exists in nonprofit
organizations. Many of them have several goals, and an organization’s effectiveness in
attaining its goals rarely can be measured by quantitative amounts. The absence of a
satisfactory, quantitative, overall mea sure of performance is the most serious management
control problem in a non profit organization.

The income statement is the most useful financial statement in a nonprofit organization, just
as it is in a business. The net income number is interpreted differently in the two types of
organizations, however. In a business, as a general rule, the larger the income, the better the
performance. In a nonprofit organization, net income should average only a small amount
above zero. A large net income signals that the organization is not providing the services that
those who supplied resources had a right to expect; a string of net losses will lead to
bankruptcy, just as in a business. Although financial performance is not the dominant goal in a
nonprofit organization, it is a necessary goal because the organization cannot survive if its
revenues on average are less than its expenses.

2. Contributed Capital
There is only one major difference between the accounting transactions in a business and
those in a nonprofit organization; it relates to the equity section of the balance sheet. A
business corporation has transactions with its shareholders— issuance of stock and the
payment of dividends—that a nonprofit organization doesn’t have. A nonprofit organization

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receives contributed capital, which few businesses have. (In both businesses and nonprofit
organizations, equity is in creased by earning income.)
There are two principal categories of contributed capital: plant and endowment. Plant includes
contributions of buildings and equipment, or contributions of funds to acquire these assets;
works of art; and other museum objects. Endowment consists of gifts whose donors intend
that the principal amount will remain intact indefinitely (or at least for many years); only the
income on this principal will be used to finance current operations.

The receipt (or pledge) of a contributed capital asset is not revenue—that is, neither
contributions of plant nor of endowment are available to finance the operating activities of the
period in which the contribution is received. Endowment assets must be kept separate from
operating assets. This is a legal requirement. for a “true” endowment, and it is sound policy
for a “board-designated” endowment—that is, funds that the trustees have decided to treat s
endowment, even though there is no legal requirement that they do so. It follows that capital
contributions should be reported separately from operating contributions, that is, from
revenues from annual fund drives, grants, and other gifts in tended to finance current
operations.

Thus, a nonprofit organization has two sets of financial statements. One set relates to
operating activities; it includes an operating statement, a balance sheet, and a statement of
cash flows that are the same as those found in business. The second set relates to contributed
capital; it has a statement of inflows and outflows of contributed capital during a period and a
balance sheet that reports contributed capital assets and the related liabilities and equity.
Inflows of contributed capital are capital contributions received in the period and gains on the
endowment portfolio; outflows are the endowment income that is re ported as operating
revenue, losses on the endowment and write-offs of plant.

3. Fund Accounting
Many nonprofit organizations use an accounting system that is called “fund ac counting.”
Accounts are kept separately for several funds, each of which is self-balancing (i.e., the sum
of the debit balances equals the sum of the credit balances). Most organizations have (1) a
general fund or operating fund, which corresponds closely to the set of operating accounts
mentioned above; (2) a plant fund and an endowment fund, which account for the contributed
capital assets and equities mentioned above; and (3) a variety of other funds for special

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purposes. Some of these other funds, such as the pension fund, are also found in business,
although in business they are reported in the notes to the financial statements, rather than in
the financial statements themselves. Others are useful for internal control purposes. For
management control purposes, the primary focus is on the general fund.

4. Governance
Nonprofit organizations are governed by boards of trustees. Trustees usually are not paid, and
many of them are unfamiliar with business management. Therefore, they generally exercise
less control than the directors of a business corporation. Moreover, because performance is
more difficult to measure in a nonprofit organization than in a business, the board is less able
to identify actual or incipient problems.
The need for a strong governing board in a nonprofit organization is greater than in a business
because the vigilance of the governing board may be the only effective way of detecting when
the nonprofit is in difficulty. In a profit-oriented organization, a decrease in profits signals this
danger automatically.

MANAGEMENT CONTROL SYSTEMS

1. Product Pricing
Many nonprofit organizations give inadequate attention to their pricing policies. Pricing of
services at their full cost is desirable.

A “full-cost” price is the sum of direct costs, indirect costs, and, perhaps, a small allowance
for increasing the organization’s equity. This principle applies to services that are directly
related to the organization’s objectives. Pricing for peripheral activities should be market-
based. Thus, a nonprofit hospital should price its health care services at full cost, but prices in
its gift shop should be market-based.

In general, the smaller and more specific the unit of service that is priced, the better the-basis
for decisions about the allocation of resources. For example, a comprehensive daily rate for
hospital ca± which was common practice a few decades ago masks the revenues for the mix of

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services actually provided. Be yond a certain point, of course, the cost of the paperwork
associated with pricing units of service outweighs the benefits.
As a general rule, management control is facilitated when prices are established prior to the
performance of the service. If an organization is able to re cover its incurred costs,
management is not motivated to worry about cost control.

2. Strategic Planning and Budget Preparation


In nonprofit organizations that must decide how best to allocate limited resources to
worthwhile activities, strategic planning is a more important and more time-consuming
process than in the typical business. The process is similar to that described in Chapter 8,
except that the absence of a profit measure makes program decisions more subjective.

The budget preparation process is similar to that described in Chapter 9. Colleges and
universities, welfare organizations, and organizations in certain other nonprofit industries
know, before the budget year begins, the approximate amount of their revenues. They do not
have the option of increasing revenues during the year by increasing their marketing efforts.
They budget expenses so the organization will at least break even at the estimated amount of
revenue. They require that managers of responsibility centers limit spending close to the
budget amounts. The budget is, therefore, the most important management control tool, at
least with respect to financial activities.

3. Operation and Evaluation


In most nonprofit organizations, there is no way of knowing what the optimum operating costs
are. Responsibility center managers, therefore, tend to spend whatever is allowed in the
budget, even though the budgeted amount may be higher than is necessary Conversely, they
may refrain from making expenditures that have an excellent payoff simply because the
expenditure was not included in the budget.

Although nonprofit organizations have had a reputation for operating inefficiently, this
perception has been changing for good reasons. Many organizations have had increasing
difficulty in raising funds, especially from government resources. This has led to belt-
tightening and o increased attention to management control. As mentioned above, the most

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dramatic change has been in hospital costs, with the introduction of reimbursement on the
basis of standard prices for diagnostic-related groups.

CONCLUSION
Management control in service organizations is different from that in manufacturing
organizations, primarily because of the absence of an inventory buffer between production
and sales, because of the difficulty of measuring quality, and because service organization are
labor intensive.

Professional Organizations do not have the dominant goal of return on assets employed;
Professionals’ behavioral characteristics do not include attention to costs, output
measurements are subjective, and there is no clear line between marketing and production
activities. Performance appraisal may be achieved by peer reviews; in any case it tends to be
subjective.

Financial Services Organizations differ in two fundamental respects from industrial


companies. First, their “raw material” is money. At any given time, the value of each unit of

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money in inventory is the same for all organizations, negation any need for control in this
area; however, the cost of using money obtained from various sources varies considerably.
Second the profitability of many transactions cannot be measured until years after the
commitment has been made, necessitating continual periodic audits. In particular, the financial
services company is profitable only if the future revenues obtained from current loans,
investments and insurance premiums exceed the cost of the funds associated with these
revenues by an amount that is sufficient to cover operating expenses and losses.

Health care organizations have tried to use the DRG system to standardize costs; they and
society, must face the fact that the current control and delivery system is unworkable.

Non profit organizations lack the advantages for control that the profit measure provides;
they must account for contributed capital, a category that rarely occurs in a business.
Expenditure decisions are subjective for non profits; nevertheless, they have succeeded in
becoming more efficient in response to shrinking sources of funds.

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