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HORG! > Final Review! > Flashcards

Final Review! Flashcards

0
Q

What is the revenue cycle? What is revenue?

A

The revenue cycle is the process in which a company from a service gains revenue. Revenue is money derived from a company’s core business.

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1
Q

What’s the average number of days of revenue in accounts receivable for US hospitals?

A

46 days

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2
Q

What’s a benchmark?

A

A benchmark is national average or standard against which a company can measure itself.

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3
Q

Who is the audience for the primary performance indicators?

A

The board

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4
Q

Who is the audience for secondary perormance indicators

A

The staff

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5
Q

What’s the formula for profitability?

A

net income/net revenue = profit margin

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6
Q

What’s the formula for productivity?

A

Units of service/FTE (full time equivilants)

FTE = 2080 hours (40 a week x 52 weeks)

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7
Q

How do you figure out net income?

A

Gross Revenue

* Deductions from Gross Revenue
       1. Bad Debt
       2. Charity Care
       3. Contractual Allowance

Net Revenue = Gross Revenue - Deductions

Expenses

    * SWB (most of the expenses)
    * Supplies, depreciation, etc.

Net income = Net Revenue - Expenses

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8
Q

In healthcare, what does “ambulatory” mean?

A

Outpatient

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9
Q

When, by whom and in what state was the first ASC begun?

A

1970 by some anesthesiologists in Arizona.

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10
Q

What’s the nosocomial rate in hospitals as opposed to ACSs?

A

4% in hospitals, .5% in ASCs

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11
Q

What are the 6 types of scope-based tech that are used in surgical procedures?

A 
Arthroscopy
Endoscopy
Laparoscopy
Laryngoscopy
Colonoscopy
Sigmoidoscopy
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12
Q

What’s a CASC admin?

A

A certified administrator of surgery centers

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13
Q

Who owns the highest percentage of freestanding ASCs?

A

Physicians…duh.

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14
Q

ASCs are not allowed to markup _____?

A

Inplants

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15
Q

How many inpatient beds do ASCs have?

A

None!

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16
Q

About how many acute care hospitals are there in the US?

A

About 5,500

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17
Q

What is acute care?

A

Medical care for the ill or injured. Short term care.

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18
Q

What advocacy organizations represent:
Non-for-profit hospitals?
For-profit hospitals?

A

AHA (American Hospital Association)

FAH (Federation of American Hospitals)

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19
Q

What does triage mean?

A 
Triage means to separate cases into the 3/4 levels of care/acuity: 
Primary
Secondary
Tertiary 
Quaternary
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20
Q

What are the levels of care and where do they most commonly occur?

A

Primary = diagnosing and planning for treatment (physicians office, ER)
low acuity

Secondary = Anything for which you are admitted into a hospital. Admitted surgery with a medium acuity.

Tertiary = Level of care that requires at least one-on-one nursing. Generally takes place in an ICU. High acuity.

Quaternary = Experimental procedures and research not yet approved by FDA. Must be approved by IRB. Considered a kind of off-shoot of tertiary care

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21
Q

What does CMS stand for?

A

Centers for Medicare and Medicaid Services

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22
Q

What are the 4 parts to the Medicare program?

A

Part A - Inpatient Services
Part B - Outpatient and Physician Services
Part C - Medicare advantage. Contract with 3rd party insurance. A+B
Part D - Drugs!

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23
Q

A critical access hospital may not have more than ___ inpatient beds.

A

25

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24
Q

Disproportionate Share Hospitals care for more than the national average of _____ patients.

A

CMS

25
Q

What is the OAA and when was it enacted?

A

The Older Americans Act in 1965.

26
Q

Identify the 4 levels of long term care (from least to most intense)

A

Home Care
Assisted Living
Nursing Home
Skilled Nursing Facility (SNF)

27
Q

What is an ADL and what 5 are there?

A

Activities of Daily Living

Ambulating
Toileting
Bathing
Eating
Medicating
28
Q

What’s the biggest source of payment for LTC?

A

Private pay

29
Q

What percentage of LTC is paid by Medicare?

A

0%!

30
Q

What’s the biggest operational challenge in LTC?

A

HR, for sure. There’s large turnover and issues of pay and benefits.

31
Q

Why do we treat rehab facilities as different from LTC?

A

Rehab is more about the acute care side of LTC. They have their own conditions of participation and are focused specifically on rehab.

Think PT, OT, ST and RT

32
Q

What are the 5 things physicians value?

A 
Quality Care
Time (money)
Efficiency
Autonomy
Control
33
Q

What percent of group practices are HOGs?

A

70%. Doh!

34
Q

What are the 8 managerial challenges of medical group practice?

A 
Business operations
Quality management
Financial management
Human Resources
Risk Management
Information Management
Organizational Governance
Patient Care
35
Q

ABMS

A

American Board of Medical Specialties

36
Q

ACHE

A

American College of Healthcare Executives

37
Q

ACOG

A

American College of Obstetricians and Gynecologists

38
Q

AHA

A

American Hospital Association

39
Q

ALOS

A

Average Length of Stay

40
Q

AMA

A

American Medical Association

41
Q

ANA

A

American Nurses Association

42
Q

ASCA

A

Ambulatory Surgical Center Association

43
Q

CRNA

A

Certified Registered Nurse Anesthetist

44
Q

DHHS

A

Department of Health and Human Services

45
Q

DME

A

Durable Medical Equipment

46
Q

DO

A

Doctor of Osteopathy

47
Q

DPM

A

Doctor of Podiatric Medicine

48
Q

FDA

A

Food and Drug Administration

49
Q

HFMA

A

Hospital Financial Management Association

50
Q

HIPAA

A

Health Insurance Portability and Accountability Act

51
Q

HMO

A

Health Maintenance Organization

52
Q

HOPD

A

Hospital Outpatient Department

53
Q

HSCA

A

Healthcare Supply Chain Association

54
Q

IRB

A

Institutional Review Board

55
Q

ISO

A

International Organization of Standards

56
Q

NICU

A

Neo-natal Intensive Care Unity

57
Q

OPPS

A

Outpatient Prospective Payment System

58
Q

PACU

A

Post anesthetic payment system

59
Q

PCP

A

Primary Care Physician

60
Q

PIP

A

Periodic Interim Payment

61
Q

What’s the definition of hospice and palliative care?

A

Hospice is pain management at the end of life.

Palliative care is addressing emotional, social, and spiritual care, for both those dying and those that are just recovering in an acute care setting.

HORG! (5 decks)

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