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PT Management and Administration > Financial Decision Making > Flashcards

Financial Decision Making Flashcards

1
Q

Performance improvement

A

A method to improve organizational performance and individual performance
Data driven and emphasizes human performance factors

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2
Q

What is the point of discussing Management Decision Making?

A

direct organizational activities

to produce the best outcomes for ongoing activities

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3
Q

Decision-Making Methods

A

Project management
Operational planning
Business planning

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4
Q

Root Cause Analysis

A

technique used with performance improvement that ID’s the conditions that initiate and undesired state
What caused the problem?

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5
Q

What is the emphasis on with root cause analysis?

A

cause

fishbone diagram

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6
Q

Quality Improvement (QI)

A

Another group of data-driven methodologies to define and close the gap between the current state and expected performance outcomes

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7
Q

What is the emphasis on with quality improvement?

A

process

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8
Q

Tools for current operations performance analysis include

A

business intelligence system

decision support system

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9
Q

Business intelligence systems

A

Applications and technologies for gathering, storing, analyzing, and providing access to data

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10
Q

Decision support systems

A

Integrated computer support systems to manage organizations and aid in making rational decisions

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11
Q

Total Quality Management

A

a management technique devoted to exceeding customers expectations

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12
Q

Business Intelligence:

A

Applications and technology for gathering, storing, analyzing, and providing access to data to help make better business decisions

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13
Q

Data mining:

A

A class of database application that look for hidden patterns in data to predict future behaviors

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14
Q

Decision Support System:

A

DSS are computer applications that aid users in judgement and choice activities

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15
Q

American Hospital Association Quality Center recommends that management should know the answer to these 4 questions

A
  1. What is the rate of process variability?
  2. What is the rate of waste?
  3. What are the types of defects or errors?
  4. What is the overall rate of organizational variability?
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16
Q

Malcolm Bridge National Quality Criteria

A

Outcome driven performance management system with basis in data, analysis and knowledge

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17
Q

Six Sigma

A

Management system utilized with the goal of reducing errors up to 2+ standard deviations
Developed by Motorola in the 1980’s adopted in the US by GE in 1995

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18
Q

What does Six Sigma seeK?

A

improve the quality of process outputs by identifying and removing the cause of defects (errors) and minimizing variability in manufacturing and business processes

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19
Q

Key Principles of Lean Six Sigma

A
  1. Focus on the customer
  2. ID and understand how the work gets done (value stream)
  3. Manage, improve, and smooth the process flow
  4. Remove non-value added steps and waste
  5. Manage by fact and reduce variation
  6. Involve and equip the people in the process
  7. Undertake improvement activity in a systematic way
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20
Q

How does Six Sigma work practically?

A 
Define
Measure
Analyze
Improve
Control
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21
Q

Define

A

problem to be solved, define everyone’s roles, define what you are doing and what is the goal

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22
Q

Measure

A

Clarify by seeing how the work gets done and measure how well it is done

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23
Q

Analyze

A

find out why things are working as well as they could. Manage by fact, get to the root cause

24
Q

Improve

A

Find a way to address root cause, come up with ideas and select the best one. Then test it out.

25
Q

Control

A

Achieve the goal you wanted and ensure the process continues and is carried out consistently

26
Q

What is value?

A

what a customer is willing to pay for out of their pocket

27
Q

International Organization of Standardization (ISO 9000)

A

Plan-do-check-act cycle

28
Q

A plan-do-check-act cycle (PDCA) can be used:

A

Plan (assess ideas)
Do (pilot phase)
Check (examine pilot results to determine what went right and wrong)
Act (implementation)

29
Q

Oversight:

A 
Care involving agencies and private groups to 
prevent waste and fraud
protect civil liberties
accumulate info useful to lawmakers
education of public
ensure compliance with laws
evaluate performance
30
Q

What has oversight been tied to?

A

provider’s ability to participate under private and governmental insurance programs

31
Q

Pay for performance

A

P4P

tie payment rates to oversight which is basically the idea behind Accountable Organizations (ACOs) in ACA

32
Q

Administration for Children and Families Act (ACF)

A

head start
low income family support or childcare
Prevention of child abuse and domestic violence

33
Q

Administration on Agining (AoA)

A

Meals on Wheels

Community service for elderly and their caregivers

34
Q

What does Medicare provide insurance to?

A

those age 65 or older
those under age 65 with certain disabilities
everyone with end-stage renal disease requiring dialysis or a kidney transplant

35
Q

Medicaid

A

Health insurance program for certain low-income people

Funded and administered jointly by a state-federal government partnership

36
Q

What must a Medicaid program cover?

A 
Inpatient and outpatient hospital services
Laboratory and x-ray services
Skilled nursing and home health services
Doctors’ services
Family planning
Periodic health checkups
Diagnosis and treatment for children
37
Q

Agency for Healthcare Research and Quality (AHRQ)

A

Supports research to improved health care and reduce cost, improve safety and reduce errors

38
Q

Center for Disease Control and Prevention (CDC)

A

Disease outbreaks, bioterrorism, disease prevention, immunizations, workplace safety, environmental disease prevention, international disease prevention

39
Q

Food and Drug Administration (FDA)

A

drugs, medical and biological products

40
Q

Health Resources and Services Administration (HRSA)

A

Health care access to poor and uninsured where health care is scarce

41
Q

National Institutes of Health (NIH)

A

medical research organization

expand knowledge base to enhance national economic well being

42
Q

Substance Abuse and Mental Health Service Administration

A

Provides grant to state for substance abuse and mental health services
Provide programs to increase the use of proven prevention and treatment methods

43
Q

DOJ

A

mission to enforce the law and interest of the USA

44
Q

State/Local Government Regulation

A 
adult day care
ambulance
HIPPA
Individual and Business background checks
hospital regulation
plan reviews of health care facilities
45
Q

Occupational Safety and Health Administration (OSHA)

A

federal administration but works with state and local government
Inspect, investigators, engineers, physicians, educators, standard writers who look at the safety and health of America workers for workplace safety.

46
Q

Which division of DOJ focus on antitrust regulation in healthcare?

A

Antitrust division of DOJ and Federal Trade Commission FTC

47
Q

Non Governmental Oversight

A

Joint Commission
CARF
Hospital and Rehab Facilities

48
Q

Joint Commission

A

Evaluates and accredits more than 15,000 health care organization in US

49
Q

Corporate (Regulatory) Compliance

A

Noncompliance with Medicare/Medicaid coverage and reimbursement guidelines represents substantial risk to the health care provider.

50
Q

Sanctions:

A

Recouping improper payments
Imprisonment for owners and managers
Exclusion from future participation in these programs

51
Q

Corporate Compliance Program (CCP)

A

Organizations establish a CCP to lessen risks of intentional or unintentional regulatory noncompliance

52
Q

Elements of a health services business CCP are

A

Organization structure for the program
Operational mechanisms to implement the program
Infrastructure to assure corporate compliance officer’s power to implement CCP program
Measures to prevent violations
Measures to respond to violations

53
Q

CCP measures to prevent violations include

A

Organization-wide training on compliance standards, policies, and procedures
Continual efforts to recognize and respond to regulatory developments
Mechanisms to measure the effectiveness of the compliance program and adherence to related policies and procedures
Mechanisms to respond to identified compliance program weaknesses

54
Q

CCP measures to respond to violations include

A

Monitoring
Responding to suspected compliance violations
Reporting suspected compliance violations
Protecting employees who report compliance violations
Policies to govern the reporting to the government of probable compliance violations

55
Q

CMS

A

Medicare
Medicaid
SCHIP

56
Q

Divisions fo HHS

A

Administration for Children and Adults
Administration on Aging
Agency for Healthcare Research and Quality
CDC
CMS
FDA
Health Resources and Service Administration
Indian Health Services
NIH
Substance Abuse and Mental Health Services Administration
US Public Health Service Commissioned Corp

PT Management and Administration (10 decks)

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