The Procedure Cost Analysis & Reporting engagement includes three phases and typically takes between 12-16 weeks to complete. Three site visits by HCI consultants are included in this study. The three phases are as follows:
- Development of Activity Based Cost by Procedure
- Validation of Procedure Cost
- Creation of the Procedure Cost Reporting Tool
A more detailed outline of each of these phases is explained below:
Phase I - Development of Activity Based Cost by Procedure - Field Work 1-2 daysThe general process is as follows:
- First, HCI consultants meet with hospital management to review the engagement.
- Existing hospital charges are reviewed for completeness and accuracy with regard to the procedural cost analysis process, and recommendations for changes may be made.
- HCI consultants meet with departmental directors and other key personnel in order to discuss existing patient charges, direct care personnel, and fixed and variable departmental expenses.
- HCI performs a comprehensive review of the resources used in providing services. These include labor, materials, and related departmental expenses.
- Allocated costs at both the departmental and hospital level are developed.
- Procedural "Cost Sheets" are created for items that comprise the largest amounts of revenue and volume (90-95% of the total) for each department. You can see a sample cost sheet here.
- Our consultants review these Cost Sheets with department directors, revising data when necessary.
- We develop procedure cost standards for each department. (We also document our methodologies and rationales to ensure accuracy.)
Phase III - Validation of Procedure Cost
There are two steps taken here:
- We use charge item volumes to verify that the earned standard costs appear accurate in comparison to actual costs from the General Ledger system. This is essentially a quality-control step.
- HCI revises procedural costs where needed.
Phase IV - Procedure Cost Reporting Development - Field Work 1 day
- Work with facility information services administrators to define the accumulated database file that will be set up in the HIS system and accessed by the PCR program.
- Set up and complete the facility tables required by Microsoft Access identifying physician, specialists and clinic codes, financial class and payor codes, service codes, and any other optional demographic codes.
- Work with the finance administration to determine the most appropriate manner of estimating payment and discount calculations on unpaid accounts, and incorporate this procedure into the program.
- Create the Procedure Cost Reporting database utilizing the cost standards developed in the Procedure Cost Analysis phase and the information obtained from the facility information system.
- Compare the Procedure Cost Analysis cost data to actual operating expenses and identify any variances.
- Provide detailed instructions that outline the steps needed to periodically update facility information and the database.
- Meet with facility Administrative personnel to review standard reports and results. Conduct a training session with facility representatives responsible for the Procedure Cost Reporting database.
