Health Care Management Principles

Define Health Care Management

Healthcare management can be defined as the use of clinical and
information technology, as well as managerial and leadership skills, to
ensure the optimal delivery of healthcare. Healthcare is an expansive
industry that ranges from preventative care, to emergency services, to
follow-up and rehabilitation. Without effective management, the coordination
of healthcare is not possible.

Management skill set

The management of a healthcare facility or a healthcare system requires
expertise. Similar to many industries, the individual that has a healthcare
leadership or management role often has a specific skill set and experience.
Skill sets frequently include project and program management, the ability to
lead staff, flexibility, and budgetary oversight. The healthcare executive
must also have the ability to relate to patients as well as the patients family.
Educational requirements often include at least a Bachelors degree and a
Masters degree may be preferred. In some cases, clinical experience, such
as a nursing background or physician experience, is needed.
Health care management requires skilled leadership.
Health care is an industry just like technology, agriculture, manufacturing
and entertainment. Like businesses in those industries, the health care field
requires managers to oversee the operation of its businesses including
hospitals, private practices, clinics and nursing homes. These professionals
ensure the business of health care runs effectively by planning,
implementing and evaluating all aspects of health care delivery.

Information technology
The National Center for Healthcare Leadership notes that healthcare
management involves the use of information technology. Healthcare is in the
process of being transformed and the role of information technology cannot
be overlooked. Information technology has numerous applications in

healthcare, from the front office registration process to the online

assessment of patients through a telemedicine system. Information
technology systems provide administrators and clinicians with metrics and
outcomes that can influence the delivery of healthcare. The use of
information technology in healthcare can also support best practices for the
optimal delivery of patient care.

Capacity
Capacity is an important aspect of healthcare management. Capacity is the
ability of an existing healthcare entity, including providers such as physicians
and nurses, to provide the services that are needed by the patients. Capacity
also supports a safe and comfortable environment for the patients Capacity
must remain a key priority for the healthcare leadership team. In a clinic or
hospital setting the management team will need to evaluate if the current
structure, such as buildings, beds, and waiting areas, are sufficient to meet
the needs of the patients, staff, and family members. The healthcare system
that does not have adequate capacity may be challenged to fully meet the
needs of the patient population.

Health Care Management Strategies

Health care is everywhere in the news these days. Health care entities have
to come up with creative ways to survive, while making sure they pay

attention to the things that define who they are. With regulations and
expenses, health care practitioners must address specific management
strategies.

Managing Costs

Health care costs are one of the biggest issues in America today. Costs
keep spiraling, but the costs most people talk about aren't the same costs
health care entities have to consider.
Health care entities have to stay on top of the cost of supplies, employees
and regulations. Strategies include standardization of processes and supply
items, instead of allowing physicians to pick and choose based on their
preferences. They have to pay for qualified personnel, weighing the benefits
of lower paid personnel without the same skill level of personnel with proven
competence. And they have to recognize that the costs of making sure their
facilities pass all state and federal standards, as well as keeping staff trained
so they maintain their certifications, are lower than being fined for violations
of each.

Competency and Staffing

The majority of people working in health care are trained and certified, but
that doesn't mean they're competent. Health care entities need to set up
minimum standards that all employees must reach based on the job they do.
Tracking and evaluating mistakes not only helps health care entities learn
how to minimize errors, but good performance numbers give them
something to promote to potential consumers.
Health care staffing can be hard to manage because some staffing is
mandated by state and federal standards. Health care entities must come up
with creative ways of managing staffing, while making sure they can
determine which staff members might be essential commodities based on
more than just revenue. One strategy might include rotation patterns,
looking at hiring staff with lesser qualifications to handle certain jobs while

qualified staff handles what they're allowed to take care of. Another could be
evaluating how much cash each person in accounts receivable brings in
before cutting positions there. Outsourcing and interim staffing are always
options.

Revenue
In many communities, there are multiple health care entities providing the
same services. Some of those services might be mandated, like emergency
rooms for hospitals. Others aren't, such as dialysis centers and cardiology
services. Sound strategies would include not providing services that another
entity or physician is much better at, and concentrating on core services that
can be provided well and with more efficiency. Another strategy is to put
more effort into promoting services that are more cost-effective, yet offer the
opportunity to provide more and better-paying outpatient procedures.

What Is Revenue Cycle Management in Healthcare?

A health care institution's senior leadership implements adequate revenue management
procedures to ensure that the institution remains financially sound in the short...

What Is Revenue Cycle Management

in Healthcare?
By Marquis Codjia, eHow Contributor
l

Health care organizations properly manage revenues to increase profits.

A health care institution's senior leadership implements adequate revenue

management procedures to ensure that the institution remains financially
sound in the short and long terms. Revenue cycle management also helps a

1.
o

efinition

Health care revenue cycle management consists of the tools,

methodologies and techniques that medical institutions use to review
patients' financial situation, issue invoices and collect payments from the
federal and state governments, insurance companies and other
organizations.

Significance
o

A health care institution must adequately manage revenues to

stay financially afloat. Some institutions use revenue management software
to record transactions and prepare accounting reports at the end of each
month and quarter. Without sound revenue cycle management procedures, a
health care institution might experience financial distress and file for
bankruptcy.

Types
o

Health care revenue cycle management involves many

strategies, including procedures that hospitals and clinics use to improve
cash collections and meet liquidity goals. These strategies also include
customer receivables valuation, underpayment recovery policies and
transactions involving federal government programs such as Medicare and
Medicaid.

What Are the Five Stages of the

Revenue Cycle?
By Julianne Russ,

The revenue cycle represents a set of activities companies go through to

exchange goods or services for cash. By looking at the stages of its revenue
cycle, a business can see how well it's making money and make changes to
any stage accordingly. Depending on the type of business, the lengths and
the description of the cycle stages may vary slightly.

Other People Are Reading

What Is Revenue Cycle Management in Healthcare?

Explanation of the Revenue Cycle

1.

Selling Product or Service

The revenue cycle starts when a company prepares to sell a

product or service to a customer. This stage involves creating a proposal, a
presentation or a sale pitch for a potential customer. The proposal process
may include a disclosure of the terms and conditions of sale, incentives and
warranties. A proposal may need to be approved by a department manager.
Documenting an Order

When a company presents a proposal for goods or services, a

client may want to make changes to it before accepting it. The sales
associate will need to document all changes before both parties sign the
modified contract. Once the contract is signed, the terms may not be
changed, unless both parties allow them.

Delivering Product or Service

A company delivers goods and services to a client during this

stage. Any delays during this the delivering stage affect the following stages.
Verifying information on the contract and the order is essential to avoiding
costly mistakes. If a client request a change during the implementation
stage, a new contract may need to be signed to reflect the changes. A
manager may need to approve the order changes.
Billing

This stages may be short or long, depending on how a company

operates. Some companies receive a payment at the time of sale or when a
service has been completed. Other companies operate on credit and do not
receive a payment until the goods are received the buyer and services
accepted. A company may need to send a bill to a client to receive a
payment. If a client has already authorized, it may need to bill his credit card
or bank account during this stage.
Collections

During the last stage of the revenue cycle, a company attempts

to collect the outstanding invoices. If a client does not pay within 30 days
after receiving a bill, the company's accounts receivable prepare a report
showing where the uncollected funds are. While some companies allow
unpaid debts to be charged off, other companies pursue other collection
attempts. By analyzing the revenue process at this stage, a company can
modify other stages of the revenue cycle to collect money more efficiently.

About Hospital Outpatient Revenue

Cycle Management
By Mitch Mitchell,

When you go to the hospital to have a service provided and go home the
same day, you are an outpatient. The revenue cycle process for outpatients
covers the charge capture, the billing, and the follow-up and collections
processes for the hospital
harge Capture

The procedures performed in each area of the hospital are captured in

some fashion. Hospitals will use charge sheets or have automatic computer
entries that contain numbers to identify each procedure that was performed.
Coding

All charges must be coded by either procedure codes, revenue codes

or a combination of both. All patient accounts have to be marked with

diagnosis codes before claims can be passed on to billing.

Billing

The billing department will send claims out either electronically or on

paper. Before claims go out, they have to pass a series of edits that check
such things as demographic information, type of insurance and correct
insurance information.
Payment or Follow-Up

Medical claims will either be paid by insurance companies or be denied

with a reason code telling the billing department what to do next. Claims not
paid in full will either be billed to another insurance company or sent to
patients to collect on outstanding balances.
Collections

Patients are given 120 days to make payment on their medical bills.
They will either receive a series of statements or collection calls from the
hospital on bills with high dollar amounts. If unsatisfied, these bills will go to
a collection agency.
What Are the Primary Sources of Operating Revenue in the Health
Care Industry?
As President Barack Obama stresses health care reform, one issue that arises

as of 2010 is how health care facilities will gain the revenue they need to
operate. The United States, unlike most other industrialized nations, does not
have national health care and therefore funds medical assistance in multiple
ways.
Government Aid

The government provides some revenue for the health care industry
through subsidies and grants. The government also provides the revenue for
health care programs like Medicare and Medicaid. American citizens usually
provide this aid indirectly through taxes or other wage deductions, but the
government also borrows some funds as part of its annual budget. Both the
federal and state governments generate health care revenue this way.
Legislators are debating whether raising taxes is an efficient solution to
getting health care to everyone, since higher taxes decrease how much
Americans have to spend on other essentials.
Out of Pocket Direct Payments

Health care patients generate the majority of revenue for the industry,
according to the HealthPAC Online website. Patients put money into health
care when they pay out of pocket for medical services -- that is, when they
cover the cost of their care without the help of a third party. The amount of
revenue that a facility gets from patient payments depends on the rates the
facility sets. Much of the health care reform movement has focused on trying
to reduce the percentage of health care revenue that comes from patient's
pockets.

Premiums

Insurance companies that provide health care insurance operate on the

principle that you'll be well more than you'll be sick and that they'll earn far
more in premiums than they end up paying out. The money insurance

companies pay to health care providers thus comes largely from the
premiums that all policy holders give the companies.
Private Donations

Sometimes medical facilities receive donations from corporations or

individuals. These individuals and corporations either believe strongly in the
services the facility provides or they are seeking a tax deduction for their
contribution. Typically, getting this type of funding does not happen by
chance. Instead, hospital administrators usually lobby for it within the
community. This is a very unstable and unpredictable source of revenue, as
health care providers cannot guarantee that the same amount of donations
will come in from year to year. However, administrators can make some
predictions about donations based on previous records.

How Does a Hospital Make Money?

Many Ways of Making Money

Hospitals can make money in many ways; the main source is insurance
companies, followed closely by pharmaceutical companies. Along with these,
hospitals earn money directly from the patients.
Hospital Insurance Plans

Each insurance plan is different, and plans pay at different rates, depending
on the state the hospital is in and the reason for hospitalization. Hospitals
will make more money caring for surgical patients than those who are there
for non-surgical purposes. Due to the nature of their stay, surgical patients
will probably require more procedures, diagnostic testing and medications,
meaning that the hospital uses more resources and makes more money from
these patients.
Length of Stay

Patients who stay for a shorter period of time generate more money for the
hospital. This explains why hospitals are often anxious to get the patient
fixed and discharged quickly. Many times, insurance companies offer rewards
for the hospitals who have shorter stay times for their patients. Guidelines
are closely followed that determine the length of time a patient with a
specific diagnosis can remain in the hospital. Doctors who insist on longer
stays are many times denied treatment for their patients in the future at
particular hospitals.

How to Write a Hospital Business

Plan
By Daniel Tolliday

The demand for health care services has increased, making this one of the most
booming industries in global economics. If you aim to establish a new hospital, one
of the first things you must do is obtain financing. Writing a business plan for your
hospital is the best way to propose, and then secure, the funding you will need. You
must know how much money you will need to start, and then run, your hospital.
Your research should encompass every aspect of the hospital from goals, to location
and development, to construction, to marketing, to staffing and administration.
Writing your plan will require a lot of research, but it will be a tremendous asset to
you as you seek funding and make further decisions about your future hospital.

nstructions
1.
o

1
Emphasize areas of special services your hospital will offer, such as whether
or not it will be a children's hospital, or a neurology facility.

2
Research the needs of the community. Evaluate what healthcare needs either
aren't being met or aren't being met well. Research the services offered by

competing healthcare facilities in the area and define how your hospital
would be different.
o
o

3
Speak with officials at other hospitals offering the same services you would
like to offer but who are not in your area and therefore not in competition
with you. Your goal is to find out what types of materials and equipment you
will need in your own hospital, as well as the type of facility you will need to
operate well. Answers to these questions will help determine the start-up
costs and the operational costs for building and running your business.

4
Consult with a commercial real estate agent to find possible tracts of land or
existing facilities that could be converted to your hospital. Consult with an
architect to determine construction or conversion costs for the facility. This
stage of the process will help you determine the size and capacity of your
hospital as well as your construction or renovation costs.

5
Determine the exact types and amounts of equipment and goods you will
need to open your hospital, given its intended size and scope. This can be
based on the information you obtained in step 3. Research the current prices
for everything. This will give you the final numbers you will need for your
start-up cost estimates.

6
Create a marketing plan and advertising budget for your hospital. Decide
upon the types of advertisements you will use to spread the word about your
new hospital, and how often they will run. You will need two different sections
to your marketing plan, one section for your initial marketing before the
hospital opens, and one section for your annual marketing efforts once the
hospital is running.

Determine your staffing and insurance needs based on the size and scope of
the hospital you're planning. Determine salaries and estimate the costs of
any benefits you would like to offer your employees. Also factor in your other
operational expenses -- utilities, office supplies, furniture, replacement of
equipment and the restocking of goods. These numbers, combined with your
marketing numbers, will provide your estimate of operating costs.

8
Draft your business plan. In many ways, the hospital business plan is similar
to a standard business plan. Within your plan, you will need to include
information on the business and a description of your hospital's goals. It will
also need to include your marketing plan, information on the competitors in
your area, personnel and operating procedures, and information on operating
expenses. Include lots of detailed financial information and an estimated
balance sheet and income summaries. Once you have gathered all of the
information from your research, writing the proposal will not be difficult.

Inspirational Quotes for Health Care Professionals

Working in the health care industry requires you to deal with a
plethora of emotions. From delivering the good news of a healthy
newborn baby to telling a family they have lost a loved one, it is
hard to always stay positive and uplifted throughout your incredibly
hectic day. Use inspirational health care quotes to remind yourself of
who you are and why you chose this rewarding, albeit demanding,
profession.

Henny Youngman

A British-American comedian famous for "one-liner" jokes, Henny

Youngman tried to make light of most every situation. Youngman

once comically said, "I told the doctor I broke my leg in two places.
He told me to quit going to those places." This is a great
inspirational quote to remind you that laughter is needed in
medicine. A well-placed joke puts a smile on the faces of patients
whose thoughts are otherwise consumed with the fear and
instability of the unknown. Use this quote to remind yourself to do
everything in your power to put a smile on the faces of your coworkers and your patients.

Tom Vilsack

Tom Vilsack is an American politician who serves as the United

States Secretary of Agriculture. He once said, "If we can get people
to focus on fruits and vegetables and more healthy food, we'll be
better in terms of our health care situation." This is a powerful quote
to remind you that your job as a health care professional is not only
to care for sick patients, but to prevent them from getting sick in the
future. Use this quote as inspiration to be proactive in your efforts to
foster healthy living and eating habits with your patients. The more
you preach and educate on preventative health measures, the more
rewarding your job becomes.

Dag Hammarskjld

A Swedish diplomat, economist and author, Dag Hammarskjld was

awarded the Nobel Peace Prize for his humanitarian efforts. In
regards to health care, Hammarskjld once said, "Constant attention
by a good nurse may be just as important as a major operation by a
surgeon." What he is basically saying is that a large part of taking
care of a patient is simply showing care and consideration. Use this
quote as inspiration to motivate yourself to be more actively
engaged with your patients. The way you act and the things you say
to a patient directly correlate to his behavior upon leaving the

hospital. If you do not stress the importance of breaking a bad

health habit, your patient may not take the concern seriously. Your
level of involvement in your patients plays a tremendous role in the
likelihood of you seeing them again for the same exact reason.

Albert Pike

Albert Pike is best known as an American attorney and writer. Pike

wrote about serious, thought-provoking topics, including death. He
once wrote, "What we have done for ourselves alone dies with us;
what we have done for others and the world remains and is
immortal." This quote directly relates to the realization that death is
inevitable. The selfless actions you make as a health care
professional when taking care of others has an everlasting effect on
not only your patients, but also their friends and family. Use this
quote as inspiration to remind yourself why you are in the health
care industry in the first place: to help others. Remember that your
actions directly affect the lives of the people you are working with,
and that you are not only saving lives, but also helping people live
better lives.
It is not always easy to go to work with a smile on your face when
you are in the health care industry. Things happen that are beyond
your control, and not dealing with the emotions that arise from
these instances has damaging effects on not only yourself, but your
future patients. Use these inspirational health care quotes to make
you smile, motivate you to keep moving and remember the great
impact you are making on the lives of others.

Steps in Filing Application for Registration Without Examination

1. Fill-out application form together with required documents for pre-evaluation
to the Office of the Assistant Secretary (3rd Flr., Main Bldg.) at the PRC
Central Office and Regional Offices processing counters.
2. Go to the cashier for payment of fees. (Ground Flr., Main Bldg.)
3. Go to the Customer Service Center for metered documentary stamp and
notarization. (Ground Flr., Annex Bldg.)
4. Submit duly accomplish application form to the Office of the Asst. Secretary.
5. After three (3) months, verify status of application at Tel. No. (02) 735-1533.

UIDANCE & COUNSELING

1. Original and photocopy of Birth Certificate (NSO)
2. Original and photocopy of Marriage Contract (NSO) married female
3. Photocopies of Diploma and Transcript of Records (BS, MS, PhD)
4. Original NBI Clearance (private employee)
5. 3 Certifications of Good Moral Character (brgy captain, church,
employer/dean)
6. Original Ombudsman Clearance and NBI Clearance (govt. employee)

7. Certificate of Active Membership and Good Moral Character from (APO) to be

issued by the President & two (2) other officers
8. Certificate of Experience (PRC Form 104
9. Certificate of Employment/Service Record

Qualification Standards for Psychologists

A person who possesses the qualifications required to take the licensure examination as a
psychologist pursuant to the provisions of R.A. No. 10029 may be registered without
examination; provided, that the applicant files with the Board within three (3) years after its
creation, or until May 21, 2015, an application for registration and issuance of certificate of
registration and professional identification card.
To qualify, the applicant must submit credentials satisfactory to the Board that:
1. He/She is a Filipino citizen, or a permanent resident or a citizen of a foreign
state/country which extends reciprocity to the Philippines relative to the
practice of the profession;
2. On or prior to June 2, 2010, the effectivity of R.A. No. 10029, he/she has
fulfilled any of the following conditions:
(a) Obtained a doctoral degree in psychology conferred by a university,
college or school in the Philippines or abroad, duly recognized/accredited by
the CHED; and has accumulated a minimum of three (3) years work
experience in the practice of psychology;
(b) Obtained a masters degree in psychology conferred by a university,
college or school in the Philippines or abroad recognized/accredited by the
CHED; and must have accumulated a minimum of five (5) years work
experience in the practice of psychology;
(c) Psychologists or employees who hold positions as Psychologists presently
employed in various government and private agencies who have a bachelors
degree in psychology, accumulated a minimum of ten (10) years work
experience in the practice of psychology as a psychologist and who have
updated their professional education in various psychology-related functions.
Professional education in various psychology-related functions shall mean
completion of at least 100 hours of updating workshops and training
programs across various areas and specialties in psychology conducted by
duly established national or international organizations of psychologists,
psychiatrists and other allied mental health professionals, in the last five (5)
years immediately preceding the effectivity of the law.

3. He/she is mentally fit and of good moral character; and

4. He/she has not been convicted by final judgment of an offense involving
moral turpitude.
s