This textbook is designed for students preparing as advanced practice clinicians, including APRNs, DNPs, DPTs, DOTs, and physician assistants. The book covers both health policy issues and practice financial management issues and is organized into two main parts. The first focuses on macro issues in healthcare finance. The second concentrates on healthcare financing management and new to the second edition, includes coverage of the role of the consumer as a payer and as a participant in ambulatory care. Case studies included with each section have been updated in the new edition. This book is suitable for healthcare finance courses in the curriculum for MSN and DNP programs and also for schools of social work, medicine, occupational, and physical therapy.

Section One : Paying for healthcare : overviews and models -- 1. Introduction to healthcare finance -- What do healthcare providers need to know about financial and financial policy? -- Characteristics of financial systems in healthcare-the social compact -- Health or healthcare-the social goal and the financial objective -- The social compact and information technologies -- 2. Models of healthcare finance -- The household as a central stakeholder in healthcare -- The stakeholders in all health-financing models -- Essential approaches to healthcare financing -- Financial flows in healthcare systems -- Section one case study: The island nation of tekram -- Section two: Paying for healthcare: goals and strategies -- 3. Health insurance in public and private markets -- The nature o frisk -- Estimating risk in health insurance -- Managing casts as a risk-control strategy -- The budget approach to health insurance -- Risk control strategies in health insurance -- Information systems in risk management -- 4. Healthcare system strategy and finance -- Goal setting in the U.S. healthcare system -- The relationship between goals and financial strategy -- Goals, strategy, and finance in the U.S. healthcare system -- Strategic dilemmas in U.S> healthcare -- Section two case study: the prisoner's dilemma -- Section three: Managing healthcare: incentives and costs -- 5. Financial management in healthcare markets -- Financial incentives int eh U.S. healthcare market -- Healthcare financial management strategies as a response to market incentives -- The linkage between healthcare financial management and operations management -- The organizational financial plan -- 6. Practice costs and cost-finding -- Cost behavior in ambulatory care practices -- Two types of cost analysis -- Costing systems useful to ambulatory care practices -- The organizational and policy uses of cost data -- Section three case study: Homegrown healthcare inc. a rural accountable care organization -- Section: managing healthcare: revenue and budgeting -- 7. Revenue planning and management -- Managing revenue -- Managing the payer-to-provider process -- Revenue optimization and account evaluation -- Account negotiation strategies -- 8. Budgeting for ambulatory care practices -- Strategic planning, budgeting, and budget evaluation -- Constructing budgets: a focus on revenue and expense -- Expense budgets and categories -- Building a chart of accounts -- Evaluating a budget performance: goal achievement -- Section four case study: new day health and associated -- Section five: managing healthcare: financial strategy and reporting -- 9. Capitalization structure and investment planning -- Planning capital structure for the practice -- The effect of capitalization structure on performance -- The world of taxation and its effects on capital -- Risk and capitalization -- Capital structure planning for the primary care provider -- 10. Basic financial statements -- the four basic financial reports -- Putting the financial picture together: the interaction of the income and expense statement and the balance sheet -- Understanding cash flow and its effect of the balance sheet -- The financial position of a practice: Financial statements and ratios -- Financial reports required by public payers -- Section six: projecting and evaluating financial performance -- 11. Financial performance evaluation -- Financial ratios as an analytical and comparative tool -- Ratio categories and their purposes in financial analysis -- Basic ratio relationships and financial performance diagnosis -- 12. Projecting financial performance -- The pro forma financial analysis: purpose and use -- Using evidence to build the pro forma analysis -- Building the pro forma financial plan -- Financial barriers and supports: SWOT analysis -- Financial interrelationships and financial strategy -- Section six case study: provider financial goals and management -- Section seven: healthcare projects-financial planning and management -- 13. Project planning and budgeting -- Project financial planning and budgeting -- Accounting for project expenses -- Integrated project management plan and team -- Projected financial management -- 14. Project financing and valuation -- Constructing project financial flows -- Project valuation methods -- Impact of financial environment of projects -- Project financial evaluation -- Section seven case study: general practice affiliates emir project -- Section eight: ambulatory healthcare financing and the consumer -- 15. The consumer's role in ambulatory healthcare financing -- Introduction -- Planning and facilitating consumer engagement with primary health costs -- Implementing effective practice engagement with consumer's financial concerns -- Evaluating the workflow process and institutionalizing consumer cost education in the practice -- 16. Financial aspects of ambulatory care for aging and chronically ill individuals -- Financial dimensions of providing primary care for aging and chronically ill individuals -- Strategic financial planning for primary care of the older adult -- Informal caregivers -- Financial concerns for palliative care in the primary care practice -- Section eight case study: general practice affiliates patient and caregiver financial challenges -- 17. Concluding thoughts on financing primary healthcare -- Emerging trends affecting healthcare financing -- The roles of macro and micro financing in responding to these trends.