Health Care Finance

This book is a thorough, balanced, and insightful study of what is happening and what should be happening in health care financing. Americans want unlimited access to the best care at affordable prices. Fiscal pressures in American health care point in all different directions, like a pile of jackstraws. This important book analyzes how new payment incentives stimulate planned competition or reregulation; and the far-reaching impact these changes have on hospitals, physicians, long-term care facilities, HMOs, public health clinics, and multihospital systems. Tools for survival include better financial planning, productivity improvement, better scheduling systems, and total quality management. Steven R. Eastaugh begins his book with a general overview of cost management, accounting, product-line selection, and new payment incentives. Part II provides an in-depth survey of fiscal trends in long-term care, managed care, HMOs, and PPOs. Part III analyzes five basic strategies that a provider may consider; with special focus on market analysis, diversification, and pricing. The next part reviews physician payment options, the new Medicare 1992 payment systems for hospitals and physicians, and cost analysis of hospital patient care, research, and education. Part V considers productivity enhancement methods, incentives to assist productivity programs, and the Deming method of total quality management. Part VI focuses on investment, financing, and capital structure decisions in health care institutions and also in large multifacility systems. The last part summarizes major strategies for success in the 1990s, future policy alternatives, and suggests a number of alternative roads to universal entitlement and national health care reform. As Eastaugh suggests in this book, Our health system faces . . . immense opportunity and danger in a reformation on four fronts: access, efficiency, effectiveness, and quality of life. The challenge for providers and managers during this period of unparalleled opportunity is to win a clear victory on all four fronts, and not erode either access or quality in the name of efficiency. The range of coverage in Health Care Finance is extremely wide and detailed--making it essential and useful reading for health care professionals and students alike.

STEVEN R. EASTAUGH is Professor of Health Economics and Finance at George Washington University. The winner of numerous awards, including the American College of Healthcare Executives Edgar Hayhow Award, Eastaugh has published widely in the areas of health care finance and economics. His companion volume, Health Economics: Efficiency, Quality, and Equity, will also be issued by Auburn House in 1992.

Preface Managerial Concerns for Payers and Providers Payment Incentives, Provider behavior, and the Need for Better Cost Management Hospital Accounting, Purchasing, and Product Specialization Access to Long-Term Care and Prepaid Managed Care HMOs, PPOs, and Competition Health Plans Long-Term Care: Issues and Options Strategy Selection, Market Analysis, Diversification, and Pricing Diversification for the Single Hospital Marketing, Pricing, and Specialization Managing Physicians, Medical Schools, and Teaching Hospitals Paying the Doctor Graduate Medical Education and the Teaching Hospital Quality Assurance and Productivity Control Hospital Productivity: Managing Cost Reductions Without Harm to Quality of Access Incentives for Productivity Improvement Quality Measurement, Value Shopping, and the Deming Method Investment, Financing, and Capital-Structure Decisions Tax-exempt and For-Profit Multihospital Systems Evaluation of Financing Alternatives Access to Capital and Debt Financing The Bumpy Road Ahead Future Policy Options: What Form Could Universal Entitlement Take? Author Index Subject Index