5 Cost Accounting Tips for a Medical Practice

Hospitals and health systems represent roughly $1 trillion of the approximately $4 trillion spent annually on U.S. healthcare. They continue to face shrinking operating margins (on average, net operating margins have dropped below 3 percent), with close to thirty percent operating at a loss. The subpar support of many existing cost accounting and decision support solutions can have massive ramifications for hospitals and health systems. With the increasing electronic documentation of a patient’s visit, healthcare providers had an opportunity to leverage that data for insights.

It’s best to negotiate a multiyear lease when possible, and be sure to consider other costs, such as common area maintenance, taxes and insurance when negotiating rent. Two of the other major ongoing expenses to run your practice include rent and insurance. Wolters Kluwer is a global provider of professional information, software solutions, and services for clinicians, nurses, accountants, lawyers, and tax, finance, audit, risk, compliance, and regulatory sectors. Call us at 888.TEMP.DEV or contact us here to get started implementing the best accounting approach for your practice. Watch videos about the digital future of healthcare, quality improvement, and much more. Gain insights about the role of data in healthcare transformation and outcomes improvement.

Medical Practice Operating Expenses Explained

This has put a strain on resources and has made it more difficult for healthcare organizations to keep track of their costs in a timely manner. For decades, policymakers have beckoned hospitals and other healthcare organizations to be more transparent in their pricing so patients know the cost of a product or service before getting it. A complicated labyrinth of legislation stipulates cost accounting transparency in healthcare, allowing patients to access pricing information and make more informed decisions about the cost and value of the healthcare they receive. Despite the traditional importance of contract-level negotiations in hospital pricing, the industry is currently experiencing changes that have the potential to increase the importance of pricing individual services competitively. These changes include an increase in coinsurance and deductibles, new reference pricing benefits, and an increase in media attention directed at health care pricing structures.

• Cost drivers used for allocating indirect costs typically include square footage, pounds of laundry, patient days, or total direct costs incurred by the department.
• Service-line leaders can look “horizontally” across the health system for potential redundancy and opportunities to consolidate and optimize care delivery and resources.
• To operate at your business efficiently and cost-effectively, you need an industry-savvy accounting team.

This all-in-one financial planning and analysis concept fully leverages existing data to combine clinical and financial data to explain business results and trends. Clinicians and administrators need real-time data and self-serve capabilities around operating performance. They need the freedom to pose and answer questions about clinical efficiency, profitability (by procedure, clinician, and site), practice variation, resource optimization, and quality cost. As a solution, PowerCosting links seamlessly to an organization’s chosen visualization tools (e.g., QlikView®, Tableau, Power BI, etc.) with both pre-populated and ad hoc capability to deliver business intelligence.

Learn the basics + methods around cost accounting for hospitals and health systems

Businesses in the healthcare sector experience some of the most complex accounting transactions, and their financial success rests on accuracy in financial reporting. To operate at your business efficiently and cost-effectively, you need an industry-savvy accounting team. At L&H, our healthcare industry services focus on sole practitioners, group medical practices, and nursing homes. With the data from clinical information systems linked to the financial systems at a patient-level, organizations can now use accurate data to find opportunities and solve previously unseen or unknown problems.

Hospitals and involves breaking down department expenditures to obtain procedure-level costs [7]. The most prevalent top-down costing approach is the ratio of cost to charge (RCC) method. This method estimates procedure-level costs by computing an overall ratio of departmental aggregate costs to charges and applying this ratio for individual procedures and services. First, costs derived through this method are based on aggregate information and may not accurately reflect the actual costs of a particular procedure provided within the department [7]. Second, charges are set on the basis of a variety of internal and external factors and do not necessarily maintain a constant relationship with costs (e.g., discounts) [7]. In Canada, for example, hospitals do not charge third-party payers for the treatment of individual patients; therefore charge data are not available in Canada.

Industry Knowledge

A careful examination of hospital cost centers may disclose the presence of unusual indirect costs at a particular hospital. Costs related to research activities, affiliated medical schools, bad debts, interest expense, or bond interest, for example, may be present in one hospital’s indirect cost pool but not in another. The potential for bias may arise if such expenses are not removed from the cost analysis. In such cases, the misclassification is likely to be differential, and the overall difference in costs between the two hospitals will be overestimated. Other potential sources of differential cost misclassification arise when hospitals use different application rates and allocation algorithms to allocate indirect costs to direct cost centers.

• If these changes materialize, cost accounting information will become a much more important part of hospital management than it has been in the past.
• You are assigned a designated accountant who will work closely with to help you achieve your goals.
• Many of the plans offered through the federal and state exchanges are narrow network plans.
• Watch online seminars by healthcare experts about trending topics and healthcare best practices.
• In addition to the individual physician and service line P&L capability mentioned previously, ABC and the PowerCosting allow finance teams to automate the completion and reporting of monthly results and financial analysis.

The more knowledgeable and reliable they are, the less that business will interfere with your day-to-day routine. Apply for financing, track your business cashflow, and more with a single lendio account. Cost of other policies such as cyber insurance, accounting for medical practices fire, flood, theft, casualty, general liability, officers’ and directors’ liability, and reinsurance. One of our Multiview team members will be in contact shortly to schedule your Demo and help you discover the benefits of Multiview’s Financial ERP.

Accounting & Tax Services

Cash accounting also lets you pay taxes only on the revenue you received during a year, not any still-outstanding accounts receivable. Finally, for practices that pre-purchase goods, like oncology practices, the cash accounting method lets you deduct those costs when you purchase the medication. Under accrual accounting, you would instead deduct the cost of prescription drugs when you provide them to a patient. With longer-storage items, the accrual method can create lengthy gaps between your purchase date and when you can deduct the cost of the purchase. Whether it’s increased regulation, shrinking reimbursements or insurance claims issues, today’s health care practice business environment is challenging.

Here is what you need to know about accrual vs cash accounting, and how to manage your accounts receivables and revenue recognition depending on your choice. This step is important because it provides the RVU managers an opportunity to better understand how the RVUs impact the unit cost calculations. Include in the review and discussion cost accounting department-level reports along with the CDM service code volumes and RVUs by cost category. This should be conducted on a one-to-one basis to allow for explanations and to make any necessary RVU adjustments. When hospitals affiliate with larger organizations, partnering entities often have inpatient and outpatient facilities that are geographically close to one another. This proximity provides both an opportunity and an imperative to optimize care delivery, quality, and cost efficiency in the service area—a service-line approach.

The 100-Percent Solution to Improving Healthcare’s Operating Margins

Adopting a more modern cost accounting approach is essential for healthcare organizations to accurately reflect the true cost of care post-COVID. This will help improve decision making, better serve patients, and, ultimately, improve the bottom line. All of these factors have created a need for a more modern cost-accounting approach that can adapt to the changing landscape of healthcare. Cost-accounting software that is designed specifically for healthcare entities can help organizations to track and manage their costs more accurately.

A simple computer error might not result in anything as extreme as a $92 million overpayment. However, outdated and incapable systems do significant financial damage to healthcare organizations and render it impossible for cost accountants and healthcare financial managers to do their jobs. Basic accounting tools and rudimentary ERP systems aren’t capable of advanced cost accounting, especially in the healthcare sector, where cost and pricing decisions intertwine with patient care. Differences in the classification of direct and indirect cost centers may arise if hospitals outsource patient care services to independent contractors.

Measurement bias may also arise due to misclassification of fixed and variable costs. In the third step of the Transition system methodology, the RVUs of individual intermediate products are estimated based on the total resources consumed when the product or service is used in patient care. The potential for measurement bias arises because a portion of the product’s consumption of fixed costs may be considered as variable costs and, conversely, variable costs related to the product may be considered as fixed costs. Depending on the circumstances, the variable and fixed costs of a given intermediate product may be either overestimated or underestimated. Healthcare cost accounting – also sometimes called hospital cost accounting – means identifying the costs of any product, service, or activity at a specific time in a healthcare organization like yours.

Thus, the transition of the marketplace using Td-ABC to show value might fall upon deaf ears and will not be an effective, freestanding tool on the road to a value- and quality-based model for health care. Lastly, departments should be periodically scheduled for a comprehensive RVU review. Performing a rotating quarterly review of a handful of departments is much more manageable than addressing all departments at once. Cycling through departments in this way assures continuity, and each pass improves the RVUs and correspondingly the unit costs.

Attempts to increase revenues by expanding the population being managed and to reduce costs by improving care management efforts may be preferred to strategies that emphasize operating cost reductions. This sort of strategic behavior was seen in at least one integrated delivery system operating in the late 1990s. The potential use of the Transition system in health services research largely depends on the accuracy of the cost estimates provided by the software. Due to the possibility for error in measuring costs, it is crucial to understand the Transition system methodology for estimating unit costs of products and services.

• In addition, frequent communication with key stakeholders will ensure that new activity codes, new payer activity, changes in strategic focus, and other drivers are accounted for ahead of time within the costing structure.
• They can also help you build the proper reporting or business intelligence needed to accurately recognize revenue.
• These costs can be analyzed at the organizational or departmental level, but Gapenski and Reiter have noted that “the holy grail of cost estimation is costing at the service or individual patient level” (2016).
• It also supports more informed clinical and business decisions that strengthen clinical and financial performance and reputation —  critical in an era of consumerism.