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Managed Healthcare
Managed Healthcare
A healthy care system that controls cost of services, manages the use of services and measures the performance of health care providers is called managed care. This system is both health care financing and health care delivery. There exists many types of managed care plans but the most common ones are health maintenance organizations (HMOs) and preferred provider organizations (PPOs) (Chowallur, 2008).
Managed care has tried to change the way health care is financed by changing the incentives in health care system. By so doing, managed care has affected health care negatively. Revenue resources under free-for-care service become costs under managed care. More so, managed care discouraged use of care except extremely necessary. This affects in patients hospital care and mental health care. Managed care affects health administrator’s revenue for they only make profits by providing health services which are only absolutely necessary to patients unlike, free- for -service providers which profits them when people get sick and make use of the health services (Todd, 2009). Managed care programs have affected significantly the employment of nurses since HMO has resulted in reduced number of discharges.
Managed care and prospective payments have tried to cause hospital staffing changes so as to cut the costs and expenses incurred in paying health administrator’s salaries. This reduction of medical staff has been associated with the poor quality of health care observed in hospitals (Chowallur, 2008).
Managed care denies the patient freedom o f choosing a health care provider as well it limits the healthcare provider’s ability to order diagnostic tests and therapeutic procedures. In this system, administrators rather than medical and health personnel make decisions about patient’s future health. This results into too few services being provided to patients especially for those patients who require long-term inpatient or out patient care.
The future of health care can be improved only if all the patients even those who odes not have insurance covers are allowed to access managed care services. Also quality of services offered may be improved by increasing employment of registered medical experts and by reimbursing them in time (Todd, 2009).
References
Chowallur Dev Chacko, M.D. (2008), Let’s reject managed care: “Managed Care: Can’t We DoBetter?” February 2008, p. 11, International Medical News Group Gale, CengageLearning.
Todd, Maria K. (2009) The managed care contracting handbook; planning and negotiating themanaged care relationship, 2nd E.d .Book News, Inc., Portland CRC / Taylor & Francis
Manage Separation or Termination Processes
Manage Separation/Termination Processes:
(Author’s name)
(Institutional Affiliation)
Abstract:
Firms tend to focus on voluntary disclosure of information of earnings disclosures, management forecasts, and to a lesser extent, overall disclosure levels.
Firms are likely to voluntarily include accounting information along with quarterly earnings announcements when current earnings are relatively less informative, or when future earnings are relatively more uncertain. This way, the information is likely to have a greater demand for additional value relevant information such as balance sheets to help assess firm’s value. These types of firms are likely to be
(1) In high technology industries;
(2) Reporting losses;
(3) With larger forecast errors;
(4) Engaging in mergers or acquisitions;
(5) That are younger; and
(6) With more volatile stock returns.
Dye (1985) argues that managers have incentives to make voluntary accounting disclosures when market participants find the disclosures useful in assessing firm value. Investors find voluntary balance sheet disclosures relatively more useful in assessing firm value when current earnings are less informative, or when future earnings are more uncertain. They are likely to demand additional value relevant disclosures to supplement the information contained in earnings. Similarly, because future earnings are more uncertain among firms whose operations are less predictable (such as younger firms), investors are more likely to demand additional disclosures when they evaluate younger firms (Lang, 1991)
High-tech firms operate in rapidly changing environments that make their future operations, and hence future earnings, relatively more uncertain. While balance sheet information is also problematic in valuing intangibles and in resolving future uncertainty, analysts find various accounting information particularly useful in valuing high technology companies. For example, cash balances are important in assessing the ability of high technology companies to enter new markets, to make new product launches, and to survive until the next round of financing. Similarly, inventory and receivables management is particularly critical for these firms due to the uncertainty of their operating environment and the untried nature of their products and customer base (Palazzo, 1999; Ramstad, 1996).
Firms are likely to disclose their accounting information when they report losses. In the presence of a loss, earnings fail in their primary role as an indicator of future earnings (Collins et al., 1997). Moreover, because losses cannot be sustained indefinitely, firms experiencing losses are more likely to liquidate, making their abandonment value more relevant in assessing shareholder value.
Accounting information disclosed is likely to be useful in interpreting the valuation implications of earnings when reported earnings differ from market expectations. The firm’s managers are likely to guide market participants in understanding why earnings diverge from expectations, as well as the valuation implications of the divergence. Balance sheet disclosures can provide this guidance because balance sheet accounts can be useful in interpreting reported earnings (McGough and Podd, 1999). For example, working capital accounts provide investors with value relevant information about the nature of reported accruals.
Firms with quarterly earnings that deviate from analysts’ forecasts are more likely to disclose balance sheet information in their quarterly earnings announcements.
Firms that engage in mergers or acquisitions during the quarter are likely to disclose balance sheet information in their quarterly earnings announcements. Investors are likely to have a relatively greater demand for balance sheet information when firms engage in merger and acquisition activity. Mergers and acquisitions are likely impact the firms’ future operating activities, which in turn are likely to increase the uncertainty related to their future earnings. Accounting disclosure will help the investors assess the impact of the merger and acquisition activity on future earnings. For example, the total asset number can be used to predict the normal component of future earnings (Ohlson, 1995).
Younger firms are more likely to disclose accounting information in their quarterly earnings announcements. This impacts the demand for value relevant information is the firm’s age. Lang (1991) argues that firms with greater uncertainty about future earnings such as younger firms are likely to reap greater benefits from additional disclosure.
Firms with more volatile stock returns are likely to disclose information in their quarterly earnings announcements. Stock return volatility is also likely to be associated with accounting disclosures. High stock return volatility is consistent with greater uncertainty about future earnings, because stock price is a function of expected future earnings. Since investors are likely to have a greater demand for information when future earnings are more uncertain, we expect that firms have greater incentives to voluntarily disclose additional value relevant information.
Verrecchia (1983) analyzes voluntary disclosure in the context of accounting information and argues that full voluntary disclosure will not always occur. He demonstrates that when private information disclosure results in proprietary costs, the market is likely to interpret non-disclosure with less suspicion because the costs of disclosure can exceed the benefits to shareholders when proprietary costs are sufficiently large. This suggests that consideration of proprietary costs may reduce management incentives to make voluntary balance sheet disclosures.
However, Verrecchia (1983) also observes that management decisions to make accounting disclosures are typically not decisions of disclosure versus non-disclosure, but rather decisions of accelerated versus delayed disclosure.
If the balance sheet disclosure firms’ earnings are relatively less value-relevant, we expect the relation between earnings and price to be relatively weaker for these firms, providing them with an incentive to supplement their earnings announcements with balance sheet disclosures.
Conclusion
Voluntary accounting information disclosures are being motivated by investor demand for additional value relevant information to supplement reported earnings. Usefulness of accounting information in valuing securities by identifying the circumstances under which market participants are likely to demand, and firms are likely to provide, voluntary balance sheet disclosures.
In summary:
Each company is unique
A one-size-fit-all accounting standard approach will not work for all companies’ disclosure demands
Accounting standards can just rule all companies to disclose some common owned information – cash, liabilities, amount of expenses, etc.
References
Collins, D.W., Maydew, E.L.,& Weiss, I.S., (1997). Changes in the value relevance of earnings and book values over the past forty years. Journal of Accounting and Economics 24.
Dye, R., 1985. Disclosure of nonproprietary information. Journal of Accounting Research 23,
Lang, M.H., 1991. Time-varying stock price response to earnings induced by uncertainty about the time- series process of earnings. Journal of Accounting Research 29.
Lang, M.H., Lundholm, R.J., 1996. Corporate disclosure policy and analyst behavior. The Accounting Review 71.
McGough, R., 2000. Lucent’s mission is to regain trust of wary investors. The Wall Street Journal
Ohlson, J., 1995. Earnings, book values, and dividends in security valuation. Contemporary Accounting
Palazzo, A., 1999. Datron weathers transition to new markets. The Wall Street Journal (June 30). Ramstad, E, 1996.
Verrecchia, R., 1983. Discretionary disclosure. Journal of Accounting and Economics 12.
Manage Accountability
Manage Accountability
Name
Professor
Institution
Course
Date
Manage Accountability
Introduction
While the allocation of resources is an I,prant uty of the management, there are many pitfalls to accountability that the management of any project can find itself ins when there are no proper structures for allocating, managing, controlling the funds allocated for any project. On the other hand, it is the duty if the management to ensure that the benefits accruing form the project overrides the cost associated with the project lest the project be declared a waste of resources. One major way by which the management of a find can ensure that the funds allocated are spent well is through control structures and benchmarks that must be specr8ic to the project at hand.
It is always ideal for management to have ideal Management Accountability Framework that includes statement that outlines the expectations of then oversight authority of the of the project. The list of management expectation in the framework is immigrant as it also helps in the attainment of high organizational performance. This call for Accountability, and Citizen Focused Services, however, other principles such as Governance and Strategic Direction, Innovation and Change Learning, People, Policy and Programs, Results and Performance, Risk Management and Stewardship, Public Service Values.
The main types of expenditures include the operating expenditures such as Employee salaries or wages and overheads, rental and utility costs, employees travel and other training expenses, communication, consultancy fees. On the other hand there are a number of capital expenditures includes , machineries and other production equipment, Vehicles, stores, furnishings, IT systems, office furniture’s and other items with depreciable values (Kelly, &, Rivenbark, 2010).
Budgetary procedures
Determining a corporate strategy in which the management team review the strategy
The budget analyst then issues the Revenue Budget Materials based on the historical report, this indicates the revenues by regions, and month, and then the budget is reviewed and adjusted
The budget analyst the Issues Expense Budget Materials that indicates the expenses
The initial budget iteration is the compiled by the budget analyst into the team’s budget model
The budget analyst team then completes the subsequent iteration and a day is set for reviewing the budget. In this meeting the notes are compared especially the historical results, the key ratios, step costing, and other change points. One other important part in this meeting is the discussion of area is the possible impacts of bottleneck on operations
The CEO approves the budget.
The final budget that has been approved is loaded into the accounting system
Lump sum budgeting,
While the project will rely entirely on lamp sum budgeting based on the source of funds and the frequency of funds allocation, it is important to note that the project would also have access to other streams of cash flows that will be used mainly for financing the daily operation over the entire life of the project (Breul, 2007).
Object-of-expenditure budgeting,
Performance budgeting.
Meyers, &, Philip, (2005) states that this system of budgeting recognizes and presents the purposes for which a budget is prepared and the purpose for the groups requires funds. It also entails listing the cost of the project and the related activities geared towards achieving these objectives. This system is considered ideal as it outlines the expected output and the. It is advisable to ensure that a comprehensive performance budgeting system quantifies the total results based chain.
Costing
Costing during the project will e based on various units cost. Example, mechanized clearing will be Mechanized Clearing time will be dependent on the tractors size and the area to be cleared. Therefore, clearing time, Tc, based on the machine hours per square miles.
Mechanized clearing
Merchandised pilling
Earth work
Grading
Surfacing
Economic Cost benefit analysis
The conventional economic cost-benefit analysis is important for analyzing the economic profitability of the highway. The two phases of the project will include upgrading of the key causeway and finally, completion of the main highways. Then the second phase will include completion and commissioning of the project to the stakeholders. Dessau Soprin International and the alignment and technical requirements that were expressed in the Functional Planning Report will base the cost on the Class “C” estimate that was primed.
Randall, (1982), argues that the procedure is important s it is the only procedure that is used to structure and examine infrastructure projects in order to determine the efficiency concern and the probability of economic growth that the projects are likely to generate. The concept of facilitating choice and the allocation of available resources are the key objectives of the ECBA. The project will use a base case and compare the perforemcne of the project against it is important to note that the techniques is commonly used to determine or appraise the publicly funded investment project such as highways. This helps in the allocation of resources in a way that the society will benefit. The main objectives of the cost benefit analysis is to set a monetary value form the benefits accruing from the public project
Benefits and cost items objects
Affecting Usersa Travel time saving
Vehicle operation and cost savings;
Security and related savings such as life and injuries, including damage to property)
Affecting Owners and Operators of the Road Network Highway construction expenses and costs;
Land acquisition cost;
Maintenance costs and repair cost
Network operating costs;
Savings related to postponement of maintenance
Costs on other roads (existing road)
Affecting Non-users Travel time savings or costs from changes in traffic on other roads or modes;
Costs and benefits related to air quality;
Costs and benefits related to energy consumption of different transportation modes;
Other externalities
Liquidity ratios are classes of financial metrics that are used determine the ability of a company to discharge the short term debt obligation that it accumulates. This also indicates a company’s margin of safety
Solvency ratios: the solvency ratios on the other hand, are used to measure the ability of corporate body to meets the long-term debt obligations associated with its daily operations. This shows how long a company can meet its debt obligation. This includes the after tax income that a company has realized and excludes any non cash depreciation expenses size of a company’s after-tax income
Profitability ratios: solvency ratios are alas of metrics that companies can use to assess their abilities to generate continued income against expenses and related relevant costs over specific duration of time
Reference
Randall, Ronald (1982) “Presidential Use of Management Tools: From PPB to ZBB.”
Presidential Studies Quarterly 12(2): 186-194.
Meyers, Roy T. and Joyce, Philip G. (2005) “Congressional Budgeting at Age 30: Is it worth
Saving?” Public Budgeting & Finance (Winter Supplement) 25: 68-82.
Breul, Jonathan D. (2007) “Three Bush Administration Management Reform Initiatives: The
President’s Management Agenda, Freedom to Manage Legislative Proposals and the
Program Assessment Rating Tool.” Public Administration Review (January/February)
67(1): 21-26.
Kelly M. &, C. Rivenbark (2010). Performance budgeting for State and LocaGovernment. 2nd Edition. M.E. Sharpe
