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Its been my havent come true yet dream in my life. Its just so cool how I can fly without wings, see the world from up there, enjoy the every second when my adrenaline starts pumping, then scream as loud as

2. If the adjustment result in a loss, first investigate whether collected revenues can be increased through a rate increase or improvements in collection efforts. If collected revenues cannot be increased, investigate whether expenses can be reduced. Usually this involves investigating variable labor expenses and reviewing both the mix of full-time to part-time to temporary as well as review of skill mix. If collected revenues cannot be increased and expenses cannot be decreased, then management must decide whether to continue the service at a loss and how that loss is going to be covered by other profitable services.
I can. Its defenetely gonna be my unforgetable "yayy-ness" moment in my life.

Source : Neil Dworkin, Ph.D., Assistant Professor of Management, Western Connectieut State University. Used with permission.

Notes
1. A term attributed to Koontz, ODonnell, and Weihrich (1984) in Management and picked up by Herkimer (1988) in Understanding Health Care Budgeting 2. For a compelling argument for zero-base planning, see Persons (1997) The ZeroBase Hospital: Survival and Success in Americas Evolving Healthcare System. Person also provides a historic perspective by identifying the U.S. Department of Agriculture as the first zero-base planner in 1964. Zero-base planning was abandoned at the Department of Agriculture, but it was successfully adopted at Texas Instrument in the late 1960s as related by Pyhrr in a 1970 Harvard Business Review article and in a 1973 book. During the 1970s and 1980s, zero-base planning was used by a variety of organizations with a variety of success. Hospitals according to Person, did not adopt it because of the financial security provided by retrospective, cost based reimbursement. 3. Continuous budgets avoid the year and sucking sound the sound of year end unneccessary spending of budgeted but not yet spent funds that occurs in organizations using diserete budgeting. 4. DRGs measure severity of illness between DRGs, but they do not measure serity of illness within the same DRG. Eastaugh (1987; 1992) discusses several severity of illness (SOI) indices that do measure how ill a patient is within a spesific DRG or condition: Horns SOI index, Horns computerized severity index, Western Pennsylvania Blue Cross patient management categories, and Brewsters MEDISGRPS.

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5. As discussed in Appendix 1.3 after Chapter 1, adjusted patient days is used to reflect outpatient production with the following formula: Inpatient days + Outpatient visits x 6. Even after adopting an RVU schedule for the production unit, most department maintain a procedure count as a basis for auditing charges (each procedure should generate a charge). 7. Multicollinearity was one of the weaknesses of the Herzlinger and Krasker study on for profit hospitals, which is referenced in Chapter 3. Arrington and Haddock used discriminate analysis to avoid the multicollinearity problem in their follow-up study, which is also referenced in Chapter 3. 8. For reporting purposes, patient revenue is reported net of contractual allowances, bad debt allowances, and charity care allowances. However, bad debt is reported as an expense based on rates, costs, or activity, along with the organizations charity care policy (see Appendix 1.1 after Chapter 1). Premium revenue is reported separately from patient revenue since it is earned by agreeing to provide care, regardless of whether the care was ever provided. 9. Benefits include not only payroll taxes and retirement and health insurance, but also sick leave (approximately 96 hours, depending on the organizations policy), holiday leave (approximately 84 hours), and vacation (approximately 80 hours). Full-time employees are paid for 2,080 hours per year (52 x 40), but are schedule (or work, depending on the defenition) approximately 1,820 per year.

Reference
Berman, H. J., F. Kukla, and I., F., Weeks. 1994. The Financial Management of Hospitaly, 8th ed. Chicago: Health Administration Press. Bittel, I., R., and M. A. Bittel. 1978. Forecasting Business Conditions. Encyclopedia of Professional Management. New York: McGraw Hill Book Company. Eastaugh, S. R. 1992. Health Care Finance Economic Incentives and Productivity Enbancement. New York: Auburn House. Eastaugh, S. R. 1987. Financing Health Cares Economic Efficiency and Equity. Dover, MA: Auburn House.

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Herkimer, A. G. 1988. Understanding Health Care Budgeting Rockville, MD: Aspen Publishers. Koontz, H., C., ODonnell, and M. Weihrich. 1984. Management, 8th ed. New York: McGraw Hill. Person, M. W. 1997. The Zero-Base Hospital: Survival and Success in Americas Employing Healthcare System. Chicago: Health Administration Press Pyhrr, P. A. 1970. Zero-Base Budgeting. Harvard Business Review 48 (11): 111-21. Rakich, J. S., B. B. Longest, and K. Darr. 1992. Managing Health Services Organizations, 3rd ed. Baltimore, MD: Health Professions Press. Reeves, P. N., D. F. Bergwall, and N. B. Woodside. 1979. Introduction to Health Planning, 2nd ed. Arlington, VA: Information Resources Press.