1. Community Benefit

2. 1 - ? ( ) - ? ? ( ) ( SWOT) 3. - ? ? ? ? Scenario planning - ? ? ( Boston Consulting Group : BCG matrix ) 4 1. 2. 3. 4. .. 2545 4. 4 .. 2545-2547 2 (Strategic theme) (Balanced Scorecard) 3 . . (Productivity) 5. . (Value health care service) 1 (Balanced Scorecard) 6. 7. 1. Key Players 1.1 (Public-private mix) . 8. Fee for Service . Fee for Service . Fee for Service 1.2 . ( ) Fee for Service Subcontractor . Subcontractor 9. Fee for Service . 2. Payers 2.1 . 13 (Tax based) 80 10. Catchment Area 10,000-100,000 . 99 10 . (Retrospective reimbursement) DRG ( Cash Inflow 45 180 Medical Record Audit) Fee for Service 11. 2.2 Contact (Third party payers) (Suppliers induce demand) (Management cost) 12. - - - - - 3 1. 2. 3. 1. (Operating Revenue) 13. (Income) (Profit margin) (Income) (Revenue) () 1.1 Gross Patient Service Revenue (GPSR) ( ) GPSR 1.2 Net Patient Service Revenue (NPSR) 14. Audited DRG RW with Global Budget ) GPSR NPSR () Differential Capitation GPSR NPSR () Differential Capitation 15. ( 3rd Party Payers) (Ability to pay) 16. 1. (Charge) (Price service) 2. (Payment) 3. (Cost) // Charge/Cost Ratio 17. Payment/Cost Ratio Payment/Cost Ratio > I Payment/Cost Ratio < I (Review payer mix) 2. (Other Operating Revenue) 1. 2. 3. Franchise 4. 18. 5. (PCU) 6. 7. 3. 3.1 3.2 3.3 3.3.1 3.3.2 (Investment income) 19. 3.3.3 (Profit margin) Software Hardware Network Outsourcing ( Balanced scorecard) (Growth) 20. ( Willing to pay) ( Suppliers induced demand) (New services and health products) 21. 2 1. (Mature stage of product life cycle 3 ) (Primary care/Special cardiovascular care) 2 . (Brand) (Cross sell) ( Acupuncture) 1 . 22. 2 . 3 . (More functionality and customer value) (New application) 1 . 23. ............... (Ability to pay) (Willing to pay) 2 . Leucovorin (Adjuvant therapy) (Air time charge) 24. (New customers and markets) 1. 2. 25. ( Catchment area) (Capitation) (Growth in the total size of market volume) (Market share growth) (Ne w relationship) 1. 2 1 2 3 26. 3 (Three in one) 2. 6 3. 3 . 1 27. / Work Shop 3.2 .... 28. 1 . ( Gross profit) Profit/Loss Account 2 . ( Return On Capital Employed ROCE) / ( ) (New pricing strategy) (Niche service) ( 5 ) 1 . 29. 2. ( Products and services mix) (Price elasticity of demand) 30. Ed (Co payment ) 0.5 10% 5% - E > 1 ( ) 31. - E < 1 - Elasticity - ( Luxury/Felt needs) - 32. - - 2.00 1.99 1.99 1.98 (Price per unit service) 1. 40 60 33. 1 .1 1 . 1 . 1 1.1.2 (Productivity) (Quality) (Cost of quality and risk claim) 1 .2 2 1.2.1 (Internal control strategy) 1 . 2 . 2 (Break even point) (Outsourcing) (Time based 34. management) 2 . 25-30 2 .1 (Procurement management) (Bargaining power) (Re Order Point ROP) ( Current liabilities) - 2 .2 ( Suppliers and Logistic management) (Just in 35. time) 2.3 (Inventory management) 2.4 (Customer relation management CRM) (CRM) 36. Call Center 3. 4. 37. 5. - - 38. - ( 8.2) (Strategic direction) (Strategic content) - 39. - - 1. 9 1.1 40. 1.2 1.5 On Call 1.3 1.4 41. 1.5 1.6 1.7 42. 1.8 Stan Pollock ( ) 4 2 . 5 3 1.9 ( Capitated patients with multiple conditions) 2. 2.1 43. 2.1.1 2.1.2 2.1.3 2.1.4 44. 2.3 Meridia Health System .. 1990 4 (Strong market position in Clevelands eastern suburbs) 45. 4 4 ( ) 4 3 4 4 4 4 46. 3 4 2.4 47. 4 2.4.1 ( Early Innovators) 2.4.2 ( Joiners) 2.4.3 (Traditionalists) 2.4.4 (Pure practitioners) 48. (Competitive State of Art) 2.5 (Individualism) 2.5.1 () 49. 2.5.2 2.5.3 60 40 Alertness Management (Scheduling) (Social environment and family life) 50. 2.5.4 51. ( Outsourcing) 1. 2-3 2. 3. Bargaining Power 4. 1,000 52. () (High volume of inventory and high expense) 1. Shortell S.M. (1990) Defender Orientation ( Too narrow) (Too provincial) (Too self satisfied in the past) (Difficulty coming to grip with change) Shortell S.M. (1990) 6 1.1 (Cross 53. training professional personnel so that fewer people are needed to do the work) 1.2 (Developing more efficient elective surgery schedule) 1.3 (Reducing the volume of laboratory tests) 1.4 (Reducing swing-bed staffing) 1.5 (Sending staff home if there is not enough work to do) 1.6 / (Instituting a value improvement program designed to eliminate certain procedures while maintaining care and service standard) 54. 6 (Selective diversification) 1. ( DRG Grouper MDC Medical, MDC Surgery ) 2. ..... ......... ..... ......... .... .... . . . ... ......... . . . . . . . 55. 3. .... .... .... ........ ........ ............ 4. ( ) 5. ( 56. ) ( ) 57. (Key persons) 2. Resource-Based Relative Value System RBRVS 500 58. Complete Financial Statement - - - - - - - (Source of hospital financial information) 59. - (Financial accounting) - (Audited financial statement) 1. 1 . 1 Generally Accepted Accounting Principles (GAAP) Guidelines 1.2 (Accrual VS Cash Method) 60. 1 . 3 ( Financial statement) 3 - (Earn a profit) - (Remain solvent) ( GAAP) 3 1.3.1 3 (Balance sheet) (Income statement) 61. (Profit and Loss Account P/L) (Statement of cash flows) 1.3.2 (Fundamental accounting model) (Balanced scorecard) (Assets) (Liabilities) (Equity) 1.4 (Profit and Loss Account P/L) Total Margin Total Margin 2% 2 100 62. Net Operating Income 1.5 (Balance sheets) 1. Accrual 12 63. 2. Intangible 3. 4 1. 2. 3. 4. 1.5.1 (Fixed asset) (Depreciation) 1.5.2 64. 1.5.3 (Liability) 2 (Current liability) (Long-term liability) 1.6 (Cash flow statement) 1.6.1 4 1) Cash Inflow -> Profit ( ) 2) () 3) 4) 1.6.2 (Operating cash flow) 2 (Operating profit) 3 2 Operating Cash Flow 65. Free Cash Flow 1) (EBIT) EBIT 2) EBIT (1-) Free Cash Flow 2. - - - - - - 66. - - - - - - 3 1. (Profitability) (Break even point) 67. 2. (Liquidity) 3. (Solvency) 68. 1. (Cash flow analysis) (Generate cash flow) 2. 69. (Affliate Chart) 1. 2544 70. 2. Alchain, A. A., and Demsetz, H. Production, Information Costs , and Economic Organization. American Economic Review. 62, 5 (1972): 777-795. 3. American Medical Association. Medical Groups in the US.: A Survey of Practice Characteristics. Chicago, 1996. 4. Baker, G. P., Jensen, M. C. and Murphy, K. J. Compensation and Incentives: Practice vs. Theory. Journal of Finance: Papers and Proceedings. 43 (July 1988): 593-616. 5. Cleverley, W. O. Factors Affecting the Valuation of Physician Practices. Healthcare Financial Management. 51, 12 (1997): 71-3. 6. Donaldson, C. and Gerard. K. Economics of Health Care Financing: the Visible Hand. 1994. 7. Gaynor, M., and Gertler, P. Moral Hazard and Risk Spreading in Partnerships. 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