Healthcare Finance & Operations Flashcards
7 cards from real CPE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Healthcare Finance & Operations flashcards as text
A hospital's accounts receivable days outstanding increases from 45 to 68 days. Which action most directly addresses this operational problem?
Answer: Accelerating charge capture and claims submission
Faster charge capture and claims submission directly shortens the revenue cycle and reduces days in accounts receivable.
Under a global capitation contract, a physician executive's primary financial risk management strategy should be to:
Answer: Control total cost of care through utilization management
Under capitation, the health system receives a fixed payment per member, so controlling utilization and total cost is the essential financial strategy.
Which financial metric best measures a hospital's ability to service its long-term debt obligations?
Answer: Debt service coverage ratio
The debt service coverage ratio compares operating income to annual debt payments, directly measuring capacity to meet long-term obligations.
A medical group is evaluating whether to bring lab services in-house versus continuing to outsource. This analysis is best performed using:
Answer: Break-even analysis comparing fixed/variable costs at projected volume
Break-even analysis identifies the volume at which in-house costs equal outsourcing costs, informing the make-or-buy decision.
Medicare's Two-Midnight Rule primarily affects which type of hospital reimbursement?
Answer: Inpatient vs. observation status classification
The Two-Midnight Rule requires a physician to expect a patient to need care spanning two midnights for inpatient admission to be appropriate under Medicare.
When a hospital negotiates a carve-out with a commercial payer, it means:
Answer: Certain high-cost services are excluded from the base contract and reimbursed separately
A carve-out removes specific services (e.g., implants, cancer drugs) from the global rate so they can be reimbursed at actual cost or a separate fee schedule.
An organization's contribution margin per case is $1,200 and fixed costs are $600,000. What is the break-even volume?
Answer: 500 cases
$600,000 fixed costs ÷ $1,200 contribution margin = 500 cases needed to break even.