Price-Transparency and Cost Accounting

PubMed Central

Eakin, Cynthia; Fischer, Katrina

2015-01-01

Health care reform is directed toward improving access and quality while containing costs. An essential part of this is improvement of pricing models to more accurately reflect the costs of providing care. Transparent prices that reflect costs are necessary to signal information to consumers and producers. This information is central in a consumer-driven marketplace. The rapid increase in high deductible insurance and other forms of cost sharing incentivizes the search for price information. The organizational ability to measure costs across a cycle of care is an integral component of creating value, and will play a greater role as reimbursements transition to episode-based care, value-based purchasing, and accountable care organization models. This article discusses use of activity-based costing (ABC) to better measure the cost of health care. It describes examples of ABC in health care organizations and discusses impediments to adoption in the United States including cultural and institutional barriers. PMID:25862425

76 FR 81295 - Cost Accounting Standards: Cost Accounting Standards 412 and 413-Cost Accounting Standards...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-27

... accounting standards governing measurement, assignment, and allocation of costs to contracts with the United... contracting parties; Measurement of pension costs must be objectively verifiable; Accounting rules must keep... cost accounting that preclude their use for the appropriate measurement, assignment and allocation of...

76 FR 53378 - Cost Accounting Standards: Accounting for Insurance Costs

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-26

... Accounting Standards: Accounting for Insurance Costs AGENCY: Cost Accounting Standards Board (Board), Office... Discontinuation of Rulemaking. SUMMARY: The Office of Federal Procurement Policy (OFPP), Cost Accounting Standards... development of an amendment to Cost Accounting Standard (CAS) 416 regarding the use of the term ``catastrophic...

Determination of chest x-ray cost using activity based costing approach at Penang General Hospital, Malaysia.

PubMed

Atif, Muhammad; Sulaiman, Syed Azhar Syed; Shafie, Asrul Akmal; Saleem, Fahad; Ahmad, Nafees

2012-01-01

Activity based costing (ABC) is an approach to get insight of true costs and to solve accounting problems. It provides more accurate information on product cost than conventional accounting system. The purpose of this study was to identify detailed resource consumption for chest x-ray procedure. Human resource cost was calculated by multiplying the mean time spent by employees doing specific activity to their per-minute salaries. The costs of consumables and clinical equipments were obtained from the procurement section of the Radiology Department. The cost of the building was calculated by multiplying the area of space used by the chest X-ray facility with the unit cost of public building department. Moreover, straight-line deprecation with a discount rate of 3% was assumed for calculation of equivalent annual costs for building and machines. Cost of electricity was calculated by multiplying number of kilo watts used by electrical appliance in the year 2010 with electricity tariff for Malaysian commercial consumers (MYR 0.31 per kWh). Five activities were identified which were required to develop one chest X-ray film. Human resource, capital, consumable and electricity cost was MYR 1.48, MYR 1.98, MYR 2.15 and MYR 0.04, respectively. Total cost of single chest X-ray was MYR 5.65 (USD 1.75). By applying ABC approach, we can have more detailed and precise estimate of cost for specific activity or service. Choice of repeating a chest X-ray can be based on our findings, when cost is a limiting factor.

Time-driven activity-based costing.

PubMed

Kaplan, Robert S; Anderson, Steven R

2004-11-01

In the classroom, activity-based costing (ABC) looks like a great way to manage a company's limited resources. But executives who have tried to implement ABC in their organizations on any significant scale have often abandoned the attempt in the face of rising costs and employee irritation. They should try again, because a new approach sidesteps the difficulties associated with large-scale ABC implementation. In the revised model, managers estimate the resource demands imposed by each transaction, product, or customer, rather than relying on time-consuming and costly employee surveys. This method is simpler since it requires, for each group of resources, estimates of only two parameters: how much it costs per time unit to supply resources to the business's activities (the total overhead expenditure of a department divided by the total number of minutes of employee time available) and how much time it takes to carry out one unit of each kind of activity (as estimated or observed by the manager). This approach also overcomes a serious technical problem associated with employee surveys: the fact that, when asked to estimate time spent on activities, employees invariably report percentages that add up to 100. Under the new system, managers take into account time that is idle or unused. Armed with the data, managers then construct time equations, a new feature that enables the model to reflect the complexity of real-world operations by showing how specific order, customer, and activity characteristics cause processing times to vary. This Tool Kit uses concrete examples to demonstrate how managers can obtain meaningful cost and profitability information, quickly and inexpensively. Rather than endlessly updating and maintaining ABC data,they can now spend their time addressing the deficiencies the model reveals: inefficient processes, unprofitable products and customers, and excess capacity.

48 CFR 9904.406 - Cost accounting standard-cost accounting period.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard-cost accounting period. 9904.406 Section 9904.406 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT...

The use of the transition cost accounting system in health services research

PubMed Central

Azoulay, Arik; Doris, Nadine M; Filion, Kristian B; Caron, Joanna; Pilote, Louise; Eisenberg, Mark J

2007-01-01

The Transition cost accounting system integrates clinical, resource utilization, and financial information and is currently being used by several hospitals in Canada and the United States to calculate the costs of patient care. Our objectives were to review the use of hospital-based cost accounting systems to measure costs of treatment and discuss potential use of the Transition cost accounting system in health services research. Such systems provide internal reports to administrators for formulating major policies and strategic plans for future activities. Our review suggests that the Transition cost accounting information system may useful for estimating in-hospital costs of treatment. PMID:17686148

The use of the transition cost accounting system in health services research.

PubMed

Azoulay, Arik; Doris, Nadine M; Filion, Kristian B; Caron, Joanna; Pilote, Louise; Eisenberg, Mark J

2007-08-08

The Transition cost accounting system integrates clinical, resource utilization, and financial information and is currently being used by several hospitals in Canada and the United States to calculate the costs of patient care. Our objectives were to review the use of hospital-based cost accounting systems to measure costs of treatment and discuss potential use of the Transition cost accounting system in health services research. Such systems provide internal reports to administrators for formulating major policies and strategic plans for future activities. Our review suggests that the Transition cost accounting information system may useful for estimating in-hospital costs of treatment.

Bridging the gap between finance and clinical operations with activity-based cost management.

PubMed

Storfjell, J L; Jessup, S

1996-12-01

Activity-based cost management (ABCM) is an exciting management tool that links financial information with operations. By determining the costs of specific activities and processes, nurse managers accurately determine true costs of services more accurately than traditional cost accounting methods, and then can target processes for improvement and monitor them for change and improvement. The authors describe the ABCM process applied to nursing management situations.

Activities identification for activity-based cost/management applications of the diagnostics outpatient procedures.

PubMed

Alrashdan, Abdalla; Momani, Amer; Ababneh, Tamador

2012-01-01

One of the most challenging problems facing healthcare providers is to determine the actual cost for their procedures, which is important for internal accounting and price justification to insurers. The objective of this paper is to find suitable categories to identify the diagnostic outpatient medical procedures and translate them from functional orientation to process orientation. A hierarchal task tree is developed based on a classification schema of procedural activities. Each procedure is seen as a process consisting of a number of activities. This makes a powerful foundation for activity-based cost/management implementation and provides enough information to discover the value-added and non-value-added activities that assist in process improvement and eventually may lead to cost reduction. Work measurement techniques are used to identify the standard time of each activity at the lowest level of the task tree. A real case study at a private hospital is presented to demonstrate the proposed methodology. © 2011 National Association for Healthcare Quality.

Benchmarking in pathology: development of an activity-based costing model.

PubMed

Burnett, Leslie; Wilson, Roger; Pfeffer, Sally; Lowry, John

2012-12-01

Benchmarking in Pathology (BiP) allows pathology laboratories to determine the unit cost of all laboratory tests and procedures, and also provides organisational productivity indices allowing comparisons of performance with other BiP participants. We describe 14 years of progressive enhancement to a BiP program, including the implementation of 'avoidable costs' as the accounting basis for allocation of costs rather than previous approaches using 'total costs'. A hierarchical tree-structured activity-based costing model distributes 'avoidable costs' attributable to the pathology activities component of a pathology laboratory operation. The hierarchical tree model permits costs to be allocated across multiple laboratory sites and organisational structures. This has enabled benchmarking on a number of levels, including test profiles and non-testing related workload activities. The development of methods for dealing with variable cost inputs, allocation of indirect costs using imputation techniques, panels of tests, and blood-bank record keeping, have been successfully integrated into the costing model. A variety of laboratory management reports are produced, including the 'cost per test' of each pathology 'test' output. Benchmarking comparisons may be undertaken at any and all of the 'cost per test' and 'cost per Benchmarking Complexity Unit' level, 'discipline/department' (sub-specialty) level, or overall laboratory/site and organisational levels. We have completed development of a national BiP program. An activity-based costing methodology based on avoidable costs overcomes many problems of previous benchmarking studies based on total costs. The use of benchmarking complexity adjustment permits correction for varying test-mix and diagnostic complexity between laboratories. Use of iterative communication strategies with program participants can overcome many obstacles and lead to innovations.

Cost accounting in radiation oncology: a computer-based model for reimbursement.

PubMed

Perez, C A; Kobeissi, B; Smith, B D; Fox, S; Grigsby, P W; Purdy, J A; Procter, H D; Wasserman, T H

1993-04-02

The skyrocketing cost of medical care in the United States has resulted in multiple efforts in cost containment. The present work offers a rational computer-based cost accounting approach to determine the actual use of resources in providing a specific service in a radiation oncology center. A procedure-level cost accounting system was developed by using recorded information on actual time and effort spent by individual staff members performing various radiation oncology procedures, and analyzing direct and indirect costs related to staffing (labor), facilities and equipment, supplies, etc. Expenditures were classified as direct or indirect and fixed or variable. A relative value unit was generated to allocate specific cost factors to each procedure. Different costs per procedure were identified according to complexity. Whereas there was no significant difference in the treatment time between low-energy (4 and 6 MV) or high-energy (18 MV) accelerators, there were significantly higher costs identified in the operation of a high-energy linear accelerator, a reflection of initial equipment investment, quality assurance and calibration procedures, maintenance costs, service contract, and replacement parts. Utilization of resources was related to the complexity of the procedures performed and whether the treatments were delivered to inpatients or outpatients. In analyzing time motion for physicians and other staff, it was apparent that a greater effort must be made to train the staff to accurately record all times involved in a given procedure, and it is strongly recommended that each institution perform its own time motion studies to more accurately determine operating costs. Sixty-six percent of our facility's global costs were for labor, 20% for other operating expenses, 10% for space, and 4% for equipment. Significant differences were noted in the cost allocation for professional or technical functions, as labor, space, and equipment costs are higher in the latter

Cost Accounting for Decision Makers.

ERIC Educational Resources Information Center

Kaneklides, Ann L.

1985-01-01

Underscores the importance of informed decision making through accurate anticipation of cost incurrence in light of changing economic and environmental conditions. Explains the concepts of cost accounting, full allocation of costs, the selection of an allocation base, the allocation of indirect costs, depreciation, and implications for community…

Extending the Aircraft Availability Model to a Constrained Depot Environment Using Activity-Based Costing and the Theory of Constraints

DTIC Science & Technology

2004-06-01

Overselling Activity-Based Concepts,” Management Accounting , September 1992:26-35. Kaplan, Robert S . and Robin Cooper. Cost & Effect. Using... Accounting .............................................14 Increasing Need for Cost Information...15 Implications for Costs Accounting Systems ....................................................17 Section 2 – Costs and Resources

Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique.

PubMed

Bayati, Mohsen; Mahboub Ahari, Alireza; Badakhshan, Abbas; Gholipour, Mahin; Joulaei, Hassan

2015-10-01

Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs) have been the main motivations to define and implement this study. The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC) as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs). We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios. Total annual cost of MRI activity center (AC) was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs. As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be implemented in MRI centers. With the settlement of a reliable cost accounting system

The business of radiology: cost accounting.

PubMed

Camponovo, Ernest J

2004-08-01

Radiology practices confront questions of resource allocation every day. Unfortunately, practices frequently fail to adequately analyze revenues and expenses, which are at the heart of success or failure in any business endeavor. Cost allocation problems permeate nearly all aspects of cost analysis and accumulation and exist throughout all types of private-sector and public-sector organizations. "Managerial" or "cost" accounting is the discipline concerned with measuring and assigning the costs of delivering services or producing products. In contrast to financial accounting, management accounting produces relevant information for internal decision making and in general is designed to answer a firm's specific operational questions. Because costs play such a critical role in deriving and planning for revenues and profits, managerial accounting is in large part devoted to measuring and accumulating costs with the aims of control and continuous cost reduction. Because radiologists' salaries are at record highs, when accounting for a practice's clinical activities, such as the provision of mammography services, some allocation of radiologist costs themselves must be made, or the practice will not be able to achieve its goal of efficient allocation of resources. Whatever cost-accounting method is used should be specific enough to allow the differentiation of costs to as detailed a level as necessary for the strategic decision at hand. It is imperative that a practice use some rational method to gather and analyze costs and that management then use these data in decision making. Successful practices will be those most aware of their costs and the minimum acceptable reimbursements necessary for their success.

Using activity-based costing to track resource use in group practices.

PubMed

Zeller, T L; Siegel, G; Kaciuba, G; Lau, A H

1999-09-01

Research shows that understanding how resources are consumed can help group practices control costs. An American Academy of Orthopaedic Surgeons study used an activity-based costing (ABC) system to measure how resources are consumed in providing medical services. Teams of accounting professors observed 18 diverse orthopedic surgery practices. The researchers identified 17 resource-consuming business processes performed by nonphysician office staff. They measured resource consumption by assigning costs to each process according to how much time is spent on related work activities. When group practices understand how their resources are being consumed, they can reduce costs and optimize revenues by making adjustments in how administrative and clinical staff work.

Activity-based costing: a practical model for cost calculation in radiotherapy.

PubMed

Lievens, Yolande; van den Bogaert, Walter; Kesteloot, Katrien

2003-10-01

The activity-based costing method was used to compute radiotherapy costs. This report describes the model developed, the calculated costs, and possible applications for the Leuven radiotherapy department. Activity-based costing is an advanced cost calculation technique that allocates resource costs to products based on activity consumption. In the Leuven model, a complex allocation principle with a large diversity of cost drivers was avoided by introducing an extra allocation step between activity groups and activities. A straightforward principle of time consumption, weighed by some factors of treatment complexity, was used. The model was developed in an iterative way, progressively defining the constituting components (costs, activities, products, and cost drivers). Radiotherapy costs are predominantly determined by personnel and equipment cost. Treatment-related activities consume the greatest proportion of the resource costs, with treatment delivery the most important component. This translates into products that have a prolonged total or daily treatment time being the most costly. The model was also used to illustrate the impact of changes in resource costs and in practice patterns. The presented activity-based costing model is a practical tool to evaluate the actual cost structure of a radiotherapy department and to evaluate possible resource or practice changes.

Library Labor Cost Accounting System.

ERIC Educational Resources Information Center

Du Bois, Dan

The Library Labor Cost Accounting System will provide visibility on current costs of manually processing library materials, at each campus as well as system-wide. The scope of the study includes the following: (1) 100 individual activities, grouped into 14 functional areas, e.g., Ordering, Receiving; and into 3 major operations: Acquisitions,…

Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique

PubMed Central

Bayati, Mohsen; Mahboub Ahari, Alireza; Badakhshan, Abbas; Gholipour, Mahin; Joulaei, Hassan

2015-01-01

Background: Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs) have been the main motivations to define and implement this study. Objectives: The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC) as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs). Materials and Methods: We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios. Results: Total annual cost of MRI activity center (AC) was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs. Conclusion: As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be implemented in MRI

Principles and methods of managerial cost-accounting systems.

PubMed

Suver, J D; Cooper, J C

1988-01-01

An introduction to cost-accounting systems for pharmacy managers is provided; terms are defined and examples of specific applications are given. Cost-accounting systems determine, record, and report the resources consumed in providing services. An effective cost-accounting system must provide the information needed for both internal and external reports. In accounting terms, cost is the value given up to secure an asset. In determining how volumes of activity affect costs, fixed costs and variable costs are calculated; applications include pricing strategies, cost determinations, and break-even analysis. Also discussed are the concepts of direct and indirect costs, opportunity costs, and incremental and sunk costs. For most pharmacy department services, process costing, an accounting of intermediate outputs and homogeneous units, is used; in determining the full cost of providing a product or service (e.g., patient stay), job-order costing is used. Development of work-performance standards is necessary for monitoring productivity and determining product costs. In allocating pharmacy department costs, a ratio of costs to charges can be used; this method is convenient, but microcosting (specific identification of the costs of products) is more accurate. Pharmacy managers can use cost-accounting systems to evaluate the pharmacy's strategies, policies, and services and to improve budgets and reports.

Costing improvement of remanufacturing crankshaft by integrating Mahalanobis-Taguchi System and Activity based Costing

NASA Astrophysics Data System (ADS)

Abu, M. Y.; Nor, E. E. Mohd; Rahman, M. S. Abd

2018-04-01

Integration between quality and costing system is very crucial in order to achieve an accurate product cost and profit. Current practice by most of remanufacturers, there are still lacking on optimization during the remanufacturing process which contributed to incorrect variables consideration to the costing system. Meanwhile, traditional costing accounting being practice has distortion in the cost unit which lead to inaccurate cost of product. The aim of this work is to identify the critical and non-critical variables during remanufacturing process using Mahalanobis-Taguchi System and simultaneously estimate the cost using Activity Based Costing method. The orthogonal array was applied to indicate the contribution of variables in the factorial effect graph and the critical variables were considered with overhead costs that are actually demanding the activities. This work improved the quality inspection together with costing system to produce an accurate profitability information. As a result, the cost per unit of remanufactured crankshaft of MAN engine model with 5 critical crankpins is MYR609.50 while Detroit engine model with 4 critical crankpins is MYR1254.80. The significant of output demonstrated through promoting green by reducing re-melting process of damaged parts to ensure consistent benefit of return cores.

Implementing Replacement Cost Accounting

DTIC Science & Technology

1976-12-01

cost accounting Clickener, John Ross Monterey, California. Naval Postgraduate School http://hdl.handle.net/10945/17810 Downloaded from NPS Archive...Calhoun IMPLEMENTING REPLACEMENT COST ACCOUNTING John Ross CHckener NAVAL POSTGRADUATE SCHOOL Monterey, California THESIS IMPLEMENTING REPLACEMENT COST ...Implementing Replacement Cost Accounting 7. AUTHORS John Ross Clickener READ INSTRUCTIONS BEFORE COMPLETING FORM 3. RECIPIENT’S CATALOG NUMBER 9. TYRE OF

75 FR 25981 - Cost Accounting Standards: Harmonization of Cost Accounting Standards 412 and 413 With the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-10

...), invites public comments concerning the harmonization of Cost Accounting Standards 412 and 413 with the... cost that is based on currently accrued benefits that have been valued using corporate bond rates... that avoid undue cost or contribution volatility. The Board agrees with the public comments that since...

Cost Impact Assessment of Cost Accounting Practice Changes.

DTIC Science & Technology

1980-09-01

7A0-A092 434 NAVAL POSTGRADUATE SCHOOL MONTEREY CA F/0 5/1 COST IMPACT ASSESSMENT OF COST ACCOUNTING PRACTICE CHANGES.(UlNL S EP 80 J S ANDERSONUN CL...MNGER 4. TITLE (mod Su&CEI* I. Tyss[ of REPORT & 11.1110 Coyenea Cost Impact Assessment of Cost Accounting Master’ s Thesis; September Practice Chages...thesis represents the results of research on cost impact assessment of cost accounting practice changes to Cost Accounting Standards-covered contracts. The

48 CFR 9904.411 - Cost accounting standard-accounting for acquisition costs of material.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard-accounting for acquisition costs of material. 9904.411 Section 9904.411 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND...

Filmless versus film-based systems in radiographic examination costs: an activity-based costing method.

PubMed

Muto, Hiroshi; Tani, Yuji; Suzuki, Shigemasa; Yokooka, Yuki; Abe, Tamotsu; Sase, Yuji; Terashita, Takayoshi; Ogasawara, Katsuhiko

2011-09-30

Since the shift from a radiographic film-based system to that of a filmless system, the change in radiographic examination costs and costs structure have been undetermined. The activity-based costing (ABC) method measures the cost and performance of activities, resources, and cost objects. The purpose of this study is to identify the cost structure of a radiographic examination comparing a filmless system to that of a film-based system using the ABC method. We calculated the costs of radiographic examinations for both a filmless and a film-based system, and assessed the costs or cost components by simulating radiographic examinations in a health clinic. The cost objects of the radiographic examinations included lumbar (six views), knee (three views), wrist (two views), and other. Indirect costs were allocated to cost objects using the ABC method. The costs of a radiographic examination using a filmless system are as follows: lumbar 2,085 yen; knee 1,599 yen; wrist 1,165 yen; and other 1,641 yen. The costs for a film-based system are: lumbar 3,407 yen; knee 2,257 yen; wrist 1,602 yen; and other 2,521 yen. The primary activities were "calling patient," "explanation of scan," "take photographs," and "aftercare" for both filmless and film-based systems. The cost of these activities cost represented 36.0% of the total cost for a filmless system and 23.6% of a film-based system. The costs of radiographic examinations using a filmless system and a film-based system were calculated using the ABC method. Our results provide clear evidence that the filmless system is more effective than the film-based system in providing greater value services directly to patients.

Filmless versus film-based systems in radiographic examination costs: an activity-based costing method

PubMed Central

2011-01-01

Background Since the shift from a radiographic film-based system to that of a filmless system, the change in radiographic examination costs and costs structure have been undetermined. The activity-based costing (ABC) method measures the cost and performance of activities, resources, and cost objects. The purpose of this study is to identify the cost structure of a radiographic examination comparing a filmless system to that of a film-based system using the ABC method. Methods We calculated the costs of radiographic examinations for both a filmless and a film-based system, and assessed the costs or cost components by simulating radiographic examinations in a health clinic. The cost objects of the radiographic examinations included lumbar (six views), knee (three views), wrist (two views), and other. Indirect costs were allocated to cost objects using the ABC method. Results The costs of a radiographic examination using a filmless system are as follows: lumbar 2,085 yen; knee 1,599 yen; wrist 1,165 yen; and other 1,641 yen. The costs for a film-based system are: lumbar 3,407 yen; knee 2,257 yen; wrist 1,602 yen; and other 2,521 yen. The primary activities were "calling patient," "explanation of scan," "take photographs," and "aftercare" for both filmless and film-based systems. The cost of these activities cost represented 36.0% of the total cost for a filmless system and 23.6% of a film-based system. Conclusions The costs of radiographic examinations using a filmless system and a film-based system were calculated using the ABC method. Our results provide clear evidence that the filmless system is more effective than the film-based system in providing greater value services directly to patients. PMID:21961846

The Role of Activity Based Costing (ABC) in Educational Support Services: A White Paper.

ERIC Educational Resources Information Center

Edds, Daniel B.

Many front-line managers who are assuming more financial responsibility for their organizations find traditional cost accounting inadequate for their needs and are turning to Activity Based Costing (ABC). ABC is not a financial reporting system to serve the needs of regulatory agencies, but a tool that tracks costs from the general ledger…

Allocating physicians' overhead costs to services: an econometric/accounting-activity based-approach.

PubMed

Peden, Al; Baker, Judith J

2002-01-01

Using the optimizing properties of econometric analysis, this study analyzes how physician overhead costs (OC) can be allocated to multiple activities to maximize precision in reimbursing the costs of services. Drawing on work by Leibenstein and Friedman, the analysis also shows that allocating OC to multiple activities unbiased by revenue requires controlling for revenue when making the estimates. Further econometric analysis shows that it is possible to save about 10 percent of OC by paying only for those that are necessary.

A user-friendly approach to cost accounting in laboratory animal facilities.

PubMed

Baker, David G

2011-08-19

Cost accounting is an essential management activity for laboratory animal facility management. In this report, the author describes basic principles of cost accounting and outlines steps for carrying out cost accounting in laboratory animal facilities. Methods of post hoc cost accounting analysis for maximizing the efficiency of facility operations are also described.

[Cost analysis of home care with activity-based costing (ABC)].

PubMed

Lee, Su-Jeong

2004-10-01

This study was carried out to substantiate the application process of activity-based costing on the current cost of hospital home care (HHC) service. The study materials were documents, 120 client charts, health insurance demand bills, salary of 215 HHC nurses, operating expense, 6 HHC agencies, and 31 HHC nurses. The research was carried out by analyzing the HHC activities and then collecting labor and operating expenses. For resource drivers, HHC activity performance time and workload were studied. For activity drivers, the number of HHC activity performances and the activity number of visits were studied. The HHC activities were classified into 70 activities. In resource, the labor cost was 245 won per minute, operating cost was 9,570 won per visit and traffic expense was an average of 12,750 won. In resource drivers, education and training had the longest time of 67 minutes. Average length of performance for activities was 13.7 minutes. The workload was applied as a relative value. The average cost of HHC was 62,741 won and the cost ranged from 55,560 won to 74,016 won. The fixed base rate for a visit in the current HHC medical fee should be increased. Exclusion from the current fee structure or flexible operation of traveling expenses should be reviewed.

A simulation model of hospital management based on cost accounting analysis according to disease.

PubMed

Tanaka, Koji; Sato, Junzo; Guo, Jinqiu; Takada, Akira; Yoshihara, Hiroyuki

2004-12-01

Since a little before 2000, hospital cost accounting has been increasingly performed at Japanese national university hospitals. At Kumamoto University Hospital, for instance, departmental costs have been analyzed since 2000. And, since 2003, the cost balance has been obtained according to certain diseases for the preparation of Diagnosis-Related Groups and Prospective Payment System. On the basis of these experiences, we have constructed a simulation model of hospital management. This program has worked correctly at repeated trials and with satisfactory speed. Although there has been room for improvement of detailed accounts and cost accounting engine, the basic model has proved satisfactory. We have constructed a hospital management model based on the financial data of an existing hospital. We will later improve this program from the viewpoint of construction and using more various data of hospital management. A prospective outlook may be obtained for the practical application of this hospital management model.

Activity-Based Costing in the After Press Services Industry

NASA Astrophysics Data System (ADS)

Shevasuthisilp, Suntichai; Punsathitwong, Kosum

2009-10-01

This research was conducted to apply activity-based costing (ABC) in an after press service company in Chiang Mai province, Thailand. The company produces all of its products by one-stop service (such as coating, stitching, binding, die cutting, and gluing). All products are made to order, and have different sizes and patterns. A strategy of low price is used to compete in the marketplace. After cost analysis, the study found that the company has high overhead (36.5% of total cost). The company's problem is its use of traditional cost accounting, which has low accuracy in assigning overhead costs. If management uses this information when pricing customer orders, losses may occur because real production costs may be higher than the selling price. Therefore, the application of ABC in cost analysis can help executives receive accurate cost information; establish a sound pricing strategy; and improve the manufacturing process by determining work activities which have excessively high production costs. According to this research, 6 out of 56 items had a production cost higher than the selling price, leading to losses of 123,923 baht per year. Methods used to solve this problem were: reducing production costs; establishing suitable prices; and creating a sales promotion with lower prices for customers whose orders include processes involving unused capacity. These actions will increase overall sales of the company, and allow more efficient use of its machinery.

Cost Accounting and Accountability for Early Education Programs for Handicapped Children.

ERIC Educational Resources Information Center

Gingold, William

The paper offers some basic information for making decisions about allocating and accounting for resources provided to young handicapped children. Sections address the following topics: reasons for costing, audiences for cost accounting and accountability information, and a process for cost accounting and accountability (defining cost categories,…

76 FR 61660 - Cost Accounting Standards: Clarification of the Exemption From Cost Accounting Standards for Firm...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-05

... Accounting Standards: Clarification of the Exemption From Cost Accounting Standards for Firm-Fixed-Price... Management and Budget (OMB), Office of Federal Procurement Policy, Cost Accounting Standards Board. ACTION: Proposed rule. SUMMARY: The Office of Federal Procurement Policy (OFPP), Cost Accounting Standards (CAS...

77 FR 69422 - Cost Accounting Standards: Revision of the Exemption From Cost Accounting Standards for Contracts...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-19

... Accounting Standards: Revision of the Exemption From Cost Accounting Standards for Contracts and Subcontracts... Federal Procurement Policy (OFPP), Cost Accounting Standards (CAS) Board. ACTION: Proposed rule. SUMMARY... J. M. Wong, Director, Cost Accounting Standards Board (telephone: 202-395-6805; email: Raymond_wong...

Applying activity-based costing in long-term care.

PubMed

Wodchis, W P

1998-01-01

As greater numbers of the elderly use health services, and as health care costs climb, effective financial tracking is essential. Cost management in health care can benefit if costs are linked to the care activities where they are incurred. Activity-based costing (ABC) provides a useful approach. The framework aligns costs (inputs), through activities (process), to outputs and outcomes. It allocates costs based on client care needs rather than management structure. The ABC framework was tested in a residential care facility and in supportive housing apartments. The results demonstrate the feasibility and advantages of ABC for long term care agencies, including community-based care.

76 FR 49365 - Cost Accounting Standards: Elimination of the Exemption From Cost Accounting Standards for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-10

... Accounting Standards: Elimination of the Exemption From Cost Accounting Standards for Contracts and...: Office of Management and Budget (OMB), Office of Federal Procurement Policy (OFPP), Cost Accounting... Accounting Standards (CAS) Board, is publishing a final rule to eliminate the exemption from regulations...

Cost accounting for the radiologist.

PubMed

Gentili, Amilcare

2014-05-01

Cost accounting is the branch of managerial accounting that deals with the analysis of the costs of a product or service. This article reviews methods of classifying and allocating costs and relationships among costs, volume, and revenues. Radiology practices need to know the cost of a procedure or service to determine the selling price of a product, bid on contracts, analyze profitability, and facilitate cost control and cost reduction.

Applying activity-based costing to healthcare settings.

PubMed

Canby, J B

1995-02-01

Activity-based costing (ABC) focuses on processes that drive cost. By tracing healthcare activities back to events that generate cost, a more accurate measurement of financial performance is possible. This article uses ABC principles and techniques to determine costs associated with the x-ray process in a midsized outpatient clinic. The article also provides several tips for initiating an ABC cost system for an entire healthcare organization.

Activity-Based Costing Systems for Higher Education.

ERIC Educational Resources Information Center

Day, Dennis H.

1993-01-01

Examines traditional costing models utilized in higher education and pinpoints shortcomings related to proper identification of costs. Describes activity-based costing systems as a superior alternative for cost identification, measurement, and allocation. (MLF)

An activity-based methodology for operations cost analysis

NASA Technical Reports Server (NTRS)

Korsmeyer, David; Bilby, Curt; Frizzell, R. A.

1991-01-01

This report describes an activity-based cost estimation method, proposed for the Space Exploration Initiative (SEI), as an alternative to NASA's traditional mass-based cost estimation method. A case study demonstrates how the activity-based cost estimation technique can be used to identify the operations that have a significant impact on costs over the life cycle of the SEI. The case study yielded an operations cost of $101 billion for the 20-year span of the lunar surface operations for the Option 5a program architecture. In addition, the results indicated that the support and training costs for the missions were the greatest contributors to the annual cost estimates. A cost-sensitivity analysis of the cultural and architectural drivers determined that the length of training and the amount of support associated with the ground support personnel for mission activities are the most significant cost contributors.

Pharmacy component of a hospital end-product cost-accounting system.

PubMed

Smith, J E; Sheaffer, S L; Meyer, G E; Giorgilli, F

1988-04-01

Determination of pharmacy department standard costs for providing drug products to patients at Thomas Jefferson University Hospital in Philadelphia is described. The hospital is implementing a cost-accounting system (CAS) that uses software developed at the New England Medical Center, Boston. The pharmacy identified nine categories of intermediate products on the basis of labor consumption. Standard labor times for each product category are based on measurement or estimation of time for each task in the preparation and distribution of a dose. Variable-labor standard time was determined by adjusting the cumulative time for the tasks to account for nonproductive time and nonroutine activities, and a variable-labor standard cost for each category was calculated. The standard cost per dose included the costs of labor and supplies (variable and fixed) and equipment; this standard cost plus the acquisition cost of a drug line item is the total intermediate product cost. Because the CAS is based on the hospital's patient charges, clinical pharmacy services are excluded. Intermediate products that substantially affect end-product costs (costs per patient case) will be identified for inclusion in CAS reports. The CAS will give a more accurate picture of resource consumption, enabling managers to focus their efforts to improve efficiency and productivity and reduce supply use; it could also improve the accuracy of the budgeting process. The CAS will support hospital administration decisions about marketing end products and department managers' decisions about controlling intermediate-product costs.

School District Program Cost Accounting: An Alternative Approach

ERIC Educational Resources Information Center

Hentschke, Guilbert C.

1975-01-01

Discusses the value for school districts of a program cost accounting system and examines different approaches to generating program cost data, with particular emphasis on the "cost allocation to program system" (CAPS) and the traditional "transaction-based system." (JG)

Activity-Based Costing in the Naval Postgraduate School

DTIC Science & Technology

2015-03-01

SCHOOL ACTIVITY-BASED COSTING MODEL ...29 A. MODELING ISSUES AND LIMITATIONS ..............................................29 B. COST POOL ALLOCATIONS TO PRODUCTION DEPARTMENTS...Activity, Monterey Bay (NSAMB). As such, MWR is not included in the costing model . Similarly, the cost of student salaries and benefits are not

48 CFR 30.101 - Cost Accounting Standards.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Cost Accounting Standards... CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION General 30.101 Cost Accounting Standards. (a... Accounting Standards (CAS) and to disclose in writing and follow consistently their cost accounting practices...

48 CFR 30.101 - Cost Accounting Standards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost Accounting Standards... CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION General 30.101 Cost Accounting Standards. (a... Accounting Standards (CAS) and to disclose in writing and follow consistently their cost accounting practices...

A new costing model in hospital management: time-driven activity-based costing system.

PubMed

Öker, Figen; Özyapıcı, Hasan

2013-01-01

Traditional cost systems cause cost distortions because they cannot meet the requirements of today's businesses. Therefore, a new and more effective cost system is needed. Consequently, time-driven activity-based costing system has emerged. The unit cost of supplying capacity and the time needed to perform an activity are the only 2 factors considered by the system. Furthermore, this system determines unused capacity by considering practical capacity. The purpose of this article is to emphasize the efficiency of the time-driven activity-based costing system and to display how it can be applied in a health care institution. A case study was conducted in a private hospital in Cyprus. Interviews and direct observations were used to collect the data. The case study revealed that the cost of unused capacity is allocated to both open and laparoscopic (closed) surgeries. Thus, by using the time-driven activity-based costing system, managers should eliminate the cost of unused capacity so as to obtain better results. Based on the results of the study, hospital management is better able to understand the costs of different surgeries. In addition, managers can easily notice the cost of unused capacity and decide how many employees to be dismissed or directed to other productive areas.

48 CFR 1699.70 - Cost accounting standards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Cost accounting standards... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION CLAUSES AND FORMS COST ACCOUNTING STANDARDS Cost Accounting Standards 1699.70 Cost accounting standards. With respect to all experience-rated contracts currently...

48 CFR 1699.70 - Cost accounting standards.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Cost accounting standards... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION CLAUSES AND FORMS COST ACCOUNTING STANDARDS Cost Accounting Standards 1699.70 Cost accounting standards. With respect to all experience-rated contracts currently...

[Analysis of cost and efficiency of a medical nursing unit using time-driven activity-based costing].

PubMed

Lim, Ji Young; Kim, Mi Ja; Park, Chang Gi

2011-08-01

Time-driven activity-based costing was applied to analyze the nursing activity cost and efficiency of a medical unit. Data were collected at a medical unit of a general hospital. Nursing activities were measured using a nursing activities inventory and classified as 6 domains using Easley-Storfjell Instrument. Descriptive statistics were used to identify general characteristics of the unit, nursing activities and activity time, and stochastic frontier model was adopted to estimate true activity time. The average efficiency of the medical unit using theoretical resource capacity was 77%, however the efficiency using practical resource capacity was 96%. According to these results, the portion of non-added value time was estimated 23% and 4% each. The sums of total nursing activity costs were estimated 109,860,977 won in traditional activity-based costing and 84,427,126 won in time-driven activity-based costing. The difference in the two cost calculating methods was 25,433,851 won. These results indicate that the time-driven activity-based costing provides useful and more realistic information about the efficiency of unit operation compared to traditional activity-based costing. So time-driven activity-based costing is recommended as a performance evaluation framework for nursing departments based on cost management.

Value in Pediatric Orthopaedic Surgery Health Care: the Role of Time-driven Activity-based Cost Accounting (TDABC) and Standardized Clinical Assessment and Management Plans (SCAMPs).

PubMed

Waters, Peter M

2015-01-01

The continuing increases in health care expenditures as well as the importance of providing safe, effective, timely, patient-centered care has brought government and commercial payer pressure on hospitals and providers to document the value of the care they deliver. This article introduces work at Boston Children's Hospital on time-driven activity-based accounting to determine cost of care delivery; combined with Systemic Clinical Assessment and Management Plans to reduce variation and improve outcomes. The focus so far has been on distal radius fracture care for children and adolescents.

The ABCs of Activity-Based Costing: A Cost Containment and Reallocation Tool.

ERIC Educational Resources Information Center

Turk, Frederick J.

1992-01-01

This article describes activity-based costing (ABC) and how this tool may help management understand the costs of major activities and identify possible alternatives. Also discussed are the traditional costing systems used by higher education and ways of applying ABC to higher education. (GLR)

Pharmaceutical services cost analysis using time-driven activity-based costing: A contribution to improve community pharmacies' management.

PubMed

Gregório, João; Russo, Giuliano; Lapão, Luís Velez

2016-01-01

The current financial crisis is pressing health systems to reduce costs while looking to improve service standards. In this context, the necessity to optimize health care systems management has become an imperative. However, little research has been conducted on health care and pharmaceutical services cost management. Pharmaceutical services optimization requires a comprehensive understanding of resources usage and its costs. This study explores the development of a time-driven activity-based costing (TDABC) model, with the objective of calculating the cost of pharmaceutical services to help inform policy-making. Pharmaceutical services supply patterns were studied in three pharmacies during a weekday through an observational study. Details of each activity's execution were recorded, including time spent per activity performed by pharmacists. Data on pharmacy costs was obtained through pharmacies' accounting records. The calculated cost of a dispensing service in these pharmacies ranged from €3.16 to €4.29. The cost of a counseling service when no medicine was supplied ranged from €1.24 to €1.46. The cost of health screening services ranged from €2.86 to €4.55. The presented TDABC model gives us new insights on management and costs of community pharmacies. This study shows the importance of cost analysis for health care services, specifically on pharmaceutical services, in order to better inform pharmacies' management and the elaboration of pharmaceutical policies. Copyright © 2016 Elsevier Inc. All rights reserved.

Automating Base Fuels Accounting.

DTIC Science & Technology

1986-03-01

base fuels accounting system as a means to decrease operating cost and increase capability. Author reviews the present accounting system, then proposes...g .:..: . . ; ,N :’- .’ :+-" : :*- . ’++ : :,:- :1:.-’ ."-..: :.:.:’’ AIR WAR COLLEGE No. AU-AWC86-0 9 0 00a AUTOMATING BASE FUELS ACCOUNTING ... ACCOUNTING by Victor E. Hardin Lieutenant Colonel, USAF A RESEARCH REPORT SUBMITTED TO THE FACULTY IN FULFILLMENT OF THE RESEARCH REQUI REMENT

Dissecting Costs of CT Study: Application of TDABC (Time-driven Activity-based Costing) in a Tertiary Academic Center.

PubMed

Anzai, Yoshimi; Heilbrun, Marta E; Haas, Derek; Boi, Luca; Moshre, Kirk; Minoshima, Satoshi; Kaplan, Robert; Lee, Vivian S

2017-02-01

The lack of understanding of the real costs (not charge) of delivering healthcare services poses tremendous challenges in the containment of healthcare costs. In this study, we applied an established cost accounting method, the time-driven activity-based costing (TDABC), to assess the costs of performing an abdomen and pelvis computed tomography (AP CT) in an academic radiology department and identified opportunities for improved efficiency in the delivery of this service. The study was exempt from an institutional review board approval. TDABC utilizes process mapping tools from industrial engineering and activity-based costing. The process map outlines every step of discrete activity and duration of use of clinical resources, personnel, and equipment. By multiplying the cost per unit of capacity by the required task time for each step, and summing each component cost, the overall costs of AP CT is determined for patients in three settings, inpatient (IP), outpatient (OP), and emergency departments (ED). The component costs to deliver an AP CT study were as follows: radiologist interpretation: 40.1%; other personnel (scheduler, technologist, nurse, pharmacist, and transporter): 39.6%; materials: 13.9%; and space and equipment: 6.4%. The cost of performing CT was 13% higher for ED patients and 31% higher for inpatients (IP), as compared to that for OP. The difference in cost was mostly due to non-radiologist personnel costs. Approximately 80% of the direct costs of AP CT to the academic medical center are related to labor. Potential opportunities to reduce the costs include increasing the efficiency of utilization of CT, substituting lower cost resources when appropriate, and streamlining the ordering system to clarify medical necessity and clinical indications. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

A tutorial on activity-based costing of electronic health records.

PubMed

Federowicz, Marie H; Grossman, Mila N; Hayes, Bryant J; Riggs, Joseph

2010-01-01

As the American Recovery and Restoration Act of 2009 allocates $19 billion to health information technology, it will be useful for health care managers to project the true cost of implementing an electronic health record (EHR). This study presents a step-by-step guide for using activity-based costing (ABC) to estimate the cost of an EHR. ABC is a cost accounting method with a "top-down" approach for estimating the cost of a project or service within an organization. The total cost to implement an EHR includes obvious costs, such as licensing fees, and hidden costs, such as impact on productivity. Unlike other methods, ABC includes all of the organization's expenditures and is less likely to miss hidden costs. Although ABC is used considerably in manufacturing and other industries, it is a relatively new phenomenon in health care. ABC is a comprehensive approach that the health care field can use to analyze the cost-effectiveness of implementing EHRs. In this article, ABC is applied to a health clinic that recently implemented an EHR, and the clinic is found to be more productive after EHR implementation. This methodology can help health care administrators assess the impact of a stimulus investment on organizational performance.

Activity-based costing via an information system: an application created for a breast imaging center.

PubMed

Hawkins, H; Langer, J; Padua, E; Reaves, J

2001-06-01

Activity-based costing (ABC) is a process that enables the estimation of the cost of producing a product or service. More accurate than traditional charge-based approaches, it emphasizes analysis of processes, and more specific identification of both direct and indirect costs. This accuracy is essential in today's healthcare environment, in which managed care organizations necessitate responsible and accountable costing. However, to be successfully utilized, it requires time, effort, expertise, and support. Data collection can be tedious and expensive. By integrating ABC with information management (IM) and systems (IS), organizations can take advantage of the process orientation of both, extend and improve ABC, and decrease resource utilization for ABC projects. In our case study, we have examined the process of a multidisciplinary breast center. We have mapped the constituent activities and established cost drivers. This information has been structured and included in our information system database for subsequent analysis.

Time-Driven Activity-Based Costing in Emergency Medicine.

PubMed

Yun, Brian J; Prabhakar, Anand M; Warsh, Jonathan; Kaplan, Robert; Brennan, John; Dempsey, Kyle E; Raja, Ali S

2016-06-01

Value in emergency medicine is determined by both patient-important outcomes and the costs associated with achieving them. However, measuring true costs is challenging. Without an understanding of costs, emergency department (ED) leaders will be unable to determine which interventions might improve value for their patients. Although ongoing research may determine which outcomes are meaningful, an accurate costing system is also needed. This article reviews current costing mechanisms in the ED and their pitfalls. It then describes how time-driven activity-based costing may be superior to these current costing systems. Time-driven activity-based costing, in addition to being a more accurate costing system, can be used for process improvements in the ED. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Comparison Between Individually and Group-Based Insulin Pump Initiation by Time-Driven Activity-Based Costing

PubMed Central

Ridderstråle, Martin

2017-01-01

Background: Depending on available resources, competencies, and pedagogic preference, initiation of insulin pump therapy can be performed on either an individual or a group basis. Here we compared the two models with respect to resources used. Methods: Time-driven activity-based costing (TDABC) was used to compare initiating insulin pump treatment in groups (GT) to individual treatment (IT). Activities and cost drivers were identified, timed, or estimated at location. Medical quality and patient satisfaction were assumed to be noninferior and were not measured. Results: GT was about 30% less time-consuming and 17% less cost driving per patient and activity compared to IT. As a batch driver (16 patients in one group) GT produced an upward jigsaw-shaped accumulative cost curve compared to the incremental increase incurred by IT. Taking the alternate cost for those not attending into account, and realizing the cost of opportunity gained, suggested that GT was cost neutral already when 5 of 16 patients attended, and that a second group could be initiated at no additional cost as the attendance rate reached 15:1. Conclusions: We found TDABC to be effective in comparing treatment alternatives, improving cost control and decision making. Everything else being equal, if the setup is available, our data suggest that initiating insulin pump treatment in groups is far more cost effective than on an individual basis and that TDABC may be used to find the balance point. PMID:28366085

[Cost of intensive care in a German hospital: cost-unit accounting based on the InEK matrix].

PubMed

Martin, J; Neurohr, C; Bauer, M; Weiss, M; Schleppers, A

2008-05-01

The aim of this study was to determine the actual cost per intensive care unit (ICU) day in Germany based on routine data from an electronic patient data management system as well as analysis of cost-driving factors. A differentiation between days with and without mechanical ventilation was performed. On the ICU of a German focused-care hospital (896 beds, 12 anesthesiology ICU beds), cost per treatment day was calculated with or without mechanical ventilation from the perspective of the hospital. Costs were derived retrospectively with respect to the period between January and October 2006 by cost-unit accounting based on routine data collected from the ICU patients. Patients with a length of stay of at least 2 days on the ICU were included. Demographic, clinical and economical data were analyzed for patient characterization. Data of 407 patients (217 male and 190 female) were included in the analysis, of which 159 patients (100 male, 59 female) were completely or partially mechanically ventilated. The mean simplified acute physiology (SAPS) II score at the onset of ICU stay was 28.2. Average cost per ICU day was 1,265 EUR and costs for ICU days with and without mechanical ventilation amounted to 1,426 EUR and 1,145 EUR, respectively. Personnel costs (50%) showed the largest cost share followed by drugs plus medicinal products (18%) and infrastructure (16%). For the first time, a cost analysis of intensive care in Germany was performed with routine data based on the matrix of the institute for reimbursement in hospitals (InEK). The results revealed a higher resource use on the ICU than previously expected. The large share of personnel costs on the ICU was evident but is comparable to other medical departments in the hospital. The need for mechanical ventilation increases the daily costs of resources by approximately 25%.

48 CFR 9903.101 - Cost Accounting Standards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost Accounting Standards. 9903.101 Section 9903.101 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD... ACCOUNTING STANDARDS CONTRACT COVERAGE General 9903.101 Cost Accounting Standards. Public Law 100-679 (41 U.S...

48 CFR 9904.405 - Accounting for unallowable costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Accounting for unallowable costs. 9904.405 Section 9904.405 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD... ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.405 Accounting for unallowable costs. ...

48 CFR 9904.416 - Accounting for insurance costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Accounting for insurance costs. 9904.416 Section 9904.416 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD... ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.416 Accounting for insurance costs. ...

Time-driven activity-based costing in health care: A systematic review of the literature.

PubMed

Keel, George; Savage, Carl; Rafiq, Muhammad; Mazzocato, Pamela

2017-07-01

Health care organizations around the world are investing heavily in value-based health care (VBHC), and time-driven activity-based costing (TDABC) has been suggested as the cost-component of VBHC capable of addressing costing challenges. The aim of this study is to explore why TDABC has been applied in health care, how its application reflects a seven-step method developed specifically for VBHC, and implications for the future use of TDABC. This is a systematic review following the PRISMA statement. Qualitative methods were employed to analyze data through content analyses. TDABC is applicable in health care and can help to efficiently cost processes, and thereby overcome a key challenge associated with current cost-accounting methods The method's ability to inform bundled payment reimbursement systems and to coordinate delivery across the care continuum remains to be demonstrated in the published literature, and the role of TDABC in this cost-accounting landscape is still developing. TDABC should be gradually incorporated into functional systems, while following and building upon the recommendations outlined in this review. In this way, TDABC will be better positioned to accurately capture the cost of care delivery for conditions and to control cost in the effort to create value in health care. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Implementing a trustworthy cost-accounting model.

PubMed

Spence, Jay; Seargeant, Dan

2015-03-01

Hospitals and health systems can develop an effective cost-accounting model and maximize the effectiveness of their cost-accounting teams by focusing on six key areas: Implementing an enhanced data model. Reconciling data efficiently. Accommodating multiple cost-modeling techniques. Improving transparency of cost allocations. Securing department manager participation. Providing essential education and training to staff members and stakeholders.

48 CFR 12.214 - Cost Accounting Standards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost Accounting Standards. 12.214 Section 12.214 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... Items 12.214 Cost Accounting Standards. Cost Accounting Standards (CAS) do not apply to contracts and...

[Cost of therapy for neurodegenerative diseases. Applying an activity-based costing system].

PubMed

Sánchez-Rebull, María-Victoria; Terceño Gómez, Antonio; Travé Bautista, Angeles

2013-01-01

To apply the activity based costing (ABC) model to calculate the cost of therapy for neurodegenerative disorders in order to improve hospital management and allocate resources more efficiently. We used the case study method in the Francolí long-term care day center. We applied all phases of an ABC system to quantify the cost of the activities developed in the center. We identified 60 activities; the information was collected in June 2009. The ABC system allowed us to calculate the average cost per patient with respect to the therapies received. The most costly and commonly applied technique was psycho-stimulation therapy. Focusing on this therapy and on others related to the admissions process could lead to significant cost savings. ABC costing is a viable method for costing activities and therapies in long-term day care centers because it can be adapted to their structure and standard practice. This type of costing allows the costs of each activity and therapy, or combination of therapies, to be determined and aids measures to improve management. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

DRG systems in Europe: variations in cost accounting systems among 12 countries.

PubMed

Tan, Siok Swan; Geissler, Alexander; Serdén, Lisbeth; Heurgren, Mona; van Ineveld, B Martin; Redekop, W Ken; Hakkaart-van Roijen, Leona

2014-12-01

Diagnosis-related group (DRG)-based hospital payment systems have gradually become the principal means of reimbursing hospitals in many European countries. Owing to the absence or inaccuracy of costs related to DRGs, these countries have started to routinely collect cost accounting data. The aim of the present article was to compare the cost accounting systems of 12 European countries. A standardized questionnaire was developed to guide comprehensive cost accounting system descriptions for each of the 12 participating countries. The cost accounting systems of European countries vary widely by the share of hospital costs reimbursed through DRG payment, the presence of mandatory cost accounting and/or costing guidelines, the share of cost collecting hospitals, costing methods and data checks on reported cost data. Each of these aspects entails a trade-off between accuracy of the cost data and feasibility constraints. Although a 'best' cost accounting system does not exist, our cross-country comparison gives insight into international differences and may help regulatory authorities and hospital managers to identify and improve areas of weakness in their cost accounting systems. Moreover, it may help health policymakers to underpin the development of a cost accounting system. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

New Federal Cost Accounting Regulations

ERIC Educational Resources Information Center

Wolff, George J.; Handzo, Joseph J.

1973-01-01

Discusses a new set of indirect cost accounting procedures which must be followed by school districts wishing to recover any indirect costs of administering federal grants and contracts. Also discusses the amount of indirect costs that may be recovered, computing indirect costs, classifying project costs, and restricted grants. (Author/DN)

Extending simulation modeling to activity-based costing for clinical procedures.

PubMed

Glick, N D; Blackmore, C C; Zelman, W N

2000-04-01

A simulation model was developed to measure costs in an Emergency Department setting for patients presenting with possible cervical-spine injury who needed radiological imaging. Simulation, a tool widely used to account for process variability but typically focused on utilization and throughput analysis, is being introduced here as a realistic means to perform an activity-based-costing (ABC) analysis, because traditional ABC methods have difficulty coping with process variation in healthcare. Though the study model has a very specific application, it can be generalized to other settings simply by changing the input parameters. In essence, simulation was found to be an accurate and viable means to conduct an ABC analysis; in fact, the output provides more complete information than could be achieved through other conventional analyses, which gives management more leverage with which to negotiate contractual reimbursements.

Applying Activity Based Costing (ABC) Method to Calculate Cost Price in Hospital and Remedy Services

PubMed Central

Rajabi, A; Dabiri, A

2012-01-01

Background Activity Based Costing (ABC) is one of the new methods began appearing as a costing methodology in the 1990’s. It calculates cost price by determining the usage of resources. In this study, ABC method was used for calculating cost price of remedial services in hospitals. Methods: To apply ABC method, Shahid Faghihi Hospital was selected. First, hospital units were divided into three main departments: administrative, diagnostic, and hospitalized. Second, activity centers were defined by the activity analysis method. Third, costs of administrative activity centers were allocated into diagnostic and operational departments based on the cost driver. Finally, with regard to the usage of cost objectives from services of activity centers, the cost price of medical services was calculated. Results: The cost price from ABC method significantly differs from tariff method. In addition, high amount of indirect costs in the hospital indicates that capacities of resources are not used properly. Conclusion: Cost price of remedial services with tariff method is not properly calculated when compared with ABC method. ABC calculates cost price by applying suitable mechanisms but tariff method is based on the fixed price. In addition, ABC represents useful information about the amount and combination of cost price services. PMID:23113171

Cost and unit cost calculations using step-down accounting.

PubMed

Conteh, Lesong; Walker, Damian

2004-03-01

There is paucity of unit cost data from low- and middle-income countries, although recent initiatives have emerged to help rectify this. The limited budgets assigned to health care facilities mean that health planners and managers must be able to account for the resources used in health facilities as well as use them efficiently. Step-down cost accounting (SDCA) offers a relatively simple method for generating cost and unit cost data at the facility level. However, to the best of our knowledge, there is a lack of clear and concise guidance on how to undertake SDCA. Therefore, this paper, using a worked example, illustrates the different steps involved to generate cost and unit costs for a small hospital.

Activity-based costs of blood transfusions in surgical patients at four hospitals.

PubMed

Shander, Aryeh; Hofmann, Axel; Ozawa, Sherri; Theusinger, Oliver M; Gombotz, Hans; Spahn, Donat R

2010-04-01

Blood utilization has long been suspected to consume more health care resources than previously reported. Incomplete accounting for blood costs has the potential to misdirect programmatic decision making by health care systems. Determining the cost of supplying patients with blood transfusions requires an in-depth examination of the complex array of activities surrounding the decision to transfuse. To accurately determine the cost of blood in a surgical population from a health system perspective, an activity-based costing (ABC) model was constructed. Tasks and resource consumption (materials, labor, third-party services, capital) related to blood administration were identified prospectively at two US and two European hospitals. Process frequency (i.e., usage) data were captured retrospectively from each hospital and used to populate the ABC model. All major process steps, staff, and consumables to provide red blood cell (RBC) transfusions to surgical patients, including usage frequencies, and direct and indirect overhead costs contributed to per-RBC-unit costs between $522 and $1183 (mean, $761 +/- $294). These exceed previously reported estimates and were 3.2- to 4.8-fold higher than blood product acquisition costs. Annual expenditures on blood and transfusion-related activities, limited to surgical patients, ranged from $1.62 to $6.03 million per hospital and were largely related to the transfusion rate. Applicable to various hospital practices, the ABC model confirms that blood costs have been underestimated and that they are geographically variable and identifies opportunities for cost containment. Studies to determine whether more stringent control of blood utilization improves health care utilization and quality, and further reduces costs, are warranted.

Cost Accounting in the Automated Manufacturing Environment

DTIC Science & Technology

1988-06-01

1 NAVAL POSTGRADUATE SCHOOL M terey, California 0 DTIC II ELECTE R AD%$° NO 0,19880 -- THESIS COST ACCOUNTING IN THE AUTOMATED MANUFACTURING...PROJECT TASK WORK UNIT ELEMENT NO. NO NO ACCESSION NO 11. TITLE (Include Security Classification) E COST ACCOUNTING IN THE AUTOMATED MANUFACTURING...GROUP ’" Cost Accounting ; Product Costing ; Automated Manufacturing; CAD/CAM- CIM 19 ABSTRACT (Continue on reverse if necessary and identify by blo

Cost accounting of radiological examinations. Cost analysis of radiological examinations of intermediate referral hospitals and general practice.

PubMed

Lääperi, A L

1996-01-01

nonmonetary variables was developed. In it the radiologist, radiographer and examination-specific equipment costs were allocated to the examinations applying estimated cost equivalents. Some minor cost items were replaced by a general cost factor (GCF). The program is suitable for internal cost accounting of radiological departments as well as regional planning. If more accurate cost information is required, cost assignment employing the actual consumption of the resources and applying the principles of activity-based cost accounting is recommended. As an application of the cost accounting formula the average costs of the radiological examinations were calculated. In conventional radiography the average proportion of the cost factors in the total material was: personnel costs 43%, equipment costs 26%, material costs 7%, real estate costs 11%, administration and overheads 14%. The average total costs including radiologist costs in the hospitals were (FIM): conventional roentgen examinations 188, contrast medium examinations 695, ultrasound 296, mammography 315, roentgen examinations with mobile equipment 1578. The average total costs without radiologist costs in the public health centres were (FIM): conventional roentgen examinations 107, contrast medium examinations 988, ultrasound 203, mammography 557. The average currency rate of exchange in 1991 was USD 1 = FIM 4.046. The following formula is proposed for calculating the cost of a radiological examination (or a group of examinations) performed with a certain piece of equipment during a period of time (e.g. 1 year): a2/ sigma ax*ax+ b2/ sigma bx*bx+ d1/d5*dx+ e1 + [(c1+ c2) + d4 + (e2 - e3) + f5 + g1+ g2+ i]/n.

48 CFR 9903.302-1 - Cost accounting practice.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., or measurement of cost. (a) Measurement of cost, as used in this part, encompasses accounting methods... practice. Examples of cost accounting practices which involve measurement of costs are— (1) The use of... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting practice...

Accountable Care Organizations and Transaction Cost Economics.

PubMed

Mick, Stephen S Farnsworth; Shay, Patrick D

2016-12-01

Using a Transaction Cost Economics (TCE) approach, this paper explores which organizational forms Accountable Care Organizations (ACOs) may take. A critical question about form is the amount of vertical integration that an ACO may have, a topic central to TCE. We posit that contextual factors outside and inside an ACO will produce variable transaction costs (the non-production costs of care) such that the decision to integrate vertically will derive from a comparison of these external versus internal costs, assuming reasonably rational management abilities. External costs include those arising from environmental uncertainty and complexity, small numbers bargaining, asset specificity, frequency of exchanges, and information "impactedness." Internal costs include those arising from human resource activities including hiring and staffing, training, evaluating (i.e., disciplining, appraising, or promoting), and otherwise administering programs. At the extreme, these different costs may produce either total vertical integration or little to no vertical integration with most ACOs falling in between. This essay demonstrates how TCE can be applied to the ACO organization form issue, explains TCE, considers ACO activity from the TCE perspective, and reflects on research directions that may inform TCE and facilitate ACO development. © The Author(s) 2016.

Cost Accounting in an Academic Community: A Small College Approach.

ERIC Educational Resources Information Center

Mathews, Keith W.

1976-01-01

Ohio Wesleyan University has demonstrated that a small private college can apply cost accounting to instructional activities. For more than six years, Ohio Wesleyan has calculated the unit cost of instruction per student and per credit until for each individual course section as well as the average unit costs for each academic discipline. Only…

48 CFR 9903.307 - Cost Accounting Standards Preambles.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost Accounting Standards Preambles. 9903.307 Section 9903.307 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD... ACCOUNTING STANDARDS CONTRACT COVERAGE CAS Rules and Regulations 9903.307 Cost Accounting Standards Preambles...

SAMICS support study. Volume 1: Cost account catalog

NASA Technical Reports Server (NTRS)

1977-01-01

The Jet Propulsion Laboratory (JPL) is examining the feasibility of a new industry to produce photovoltaic solar energy collectors similar to those used on spacecraft. To do this, a standardized costing procedure was developed. The Solar Array Manufacturing Industry Costing Standards (SAMICS) support study supplies the following information: (1) SAMICS critique; (2) Standard data base--cost account structure, expense item costs, inflation rates, indirect requirements relationships, and standard financial parameter values; (3) Facilities capital cost estimating relationships; (4) Conceptual plant designs; (5) Construction lead times; (6) Production start-up times; (7) Manufacturing price estimates.

Cost Accounting, Business Education: 7709.41.

ERIC Educational Resources Information Center

Carino, Mariano G.

Cost accounting principles and procedures provide students with sufficient background to apply cost accounting factors to service and manufacturing businesses. Overhead, materials, goods in process, and finished goods are emphasized. Students complete a practice set in the course, which has guidelines, performance objectives, learning activities…

48 CFR 9905.506 - Cost accounting period-Educational institutions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting period-Educational institutions. 9905.506 Section 9905.506 Federal Acquisition Regulations System COST ACCOUNTING... AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS FOR EDUCATIONAL INSTITUTIONS 9905.506 Cost...

A critical review of accounting and economic methods for estimating the costs of addiction treatment.

PubMed

Cartwright, William S

2008-04-01

Researchers have been at the forefront of applying new costing methods to drug abuse treatment programs and innovations. The motivation for such work has been to improve costing accuracy. Recent work has seen applications initiated in establishing charts of account and cost accounting for service delivery. As a result, researchers now have available five methods to apply to the costing of drug abuse treatment programs. In all areas of costing, there is room for more research on costing concepts and measurement applications. Additional work would be useful in establishing studies with activity-based costing for both research and managerial purposes. Studies of economies of scope are particularly relevant because of the integration of social services and criminal justice in drug abuse treatment. In the long run, managerial initiatives to improve the administration and quality of drug abuse treatment will benefit directly from research with new information on costing techniques.

48 CFR 9904.401 - Cost accounting standard-consistency in estimating, accumulating and reporting costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.401 Cost... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard...

Time-driven activity-based costing to identify opportunities for cost reduction in pediatric appendectomy.

PubMed

Yu, Yangyang R; Abbas, Paulette I; Smith, Carolyn M; Carberry, Kathleen E; Ren, Hui; Patel, Binita; Nuchtern, Jed G; Lopez, Monica E

2016-12-01

As reimbursement programs shift to value-based payment models emphasizing quality and efficient healthcare delivery, there exists a need to better understand process management to unearth true costs of patient care. We sought to identify cost-reduction opportunities in simple appendicitis management by applying a time-driven activity-based costing (TDABC) methodology to this high-volume surgical condition. Process maps were created using medical record time stamps. Labor capacity cost rates were calculated using national median physician salaries, weighted nurse-patient ratios, and hospital cost data. Consumable costs for supplies, pharmacy, laboratory, and food were derived from the hospital general ledger. Time-driven activity-based costing resulted in precise per-minute calculation of personnel costs. Highest costs were in the operating room ($747.07), hospital floor ($388.20), and emergency department ($296.21). Major contributors to length of stay were emergency department evaluation (270min), operating room availability (395min), and post-operative monitoring (1128min). The TDABC model led to $1712.16 in personnel costs and $1041.23 in consumable costs for a total appendicitis cost of $2753.39. Inefficiencies in healthcare delivery can be identified through TDABC. Triage-based standing delegation orders, advanced practice providers, and same day discharge protocols are proposed cost-reducing interventions to optimize value-based care for simple appendicitis. II. Copyright © 2016 Elsevier Inc. All rights reserved.

A Trial of Nursing Cost Accounting using Nursing Practice Data on a Hospital Information System.

PubMed

Miyahira, Akiko; Tada, Kazuko; Ishima, Masatoshi; Nagao, Hidenori; Miyamoto, Tadashi; Nakagawa, Yoshiaki; Takemura, Tadamasa

2015-01-01

Hospital administration is very important and many hospitals carry out activity-based costing under comprehensive medicine. However, nursing cost is unclear, because nursing practice is expanding both quantitatively and qualitatively and it is difficult to grasp all nursing practices, and nursing cost is calculated in many cases comprehensively. On the other hand, a nursing information system (NIS) is implemented in many hospitals in Japan and we are beginning to get nursing practical data. In this paper, we propose a nursing cost accounting model and we simulate a cost by nursing contribution using NIS data.

Cost analysis of prenatal care using the activity-based costing model: a pilot study.

PubMed

Gesse, T; Golembeski, S; Potter, J

1999-01-01

The cost of prenatal care in a private nurse-midwifery practice was examined using the activity-based costing system. Findings suggest that the activities of the nurse-midwife (the health care provider) constitute the major cost driver of this practice and that the model of care and associated, time-related activities influence the cost. This pilot study information will be used in the development of a comparative study of prenatal care, client education, and self care.

Cost Analysis of Prenatal Care Using the Activity-Based Costing Model: A Pilot Study

PubMed Central

Gesse, Theresa; Golembeski, Susan; Potter, Jonell

1999-01-01

The cost of prenatal care in a private nurse-midwifery practice was examined using the activity-based costing system. Findings suggest that the activities of the nurse-midwife (the health care provider) constitute the major cost driver of this practice and that the model of care and associated, time-related activities influence the cost. This pilot study information will be used in the development of a comparative study of prenatal care, client education, and self care. PMID:22945985

Cost Accounting as a Tool for Increasing Cost Transparency in Selective Hepatic Transarterial Chemoembolization.

PubMed

Ahmed, Osman; Patel, Mikin; Ward, Thomas; Sze, Daniel Y; Telischak, Kristen; Kothary, Nishita; Hofmann, Lawrence V

2015-12-01

To increase cost transparency and uncover potential areas for savings in patients receiving selective transarterial chemoembolization at a tertiary care academic center. The hospital cost accounting system charge master sheet for direct and total costs associated with selective transarterial chemoembolization in fiscal years 2013 and 2014 was queried for each of the four highest volume interventional radiologists at a single institution. There were 517 cases (range, 83-150 per physician) performed; direct costs incurred relating to care before, during, and after the procedure with respect to labor, supply, and equipment fees were calculated. A median of 48 activity codes were charged per selective transarterial chemoembolization from five cost centers, represented by the angiography suite, units for care before and after the procedure, pharmacy, and observation floors. The average direct cost of selective transarterial chemoembolization did not significantly differ among operators at $9,126.94, $8,768.77, $9,027.33, and $8,909.75 (P = .31). Intraprocedural costs accounted for 82.8% of total direct costs and provided the greatest degree in cost variability ($7,268.47-$7,691.27). The differences in intraprocedural expense among providers were not statistically significant (P = .09), even when separated into more specific procedure-related labor and supply costs. Cost accounting systems could effectively be interrogated as a method for calculating direct costs associated with selective transarterial chemoembolization. The greatest source of expenditure and variability in cost among providers was shown to be intraprocedural labor and supplies, although the effect did not appear to be operator dependent. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

Recruitment strategies and costs for a community-based physical activity program.

PubMed

Peck, Lara E; Sharpe, Patricia A; Burroughs, Ericka L; Granner, Michelle L

2008-04-01

A community-based participatory research project using social marketing strategies was implemented to promote physical activity among women aged 35 to 54 who were insufficiently active or completely inactive. A variety of media were used to disseminate messages about how to enroll in Step Up. Step Out! This article describes the effectiveness and cost of the recruitment strategies and lessons learned in recruiting the women. Of the total inquiries (n = 691), 430 women were eligible and enrolled in the program. Based on data from questionnaires, the most effective method of recruiting women into Step Up. Step Out! was word of mouth (36%). Newspaper ads accounted for 29% of the women's responses. The least effective method was billboards. Mass media was not as effective in recruiting women for the program as interpersonal efforts such as word of mouth. Interpersonal efforts are a valuable and possibly underrated recruitment and promotion tool.

Cost Accounting and Accountability: One Approach.

ERIC Educational Resources Information Center

Gingold, William

This paper outlines an approach designed to provide an accurate and efficient cost accounting system for use in schools and other social service organizations. In his discussion, the author presents a detailed step-by-step description of how to establish, plan, and operate the system. The basic element of the system is the Daily Event Record…

Assessing DRG cost accounting with respect to resource allocation and tariff calculation: the case of Germany

PubMed Central

2012-01-01

The purpose of this paper is to analyze the German diagnosis related groups (G-DRG) cost accounting scheme by assessing its resource allocation at hospital level and its tariff calculation at national level. First, the paper reviews and assesses the three steps in the G-DRG resource allocation scheme at hospital level: (1) the groundwork; (2) cost-center accounting; and (3) patient-level costing. Second, the paper reviews and assesses the three steps in G-DRG national tariff calculation: (1) plausibility checks; (2) inlier calculation; and (3) the “one hospital” approach. The assessment is based on the two main goals of G-DRG introduction: improving transparency and efficiency. A further empirical assessment attests high costing quality. The G-DRG cost accounting scheme shows high system quality in resource allocation at hospital level, with limitations concerning a managerially relevant full cost approach and limitations in terms of advanced activity-based costing at patient-level. However, the scheme has serious flaws in national tariff calculation: inlier calculation is normative, and the “one hospital” model causes cost bias, adjustment and representativeness issues. The G-DRG system was designed for reimbursement calculation, but developed to a standard with strategic management implications, generalized by the idea of adapting a hospital’s cost structures to DRG revenues. This combination causes problems in actual hospital financing, although resource allocation is advanced at hospital level. PMID:22935314

Assessing DRG cost accounting with respect to resource allocation and tariff calculation: the case of Germany.

PubMed

Vogl, Matthias

2012-08-30

The purpose of this paper is to analyze the German diagnosis related groups (G-DRG) cost accounting scheme by assessing its resource allocation at hospital level and its tariff calculation at national level. First, the paper reviews and assesses the three steps in the G-DRG resource allocation scheme at hospital level: (1) the groundwork; (2) cost-center accounting; and (3) patient-level costing. Second, the paper reviews and assesses the three steps in G-DRG national tariff calculation: (1) plausibility checks; (2) inlier calculation; and (3) the "one hospital" approach. The assessment is based on the two main goals of G-DRG introduction: improving transparency and efficiency. A further empirical assessment attests high costing quality. The G-DRG cost accounting scheme shows high system quality in resource allocation at hospital level, with limitations concerning a managerially relevant full cost approach and limitations in terms of advanced activity-based costing at patient-level. However, the scheme has serious flaws in national tariff calculation: inlier calculation is normative, and the "one hospital" model causes cost bias, adjustment and representativeness issues. The G-DRG system was designed for reimbursement calculation, but developed to a standard with strategic management implications, generalized by the idea of adapting a hospital's cost structures to DRG revenues. This combination causes problems in actual hospital financing, although resource allocation is advanced at hospital level.

Evaluation of Uniform Cost Accounting System to Fully Capture Depot Level Repair Costs.

DTIC Science & Technology

1985-12-01

RD-RI65 522 EVALUATION OF UNIFORM COST ACCOUNTING SYSTEM TO FULLY i/I CAPTURE DEPOT LEVEL REPAIR COSTS (U) NAVAL POSTGRADUATE SCHOOL MONTEREY CA D R...8217.LECTE B ,- THESIS EVALUATION OF UNIFORM COST ACCOUNTING SYSTEM 0TO FULLY CAPTURE DEPOT LEVEL REPAIR COSTS Jby __jDavid Richmond O’Brien lj,,, December...Include Security Classification) EVALUATION OF UNIFORM COST ACCOUNTING SYSTEM TO FULLY CAPTURE DEPOT LEVEL REPAIR COSTS 12 PERSONAL AUTHOR(S) O’Brien- David

A Web-Based Physical Activity Intervention for Spanish-Speaking Latinas: A Costs and Cost-Effectiveness Analysis

PubMed Central

Marcus, Bess; Pekmezi, Dori; Hartman, Sheri; Gilmer, Todd

2017-01-01

Background Latinas report particularly low levels of physical activity and suffer from greater rates of lifestyle-related conditions such as obesity and diabetes. Interventions are needed that can increase physical activity in this growing population in a large-scale, cost-effective manner. Web-based interventions may have potential given the increase in Internet use among Latinas and the scalability of Web-based programs. Objective To examine the costs and cost-effectiveness of a Web-based, Spanish-language physical activity intervention for Latinas compared to a wellness contact control. Methods Healthy adult Latina women (N=205) were recruited from the community and randomly assigned to receive a Spanish-language, Web-based, individually tailored physical activity intervention (intervention group) or were given access to a website with content on wellness topics other than physical activity (control group). Physical activity was measured using the 7-Day Physical Activity Recall interview and ActiGraph accelerometers at baseline, 6 months (ie, postintervention), and 12 months (ie, maintenance phase). Costs were estimated from a payer perspective and included all features necessary to implement the intervention in a community setting, including staff time (ie, wages, benefits, and overhead), materials, hardware, website hosting, and routine website maintenance. Results At 6 months, the costs of running the intervention and control groups were US $17 and US $8 per person per month, respectively. These costs fell to US $12 and US $6 per person per month at 12 months, respectively. Linear interpolation showed that intervention participants increased their physical activity by 1362 total minutes at 6 months (523 minutes by accelerometer) compared to 715 minutes for control participants (186 minutes by accelerometer). At 6 months, each minute increase in physical activity for the intervention group cost US $0.08 (US $0.20 by accelerometer) compared to US $0.07 for

Implementation of a cost-accounting model in a biobank: practical implications.

PubMed

Gonzalez-Sanchez, Maria Beatriz; Lopez-Valeiras, Ernesto; García-Montero, Andres C

2014-01-01

Given the state of global economy, cost measurement and control have become increasingly relevant over the past years. The scarcity of resources and the need to use these resources more efficiently is making cost information essential in management, even in non-profit public institutions. Biobanks are no exception. However, no empirical experiences on the implementation of cost accounting in biobanks have been published to date. The aim of this paper is to present a step-by-step implementation of a cost-accounting tool for the main production and distribution activities of a real/active biobank, including a comprehensive explanation on how to perform the calculations carried out in this model. Two mathematical models for the analysis of (1) production costs and (2) request costs (order management and sample distribution) have stemmed from the analysis of the results of this implementation, and different theoretical scenarios have been prepared. Global analysis and discussion provides valuable information for internal biobank management and even for strategic decisions at the research and development governmental policies level.

Cost unit accounting based on a clinical pathway: a practical tool for DRG implementation.

PubMed

Feyrer, R; Rösch, J; Weyand, M; Kunzmann, U

2005-10-01

Setting up a reliable cost unit accounting system in a hospital is a fundamental necessity for economic survival, given the current general conditions in the healthcare system. Definition of a suitable cost unit is a crucial factor for success. We present here the development and use of a clinical pathway as a cost unit as an alternative to the DRG. Elective coronary artery bypass grafting was selected as an example. Development of the clinical pathway was conducted according to a modular concept that mirrored all the treatment processes across various levels and modules. Using service records and analyses the process algorithms of the clinical pathway were developed and visualized with CorelTM iGrafix Process 2003. A detailed process cost record constituted the basis of the pathway costing, in which financial evaluation of the treatment processes was performed. The result of this study was a structured clinical pathway for coronary artery bypass grafting together with a cost calculation in the form of cost unit accounting. The use of a clinical pathway as a cost unit offers considerable advantages compared to the DRG or clinical case. The variance in the diagnoses and procedures within a pathway is minimal, so the consumption of resources is homogeneous. This leads to a considerable improvement in the value of cost unit accounting as a strategic control instrument in hospitals.

48 CFR 52.230-2 - Cost Accounting Standards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Cost Accounting Standards....230-2 Cost Accounting Standards. As prescribed in 30.201-4(a), insert the following clause: Cost Accounting Standards (OCT 2010) (a) Unless the contract is exempt under 48 CFR 9903.201-1 and 9903.201-2, the...

Activity-based costing of health-care delivery, Haiti.

PubMed

McBain, Ryan K; Jerome, Gregory; Leandre, Fernet; Browning, Micaela; Warsh, Jonathan; Shah, Mahek; Mistry, Bipin; Faure, Peterson Abnis I; Pierre, Claire; Fang, Anna P; Mugunga, Jean Claude; Gottlieb, Gary; Rhatigan, Joseph; Kaplan, Robert

2018-01-01

To evaluate the implementation of a time-driven activity-based costing analysis at five community health facilities in Haiti. Together with stakeholders, the project team decided that health-care providers should enter start and end times of the patient encounter in every fifth patient's medical dossier. We trained one data collector per facility, who manually entered the time recordings and patient characteristics in a database and submitted the data to a cloud-based data warehouse each week. We calculated the capacity cost per minute for each resource used. An automated web-based platform multiplied reported time with capacity cost rate and provided the information to health-facilities administrators. Between March 2014 and June 2015, the project tracked the clinical services for 7162 outpatients. The cost of care for specific conditions varied widely across the five facilities, due to heterogeneity in staffing and resources. For example, the average cost of a first antenatal-care visit ranged from 6.87 United States dollars (US$) at a low-level facility to US$ 25.06 at a high-level facility. Within facilities, we observed similarly variation in costs, due to factors such as patient comorbidities, patient arrival time, stocking of supplies at facilities and type of visit. Time-driven activity-based costing can be implemented in low-resource settings to guide resource allocation decisions. However, the extent to which this information will drive observable changes at patient, provider and institutional levels depends on several contextual factors, including budget constraints, management, policies and the political economy in which the health system is situated.

Why revisit your cost-accounting strategy.

PubMed

Arredondo, Ricky

2014-07-01

Healthcare entities seeking to develop effective cost-accounting systems should take six steps to avoid potential pitfalls: Secure broad executive-level support for the effort. Ensure systems are in place to analyze the disparate data. Define measurable objectives to ensure that implementation achieves desired results. Give due consideration to implementation planning. Train support staff sufficiently to avoid underutilization. Develop a sufficiently broad base of staff support for the system.

18. Uniform cost accounting in long-term care.

PubMed

Sorensen, J E

1976-05-01

Uniform cost data are essential for managing health services, establishing billing and reimbursement rates, and measuring effectiveness and impact. Although it is especially difficult in the case of long-term health care to develop standard cost accounting procedures because of the varied configurations of inpatient, intermediate, and ambulatory services, the overall approaches to cost accounting and its content can be made more uniform. With this purpose in mind, a general model of cost accounting is presented for a multilevel program of long-term services, together with a special method for ambulatory services using "hours accounted for" as the basic measure.

The Effects of the Use of Activity-Based Costing Software in the Learning Process: An Empirical Analysis

ERIC Educational Resources Information Center

Tan, Andrea; Ferreira, Aldónio

2012-01-01

This study investigates the influence of the use of accounting software in teaching activity-based costing (ABC) on the learning process. It draws upon the Theory of Planned Behaviour and uses the end-user computer satisfaction (EUCS) framework to examine students' satisfaction with the ABC software. The study examines students' satisfaction with…

A Web-Based Physical Activity Intervention for Spanish-Speaking Latinas: A Costs and Cost-Effectiveness Analysis.

PubMed

Larsen, Britta; Marcus, Bess; Pekmezi, Dori; Hartman, Sheri; Gilmer, Todd

2017-02-22

Latinas report particularly low levels of physical activity and suffer from greater rates of lifestyle-related conditions such as obesity and diabetes. Interventions are needed that can increase physical activity in this growing population in a large-scale, cost-effective manner. Web-based interventions may have potential given the increase in Internet use among Latinas and the scalability of Web-based programs. To examine the costs and cost-effectiveness of a Web-based, Spanish-language physical activity intervention for Latinas compared to a wellness contact control. Healthy adult Latina women (N=205) were recruited from the community and randomly assigned to receive a Spanish-language, Web-based, individually tailored physical activity intervention (intervention group) or were given access to a website with content on wellness topics other than physical activity (control group). Physical activity was measured using the 7-Day Physical Activity Recall interview and ActiGraph accelerometers at baseline, 6 months (ie, postintervention), and 12 months (ie, maintenance phase). Costs were estimated from a payer perspective and included all features necessary to implement the intervention in a community setting, including staff time (ie, wages, benefits, and overhead), materials, hardware, website hosting, and routine website maintenance. At 6 months, the costs of running the intervention and control groups were US $17 and US $8 per person per month, respectively. These costs fell to US $12 and US $6 per person per month at 12 months, respectively. Linear interpolation showed that intervention participants increased their physical activity by 1362 total minutes at 6 months (523 minutes by accelerometer) compared to 715 minutes for control participants (186 minutes by accelerometer). At 6 months, each minute increase in physical activity for the intervention group cost US $0.08 (US $0.20 by accelerometer) compared to US $0.07 for control participants (US $0.26 by

48 CFR 9904.414 - Cost accounting standard-cost of money as an element of the cost of facilities capital.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard... Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING...

48 CFR 31.201-6 - Accounting for unallowable costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Accounting for unallowable... Organizations 31.201-6 Accounting for unallowable costs. (a) Costs that are expressly unallowable or mutually... accounting for and presentation of unallowable costs must be those described in 48 CFR 9904.405, Accounting...

Cost Accounting: Production and Equipment Services.

ERIC Educational Resources Information Center

Schmid, William T.

Cost accounting for audiovisual productions should include direct costs, and, in some cases, the media administrator may have to calculate a per-hour surcharge for general operating overhead as well. Such procedures enable the administrator to determine cost effectiveness, to control cost overruns, and to generate more staff efficiency. Cost…

Activity-based costing of health-care delivery, Haiti

PubMed Central

Jerome, Gregory; Leandre, Fernet; Browning, Micaela; Warsh, Jonathan; Shah, Mahek; Mistry, Bipin; Faure, Peterson Abnis I; Pierre, Claire; Fang, Anna P; Mugunga, Jean Claude; Gottlieb, Gary; Rhatigan, Joseph; Kaplan, Robert

2018-01-01

Abstract Objective To evaluate the implementation of a time-driven activity-based costing analysis at five community health facilities in Haiti. Methods Together with stakeholders, the project team decided that health-care providers should enter start and end times of the patient encounter in every fifth patient’s medical dossier. We trained one data collector per facility, who manually entered the time recordings and patient characteristics in a database and submitted the data to a cloud-based data warehouse each week. We calculated the capacity cost per minute for each resource used. An automated web-based platform multiplied reported time with capacity cost rate and provided the information to health-facilities administrators. Findings Between March 2014 and June 2015, the project tracked the clinical services for 7162 outpatients. The cost of care for specific conditions varied widely across the five facilities, due to heterogeneity in staffing and resources. For example, the average cost of a first antenatal-care visit ranged from 6.87 United States dollars (US$) at a low-level facility to US$ 25.06 at a high-level facility. Within facilities, we observed similarly variation in costs, due to factors such as patient comorbidities, patient arrival time, stocking of supplies at facilities and type of visit. Conclusion Time-driven activity-based costing can be implemented in low-resource settings to guide resource allocation decisions. However, the extent to which this information will drive observable changes at patient, provider and institutional levels depends on several contextual factors, including budget constraints, management, policies and the political economy in which the health system is situated. PMID:29403096

Operations Assessment of Launch Vehicle Architectures using Activity Based Cost Models

NASA Technical Reports Server (NTRS)

Ruiz-Torres, Alex J.; McCleskey, Carey

2000-01-01

The growing emphasis on affordability for space transportation systems requires the assessment of new space vehicles for all life cycle activities, from design and development, through manufacturing and operations. This paper addresses the operational assessment of launch vehicles, focusing on modeling the ground support requirements of a vehicle architecture, and estimating the resulting costs and flight rate. This paper proposes the use of Activity Based Costing (ABC) modeling for this assessment. The model uses expert knowledge to determine the activities, the activity times and the activity costs based on vehicle design characteristics. The approach provides several advantages to current approaches to vehicle architecture assessment including easier validation and allowing vehicle designers to understand the cost and cycle time drivers.

Use of a cost accounting system to evaluate costs of a VA special program.

PubMed

Menke, T J; Wray, N P

1999-04-01

The Department of Veterans Affairs (VA) established six mobile clinics to provide care for rural veterans. Each was operated by a parent VA Medical Center (VAMC). To describe the use of a cost-accounting system which does not provide costs at the service or patient level to determine the costs of the mobile clinics. Costs per visit were compared among the mobile clinics with the parent VAMCs and with simulated fixed-location clinics. Cost data came from VA's Centralized Accounting for Local Management (CALM) data. Utilization data came from VA's outpatient file. Information was obtained from the VAMCs' fiscal services to reallocate costs among the CALM subaccounts to generate cost data that was comparable among the mobile clinics. Costs per visit for the mobile clinics were twice as high as those of the parent VAMCs. Costs per visit would be lower at fixed-location clinics unless the volume were substantially less than that provided by the mobile clinics. Differences between cost allocations for accounting purposes and research are likely to necessitate adjusting cost accounting data for research purposes. Fortunately, information from the accountants or primary data can lead to a cost database which is appropriate for research evaluations. In the mobile clinics study, the analysis of cost accounting data led to the conclusion that mobile clinics were not a cost-effective way in which to provide care to rural veterans.

Cost effectiveness of community-based physical activity interventions.

PubMed

Roux, Larissa; Pratt, Michael; Tengs, Tammy O; Yore, Michelle M; Yanagawa, Teri L; Van Den Bos, Jill; Rutt, Candace; Brownson, Ross C; Powell, Kenneth E; Heath, Gregory; Kohl, Harold W; Teutsch, Steven; Cawley, John; Lee, I-Min; West, Linda; Buchner, David M

2008-12-01

Physical inactivity is associated with the increased risk of many chronic diseases. Such risks decrease with increases in physical activity. This study assessed the cost-effectiveness of population-wide strategies to promote physical activity in adults and followed disease incidence over a lifetime. A lifetime cost-effectiveness analysis from a societal perspective was conducted to estimate the costs, health gains, and cost-effectiveness (dollars per quality-adjusted life year [QALY] gained, relative to no intervention) of seven public health interventions to promote physical activity in a simulated cohort of healthy U.S. adults stratified by age, gender, and physical activity level. Interventions exemplifying each of four strategies strongly recommended by the Task Force on Community Preventive Services were evaluated: community-wide campaigns, individually adapted health behavior change, community social-support interventions, and the creation of or enhanced access to physical activity information and opportunities. Each intervention was compared to a no-intervention alternative. A systematic review of disease burden by physical activity status was used to assess the relative risk of five diseases (coronary heart disease, ischemic stroke, type 2 diabetes, breast cancer, and colorectal cancer) across a spectrum of physical activity levels. Other data were obtained from clinical trials, population-based surveys, and other published literature. Cost-effectiveness ratios ranged between $14,000 and $69,000 per QALY gained, relative to no intervention. Results were sensitive to intervention-related costs and effect size. All of the evaluated physical activity interventions appeared to reduce disease incidence, to be cost-effective, and--compared with other well-accepted preventive strategies--to offer good value for money. The results support using any of the seven evaluated interventions as part of public health efforts to promote physical activity.

Price-transparency and cost accounting: challenges for health care organizations in the consumer-driven era.

PubMed

Hilsenrath, Peter; Eakin, Cynthia; Fischer, Katrina

2015-01-01

Health care reform is directed toward improving access and quality while containing costs. An essential part of this is improvement of pricing models to more accurately reflect the costs of providing care. Transparent prices that reflect costs are necessary to signal information to consumers and producers. This information is central in a consumer-driven marketplace. The rapid increase in high deductible insurance and other forms of cost sharing incentivizes the search for price information. The organizational ability to measure costs across a cycle of care is an integral component of creating value, and will play a greater role as reimbursements transition to episode-based care, value-based purchasing, and accountable care organization models. This article discusses use of activity-based costing (ABC) to better measure the cost of health care. It describes examples of ABC in health care organizations and discusses impediments to adoption in the United States including cultural and institutional barriers. © The Author(s) 2015.

48 CFR 9904.420 - Accounting for independent research and development costs and bid and proposal costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.420 Accounting for independent research and development costs and bid and proposal costs. ...

[Cost management: the implementation of the activity-based costing method in sterile processing department].

PubMed

Jericó, Marli de Carvalho; Castilho, Valéria

2010-09-01

This exploratory case study was performed aiming at implementing the Activity-based Costing (ABC) method in a sterile processing department (SPD) of a major teaching hospital. Data collection was performed throughout 2006. Documentary research techniques and non participant closed observation were used. The ABC implementation allowed for learning the activity-based costing of both the chemical and physical disinfection cycle/load: (dollar 9.95) and (dollar 12.63), respectively; as well as the cost for sterilization by steam under pressure (autoclave) (dollar 31.37) and low temperature steam and gaseous formaldehyde sterilization (LTSF) (dollar 255.28). The information provided by the ABC method has optimized the overall understanding of the cost driver process and provided the foundation for assessing performance and improvement in the SPD processes.

48 CFR 9904.402 - Cost accounting standard-consistency in allocating costs incurred for the same purpose.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.402 Cost... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard...

48 CFR 30.102 - Cost Accounting Standards Board publication.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost Accounting Standards... REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION General 30.102 Cost Accounting Standards Board publication. Copies of the CASB Standards and Regulations are printed in title 48...

Educational Costs.

ERIC Educational Resources Information Center

Arnold, Robert

Problems in educational cost accounting and a new cost accounting approach are described in this paper. The limitations of the individualized cost (student units) approach and the comparative cost approach (in the form of fund-function-object) are illustrated. A new strategy, an activity-based system of accounting, is advocated. Borrowed from…

14 CFR 1274.919 - Cost principles and accounting standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Cost principles and accounting standards... principles and accounting standards. Cost Principles and Accounting Standards July 2002 The expenditure of... Recipient (See clause entitled “Resource Sharing Requirements”) shall be governed by the FAR cost principles...

Time-driven activity-based costing: a driver for provider engagement in costing activities and redesign initiatives.

PubMed

McLaughlin, Nancy; Burke, Michael A; Setlur, Nisheeta P; Niedzwiecki, Douglas R; Kaplan, Alan L; Saigal, Christopher; Mahajan, Aman; Martin, Neil A; Kaplan, Robert S

2014-11-01

To date, health care providers have devoted significant efforts to improve performance regarding patient safety and quality of care. To address the lagging involvement of health care providers in the cost component of the value equation, UCLA Health piloted the implementation of time-driven activity-based costing (TDABC). Here, the authors describe the implementation experiment, share lessons learned across the care continuum, and report how TDABC has actively engaged health care providers in costing activities and care redesign. After the selection of pilots in neurosurgery and urology and the creation of the TDABC team, multidisciplinary process mapping sessions, capacity-cost calculations, and model integration were coordinated and offered to engage care providers at each phase. Reviewing the maps for the entire episode of care, varying types of personnel involved in the delivery of care were noted: 63 for the neurosurgery pilot and 61 for the urology pilot. The average cost capacities for care coordinators, nurses, residents, and faculty were $0.70 (range $0.63-$0.75), $1.55 (range $1.28-$2.04), $0.58 (range $0.56-$0.62), and $3.54 (range $2.29-$4.52), across both pilots. After calculating the costs for material, equipment, and space, the TDABC model enabled the linking of a specific step of the care cycle (who performed the step and its duration) and its associated costs. Both pilots identified important opportunities to redesign care delivery in a costconscious fashion. The experimentation and implementation phases of the TDABC model have succeeded in engaging health care providers in process assessment and costing activities. The TDABC model proved to be a catalyzing agent for cost-conscious care redesign.

Hospital cost accounting and the new imperative.

PubMed

Sabin, P

1987-05-01

Government regulatory structures, prospective payment mechanisms, a more competitive environment, and attempts to link cost accounting principles to planning, budgeting, and fiscal control all have served as catalysts for hospitals to increase their reliance and emphasis on cost accounting. Current hospital accounting systems are relatively inexpensive to develop and maintain, and they fulfill the financial reporting requirements mandated by Medicare and other third-party payers. These systems, however, do not provide information on what specific service units cost, and managers must have this information to make optimal trade-offs between quality, availability, and cost of medical services. Most health care organizations have a predetermined charge for each type of service, but the charge may not accurately portray the cost of providing the service. Knowing true costs will enable managers to select the most cost-effective method of treating a patient; know the financial implications of adding tests or procedures; relate costs to established norms of care; establish ranges of acceptable costs in various diagnostic groups; negotiate more successfully with rate review organizations and health maintenance organizations; and vigorously market and advertise the services that most contribute to the organization's overall financial health. The goal of microcosting is to determine the full cost of providing specific service units. The microcosting process comprises three components: data collection, cost modeling, and cost analysis. Microcosting is used to determine full costs for 20 percent of the hospital's procedures that are responsible for generating 80 percent of the hospital's gross revenue. Full costs are established by adding labor costs, materials costs, equipment depreciation costs, departmental overhead costs, and corporate overhead costs.(ABSTRACT TRUNCATED AT 250 WORDS)

48 CFR 9905.501 - Cost accounting standard-consistency in estimating, accumulating and reporting costs by...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard....501 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST...

Cost Accounting in Higher Education. Simplified Macro- and Micro-Costing Techniques.

ERIC Educational Resources Information Center

Jenny, Hans H.

This manual covers cost accounting applications and techniques as they apply to institutions of higher education, focusing mainly on the different methods of allocating costs. The manual covers four major costing topics: aggregate institution and systemwide costs; major academic and administrative program costs; academic and administrative…

[An evaluation of costs in nephrology by means of analytical accounting system].

PubMed

Hernández-Jaras, J; García Pérez, H; Pons, R; Calvo, C

2005-01-01

The analytical accounting is a countable technique directed to the evaluation, by means of pre-established criteria of distribution, of the internal economy of the hospital, in order to know the effectiveness and efficiency of Clinical Units. The aim of this study was to analyze the activity and costs of the Nephrology Department of General Hospital of Castellón. Activity of Hospitalization and Ambulatory Care, during 2003 was analysed. Hospitalization discharges were grouped in DGR and the costs per DGR were determinated. Total costs Hospitalisation and Ambulatory Care were 560.434,9 and 146.317,8 Euros, respectively. And the costs of one stay, one first outpatient visit and maintenance visit were 200, 63, and 31,6 Euros, respectively. Eighty per cent of the discharges were grouped in 9 DGR and DRG number 316 (Renal Failure) represented 30% of the total productivity. Costs of DGR 316 were 3.178,2 Euros and 16% represented laboratory cost and costs of diagnostic or therapeutic procedures. With introduction of analytical accounting and DGR system, the Nephrology Departments can acquire more full information on the results and costs of treatment. These techniques permits to improve the financial and economic performance.

Activity Analysis and Cost Analysis in Medical Schools.

ERIC Educational Resources Information Center

Koehler, John E.; Slighton, Robert L.

There is no unique answer to the question of what an ongoing program costs in medical schools. The estimates of program costs generated by classical methods of cost accounting are unsatisfactory because such accounting cannot deal with the joint production or joint cost problem. Activity analysis models aim at calculating the impact of alternative…

48 CFR 9904.408 - Accounting for costs of compensated personal absence.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Accounting for costs of compensated personal absence. 9904.408 Section 9904.408 Federal Acquisition Regulations System COST ACCOUNTING... AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.408 Accounting for costs of compensated...

48 CFR 9904.415 - Accounting for the cost of deferred compensation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Accounting for the cost of deferred compensation. 9904.415 Section 9904.415 Federal Acquisition Regulations System COST ACCOUNTING... AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.415 Accounting for the cost of deferred...

Designing an activity-based costing model for a non-admitted prisoner healthcare setting.

PubMed

Cai, Xiao; Moore, Elizabeth; McNamara, Martin

2013-09-01

To design and deliver an activity-based costing model within a non-admitted prisoner healthcare setting. Key phases from the NSW Health clinical redesign methodology were utilised: diagnostic, solution design and implementation. The diagnostic phase utilised a range of strategies to identify issues requiring attention in the development of the costing model. The solution design phase conceptualised distinct 'building blocks' of activity and cost based on the speciality of clinicians providing care. These building blocks enabled the classification of activity and comparisons of costs between similar facilities. The implementation phase validated the model. The project generated an activity-based costing model based on actual activity performed, gained acceptability among clinicians and managers, and provided the basis for ongoing efficiency and benchmarking efforts.

IVF cycle cost estimation using Activity Based Costing and Monte Carlo simulation.

PubMed

Cassettari, Lucia; Mosca, Marco; Mosca, Roberto; Rolando, Fabio; Costa, Mauro; Pisaturo, Valerio

2016-03-01

The Authors present a new methodological approach in stochastic regime to determine the actual costs of an healthcare process. The paper specifically shows the application of the methodology for the determination of the cost of an Assisted reproductive technology (ART) treatment in Italy. The reason of this research comes from the fact that deterministic regime is inadequate to implement an accurate estimate of the cost of this particular treatment. In fact the durations of the different activities involved are unfixed and described by means of frequency distributions. Hence the need to determine in addition to the mean value of the cost, the interval within which it is intended to vary with a known confidence level. Consequently the cost obtained for each type of cycle investigated (in vitro fertilization and embryo transfer with or without intracytoplasmic sperm injection), shows tolerance intervals around the mean value sufficiently restricted as to make the data obtained statistically robust and therefore usable also as reference for any benchmark with other Countries. It should be noted that under a methodological point of view the approach was rigorous. In fact it was used both the technique of Activity Based Costing for determining the cost of individual activities of the process both the Monte Carlo simulation, with control of experimental error, for the construction of the tolerance intervals on the final result.

48 CFR 1652.216-71 - Accounting and Allowable Cost.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Accounting and Allowable... of FEHBP Clauses 1652.216-71 Accounting and Allowable Cost. As prescribed in section 1616.7002, the...). Accounting and Allowable Cost (FEHBAR 1652.216-71) (JAN 2003) (a) Annual Accounting Statements. (1) The...

Time-driven activity-based costing to estimate cost of care at multidisciplinary aerodigestive centers.

PubMed

Garcia, Jordan A; Mistry, Bipin; Hardy, Stephen; Fracchia, Mary Shannon; Hersh, Cheryl; Wentland, Carissa; Vadakekalam, Joseph; Kaplan, Robert; Hartnick, Christopher J

2017-09-01

Providing high-value healthcare to patients is increasingly becoming an objective for providers including those at multidisciplinary aerodigestive centers. Measuring value has two components: 1) identify relevant health outcomes and 2) determine relevant treatment costs. Via their inherent structure, multidisciplinary care units consolidate care for complex patients. However, their potential impact on decreasing healthcare costs is less clear. The goal of this study was to estimate the potential cost savings of treating patients with laryngeal clefts at multidisciplinary aerodigestive centers. Retrospective chart review. Time-driven activity-based costing was used to estimate the cost of care for patients with laryngeal cleft seen between 2008 and 2013 at the Massachusetts Eye and Ear Infirmary Pediatric Aerodigestive Center. Retrospective chart review was performed to identify clinic utilization by patients as well as patient diet outcomes after treatment. Patients were stratified into neurologically complex and neurologically noncomplex groups. The cost of care for patients requiring surgical intervention was five and three times as expensive of the cost of care for patients not requiring surgery for neurologically noncomplex and complex patients, respectively. Following treatment, 50% and 55% of complex and noncomplex patients returned to normal diet, whereas 83% and 87% of patients experienced improved diets, respectively. Additionally, multidisciplinary team-based care for children with laryngeal clefts potentially achieves 20% to 40% cost savings. These findings demonstrate how time-driven activity-based costing can be used to estimate and compare patient costs in multidisciplinary aerodigestive centers. 2c. Laryngoscope, 127:2152-2158, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

48 CFR 9904.412 - Cost accounting standard for composition and measurement of pension cost.

Code of Federal Regulations, 2010 CFR

2010-10-01

... accounting standard for composition and measurement of pension cost. ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard for composition and measurement of pension cost. 9904.412 Section 9904.412 Federal Acquisition...

Clinical process analysis and activity-based costing at a heart center.

PubMed

Ridderstolpe, Lisa; Johansson, Andreas; Skau, Tommy; Rutberg, Hans; Ahlfeldt, Hans

2002-08-01

Cost studies, productivity, efficiency, and quality of care measures, the links between resources and patient outcomes, are fundamental issues for hospital management today. This paper describes the implementation of a model for process analysis and activity-based costing (ABC)/management at a Heart Center in Sweden as a tool for administrative cost information, strategic decision-making, quality improvement, and cost reduction. A commercial software package (QPR) containing two interrelated parts, "ProcessGuide and CostControl," was used. All processes at the Heart Center were mapped and graphically outlined. Processes and activities such as health care procedures, research, and education were identified together with their causal relationship to costs and products/services. The construction of the ABC model in CostControl was time-consuming. However, after the ABC/management system was created, it opened the way for new possibilities including process and activity analysis, simulation, and price calculations. Cost analysis showed large variations in the cost obtained for individual patients undergoing coronary artery bypass grafting (CABG) surgery. We conclude that a process-based costing system is applicable and has the potential to be useful in hospital management.

48 CFR 30.102 - Cost Accounting Standards Board publication.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Cost Accounting Standards Board publication. 30.102 Section 30.102 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION General 30.102 Cost...

Procurement Contracting Officer’s Guide to Cost Accounting Standards,

DTIC Science & Technology

1977-09-01

ACCESSION MO r P.R0CUR2K2NT CONTRACTING ^FFICDR’S %UID2 TO COST ACCOUNTING STANDARDS. .-IB’ i 4fiSj irPBVPWra ONOANIZATION NAME MB AOONESS...discussing the history and development of Cost Accounting Standards, the functions of the Cost Accounting Standards Board, and the methodology...20. Abstract (continued) the tasks that Cost Accounting Standards have placed on the procurement officer. 3y understanding these tasks the

Activity-based costing in radiology. Application in a pediatric radiological unit.

PubMed

Laurila, J; Suramo, I; Brommels, M; Tolppanen, E M; Koivukangas, P; Lanning, P; Standertskjöld-Nordenstam, G

2000-03-01

To get an informative and detailed picture of the resource utilization in a radiology department in order to support its pricing and management. A system based mainly on the theoretical foundations of activity-based costing (ABC) was designed, tested and compared with conventional costing. The study was performed at the Pediatric Unit of the Department of Radiology, Oulu University Hospital. The material consisted of all the 7,452 radiological procedures done in the unit during the first half of 1994, when both methods of costing where in use. Detailed cost data were obtained from the hospital financial and personnel systems and then related to activity data captured in the radiology information system. The allocation of overhead costs was greatly reduced by the introduction of ABC compared to conventional costing. The overhead cost as a percentage of total costs dropped to one-fourth of total costs, from 57% to 16%. The change of unit costs of radiological procedures varied from -42% to +82%. Costing is much more detailed and precise, and the percentage of unspecified allocated overhead costs diminishes drastically when ABC is used. The new information enhances effective departmental management, as the whole process of radiological procedures is identifiable by single activities, amenable to corrective actions and process improvement.

48 CFR 9903.302-2 - Change to a cost accounting practice.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Disclosure Statement, except for the following: (a) The initial adoption of a cost accounting practice for... accounting practice. 9903.302-2 Section 9903.302-2 Federal Acquisition Regulations System COST ACCOUNTING... AND COST ACCOUNTING STANDARDS CONTRACT COVERAGE CAS Rules and Regulations 9903.302-2 Change to a cost...

48 CFR 9905.505 - Accounting for unallowable costs-Educational institutions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS FOR EDUCATIONAL INSTITUTIONS 9905.505 Accounting for unallowable costs—Educational institutions. ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Accounting for unallowable...

48 CFR 52.230-6 - Administration of Cost Accounting Standards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Clauses 52.230-6 Administration of Cost Accounting Standards. As prescribed in 30.201-4(d)(1), insert the following clause: Administration of Cost Accounting Standards (JUN 2010) For the purpose of administering the Cost Accounting Standards (CAS) requirements under this contract, the Contractor shall take the...

48 CFR 52.230-5 - Cost Accounting Standards-Educational Institution.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Cost Accounting Standards... Clauses 52.230-5 Cost Accounting Standards—Educational Institution. As prescribed in 30.201-4(e), insert the following clause: Cost Accounting Standards—Educational Institution (OCT 2010) (a) Unless the...

The hidden costs of accounts receivable.

PubMed

McCormick, E J

1993-11-01

To maintain and expand their missions, hospitals must make the best use of their assets. Knowing the true cost of accounts receivable is important for efficient operations. Knowing how to reduce this cost is critical for liquidity. This article offers a guide to ensuring these assets are used most productively.

17 CFR 256.01-5 - Determination of service cost accounting.

Code of Federal Regulations, 2010 CFR

2010-04-01

... accounting. Service at cost and fair allocation of costs require, first of all, an accurate accounting for... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Determination of service cost accounting. 256.01-5 Section 256.01-5 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION...

Hospital cost accounting: implementing the system successfully.

PubMed

Burik, D; Duvall, T J

1985-05-01

To successfully implement a cost accounting system, certain key steps should be undertaken. These steps include developing and installing software; developing cost center budgets and inter-cost center allocations; developing service item standard costs; generating cost center level and patient level standard cost reports and reconciling these costs to actual costs; generating product line profitability reports and reconciling these reports to the financial statements; and providing ad hoc reporting capabilities. By following these steps, potential problems in the implementation process can be anticipated and avoided.

Cost accounting for end-of-life care: recommendations to the field by the Cost Accounting Workgroup.

PubMed

Seninger, Stephen; Smith, Dean G

2004-01-01

Accurate measurement of economic costs is prerequisite to progress in improving the care delivered to Americans during the last stage of life. The Robert Wood Johnson Excellence in End-of-Life Care national program assembled a Cost Accounting Workgroup to identify accurate and meaningful methods to measure palliative and end-of-life health care use and costs. Eight key issues were identified: (1) planning the cost analysis; (2) identifying the perspective for cost analysis; (3) describing the end-of-life care program; (4) identifying the appropriate comparison group; (5) defining the period of care to be studied; (6) identifying the units of health care services; (7) assigning monetary values to health care service units; and (8) calculating costs. Economic principles of cost measurement and cost measurement issues encountered by practitioners were reviewed and incorporated into a set of recommendations.

Cost-price estimation of clinical laboratory services based on activity-based costing: A case study from a developing country

PubMed Central

Mouseli, Ali; Barouni, Mohsen; Amiresmaili, Mohammadreza; Samiee, Siamak Mirab; Vali, Leila

2017-01-01

Background It is believed that laboratory tariffs in Iran don’t reflect the real costs. This might expose private laboratories at financial hardship. Activity Based Costing is widely used as a cost measurement instrument to more closely approximate the true cost of operations. Objective This study aimed to determine the real price of different clinical tests of a selected private clinical laboratory. Methods This study was a cross sectional study carried out in 2015. The study setting was the private laboratories in the city of Kerman, Iran. Of 629 tests in the tariff book of the laboratory (relative value), 188 tests were conducted in the laboratory that used Activity Based Costing (ABC) methodology to estimate cost-price. Analyzing and cost-price estimating of laboratory services were performed by MY ABCM software Version 5.0. Results In 2015, the total costs were $641,645. Direct and indirect costs were 78.3% and 21.7% respectively. Laboratory consumable costs by 37% and personnel costs by 36.3% had the largest share of the costing. Also, group of hormone tests cost the most $147,741 (23.03%), and other tests group cost the least $3,611 (0.56%). Also after calculating the cost of laboratory services, a comparison was made between the calculated price and the private sector’s tariffs in 2015. Conclusion This study showed that there was a difference between costs and tariffs in the private laboratory. One way to overcome this problem is to increase the number of laboratory tests with regard to capacity of the laboratories. PMID:28607638

Cost-price estimation of clinical laboratory services based on activity-based costing: A case study from a developing country.

PubMed

Mouseli, Ali; Barouni, Mohsen; Amiresmaili, Mohammadreza; Samiee, Siamak Mirab; Vali, Leila

2017-04-01

It is believed that laboratory tariffs in Iran don't reflect the real costs. This might expose private laboratories at financial hardship. Activity Based Costing is widely used as a cost measurement instrument to more closely approximate the true cost of operations. This study aimed to determine the real price of different clinical tests of a selected private clinical laboratory. This study was a cross sectional study carried out in 2015. The study setting was the private laboratories in the city of Kerman, Iran. Of 629 tests in the tariff book of the laboratory (relative value), 188 tests were conducted in the laboratory that used Activity Based Costing (ABC) methodology to estimate cost-price. Analyzing and cost-price estimating of laboratory services were performed by MY ABCM software Version 5.0. In 2015, the total costs were $641,645. Direct and indirect costs were 78.3% and 21.7% respectively. Laboratory consumable costs by 37% and personnel costs by 36.3% had the largest share of the costing. Also, group of hormone tests cost the most $147,741 (23.03%), and other tests group cost the least $3,611 (0.56%). Also after calculating the cost of laboratory services, a comparison was made between the calculated price and the private sector's tariffs in 2015. This study showed that there was a difference between costs and tariffs in the private laboratory. One way to overcome this problem is to increase the number of laboratory tests with regard to capacity of the laboratories.

48 CFR 9904.409 - Cost accounting standard-depreciation of tangible capital assets.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard... ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.409 Cost accounting standard...

Activity-based costs of plasma transfusions in medical and surgical inpatients at a US hospital.

PubMed

Shander, A; Ozawa, S; Hofmann, A

2016-07-01

Fresh frozen plasma (FFP) usage has significantly increased over the last decade leading to elevated healthcare costs. Although FFP is used in several clinical settings, it is often inappropriately transfused and evidence for its clinical efficacy is poor. Here, we describe plasma usage and transfusion costs in a real-world US inpatient setting to determine the cost-effectiveness of FFP transfusion and for comparison to various patient blood management (PBM) options to treat coagulopathies. All activities related to plasma transfusion recorded at a single US hospital over one calendar year were collected in a stepwise manner using an activity-based costing (ABC) methodology. This model maps all technical, administrative and clinical processes inherent to the cost of plasma. Of 18 200 inpatients recorded, 849 were charged for blood products. In total, 136 medical and surgical inpatients were charged for 577 units of FFP, receiving a total of 534 units; 43 units were charged but not transfused. The total cost per unit of FFP transfused was $409·62 and $1,608·37 per patient transfused with FFP. Wasted products, in-hospital processes and overhead costs were found to account for 89·8% of the total cost of FFP transfusions. This study is the first to use ABC methodology to determine the full cost of plasma transfusion in a US inpatient setting. These data reveal the true cost of plasma, providing a useful reference point to compare with the cost of other PBM options to manage coagulation disorders. © 2016 International Society of Blood Transfusion.

Cost-effectiveness and cost-utility of a Web-based or print-delivered tailored intervention to promote physical activity among adults aged over fifty: an economic evaluation of the Active Plus intervention.

PubMed

Golsteijn, Rianne Hj; Peels, Denise A; Evers, Silvia Maa; Bolman, Catherine; Mudde, Aart N; de Vries, Hein; Lechner, Lilian

2014-09-28

The adverse health effects of insufficient physical activity (PA) result in high costs to society. The economic burden of insufficient PA, which increases in our aging population, stresses the urgency for cost-effective interventions to promote PA among older adults. The current study provides insight in the cost-effectiveness and cost-utility of different versions of a tailored PA intervention (Active Plus) among adults aged over fifty. The intervention conditions (i.e. print-delivered basic (PB; N = 439), print-delivered environmental (PE; N = 435), Web-based basic (WB; N = 423), Web-based environmental (WE; N = 432)) and a waiting-list control group were studied in a clustered randomized controlled trial. Intervention costs were registered during the trial. Health care costs, participant costs and productivity losses were identified and compared with the intervention effects on PA (in MET-hours per week) and quality-adjusted life years (QALYs) 12 months after the start of the intervention. Cost-effectiveness ratios (ICERs) and cost-utility ratios (ICURs) were calculated per intervention condition. Non-parametric bootstrapping techniques and sensitivity analyses were performed to account for uncertainty. As a whole (i.e. the four intervention conditions together) the Active Plus intervention was found to be cost-effective. The PB-intervention (ICER = €-55/MET-hour), PE-intervention (ICER = €-94/MET-hour) and the WE-intervention (ICER = €-139/MET-hour) all resulted in higher effects on PA and lower societal costs than the control group. With regard to QALYs, the PB-intervention (ICUR = €38,120/QALY), the PE-intervention (ICUR = €405,892/QALY) and the WE-intervention (ICUR = €-47,293/QALY) were found to be cost-effective when considering a willingness-to-pay threshold of €20,000/QALY. In most cases PE had the highest probability to be cost-effective. The Active Plus intervention was found to be a cost

48 CFR 9905.502 - Cost accounting standard-consistency in allocating costs incurred for the same purpose by...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard... 9905.502 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST...

Using the Student Research Project to Integrate Macroeconomics and Statistics in an Advanced Cost Accounting Course

ERIC Educational Resources Information Center

Hassan, Mahamood M.; Schwartz, Bill N.

2014-01-01

This paper discusses a student research project that is part of an advanced cost accounting class. The project emphasizes active learning, integrates cost accounting with macroeconomics and statistics by "learning by doing" using real world data. Students analyze sales data for a publicly listed company by focusing on the company's…

The same-location cost is unrelated to attentional settings: an object-updating account.

PubMed

Carmel, Tomer; Lamy, Dominique

2014-08-01

What mechanisms allow us to ignore salient yet irrelevant visual information has been a matter of intense debate. According to the contingent-capture hypothesis, such information is filtered out, whereas according to the salience-based account, it captures attention automatically. Several recent studies have reported a same-location cost that appears to fit neither of these accounts. These showed that responses may actually be slower when the target appears at the location just occupied by an irrelevant singleton distractor. Here, we investigated the mechanisms underlying this same-location cost. Our findings show that the same-location cost is unrelated to automatic attentional capture or strategic setting of attentional priorities, and therefore invalidate the feature-based inhibition and fast attentional disengagement accounts of this effect. In addition, we show that the cost is wiped out when the cue and target are not perceived as parts of the same object. We interpret these findings as indicating that the same-location cost has been previously misinterpreted by both bottom-up and top-down theories of attentional capture. We propose that it is better understood as a consequence of object updating, namely, as the cost of updating the information stored about an object when this object changes across time.

Cost Accounting and Analysis for University Libraries.

ERIC Educational Resources Information Center

Leimkuhler, Ferdinand F.; Cooper, Michael D.

The approach to library planning studied in this report is the use of accounting models to measure library costs and implement program budgets. A cost-flow model for a university library is developed and listed with historical data from the Berkeley General Library. Various comparisons of an exploratory nature are made of the unit costs for…

A managerial accounting analysis of hospital costs.

PubMed

Frank, W G

1976-01-01

Variance analysis, an accounting technique, is applied to an eight-component model of hospital costs to determine the contribution each component makes to cost increases. The method is illustrated by application to data on total costs from 1950 to 1973 for all U.S. nongovernmental not-for-profit short-term general hospitals. The costs of a single hospital are analyzed and compared to the group costs. The potential uses and limitations of the method as a planning and research tool are discussed.

Time-Driven Activity-Based Costing: A Comparative Cost Analysis of Whole-Breast Radiotherapy Versus Balloon-Based Brachytherapy in the Management of Early-Stage Breast Cancer.

PubMed

Schutzer, Matthew E; Arthur, Douglas W; Anscher, Mitchell S

2016-05-01

Value in health care is defined as outcomes achieved per dollar spent, and understanding cost is critical to delivering high-value care. Traditional costing methods reflect charges rather than fundamental costs to provide a service. The more rigorous method of time-driven activity-based costing was used to compare cost between whole-breast radiotherapy (WBRT) and accelerated partial-breast irradiation (APBI) using balloon-based brachytherapy. For WBRT (25 fractions with five-fraction boost) and APBI (10 fractions twice daily), process maps were created outlining each activity from consultation to post-treatment follow up. Through staff interviews, time estimates were obtained for each activity. The capacity cost rates (CCR), defined as cost per minute, were calculated for personnel, equipment, and physical space. Total cost was calculated by multiplying the time required of each resource by its CCR. This was then summed and combined with cost of consumable materials. The total cost for WBRT was $5,333 and comprised 56% personnel costs and 44% space/equipment costs. For APBI, the total cost was $6,941 (30% higher than WBRT) and comprised 51% personnel costs, 6% space/equipment costs, and 43% consumable materials costs. The attending physician had the highest CCR of all personnel ($4.28/min), and APBI required 24% more attending time than WBRT. The most expensive activity for APBI was balloon placement and for WBRT was computed tomography simulation. APBI cost more than WBRT when using the dose/fractionation schemes analyzed. Future research should use time-driven activity-based costing to better understand cost with the aim of reducing expenditure and defining bundled payments. Copyright © 2016 by American Society of Clinical Oncology.

Cost accounting models used for price-setting of health services: an international review.

PubMed

Raulinajtys-Grzybek, Monika

2014-12-01

The aim of the article was to present and compare cost accounting models which are used in the area of healthcare for pricing purposes in different countries. Cost information generated by hospitals is further used by regulatory bodies for setting or updating prices of public health services. The article presents a set of examples from different countries of the European Union, Australia and the United States and concentrates on DRG-based payment systems as they primarily use cost information for pricing. Differences between countries concern the methodology used, as well as the data collection process and the scope of the regulations on cost accounting. The article indicates that the accuracy of the calculation is only one of the factors that determine the choice of the cost accounting methodology. Important aspects are also the selection of the reference hospitals, precise and detailed regulations and the existence of complex healthcare information systems in hospitals. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The Cost of Library Services: Activity-Based Costing in an Australian Academic Library.

ERIC Educational Resources Information Center

Robinson, Peter; Ellis-Newman, Jennifer

1998-01-01

Explains activity-based costing (ABC), discusses the benefits of ABC to library managers, and describes the steps involved in implementing ABC in an Australian academic library. Discusses the budgeting process in universities, and considers benefits to the library. (Author/LRW)

Using activity-based costing and theory of constraints to guide continuous improvement in managed care.

PubMed

Roybal, H; Baxendale, S J; Gupta, M

1999-01-01

Activity-based costing and the theory of constraints have been applied successfully in many manufacturing organizations. Recently, those concepts have been applied in service organizations. This article describes the application of activity-based costing and the theory of constraints in a managed care mental health and substance abuse organization. One of the unique aspects of this particular application was the integration of activity-based costing and the theory of constraints to guide process improvement efforts. This article describes the activity-based costing model and the application of the theory of constraint's focusing steps with an emphasis on unused capacities of activities in the organization.

Rethinking the cost of healthcare in low-resource settings: the value of time-driven activity-based costing

PubMed Central

McBain, Ryan K; Jerome, Gregory; Warsh, Jonathan; Browning, Micaela; Mistry, Bipin; Faure, Peterson Abnis I; Pierre, Claire; Fang, Anna P; Mugunga, Jean Claude; Rhatigan, Joseph; Leandre, Fernet; Kaplan, Robert

2016-01-01

Low-income and middle-income countries account for over 80% of the world's infectious disease burden, but <20% of global expenditures on health. In this context, judicious resource allocation can mean the difference between life and death, not just for individual patients, but entire patient populations. Understanding the cost of healthcare delivery is a prerequisite for allocating health resources, such as staff and medicines, in a way that is effective, efficient, just and fair. Nevertheless, health costs are often poorly understood, undermining effectiveness and efficiency of service delivery. We outline shortcomings, and consequences, of common approaches to estimating the cost of healthcare in low-resource settings, as well as advantages of a newly introduced approach in healthcare known as time-driven activity-based costing (TDABC). TDABC is a patient-centred approach to cost analysis, meaning that it begins by studying the flow of individual patients through the health system, and measuring the human, equipment and facility resources used to treat the patients. The benefits of this approach are numerous: fewer assumptions need to be made, heterogeneity in expenditures can be studied, service delivery can be modelled and streamlined and stronger linkages can be established between resource allocation and health outcomes. TDABC has demonstrated significant benefits for improving health service delivery in high-income countries but has yet to be adopted in resource-limited settings. We provide an illustrative case study of its application throughout a network of hospitals in Haiti, as well as a simplified framework for policymakers to apply this approach in low-resource settings around the world. PMID:28588971

Rethinking the cost of healthcare in low-resource settings: the value of time-driven activity-based costing.

PubMed

McBain, Ryan K; Jerome, Gregory; Warsh, Jonathan; Browning, Micaela; Mistry, Bipin; Faure, Peterson Abnis I; Pierre, Claire; Fang, Anna P; Mugunga, Jean Claude; Rhatigan, Joseph; Leandre, Fernet; Kaplan, Robert

2016-01-01

Low-income and middle-income countries account for over 80% of the world's infectious disease burden, but <20% of global expenditures on health. In this context, judicious resource allocation can mean the difference between life and death, not just for individual patients, but entire patient populations. Understanding the cost of healthcare delivery is a prerequisite for allocating health resources, such as staff and medicines, in a way that is effective, efficient, just and fair. Nevertheless, health costs are often poorly understood, undermining effectiveness and efficiency of service delivery. We outline shortcomings, and consequences, of common approaches to estimating the cost of healthcare in low-resource settings, as well as advantages of a newly introduced approach in healthcare known as time-driven activity-based costing (TDABC). TDABC is a patient-centred approach to cost analysis, meaning that it begins by studying the flow of individual patients through the health system, and measuring the human, equipment and facility resources used to treat the patients. The benefits of this approach are numerous: fewer assumptions need to be made, heterogeneity in expenditures can be studied, service delivery can be modelled and streamlined and stronger linkages can be established between resource allocation and health outcomes. TDABC has demonstrated significant benefits for improving health service delivery in high-income countries but has yet to be adopted in resource-limited settings. We provide an illustrative case study of its application throughout a network of hospitals in Haiti, as well as a simplified framework for policymakers to apply this approach in low-resource settings around the world.

Cost accounting and public reimbursement schemes in Spanish hospitals.

PubMed

Sánchez-Martínez, Fernando; Abellán-Perpiñán, José-María; Martínez-Pérez, Jorge-Eduardo; Puig-Junoy, Jaume

2006-08-01

The objective of this paper is to provide a description and analysis of the main costing and pricing (reimbursement) systems employed by hospitals in the Spanish National Health System (NHS). Hospitals cost calculations are mostly based on a full costing approach as opposite to other systems like direct costing or activity based costing. Regional and hospital differences arise on the method used to allocate indirect costs to cost centres and also on the approach used to measure resource consumption. Costs are typically calculated by disaggregating expenditure and allocating it to cost centres, and then to patients and DRGs. Regarding public reimbursement systems, the impression is that unit costs are ignored, except for certain type of high technology processes and treatments.

A managerial accounting analysis of hospital costs.

PubMed Central

Frank, W G

1976-01-01

Variance analysis, an accounting technique, is applied to an eight-component model of hospital costs to determine the contribution each component makes to cost increases. The method is illustrated by application to data on total costs from 1950 to 1973 for all U.S. nongovernmental not-for-profit short-term general hospitals. The costs of a single hospital are analyzed and compared to the group costs. The potential uses and limitations of the method as a planning and research tool are discussed. PMID:965233

48 CFR 52.230-1 - Cost Accounting Standards Notices and Certification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Cost Accounting Standards... Provisions and Clauses 52.230-1 Cost Accounting Standards Notices and Certification. As prescribed in 30.201-3, insert the following provisions: Cost Accounting Standards Notices and Certification (OCT 2008...

SCATS: SRB Cost Accounting and Tracking System handbook

NASA Technical Reports Server (NTRS)

Zorv, R. B.; Stewart, R. D.; Coley, G.; Higginbotham, M.

1978-01-01

The Solid Rocket Booster Cost Accounting and Tracking System (SCATS) which is an automatic data processing system designed to keep a running account of the number, description, and estimated cost of Level 2, 3, and 4 changes is described. Although designed specifically for the Space Shuttle Solid Rocket Booster Program, the ADP system can be used for any other program that has a similar structure for recording, reporting, and summing numbers and costs of changes. The program stores the alpha-numeric designators for changes, government estimated costs, proposed costs, and negotiated value in a MIRADS (Marshall Information Retrieval and Display System) format which permits rapid access, manipulation, and reporting of current change status. Output reports listing all changes, totals of each level, and totals of all levels, can be derived for any calendar interval period.

Enhancing efficiency of production cost on seafood process with activity based management method

NASA Astrophysics Data System (ADS)

Tarigan, U.; Tarigan, U. P. P.

2018-02-01

The efficiency of production costs has an important impact maintaining company presence in the business world, as well as in the face of increasingly sharp global competition. It was done by identifying and reducing non-value-added activities to decrease production costs and increase profits. The study was conducted at a company engaged in the production of squid (seafood). It has a higher product price than the market as Rp 50,000 per kg while the market price of squid is only Rp 35,000 per kg. The price of the product to be more expensive compared with market price, and thereby a lot more consumers choose the lower market price. Based on the discussions conducted, the implementation of Activity Based Management was seen in the reduction of activities that are not added value in the production process. Since each activities consumers cost, the reduction of nonvalue-added activities has effects on the decline of production cost. The production’s decline costs mainly occur in the reduction of material transfer costs. The results showed that there was an increase after the improvement of 2.60%. Increased production cost efficiency causes decreased production costs and increased profits.

Design and implementation of a cost-accounting system in hospital pharmacy.

PubMed

Gouveia, W A; Anderson, E R; Decker, E L; Backer, K

1988-03-01

The design and implementation of a cost-accounting system in a hospital pharmacy department is described. Pharmacy resource use (labor, drugs, supplies, and overhead), or pharmacy's intermediate products, was clearly defined in terms of dosage forms (10 groupings representing variable labor and supplies) and drug products (more than 100 categories that incorporate cost and volume of use for 3000 line items). Costs were defined as variable or nonvariable (fixed), based on whether they were related to a specific medication order. Labor was divided into variable and fixed components. Time standards were developed using time and motion studies. Variable labor hours were determined as follows: specified hours (the volume of each dosage form multiplied by the standard time for each dosage form); nonspecified hours (time not directly associated with production); hours worked (specified plus nonspecified hours); and hours paid (hours worked plus sick leave and vacation). A standard cost for each drug product was based on the weighted average of volume and cost of the individual line items. The total drug budget was constructed by multiplying the standard cost for each drug product times the projected volume for each drug product. The pharmacy budget was developed by calculating the number and mix of pharmacy products used in association with the projected number and type of cases for the fiscal year. The monthly pharmacy budget reports were assembled with data from the payroll, billing, and cost-accounting systems.(ABSTRACT TRUNCATED AT 250 WORDS)

Counting the costs of accreditation in acute care: an activity-based costing approach

PubMed Central

Mumford, Virginia; Greenfield, David; Hogden, Anne; Forde, Kevin; Westbrook, Johanna; Braithwaite, Jeffrey

2015-01-01

Objectives To assess the costs of hospital accreditation in Australia. Design Mixed methods design incorporating: stakeholder analysis; survey design and implementation; activity-based costs analysis; and expert panel review. Setting Acute care hospitals accredited by the Australian Council for Health Care Standards. Participants Six acute public hospitals across four States. Results Accreditation costs varied from 0.03% to 0.60% of total hospital operating costs per year, averaged across the 4-year accreditation cycle. Relatively higher costs were associated with the surveys years and with smaller facilities. At a national level these costs translate to $A36.83 million, equivalent to 0.1% of acute public hospital recurrent expenditure in the 2012 fiscal year. Conclusions This is the first time accreditation costs have been independently evaluated across a wide range of hospitals and highlights the additional cost burden for smaller facilities. A better understanding of the costs allows policymakers to assess alternative accreditation and other quality improvement strategies, and understand their impact across a range of facilities. This methodology can be adapted to assess international accreditation programmes. PMID:26351190

Activity-based analyses lead to better decision making.

PubMed

Player, S

1998-08-01

Activity-based costing (ABC) and activity-based management (ABM) are cost-management tools that are relatively new to the healthcare industry. ABC is used for strategic decision making. It assesses the costs associated with specific activities and resources and links those costs to specific internal and external customers of the healthcare enterprise (e.g., patients, service lines, and physician groups) to determine the costs associated with each customer. This cost information then can be adjusted to account for anticipated changes and to predict future costs. ABM, on the other hand, supports operations by focusing on the causes of costs and how costs can be reduced. It assesses cost drivers that directly affect the cost of a product or service, and uses performance measures to evaluate the financial or nonfinancial benefit an activity provides. By identifying each cost driver and assessing the value the element adds to the healthcare enterprise, ABM provides a basis for selecting areas that can be changed to reduce costs.

Activity-Based Costing for Agile Manufacturing Control

DTIC Science & Technology

1998-08-01

INVESTMENT FOR A PROPOSED CAPITAL EQUIPMENT .... PURCHASE...to maintain a complex accounting system to meet your decision-making needs and the requirements of GAAP (Generally Accepted Accounting Principles). An...to be used primarily for job quotation, then some of the secondary activities can be consolidated into "higher" level activities that would shorten the

A U.K. cost-benefit analysis of circles of support and accountability interventions.

PubMed

Elliott, Ian A; Beech, Anthony R

2013-06-01

Circles of Support and Accountability (CoSA) aim to augment sex offender risk management at the point of community reentry by facilitating "Circles" of volunteers who provide support, guidance, and advice, while ensuring that the offender remains accountable for their actions. In this study, the authors provide (a) a rapid evidence assessment of the effectiveness of CoSA in reducing reoffending, and (b) a U.K. cost-benefit analysis for CoSA when compared to the criminal justice costs of reoffending. From the study analysis, the average cost of a "Circle" was estimated to be £11,303 per annum and appears to produce a 50% reduction in reoffending (sexual and nonsexual), as the estimated cost of reoffending was estimated to be £147,161 per offender, per annum. Based on a hypothetical cohort of 100 offenders--50 of whom receive CoSA and 50 of whom do not--investment in CoSA appears to provide a cost saving of £23,494 and a benefit-cost ratio of 1.04. Accounting for estimates that the full extent of the cost to society may be 5 to 10 times the tangible costs substantially increases estimated cost savings related to CoSA.

Comparison of cost accounting methods from different DRG systems and their effect on health care quality.

PubMed

Leister, Jan Eric; Stausberg, Jürgen

2005-09-28

Diagnosis related groups (DRGs) are a well-established provider payment system. Because of their imminent potential of cost reduction, they have been widely introduced. In addition to cost cutting, several social objectives - e.g., improving overall health care quality - feed into the DRG system. The WHO compared different provider payment systems with regard to the following objectives: prevention of further health problems, providing services and solving health problems, and responsiveness to people's legitimate expectations. However, no study has been published which takes the impact of different cost accounting systems across the DRG systems into account. We compared the impact of different cost accounting methods within DRG-like systems by developing six criteria: integration of patients' health risk into pricing practice, incentives for quality improvement and innovation, availability of high class evidence based therapy, prohibition of economically founded exclusions, reduction of fragmentation incentives, and improvement of patient oriented treatment. We set up a first overview of potential and actual impacts of the pricing practices within Yale-DRGs, AR-DRGs, G-DRGs, Swiss AP-DRGs adoption and Swiss MIPP. It could be demonstrated that DRGs are not only a 'homogenous' group of similar provider payment systems but quite different by fulfilling major health care objectives connected with the used cost accounting methods. If not only the possible cost reduction is used to put in a good word for DRG-based provider payment systems, maximum accurateness concerning the method of cost accounting should prevail when implementing a new DRG-based provider payment system.

Cost accounting helps ensure group practice profitability.

PubMed

Conrad, K A; Nagle, C B; Wunar, R J

1996-11-01

Physician practice managers are faced with the challenge of developing overall practice budgets, identifying strategies for the practice, and negotiating profitable managed care contracts. To accomplish these objectives, they need to understand and manage the costs associated with practice operations. Practices that have used cost accounting methodologies to identify their operational costs in greater detail and have developed methods to effectively manage their costs are likely to be more attractive partners to health plans and better positioned to thrive under managed care.

Improving Efficiency Using Time-Driven Activity-Based Costing Methodology.

PubMed

Tibor, Laura C; Schultz, Stacy R; Menaker, Ronald; Weber, Bradley D; Ness, Jay; Smith, Paula; Young, Phillip M

2017-03-01

The aim of this study was to increase efficiency in MR enterography using a time-driven activity-based costing methodology. In February 2015, a multidisciplinary team was formed to identify the personnel, equipment, space, and supply costs of providing outpatient MR enterography. The team mapped the current state, completed observations, performed timings, and calculated costs associated with each element of the process. The team used Pareto charts to understand the highest cost and most time-consuming activities, brainstormed opportunities, and assessed impact. Plan-do-study-act cycles were developed to test the changes, and run charts were used to monitor progress. The process changes consisted of revising the workflow associated with the preparation and administration of glucagon, with completed implementation in November 2015. The time-driven activity-based costing methodology allowed the radiology department to develop a process to more accurately identify the costs of providing MR enterography. The primary process modification was reassigning responsibility for the administration of glucagon from nurses to technologists. After implementation, the improvements demonstrated success by reducing non-value-added steps and cost by 13%, staff time by 16%, and patient process time by 17%. The saved process time was used to augment existing examination time slots to more accurately accommodate the entire enterographic examination. Anecdotal comments were captured to validate improved staff satisfaction within the multidisciplinary team. This process provided a successful outcome to address daily workflow frustrations that could not previously be improved. A multidisciplinary team was necessary to achieve success, in addition to the use of a structured problem-solving approach. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Cost Accounting and Analysis for University Libraries

ERIC Educational Resources Information Center

Leimkuhler, Ferdinand F.; Cooper, Michael D.

1971-01-01

The approach to library planning studied in this paper is the use of accounting models to measure library costs and implement program budgets. A cost-flow model for a university library is developed and tested with historical data from the General Library at the University of California, Berkeley. (4 references) (Author)

48 CFR 30.603 - Changes to disclosed or established cost accounting practices.

Code of Federal Regulations, 2010 CFR

2010-10-01

... established cost accounting practices. 30.603 Section 30.603 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Administration 30.603 Changes to disclosed or established cost accounting practices. ...

48 CFR 30.603 - Changes to disclosed or established cost accounting practices.

Code of Federal Regulations, 2011 CFR

2011-10-01

... established cost accounting practices. 30.603 Section 30.603 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Administration 30.603 Changes to disclosed or established cost accounting practices. ...

75 FR 64684 - Cost Accounting Standards: Elimination of the Exemption From Cost Accounting Standards for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-20

... financial accounting practices and internal controls. Consistency will be better served by all companies... such as the ownership and control of the company, and whether the contractor's accounting activities... argues that there must be some type of accounting system in foreign entities to ensure that billings...

77 FR 69441 - Federal Acquisition Regulation; Information Collection; Cost Accounting Standards Administration

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-19

...; Information Collection; Cost Accounting Standards Administration AGENCY: Department of Defense (DOD), General... collection requirement concerning cost accounting standards administration. Public comments are particularly... Information Collection 9000- 0129, Cost Accounting Standards Administration by any of the following methods...

An Analysis of the Cost Accounting System for the Depot Maintenance Service, Air Force Industrial Fund.

DTIC Science & Technology

1987-09-01

AN A NALYSIS OF THE COST ACCOUNTING SYSTEM FOR THE DEPOT 1/1 MRINTENANCE SERVI..(U) MIR FORCE INST OF TECH IIGHT-PTTERSON RFB OH SCHOOL OF SYST.. 0 L...I "VV h S~ ~~i FiLE COV, THSI CIO ~OF AN ANALYSIS OF THE COST ACCOUNTING SYSTEM FOR THE DEPOT MAINTENANCE SERVICE, AIR FORCE INDUSTRIAL FUND...Patterson Air Force Base, Ohio ~ p~UOW~~ ’ I ~ 1 12 02 0 AFIT/GLM/LSY/87S-83 AN ANALYSIS OF THE COST ACCOUNTING SYSTEM FOR THE DEPOT MAINTENANCE SERVICE, AIR

Development of an activity-based costing model to evaluate physician office practice profitability.

PubMed

Dugel, Pravin U; Tong, Kuo Bianchini

2011-01-01

Newer treatment regimens for age-related macular degeneration have significantly affected traditional and non-traditional retinal services across all types of practice settings around the country as they seek to find a balance among delivering best patient care, keeping operating costs under control, and maintaining profitability. A systematic retrospective review of a multi-city, multi-physician retinal practice's accounting system to obtain data on revenues, expenses, and profit. Data reviewed were from practice management systems to obtain claims level data on clinical procedures across 7 primary activity centers: non-laser surgery, laser surgery, office visits, optical coherence tomography (OCT), non-OCT diagnostics, drugs and drug injections, and research. All treated patients from a retina practice from January 1, 2005, to December 31, 2007. Retrospective claims data review from a multi-physician retina practice detailing Current Procedural Terminology and Healthcare Common Procedure Coding System procedures performed and billed, submitted charges, allowed charges, and net collections. Analyses were performed by an outside firm and verified by a risk advisory firm. Identifying practice efficiencies/inefficiencies as they relate to patient care. An elaborate analysis using activity-based costing (ABC) showed that increased office visits and OCT and non-OCT diagnostics had a significant negative impact on the practice's profit margins, whereas surgical procedures contributed to the majority of the practice's profit margins because of the lower operating costs associated with surgery. The practice was able to accommodate the demand in patient volume, medical retina services, and medical imaging with the advent of anti-vascular endothelial growth factor therapy and realized a seismic shift in operating costs. The practice attempted to deliver state-of-the-art patient care in a cost-effective manner, yet underwent a significant decline in its financial health

How can activity-based costing methodology be performed as a powerful tool to calculate costs and secure appropriate patient care?

PubMed

Lin, Blossom Yen-Ju; Chao, Te-Hsin; Yao, Yuh; Tu, Shu-Min; Wu, Chun-Ching; Chern, Jin-Yuan; Chao, Shiu-Hsiung; Shaw, Keh-Yuong

2007-04-01

Previous studies have shown the advantages of using activity-based costing (ABC) methodology in the health care industry. The potential values of ABC methodology in health care are derived from the more accurate cost calculation compared to the traditional step-down costing, and the potentials to evaluate quality or effectiveness of health care based on health care activities. This project used ABC methodology to profile the cost structure of inpatients with surgical procedures at the Department of Colorectal Surgery in a public teaching hospital, and to identify the missing or inappropriate clinical procedures. We found that ABC methodology was able to accurately calculate costs and to identify several missing pre- and post-surgical nursing education activities in the course of treatment.

77 FR 27550 - Federal Acquisition Regulation; Revision of Cost Accounting Standards Threshold

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-10

...] RIN 9000-AM25 Federal Acquisition Regulation; Revision of Cost Accounting Standards Threshold AGENCY... Federal Acquisition Regulation (FAR) to revise the threshold for applicability of cost accounting standards in order to implement a recent rule of the Cost Accounting Standards Board and statutory...

Development of Activity-based Cost Functions for Cellulase, Invertase, and Other Enzymes

NASA Astrophysics Data System (ADS)

Stowers, Chris C.; Ferguson, Elizabeth M.; Tanner, Robert D.

As enzyme chemistry plays an increasingly important role in the chemical industry, cost analysis of these enzymes becomes a necessity. In this paper, we examine the aspects that affect the cost of enzymes based upon enzyme activity. The basis for this study stems from a previously developed objective function that quantifies the tradeoffs in enzyme purification via the foam fractionation process (Cherry et al., Braz J Chem Eng 17:233-238, 2000). A generalized cost function is developed from our results that could be used to aid in both industrial and lab scale chemical processing. The generalized cost function shows several nonobvious results that could lead to significant savings. Additionally, the parameters involved in the operation and scaling up of enzyme processing could be optimized to minimize costs. We show that there are typically three regimes in the enzyme cost analysis function: the low activity prelinear region, the moderate activity linear region, and high activity power-law region. The overall form of the cost analysis function appears to robustly fit the power law form.

48 CFR 970.5232-5 - Liability with respect to cost accounting standards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... cost accounting standards. 970.5232-5 Section 970.5232-5 Federal Acquisition Regulations System... cost accounting standards. As prescribed in 970.3270(a)(5), insert the following clause: Liability With Respect to Cost Accounting Standards (DEC 2000) (a) The Contractor is not liable to the Government for...

48 CFR 4.705-1 - Financial and cost accounting records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Financial and cost accounting records. 4.705-1 Section 4.705-1 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL ADMINISTRATIVE MATTERS Contractor Records Retention 4.705-1 Financial and cost accounting...

Counting the costs of accreditation in acute care: an activity-based costing approach.

PubMed

Mumford, Virginia; Greenfield, David; Hogden, Anne; Forde, Kevin; Westbrook, Johanna; Braithwaite, Jeffrey

2015-09-08

To assess the costs of hospital accreditation in Australia. Mixed methods design incorporating: stakeholder analysis; survey design and implementation; activity-based costs analysis; and expert panel review. Acute care hospitals accredited by the Australian Council for Health Care Standards. Six acute public hospitals across four States. Accreditation costs varied from 0.03% to 0.60% of total hospital operating costs per year, averaged across the 4-year accreditation cycle. Relatively higher costs were associated with the surveys years and with smaller facilities. At a national level these costs translate to $A36.83 million, equivalent to 0.1% of acute public hospital recurrent expenditure in the 2012 fiscal year. This is the first time accreditation costs have been independently evaluated across a wide range of hospitals and highlights the additional cost burden for smaller facilities. A better understanding of the costs allows policymakers to assess alternative accreditation and other quality improvement strategies, and understand their impact across a range of facilities. This methodology can be adapted to assess international accreditation programmes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

78 FR 40665 - Cost Accounting Standards: CAS 413 Pension Adjustments for Extraordinary Events

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-08

... Accounting Standards: CAS 413 Pension Adjustments for Extraordinary Events AGENCY: Cost Accounting Standards...: The Office of Federal Procurement Policy (OFPP), Cost Accounting Standards (CAS) Board, is conducting..., Director, Cost Accounting Standards Board (telephone: 202-395-6805; email: [email protected

48 CFR 52.230-7 - Proposal Disclosure-Cost Accounting Practice Changes.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Provisions and Clauses 52.230-7 Proposal Disclosure—Cost Accounting Practice Changes. As prescribed in 30.201-3(c), insert the following provision: Proposal Disclosure—Cost Accounting Practice Changes (APR 2005... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Proposal Disclosure-Cost...

Why is traditional accounting failing managers?

PubMed

Cokins, G

1998-11-01

This article provides an account of activity-based costing. It presents a general overview of this costing method, lists benefits and key concerns, discusses some of the impediments to its spread, and predicts its increasing use.

Developing a cost accounting system for a physician group practice.

PubMed

Mays, J; Gordon, G

1996-10-01

Physicians in group practices must gain a competitive edge to survive in a healthcare environment in which cost efficiency has become critical to success. One tool that can help them is a cost accounting system that yields reliable, detailed data on the costs of delivering care. Such a system not only can enable physicians and group administrators to manage their operations more cost-effectively, but also can help them accurately assess the potential profitability of prospective managed care plans. An otolaryngology practice located in Mississippi provides a model for developing a cost accounting system that can be applied to physician group practices.

An analysis of the adoption of managerial innovation: cost accounting systems in hospitals.

PubMed

Glandon, G L; Counte, M A

1995-11-01

The adoption of new medical technologies has received significant attention in the hospital industry, in part, because of its observed relation to hospital cost increases. However, few comprehensive studies exist regarding the adoption of non-medical technologies in the hospital setting. This paper develops and tests a model of the adoption of a managerial innovation, new to the hospital industry, that of cost accounting systems based upon standard costs. The conceptual model hypothesizes that four organizational context factors (size, complexity, ownership and slack resources) and two environmental factors (payor mix and interorganizational dependency) influence hospital adoption of cost accounting systems. Based on responses to a mail survey of hospitals in the Chicago area and AHA annual survey information for 1986, a sample of 92 hospitals was analyzed. Greater hospital size, complexity, slack resources, and interorganizational dependency all were associated with adoption. Payor mix had no significant influence and the hospital ownership variables had a mixed influence. The logistic regression model was significant overall and explained over 15% of the variance in the adoption decision.

Improving health care costing with resource consumption accounting.

PubMed

Ozyapici, Hasan; Tanis, Veyis Naci

2016-07-11

Purpose - The purpose of this paper is to explore the differences between a traditional costing system (TCS) and resource consumption accounting (RCA) based on a case study carried out in a hospital. Design/methodology/approach - A descriptive case study was first carried out to identify the current costing system of the case hospital. An exploratory case study was then conducted to reveal how implementing RCA within the case hospital assigns costs differently to gallbladder surgeries than the current costing system (i.e. a TCS). Findings - The study showed that, in contrast to a TCS, RCA considers the unused capacity, which is the difference between the work that can be performed based on current resources and the work that is actually being performed. Therefore, it assigns lower total costs to open and laparoscopic gallbladder surgeries. The study also showed that by separating costs into fixed and variable RCA allows managers to benefit from a pricing strategy based on the difference between the service's selling price and variable costs incurred in providing that service. Research limitations/implications - The limitation of this study is that, because of time constraints, the implementation was performed in the general surgery department only. However, since RCA is an advanced system that has the same application procedures for any department inside in a hospital, managers need only time gaps to implement this system to all parts of the hospital. Practical implications - This study concluded that RCA is better than a TCS for use in health care settings that have high overhead costs because it accurately assigns overhead costs to services by considering unused capacities incurred by a hospital. Consequently, this study provides insight into both measuring and managing unused capacities within the health care sector. This study also concluded that RCA helps health care administrators increase their competitive advantage by allowing them to determine the lowest

Laboratory manager's financial handbook. Cost accounting: the road map to financial success.

PubMed

Travers, E M

1996-01-01

Cost accounting is the most basic element of the laboratory's financial management structure. Historically, cost accounting in the nonmedical world referred to accumulating and assigning costs to units of production and departments, primarily for inventory valuation and income determination. In the health industry, microcost accounting is distinguishable from macrocost (management/internal) accounting and serves multiple purposes. Microcost accounting pertains to gathering and providing information for decision making. The range of decisions include managing recurring operations, making nonrecurring strategic decisions, and formulating major organizational policies. Macrocost accounting fulfills the legal requirements of reporting to stockholders, auditors, governmental agencies, and other external parties.

Combining Time-Driven Activity-Based Costing with Clinical Outcome in Cost-Effectiveness Analysis to Measure Value in Treatment of Depression.

PubMed

El Alaoui, Samir; Lindefors, Nils

2016-01-01

A major challenge of mental health care is to provide safe and effective treatment with limited resources. The main purpose of this study was to examine a value-based approach in clinical psychiatry when evaluating a process improvement initiative. This was accomplished by using the relatively new time driven activity based costing (TDABC) method within the more widely adopted cost-effectiveness analysis framework for economic evaluation of healthcare technologies. The objective was to evaluate the cost-effectiveness of allowing psychologists to perform post-treatment assessment previously performed by psychiatrists at an outpatient clinic treating depression using internet-based cognitive-behavioral therapy (ICBT). Data was collected from 568 adult patients treated with ICBT for depression during 2013-2014. The TDABC methodology was used to estimate total healthcare costs, including development of process maps for the complete cycle of care and estimation of resource use and minute costs of staff, hospital space and materials based on their relative proportions used. Clinical outcomes were measured using the Patient Health Questionnaire depression scale (PHQ-9) before and after treatment and at 6-month follow-up. Cost-effectiveness analyses (CEA) was performed and the results presented as incremental net benefits (INB), cost-effectiveness acceptability curves (CEACs) and confidence ellipses to demonstrate uncertainty around the value of the organizational intervention. Taking into account the complete healthcare process (from referral to follow-up assessment), treatment costs decreased from $709 (SD = $130) per patient in 2013 to $659 (SD = $134) in 2014 while treatment effectiveness was maintained; 27% had achieved full remission from depression after treatment (PHQ-9 < 5) during both 2013 and 2014 and an additional 35% and 33% had achieved partial remission in 2013 and 2014, respectively. At follow-up, 42% were in full remission after treatment during both 2013

Combining Time-Driven Activity-Based Costing with Clinical Outcome in Cost-Effectiveness Analysis to Measure Value in Treatment of Depression

PubMed Central

Lindefors, Nils

2016-01-01

Background A major challenge of mental health care is to provide safe and effective treatment with limited resources. The main purpose of this study was to examine a value-based approach in clinical psychiatry when evaluating a process improvement initiative. This was accomplished by using the relatively new time driven activity based costing (TDABC) method within the more widely adopted cost-effectiveness analysis framework for economic evaluation of healthcare technologies. The objective was to evaluate the cost-effectiveness of allowing psychologists to perform post-treatment assessment previously performed by psychiatrists at an outpatient clinic treating depression using internet-based cognitive-behavioral therapy (ICBT). Methods Data was collected from 568 adult patients treated with ICBT for depression during 2013–2014. The TDABC methodology was used to estimate total healthcare costs, including development of process maps for the complete cycle of care and estimation of resource use and minute costs of staff, hospital space and materials based on their relative proportions used. Clinical outcomes were measured using the Patient Health Questionnaire depression scale (PHQ-9) before and after treatment and at 6-month follow-up. Cost-effectiveness analyses (CEA) was performed and the results presented as incremental net benefits (INB), cost-effectiveness acceptability curves (CEACs) and confidence ellipses to demonstrate uncertainty around the value of the organizational intervention. Outcomes Taking into account the complete healthcare process (from referral to follow-up assessment), treatment costs decreased from $709 (SD = $130) per patient in 2013 to $659 (SD = $134) in 2014 while treatment effectiveness was maintained; 27% had achieved full remission from depression after treatment (PHQ-9 < 5) during both 2013 and 2014 and an additional 35% and 33% had achieved partial remission in 2013 and 2014, respectively. At follow-up, 42% were in full remission

Using a Time-Driven Activity-Based Costing Model To Determine the Actual Cost of Services Provided by a Transgenic Core.

PubMed

Gerwin, Philip M; Norinsky, Rada M; Tolwani, Ravi J

2018-03-01

Laboratory animal programs and core laboratories often set service rates based on cost estimates. However, actual costs may be unknown, and service rates may not reflect the actual cost of services. Accurately evaluating the actual costs of services can be challenging and time-consuming. We used a time-driven activity-based costing (ABC) model to determine the cost of services provided by a resource laboratory at our institution. The time-driven approach is a more efficient approach to calculating costs than using a traditional ABC model. We calculated only 2 parameters: the time required to perform an activity and the unit cost of the activity based on employee cost. This method allowed us to rapidly and accurately calculate the actual cost of services provided, including microinjection of a DNA construct, microinjection of embryonic stem cells, embryo transfer, and in vitro fertilization. We successfully implemented a time-driven ABC model to evaluate the cost of these services and the capacity of labor used to deliver them. We determined how actual costs compared with current service rates. In addition, we determined that the labor supplied to conduct all services (10,645 min/wk) exceeded the practical labor capacity (8400 min/wk), indicating that the laboratory team was highly efficient and that additional labor capacity was needed to prevent overloading of the current team. Importantly, this time-driven ABC approach allowed us to establish a baseline model that can easily be updated to reflect operational changes or changes in labor costs. We demonstrated that a time-driven ABC model is a powerful management tool that can be applied to other core facilities as well as to entire animal programs, providing valuable information that can be used to set rates based on the actual cost of services and to improve operating efficiency.

48 CFR 52.230-6 - Administration of Cost Accounting Standards.

Code of Federal Regulations, 2013 CFR

2013-10-01

... following clause: Administration of Cost Accounting Standards (JUN 2010) For the purpose of administering... cost accounting practice that a Contractor is required to make in order to comply with applicable... subcontract(s) elects to make that has not been deemed a desirable change by the CFAO and for which the...

48 CFR 52.230-6 - Administration of Cost Accounting Standards.

Code of Federal Regulations, 2014 CFR

2014-10-01

... following clause: Administration of Cost Accounting Standards (JUN 2010) For the purpose of administering... cost accounting practice that a Contractor is required to make in order to comply with applicable... subcontract(s) elects to make that has not been deemed a desirable change by the CFAO and for which the...

48 CFR 52.230-6 - Administration of Cost Accounting Standards.

Code of Federal Regulations, 2012 CFR

2012-10-01

... following clause: Administration of Cost Accounting Standards (JUN 2010) For the purpose of administering... cost accounting practice that a Contractor is required to make in order to comply with applicable... subcontract(s) elects to make that has not been deemed a desirable change by the CFAO and for which the...

48 CFR 30.604 - Processing changes to disclosed or established cost accounting practices.

Code of Federal Regulations, 2010 CFR

2010-10-01

... disclosed or established cost accounting practices. 30.604 Section 30.604 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Administration 30.604 Processing changes to disclosed or established cost accounting practices...

48 CFR 30.604 - Processing changes to disclosed or established cost accounting practices.

Code of Federal Regulations, 2011 CFR

2011-10-01

... disclosed or established cost accounting practices. 30.604 Section 30.604 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Administration 30.604 Processing changes to disclosed or established cost accounting practices...

Applying activity-based costing to the nuclear medicine unit.

PubMed

Suthummanon, Sakesun; Omachonu, Vincent K; Akcin, Mehmet

2005-08-01

Previous studies have shown the feasibility of using activity-based costing (ABC) in hospital environments. However, many of these studies discuss the general applications of ABC in health-care organizations. This research explores the potential application of ABC to the nuclear medicine unit (NMU) at a teaching hospital. The finding indicates that the current cost averages 236.11 US dollars for all procedures, which is quite different from the costs computed by using ABC. The difference is most significant with positron emission tomography scan, 463 US dollars (an increase of 96%), as well as bone scan and thyroid scan, 114 US dollars (a decrease of 52%). The result of ABC analysis demonstrates that the operational time (machine time and direct labour time) and the cost of drugs have the most influence on cost per procedure. Clearly, to reduce the cost per procedure for the NMU, the reduction in operational time and cost of drugs should be analysed. The result also indicates that ABC can be used to improve resource allocation and management. It can be an important aid in making management decisions, particularly for improving pricing practices by making costing more accurate. It also facilitates the identification of underutilized resources and related costs, leading to cost reduction. The ABC system will also help hospitals control costs, improve the quality and efficiency of the care they provide, and manage their resources better.

Does Accumulated Knowledge Impact Academic Performance in Cost Accounting?

ERIC Educational Resources Information Center

Alanzi, Khalid A.; Alfraih, Mishari M.

2017-01-01

Purpose: This quantitative study aims to examine the impact of accumulated knowledge of accounting on the academic performance of Cost Accounting students. Design/methodology/approach The sample consisted of 89 students enrolled in the Accounting program run by a business college in Kuwait during 2015. Correlation and linear least squares…

Managerial Cost Accounting for a Technical Information Center.

ERIC Educational Resources Information Center

Helmkamp, John G.

A two-fold solution to the cost information deficiency problem is proposed. A formal managerial cost accounting system is designed expressly for the two information services of retrospective search and selective dissemination. The system was employed during a trial period to test its effectiveness in a technical information center. Once…

Management accounting for advanced technological environments.

PubMed

Kaplan, R S

1989-08-25

Management accounting systems designed decades ago no longer provide timely, relevant information for companies in today's highly competitive environment. New operational control and performance measurement systems are recognizing the importance of direct measurement of quality, manufacturing lead times, flexibility, and customer responsiveness, as well as more accurate measures of the actual costs of consumed resources. Activity-based cost systems can assign the costs of indirect and support resources to the specific products and activities that benefit from these resources. Both operational control and activity-based systems represent new opportunities for improved managerial information in complex, technologically advanced environments.

Effects of an incentive-based online physical activity intervention on health care costs.

PubMed

Lu, Chifung; Schultz, Alyssa B; Sill, Stewart; Petersen, Ruth; Young, Joyce M; Edington, Dee W

2008-11-01

To test whether participation in an incentive-based online physical activity program for employees was associated with a moderation in health care costs. Health care claims trends from 2003 to 2005 were analyzed among a matched sample of participants and nonparticipants. Medical and pharmacy costs, hospital inpatient costs, and emergency room costs were examined. The average annual health care costs for participants increased by $291 per year compared with an increase of $360 for nonparticipants (P = 0.09). Higher levels of participation were associated with smaller increases in health care costs. Participants had a significantly smaller increase in inpatient hospital costs (+$20 vs +$119), heart disease costs ($-8 vs $46), and diabetic costs (+$1 vs +$16) compared with nonparticipants. Participation in an online employee physical activity intervention was associated with smaller increases in health care costs compared to nonparticipants.

Time-driven activity-based costing: A dynamic value assessment model in pediatric appendicitis.

PubMed

Yu, Yangyang R; Abbas, Paulette I; Smith, Carolyn M; Carberry, Kathleen E; Ren, Hui; Patel, Binita; Nuchtern, Jed G; Lopez, Monica E

2017-06-01

Healthcare reform policies are emphasizing value-based healthcare delivery. We hypothesize that time-driven activity-based costing (TDABC) can be used to appraise healthcare interventions in pediatric appendicitis. Triage-based standing delegation orders, surgical advanced practice providers, and a same-day discharge protocol were implemented to target deficiencies identified in our initial TDABC model. Post-intervention process maps for a hospital episode were created using electronic time stamp data for simple appendicitis cases during February to March 2016. Total personnel and consumable costs were determined using TDABC methodology. The post-intervention TDABC model featured 6 phases of care, 33 processes, and 19 personnel types. Our interventions reduced duration and costs in the emergency department (-41min, -$23) and pre-operative floor (-57min, -$18). While post-anesthesia care unit duration and costs increased (+224min, +$41), the same-day discharge protocol eliminated post-operative floor costs (-$306). Our model incorporating all three interventions reduced total direct costs by 11% ($2753.39 to $2447.68) and duration of hospitalization by 51% (1984min to 966min). Time-driven activity-based costing can dynamically model changes in our healthcare delivery as a result of process improvement interventions. It is an effective tool to continuously assess the impact of these interventions on the value of appendicitis care. II, Type of study: Economic Analysis. Copyright © 2017 Elsevier Inc. All rights reserved.

Application of activity-based costing (ABC) for a Peruvian NGO healthcare provider.

PubMed

Waters, H; Abdallah, H; Santillán, D

2001-01-01

This article describes the application of activity-based costing (ABC) to calculate the unit costs of the services for a health care provider in Peru. While traditional costing allocates overhead and indirect costs in proportion to production volume or to direct costs, ABC assigns costs through activities within an organization. ABC uses personnel interviews to determine principal activities and the distribution of individual's time among these activities. Indirect costs are linked to services through time allocation and other tracing methods, and the result is a more accurate estimate of unit costs. The study concludes that applying ABC in a developing country setting is feasible, yielding results that are directly applicable to pricing and management. ABC determines costs for individual clinics, departments and services according to the activities that originate these costs, showing where an organization spends its money. With this information, it is possible to identify services that are generating extra revenue and those operating at a loss, and to calculate cross subsidies across services. ABC also highlights areas in the health care process where efficiency improvements are possible. Conclusions about the ultimate impact of the methodology are not drawn here, since the study was not repeated and changes in utilization patterns and the addition of new clinics affected applicability of the results. A potential constraint to implementing ABC is the availability and organization of cost information. Applying ABC efficiently requires information to be readily available, by cost category and department, since the greatest benefits of ABC come from frequent, systematic application of the methodology in order to monitor efficiency and provide feedback for management. The article concludes with a discussion of the potential applications of ABC in the health sector in developing countries.

Increasing value in plagiocephaly care: a time-driven activity-based costing pilot study.

PubMed

Inverso, Gino; Lappi, Michael D; Flath-Sporn, Susan J; Heald, Ronald; Kim, David C; Meara, John G

2015-06-01

Process management within a health care setting is poorly understood and often leads to an incomplete understanding of the true costs of patient care. Using time-driven activity-based costing methods, we evaluated the high-volume, low-complexity diagnosis of plagiocephaly to increase value within our clinic. A total of 59 plagiocephaly patients were evaluated in phase 1 (n = 31) and phase 2 (n = 28) of this study. During phase 1, a process map was created, encompassing each of the 5 clinicians and administrative personnel delivering 23 unique activities. After analysis of the phase 1 process maps, average times as well as costs of these activities were evaluated for potential modifications in workflow. These modifications were implemented in phase 2 to determine overall impact on visit-time and costs of care. Improvements in patient education, workflow coordination, and examination room allocation were implemented during phase 2, resulting in a reduced patient visit-time of 13:25 (19.9% improvement) and an increased cost of $8.22 per patient (7.7% increase) due to changes in physician process times. However, this increased cost was directly offset by the availability of 2 additional appointments per day, potentially generating $7904 of additional annual revenue. Quantifying the impact of a 19.9% reduction in patient visit-time at an increased cost of 7.7% resulted in an increased value ratio of 1.113. This pilot study effectively demonstrates the novel use of time-driven activity-based costing in combination with the value equation as a metric for continuous process improvement programs within the health care setting.

A time-driven, activity-based costing methodology for determining the costs of red blood cell transfusion in patients with beta thalassaemia major.

PubMed

Burns, K E; Haysom, H E; Higgins, A M; Waters, N; Tahiri, R; Rushford, K; Dunstan, T; Saxby, K; Kaplan, Z; Chunilal, S; McQuilten, Z K; Wood, E M

2018-04-10

To describe the methodology to estimate the total cost of administration of a single unit of red blood cells (RBC) in adults with beta thalassaemia major in an Australian specialist haemoglobinopathy centre. Beta thalassaemia major is a genetic disorder of haemoglobin associated with multiple end-organ complications and typically requiring lifelong RBC transfusion therapy. New therapeutic agents are becoming available based on advances in understanding of the disorder and its consequences. Assessment of the true total cost of transfusion, incorporating both product and activity costs, is required in order to evaluate the benefits and costs of these new therapies. We describe the bottom-up, time-driven, activity-based costing methodology used to develop process maps to provide a step-by-step outline of the entire transfusion pathway. Detailed flowcharts for each process are described. Direct observations and timing of the process maps document all activities, resources, staff, equipment and consumables in detail. The analysis will include costs associated with performing these processes, including resources and consumables. Sensitivity analyses will be performed to determine the impact of different staffing levels, timings and probabilities associated with performing different tasks. Thirty-one process maps have been developed, with over 600 individual activities requiring multiple timings. These will be used for future detailed cost analyses. Detailed process maps using bottom-up, time-driven, activity-based costing for determining the cost of RBC transfusion in thalassaemia major have been developed. These could be adapted for wider use to understand and compare the costs and complexities of transfusion in other settings. © 2018 British Blood Transfusion Society.

76 FR 60357 - Federal Regulations; OMB Circulars, OFPP Policy Letters, and CASB Cost Accounting Standards...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

... derived from 41 U.S.C. 1501. Cost Accounting Standards are rules governing the measurement, assignment... Circulars, OFPP Policy Letters, and CASB Cost Accounting Standards Included in the Semiannual Agenda of..., and Cost Accounting Standards Board (CASB) Cost Accounting Standards. OMB Circulars and OFPP Policy...

78 FR 13675 - Federal Acquisition Regulation; Submission for OMB Review; Cost Accounting Standards Administration

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-28

...; Submission for OMB Review; Cost Accounting Standards Administration AGENCY: Department of Defense (DOD... collection requirement concerning cost accounting standards administration. A notice was published in the...- 0129, Cost Accounting Standards Administration by any of the following methods: Regulations.gov : http...

Value based care and bundled payments: Anesthesia care costs for outpatient oncology surgery using time-driven activity-based costing.

PubMed

French, Katy E; Guzman, Alexis B; Rubio, Augustin C; Frenzel, John C; Feeley, Thomas W

2016-09-01

With the movement towards bundled payments, stakeholders should know the true cost of the care they deliver. Time-driven activity-based costing (TDABC) can be used to estimate costs for each episode of care. In this analysis, TDABC is used to both estimate the costs of anesthesia care and identify the primary drivers of those costs of 11 common oncologic outpatient surgical procedures. Personnel cost were calculated by determining the hourly cost of each provider and the associated process time of the 11 surgical procedures. Using the anesthesia record, drugs, supplies and equipment costs were identified and calculated. The current staffing model was used to determine baseline personnel costs for each procedure. Using the costs identified through TDABC analysis, the effect of different staffing ratios on anesthesia costs could be predicted. Costs for each of the procedures were determined. Process time and costs are linearly related. Personnel represented 79% of overall cost while drugs, supplies and equipment represented the remaining 21%. Changing staffing ratios shows potential savings between 13% and 28% across the 11 procedures. TDABC can be used to estimate the costs of anesthesia care. This costing information is critical to assessing the anesthesiology component in a bundled payment. It can also be used to identify areas of cost savings and model costs of anesthesia care. CRNA to anesthesiologist staffing ratios profoundly influence the cost of care. This methodology could be applied to other medical specialties to help determine costs in the setting of bundled payments. Copyright © 2015 Elsevier Inc. All rights reserved.

Value Based Care and Bundled Payments: Anesthesia Care Costs for Outpatient Oncology Surgery Using Time-Driven Activity-Based Costing

PubMed Central

French, Katy E.; Guzman, Alexis B.; Rubio, Augustin C.; Frenzel, John C.; Feeley, Thomas W

2015-01-01

Background With the movement towards bundled payments, stakeholders should know the true cost of the care they deliver. Time-driven activity-based costing (TDABC) can be used to estimate costs for each episode of care. In this analysis, TDABC is used to both estimate the costs of anesthesia care and identify the primary drivers of those costs of 11 common oncologic outpatient surgical procedures. Methods Personnel cost were calculated by determining the hourly cost of each provider and the associated process time of the 11 surgical procedures. Using the anesthesia record, drugs, supplies and equipment costs were identified and calculated. The current staffing model was used to determine baseline personnel costs for each procedure. Using the costs identified through TDABC analysis, the effect of different staffing ratios on anesthesia costs could be predicted. Results Costs for each of the procedures were determined. Process time and costs are linearly related. Personnel represented 79% of overall cost while drugs, supplies and equipment represented the remaining 21%. Changing staffing ratios shows potential savings between 13-28% across the 11 procedures. Conclusions TDABC can be used to estimate the costs of anesthesia care. This costing information is critical to assessing the anesthesiology component in a bundled payment. It can also be used to identify areas of cost savings and model costs of anesthesia care. CRNA to anesthesiologist staffing ratios profoundly influence the cost of care. This methodology could be applied to other medical specialties to help determine costs in the setting of bundled payments. PMID:27637823

Savings account for health care costs

MedlinePlus

... These accounts are approved or regulated by the Internal Revenue Service (IRS). The accounts differ based on how much ... MSA; FSA; HRA References Department of the Treasury - Internal Revenue Service. Health Savings Accounts and Other Tax-Favored Health ...

76 FR 14570 - Federal Acquisition Regulation; Disclosure and Consistency of Cost Accounting Practices for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-16

...] RIN 9000-AL58 Federal Acquisition Regulation; Disclosure and Consistency of Cost Accounting Practices... Regulation (FAR) to align it with a Cost Accounting Standards (CAS) Board clause, Disclosure and Consistency of Cost Accounting Practices-Foreign Concerns. DATES: Effective Date: March 16, 2011. FOR FURTHER...

[Cost accounting for gastrectomy under critical path--the usefulness of direct accounting of personnel expenses and a guide to shortening hospital stay].

PubMed

Nozue, M; Maruyama, T; Imamura, F; Fukue, M

2000-08-01

In this study, cost accounting was made for a surgical case of gastrectomy according to critical path (path) and the economic contribution of the path was determined. In addition, changes in the cost percentage with changes in number of hospital days were simulated. Basically, cost accounting was done by means of cost accounting by departments, which meets the concept of direct cost accounting of administered accounts. Personnel expenses were calculated by means of both direct and indirect calculations. In the direct method, the total hours personnel participated were recorded for calculation. In the indirect method, personnel expenses were calculated from the ratio of the income of the surgical department to that of other departments. Purchase prices for all materials and drugs used were recorded to check buying costs. According to the direct calculating method, the personnel expenses came to approximately 300,000 yen, total cost was approximately 700,000 yen, and the cost percentage was 59%. According to the indirect method, the personnel expenses were approximately 540,000 yen and the total cost was approximately 940,000 yen, the cost percentage being 80%. A simulation study of changes in the cost with changes in hospital days revealed that the cost percentages were assessed to be approximately 53% in 19 hospital days and approximately 45% in 12 hospital days.

76 FR 70037 - Federal Regulations; OMB Circulars, OFPP Policy Letters, and CASB Cost Accounting Standards...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-10

... Circulars, OFPP Policy Letters, and CASB Cost Accounting Standards Included in the Semiannual Agenda of..., and Cost Accounting Standards Board (CASB) Cost Accounting Standards. DATES: The withdrawal is...

Estimation of the diagnostic threshold accounting for decision costs and sampling uncertainty.

PubMed

Skaltsa, Konstantina; Jover, Lluís; Carrasco, Josep Lluís

2010-10-01

Medical diagnostic tests are used to classify subjects as non-diseased or diseased. The classification rule usually consists of classifying subjects using the values of a continuous marker that is dichotomised by means of a threshold. Here, the optimum threshold estimate is found by minimising a cost function that accounts for both decision costs and sampling uncertainty. The cost function is optimised either analytically in a normal distribution setting or empirically in a free-distribution setting when the underlying probability distributions of diseased and non-diseased subjects are unknown. Inference of the threshold estimates is based on approximate analytically standard errors and bootstrap-based approaches. The performance of the proposed methodology is assessed by means of a simulation study, and the sample size required for a given confidence interval precision and sample size ratio is also calculated. Finally, a case example based on previously published data concerning the diagnosis of Alzheimer's patients is provided in order to illustrate the procedure.

Study of activity based costing implementation for palm oil production using value-added and non-value-added activity consideration in PT XYZ palm oil mill

NASA Astrophysics Data System (ADS)

Sembiring, M. T.; Wahyuni, D.; Sinaga, T. S.; Silaban, A.

2018-02-01

Cost allocation at manufacturing industry particularly in Palm Oil Mill still widely practiced based on estimation. It leads to cost distortion. Besides, processing time determined by company is not in accordance with actual processing time in work station. Hence, the purpose of this study is to eliminates non-value-added activities therefore processing time could be shortened and production cost could be reduced. Activity Based Costing Method is used in this research to calculate production cost with Value Added and Non-Value-Added Activities consideration. The result of this study is processing time decreasing for 35.75% at Weighting Bridge Station, 29.77% at Sorting Station, 5.05% at Loading Ramp Station, and 0.79% at Sterilizer Station. Cost of Manufactured for Crude Palm Oil are IDR 5.236,81/kg calculated by Traditional Method, IDR 4.583,37/kg calculated by Activity Based Costing Method before implementation of Activity Improvement and IDR 4.581,71/kg after implementation of Activity Improvement Meanwhile Cost of Manufactured for Palm Kernel are IDR 2.159,50/kg calculated by Traditional Method, IDR 4.584,63/kg calculated by Activity Based Costing Method before implementation of Activity Improvement and IDR 4.582,97/kg after implementation of Activity Improvement.

18 CFR 367.4031 - Account 403.1, Depreciation expense for asset retirement costs.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., Depreciation expense for asset retirement costs. 367.4031 Section 367.4031 Conservation of Power and Water... § 367.4031 Account 403.1, Depreciation expense for asset retirement costs. This account must include the depreciation expense for asset retirement costs included in service company property. ...

Defining the Costs of Reusable Flexible Ureteroscope Reprocessing Using Time-Driven Activity-Based Costing.

PubMed

Isaacson, Dylan; Ahmad, Tessnim; Metzler, Ian; Tzou, David T; Taguchi, Kazumi; Usawachintachit, Manint; Zetumer, Samuel; Sherer, Benjamin; Stoller, Marshall; Chi, Thomas

2017-10-01

Careful decontamination and sterilization of reusable flexible ureteroscopes used in ureterorenoscopy cases prevent the spread of infectious pathogens to patients and technicians. However, inefficient reprocessing and unavailability of ureteroscopes sent out for repair can contribute to expensive operating room (OR) delays. Time-driven activity-based costing (TDABC) was applied to describe the time and costs involved in reprocessing. Direct observation and timing were performed for all steps in reprocessing of reusable flexible ureteroscopes following operative procedures. Estimated times needed for each step by which damaged ureteroscopes identified during reprocessing are sent for repair were characterized through interviews with purchasing analyst staff. Process maps were created for reprocessing and repair detailing individual step times and their variances. Cost data for labor and disposables used were applied to calculate per minute and average step costs. Ten ureteroscopes were followed through reprocessing. Process mapping for ureteroscope reprocessing averaged 229.0 ± 74.4 minutes, whereas sending a ureteroscope for repair required an estimated 143 minutes per repair. Most steps demonstrated low variance between timed observations. Ureteroscope drying was the longest and highest variance step at 126.5 ± 55.7 minutes and was highly dependent on manual air flushing through the ureteroscope working channel and ureteroscope positioning in the drying cabinet. Total costs for reprocessing totaled $96.13 per episode, including the cost of labor and disposable items. Utilizing TDABC delineates the full spectrum of costs associated with ureteroscope reprocessing and identifies areas for process improvement to drive value-based care. At our institution, ureteroscope drying was one clearly identified target area. Implementing training in ureteroscope drying technique could save up to 2 hours per reprocessing event, potentially preventing expensive OR delays.

INVENTORY ANALYSIS AND COST ACCOUNTING OF FACILITY MAINTANANCE IN WASTE INCINERATION

NASA Astrophysics Data System (ADS)

Morioka, Tohru; Ozaki, Taira; Kitazume, Keiichi; Yamamoto, Tsukasa

A solid waste incineration plant consists of so many facilities and mechanical parts that it requires periodic careful maintenance of them for stable solid waste management. The current research investigates maintenance costs of the stoker type incinerator and continuous firing plants in detail and develops an accounting model for maintenance of them. This model is able to distinguish among the costs of inspection, repair and renewal by plant with seven process flaw s and three common factors. Parameters based on real data collected by questionnaire surveys give appropriate results in comparison with other plants and enable to apply the model to plants which incinerates 500 - 600 ton solid waste per day.

[Cost of hospitalization by the Activity Based Costing method in the neonatal department of Principal Hospital of Dakar].

PubMed

Tchamdja, T; Balaka, A; Tchandana, M; Agbétra, A

2015-01-01

To determine the cost of hospitalization per day in the neonatal department of Principal Hospital of Dakar. This prospective study took place during the month of July 2011 in the newborn unit. The activity-based costing method was used to analyze costs. During the study period, 52 newborns were hospitalized for a total of 590 days. The cost of the human resources during that month was 9,907,832 FCFA (US $ 19,815.66), the cost of depreciation of fixed assets was estimated at 571,952 FCFA (US $ 1143.90), and supplies at 112,084 FCFA (US $ 224.17). External services cost 386,753 FCFA (US $ 773.51) and support services 6,917,380.65 FCFA (US $ 13,834.7613). The monthly expenses incurred for the hospitalization of newborns totaled 17,896,002 FCFA (US $ 35,792), for a cost per patient per day of 30,332.20 FCFA (US $ 60.66) and an average cost of hospitalization 334,153.88 FCFA (US $ 668,31). This study is the first of its kind in Senegal and neighboring countries. By applying the ABC approach, we can obtain a more detailed and precise estimate of the cost of activities and services. Process improvements and corrective actions should make it possible to identify cost drivers, such as time.

Cost Evaluation of Evidence-Based Treatments

PubMed Central

Sindelar, Jody L.; Ball, Samuel A.

2010-01-01

Many treatment programs have adopted or are considering adopting evidence-based treatments (EBTs). When a program evaluates whether to adopt a new intervention, it must consider program objectives, operational goals, and costs. This article examines cost concepts, cost estimation, and use of cost information to make the final decision on whether to adopt an EBT. Cost categories, including variable and fixed, accounting and opportunity, and costs borne by patients and others, are defined and illustrated using the example of expenditures for contingency management. Ultimately, cost is one consideration in the overall determination of whether implementing an EBT is the best use of a program’s resources. PMID:22002453

Corporate cost of occupational accidents: an activity-based analysis.

PubMed

Rikhardsson, Pall M; Impgaard, Martin

2004-03-01

The systematic accident cost analysis (SACA) project was carried out during 2001 by The Aarhus School of Business and PricewaterhouseCoopers Denmark with financial support from The Danish National Working Environment Authority. Its focused on developing and testing a method for evaluating occupational costs of companies for use by occupational health and safety professionals. The method was tested in nine Danish companies within three different industry sectors and the costs of 27 selected occupational accidents in these companies were calculated. One of the main conclusions is that the SACA method could be used in all of the companies without revisions. The evaluation of accident cost showed that 2/3 of the costs of occupational accidents are visible in the Danish corporate accounting systems reviewed while 1/3 is hidden from management view. The highest cost of occupational accidents for a company with 3.600 employees was estimated to approximately US$ 682.000. The paper includes an introduction regarding accident cost analysis in companies, a presentation of the SACA project methodology and the SACA method itself, a short overview of some of the results of the SACA project and a conclusion. Further information about the project is available at http://www.asb.dk/saca.

Measuring the cost of care in benign prostatic hyperplasia using time-driven activity-based costing (TDABC).

PubMed

Kaplan, A L; Agarwal, N; Setlur, N P; Tan, H J; Niedzwiecki, D; McLaughlin, N; Burke, M A; Steinberg, K; Chamie, K; Saigal, C S

2015-03-01

Determining '"value'" in health care, defined as outcomes per unit cost, depends on accurately measuring cost. We used time-driven activity-based costing (TDABC) to determine the cost of care in men with benign prostatic hyperplasia (BPH) - a common urologic condition. We implemented TDABC across the entire care pathway for BPH including primary and specialist care in both inpatient and outpatient settings. A team of expert stakeholders created detailed process maps, determined space and product costs, and calculated personnel capacity cost rates. A model pathway was derived from practice guidelines and calculated costs were applied. Although listed as 'optional' in practice guidelines, invasive diagnostic testing can increase costs by 150% compared with the standalone urology clinic visit. Of five different surgical options, a 400% cost discrepancy exists between the most and least expensive treatments. TDABC can be used to measure cost across an entire care pathway in a large academic medical center. Sizable cost variation exists between diagnostic and surgical modalities for men with BPH. As financial risk is shifted toward providers, understanding the cost of care will be vital. Future work is needed to determine outcome discrepancy between the diagnostic and surgical modalities in BPH. Copyright © 2014 Elsevier Inc. All rights reserved.

18 CFR 367.4572 - Account 457.2, Indirect costs charged to associate companies.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., Indirect costs charged to associate companies. This account must include recovery of those indirect costs... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Account 457.2, Indirect costs charged to associate companies. 367.4572 Section 367.4572 Conservation of Power and Water...

Time-driven activity-based costing of low-dose-rate and high-dose-rate brachytherapy for low-risk prostate cancer.

PubMed

Ilg, Annette M; Laviana, Aaron A; Kamrava, Mitchell; Veruttipong, Darlene; Steinberg, Michael; Park, Sang-June; Burke, Michael A; Niedzwiecki, Douglas; Kupelian, Patrick A; Saigal, Christopher

Cost estimates through traditional hospital accounting systems are often arbitrary and ambiguous. We used time-driven activity-based costing (TDABC) to determine the true cost of low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy for prostate cancer and demonstrate opportunities for cost containment at an academic referral center. We implemented TDABC for patients treated with I-125, preplanned LDR and computed tomography based HDR brachytherapy with two implants from initial consultation through 12-month followup. We constructed detailed process maps for provision of both HDR and LDR. Personnel, space, equipment, and material costs of each step were identified and used to derive capacity cost rates, defined as price per minute. Each capacity cost rate was then multiplied by the relevant process time and products were summed to determine total cost of care. The calculated cost to deliver HDR was greater than LDR by $2,668.86 ($9,538 vs. $6,869). The first and second HDR treatment day cost $3,999.67 and $3,955.67, whereas LDR was delivered on one treatment day and cost $3,887.55. The greatest overall cost driver for both LDR and HDR was personnel at 65.6% ($4,506.82) and 67.0% ($6,387.27) of the total cost. After personnel costs, disposable materials contributed the second most for LDR ($1,920.66, 28.0%) and for HDR ($2,295.94, 24.0%). With TDABC, the true costs to deliver LDR and HDR from the health system perspective were derived. Analysis by physicians and hospital administrators regarding the cost of care afforded redesign opportunities including delivering HDR as one implant. Our work underscores the need to assess clinical outcomes to understand the true difference in value between these modalities. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

48 CFR 52.230-3 - Disclosure and Consistency of Cost Accounting Practices.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Text of Provisions and Clauses 52.230-3 Disclosure and Consistency of Cost Accounting Practices. As prescribed in 30.201-4(b)(1), insert the following clause: Disclosure and Consistency of Cost Accounting... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Disclosure and Consistency...

Cost evaluation of clinical laboratory in Taiwan's National Health System by using activity-based costing.

PubMed

Su, Bin-Guang; Chen, Shao-Fen; Yeh, Shu-Hsing; Shih, Po-Wen; Lin, Ching-Chiang

2016-11-01

To cope with the government's policies to reduce medical costs, Taiwan's healthcare service providers are striving to survive by pursuing profit maximization through cost control. This article aimed to present the results of cost evaluation using activity-based costing performed in the laboratory in order to throw light on the differences between costs and the payment system of National Health Insurance (NHI). This study analyzed the data of costs and income of the clinical laboratory. Direct costs belong to their respective sections of the department. The department's shared costs, including public expenses and administrative assigned costs, were allocated to the department's respective sections. A simple regression equation was created to predict profit and loss, and evaluate the department's break-even point, fixed cost, and contribution margin ratio. In clinical chemistry and seroimmunology sections, the cost per test was lower than the NHI payment and their major laboratory tests had revenues with the profitability ratio of 8.7%, while the other sections had a higher cost per test than the NHI payment and their major tests were in deficit. The study found a simple linear regression model as follows: "Balance=-84,995+0.543×income (R2=0.544)". In order to avoid deficit, laboratories are suggested to increase test volumes, enhance laboratory test specialization, and become marginal scale. A hospital could integrate with regional medical institutions through alliances or OEM methods to increase volumes to reach marginal scale and reduce laboratory costs, enhancing the level and quality of laboratory medicine.

Comprehensive cost analysis of sentinel node biopsy in solid head and neck tumors using a time-driven activity-based costing approach.

PubMed

Crott, Ralph; Lawson, Georges; Nollevaux, Marie-Cécile; Castiaux, Annick; Krug, Bruno

2016-09-01

Head and neck cancer (HNC) is predominantly a locoregional disease. Sentinel lymph node (SLN) biopsy offers a minimally invasive means of accurately staging the neck. Value in healthcare is determined by both outcomes and the costs associated with achieving them. Time-driven activity-based costing (TDABC) may offer more precise estimates of the true cost. Process maps were developed for nuclear medicine, operating room and pathology care phases. TDABC estimates the costs by combining information about the process with the unit cost of each resource used. Resource utilization is based on observation of care and staff interviews. Unit costs are calculated as a capacity cost rate, measured as a Euros/min (2014), for each resource consumed. Multiplying together the unit costs and resource quantities and summing across all resources used will produce the average cost for each phase of care. Three time equations with six different scenarios were modeled based on the type of camera, the number of SLN and the type of staining used. Total times for different SLN scenarios vary between 284 and 307 min, respectively, with a total cost between 2794 and 3541€. The unit costs vary between 788€/h for the intraoperative evaluation with a gamma-probe and 889€/h for a preoperative imaging with a SPECT/CT. The unit costs for the lymphadenectomy and the pathological examination are, respectively, 560 and 713€/h. A 10 % increase of time per individual activity generates only 1 % change in the total cost. TDABC evaluates the cost of SLN in HNC. The total costs across all phases which varied between 2761 and 3744€ per standard case.

75 FR 3236 - Federal Acquisition Regulation; Submission for OMB Review; Cost Accounting Standards Administration

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-20

... Accounting Standards Administration AGENCIES: Department of Defense (DOD), General Services Administration... extension of a previously approved information collection requirement concerning cost accounting standards... include pertinent rules and regulations related to the Cost Accounting Standards along with necessary...

Cost analysis and the practicing radiologist/manager: an introduction to managerial accounting.

PubMed

Forman, H P; Yin, D

1996-06-01

Cost analysis is inherently one of the most tedious tasks falling on the shoulders of any manager. In today's world, whether in a service business such as radiology or medicine or in a product line such as car manufacturing, accurate cost analysis is critical to all aspects of management: marketing, competitive strategy, quality control, human resource management, accounting (financial), and operations management, to name but a few. This is a topic that we will explore with the intention of giving the radiologist/manager the understanding and the basic skills to use cost analysis efficiently, making sure that major financial decisions are being made with adequate cost information, and showing that cost accounting is really managerial accounting in that it pays little attention to the bottom line of financial statements but places much more emphasis on equipping managers with the information to determine budgets, prices, salaries, and incentives and influences capital budgeting decisions through an understanding of product profitability rather than firm profitability.

The Cost-Accounting Mechanism in Higher Educational Institutions.

ERIC Educational Resources Information Center

Lukoshkin, A. P.; Min'ko, E. V.

1990-01-01

Examines the need to increase expenditures per student at Soviet technical institutes. Proposes seeking financial assistance from enterprises employing technical specialists. Outlines an experimental program in cost accounting. Suggests stipend and wage allotments and explains some of the contractual obligations involved. (CH)

Patients with lower activation associated with higher costs; delivery systems should know their patients' 'scores'.

PubMed

Hibbard, Judith H; Greene, Jessica; Overton, Valerie

2013-02-01

Patient activation is a term that describes the skills and confidence that equip patients to become actively engaged in their health care. Health care delivery systems are turning to patient activation as yet another tool to help them and their patients improve outcomes and influence costs. In this article we examine the relationship between patient activation levels and billed care costs. In an analysis of 33,163 patients of Fairview Health Services, a large health care delivery system in Minnesota, we found that patients with the lowest activation levels had predicted average costs that were 8 percent higher in the base year and 21 percent higher in the first half of the next year than the costs of patients with the highest activation levels, both significant differences. What's more, patient activation was a significant predictor of cost even after adjustment for a commonly used "risk score" specifically designed to predict future costs. As health care delivery systems move toward assuming greater accountability for costs and outcomes for defined patient populations, knowing patients' ability and willingness to manage their health will be a relevant piece of information integral to health care providers' ability to improve outcomes and lower costs.

Documentation and Analysis of the ’Miscellaneous’ Account Category within the DoD Instruction 7220.29-H Depot Level Maintenance Cost Accounting System.

DTIC Science & Technology

1984-12-01

34MISCELLANEOUS" ACCOUNT CATEGORY WITHIN THE DOD INSTRUCTION 7220.29-H DEPOT LEVEL MAINTENANCE COST ACCOUNTING SYSTEM by a. Steven Eugene Lehr CDecember 1984...PERFORMING ONG. REPORT NUMBER Maintenance Cost Accounting System 7. AUTHOR(&) S. CONTRACT OR GRANT NUMBER(@) Steven Eugene Lehr 9. PERFORMING ORGANIZATION...Availability Codes IS. KEY WORDS (Continue on reverse *ids It necessary and Identify by block number) Dvi Special Uniform Cost Accounting System DoD

Status of costing hospital nursing work within Australian casemix activity-based funding policy.

PubMed

Heslop, Liza

2012-02-01

Australia has a long history of patient level costing initiated when casemix funding was implemented in several states in the early 1990s. Australia includes, to some extent, hospital payment based on nursing intensity adopted within casemix funding policy and the Diagnostic Related Group system. Costing of hospital nursing services in Australia has not changed significantly in the last few decades despite widespread introduction of casemix funding policy at the state level. Recent Commonwealth of Australia National Health Reform presents change to the management of the delivery of health care including health-care costing. There is agreement for all Australian jurisdictions to progress to casemix-based activity funding. Within this context, nurse costing infrastructure presents contemporary issues and challenges. An assessment is made of the progress of costing nursing services within casemix funding models in Australian hospitals. Valid and reliable Australian-refined nursing service weights might overcome present cost deficiencies and limitations. © 2012 Blackwell Publishing Asia Pty Ltd.

Activity-based costing evaluation of a [(18)F]-fludeoxyglucose positron emission tomography study.

PubMed

Krug, Bruno; Van Zanten, Annie; Pirson, Anne-Sophie; Crott, Ralph; Borght, Thierry Vander

2009-10-01

The aim of the study is to use the activity-based costing approach to give a better insight in the actual cost structure of a positron emission tomography procedure (FDG-PET) by defining the constituting components and by simulating the impact of possible resource or practice changes. The cost data were obtained from the hospital administration, personnel and vendor interviews as well as from structured questionnaires. A process map separates the process in 16 patient- and non-patient-related activities, to which the detailed cost data are related. One-way sensitivity analyses shows to which degree of uncertainty the different parameters affect the individual cost and evaluate the impact of possible resource or practice changes like the acquisition of a hybrid PET/CT device, the patient throughput or the sales price of a 370MBq (18)F-FDG patient dose. The PET centre spends 73% of time in clinical activities and the resting time after injection of the tracer (42%) is the single largest departmental cost element. The tracer cost and the operational time have the most influence on cost per procedure. The analysis shows a total cost per FDG-PET ranging from 859 Euro for a BGO PET camera to 1142 Euro for a 16 slices PET-CT system, with a distribution of the resource costs in decreasing order: materials (44%), equipment (24%), wage (16%), space (6%) and hospital overhead (10%). The cost of FDG-PET is mainly influenced by the cost of the radiopharmaceutical. Therefore, the latter rather than the operational time should be reduced in order to improve its cost-effectiveness.

Low-Cost Charged-Coupled Device (CCD) Based Detectors for Shiga Toxins Activity Analysis.

PubMed

Rasooly, Reuven; Prickril, Ben; Bruck, Hugh A; Rasooly, Avraham

2017-01-01

To improve food safety there is a need to develop simple, low-cost sensitive devices for detection of food-borne pathogens and their toxins. We describe a simple, low-cost webcam-based detector which can be used for various optical detection modalities, including fluorescence, chemiluminescence, densitometry, and colorimetric assays. The portable battery-operated CCD-based detection system consists of four modules: (1) a webcam to measure and record light emission, (2) a sample plate to perform assays, (3) a light emitting diode (LED) for illumination, and (4) a portable computer to acquire and analyze images. To demonstrate the technology, we used a cell based assay for fluorescence detection of the activity of the food borne Shiga toxin type 2 (Stx2), differentiating between biologically active toxin and inactive toxin which is not a risk. The assay is based on Shiga toxin inhibition of cell protein synthesis measured through inhibition of the green fluorescent protein (GFP). In this assay, GFP emits light at 509 nm when excited with a blue LED equipped with a filter at 486 nm. The emitted light is then detected with a green filter at 535 nm. Toxin activity is measured through a reduction in the 509 nm emission. In this system the level of detection (LOD) for Stx2 was 0.1 pg/ml, similar to the LOD of commercial fluorometers. These results demonstrate the utility and potential of low cost detectors for toxin activity. This approach could be readily adapted to the detection of other food-borne toxins.

A Study of the Impact of the Lack of a Cost Accounting Standards Board.

DTIC Science & Technology

1987-06-01

California 00 ,: SE P 9 7 THESIS SE& A STUDY OF THE IMPACT OF THE LACK OF A COST ACCOUNTING STANDARDS BOARD by James F. Sumner, III June 1987 Thesis...O’ATON COSA1. CODES 16 SuB,*CT j’J.45 Comr~nue n- p.ono ol neeeterV ani denltiy by flO(k f1LrmbCr) E,) ROUP StA IRucost accounting , cost accounting ...thesis has two purposes. First, it attempts to determine whether the absence of the Cost Accounting Standards Board (CASB) has given rise to any areas

Measuring the Cost of the Patient-Centered Medical Home: A Cost-Accounting Approach.

PubMed

Lieberthal, Robert D; Payton, Colleen; Sarfaty, Mona; Valko, George

To explore the cost for individual practices to become more patient-centered, we inventoried and calculated the cost of costly activities involved in implementing the Patient-Centered Medical Home (PCMH) as defined by the National Committee for Quality Assurance. There were 3 key findings. The cost of each PCMH-related clinical activity can be classified in 1 of 3 major categories. Cost offsets can be used to defray part of the cost recognition. The cost of PCMH transformation varied by practice with no clear level or pattern of costs. Our study suggests that small- and medium-sized practices may experience difficulty with the financial burden of PCMH recognition.

48 CFR 2152.231-70 - Accounting and allowable cost.

Code of Federal Regulations, 2010 CFR

2010-10-01

... firm that ascribes to the standards of the American Institute of Certified Public Accountants. The... include, but are not limited to, taxes, service charges to reinsurers, the cost of investigation and...

Cost Accounting Standards: Determining an Institution's Disclosure Requirements.

ERIC Educational Resources Information Center

Bruce, Janet D.

1995-01-01

This article discusses the implications of recently adopted U.S. Cost Accounting Standards (CAS) that apply to educational institutions that contract with or receive grants from the federal government. It focuses on the disclosure requirements that colleges and universities must follow to comply with CAS. (MDM)

Development of a practical costing method for hospitals.

PubMed

Cao, Pengyu; Toyabe, Shin-Ichi; Akazawa, Kouhei

2006-03-01

To realize an effective cost control, a practical and accurate cost accounting system is indispensable in hospitals. In traditional cost accounting systems, the volume-based costing (VBC) is the most popular cost accounting method. In this method, the indirect costs are allocated to each cost object (services or units of a hospital) using a single indicator named a cost driver (e.g., Labor hours, revenues or the number of patients). However, this method often results in rough and inaccurate results. The activity based costing (ABC) method introduced in the mid 1990s can prove more accurate results. With the ABC method, all events or transactions that cause costs are recognized as "activities", and a specific cost driver is prepared for each activity. Finally, the costs of activities are allocated to cost objects by the corresponding cost driver. However, it is much more complex and costly than other traditional cost accounting methods because the data collection for cost drivers is not always easy. In this study, we developed a simplified ABC (S-ABC) costing method to reduce the workload of ABC costing by reducing the number of cost drivers used in the ABC method. Using the S-ABC method, we estimated the cost of the laboratory tests, and as a result, similarly accurate results were obtained with the ABC method (largest difference was 2.64%). Simultaneously, this new method reduces the seven cost drivers used in the ABC method to four. Moreover, we performed an evaluation using other sample data from physiological laboratory department to certify the effectiveness of this new method. In conclusion, the S-ABC method provides two advantages in comparison to the VBC and ABC methods: (1) it can obtain accurate results, and (2) it is simpler to perform. Once we reduce the number of cost drivers by applying the proposed S-ABC method to the data for the ABC method, we can easily perform the cost accounting using few cost drivers after the second round of costing.

Student Accountability in Team-Based Learning Classes

ERIC Educational Resources Information Center

Stein, Rachel E.; Colyer, Corey J.; Manning, Jason

2016-01-01

Team-based learning (TBL) is a form of small-group learning that assumes stable teams promote accountability. Teamwork promotes communication among members; application exercises promote active learning. Students must prepare for each class; failure to do so harms their team's performance. Therefore, TBL promotes accountability. As part of the…

The use of a resource-based relative value scale (RBRVS) to determine practice expense costs: a novel technique of practice management for the vascular surgeon.

PubMed

Mabry, C D

2001-03-01

Vascular surgeons have had to contend with rising costs while their reimbursements have undergone steady reductions. The use of newer accounting techniques can help vascular surgeons better manage their practices, plan for future expansion, and control costs. This article reviews traditional accounting methods, together with activity-based costing (ABC) principles that have been used in the past for practice expense analysis. The main focus is on a new technique-resource-based costing (RBC)-which uses the widely available Resource-Based Relative Value Scale (RBRVS) as its basis. The RBC technique promises easier implementation as well as more flexibility in determining true costs of performing various procedures, as opposed to more traditional accounting methods. It is hoped that RBC will assist vascular surgeons in coping with decreasing reimbursement. Copyright 2001 by W.B. Saunders Company

Implementation of activity-based costing (ABC) to drive cost reduction efforts in a semiconductor manufacturing operation

NASA Astrophysics Data System (ADS)

Naguib, Hussein; Bol, Igor I.; Lora, J.; Chowdhry, R.

1994-09-01

This paper presents a case study on the implementation of ABC to calculate the cost per wafer and to drive cost reduction efforts for a new IC product line. The cost reduction activities were conducted through the efforts of 11 cross-functional teams which included members of the finance, purchasing, technology development, process engineering, equipment engineering, production control, and facility groups. The activities of these cross functional teams were coordinated by a cost council. It will be shown that these activities have resulted in a 57% reduction in the wafer manufacturing cost of the new product line. Factors contributed to successful implementation of an ABC management system are discussed.

41 CFR 102-33.195 - Do we need an automated system to account for aircraft costs?

Code of Federal Regulations, 2011 CFR

2011-01-01

... system to account for aircraft costs? 102-33.195 Section 102-33.195 Public Contracts and Property... for the Cost of Government Aircraft § 102-33.195 Do we need an automated system to account for... automated system to account for aircraft costs by collecting the cost data elements required by the Federal...

The Impact of Accounting Methods on Cost Reduction Rates in Defense Aerospace Weapons System Programs

DTIC Science & Technology

1988-12-01

and adhered to in U.S. industry, allow some flexibility in accounting. Under GAAP , accounting areas such as depreciation , inventory, investment tax... depreciation , inventory and investment tax credit) in predicting cost reduction rates are studied. Of the three accounting variables, only inventory...RATES .. ................. ........... 5 1. Depreciation ........ ............... 6 2. Capitalizing or Expensing of Costs . . .. 6 3. Material Costs

Cost-effectiveness of population-level physical activity interventions: a systematic review.

PubMed

Laine, Johanna; Kuvaja-Köllner, Virpi; Pietilä, Eija; Koivuneva, Mikko; Valtonen, Hannu; Kankaanpää, Eila

2014-01-01

This systematic review synthesizes the evidence on the cost-effectiveness of population-level interventions to promote physical activity. A systematic literature search was conducted between May and August 2013 in four databases: PubMed, Scopus, Web of Science, and SPORTDiscus. Only primary and preventive interventions aimed at promoting and maintaining physical activity in wide population groups were included. An economic evaluation of both effectiveness and cost was required. Secondary interventions and interventions targeting selected population groups or focusing on single individuals were excluded. Interventions were searched for in six different categories: (1) environment, (2) built environment, (3) sports clubs and enhanced access, (4) schools, (5) mass media and community-based, and (6) workplace. The systematic search yielded 2058 articles, of which 10 articles met the selection criteria. The costs of interventions were converted to costs per person per day in 2012 U.S. dollars. The physical activity results were calculated as metabolic equivalent of task hours (MET-hours, or MET-h) gained per person per day. Cost-effectiveness ratios were presented as dollars per MET-hours gained. The intervention scale and the budget impact of interventions were taken into account. The most efficient interventions to increase physical activity were community rail-trails ($.006/MET-h), pedometers ($.014/MET-h), and school health education programs ($.056/MET-h). Improving opportunities for walking and biking seems to increase physical activity cost-effectively. However, it is necessary to be careful in generalizing the results because of the small number of studies. This review provides important information for decision makers.

76 FR 79545 - Cost Accounting Standards: Change to the CAS Applicability Threshold for the Inflation Adjustment...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-22

... Cost Accounting Standards: Change to the CAS Applicability Threshold for the Inflation Adjustment to... Federal Procurement Policy, Cost Accounting Standards Board. ACTION: Final rule. SUMMARY: The Office of Federal Procurement Policy (OFPP), Cost Accounting Standards (CAS) Board (Board), has adopted, without...

Activity based costing of probation with and without substance abuse treatment: a case study.

PubMed

Alemi, Farrokh; Taxman, Faye; Doyon, Victoria; Thanner, Meridith; Baghi, Heibatollah

2004-06-01

Since many offenders have drug problems, investigators have proposed that drug testing and treatment should be an integral part of probation. In 1994, the Office of National Drug Control Policy (ONDCP) funded a demonstration project designed to integrate drug treatment with traditional supervision services. As part of this demonstration a new procedure called 'seamless' probation was set up in which treatment providers were co-located with probation officers and probation officers coordinated offenders' participation in treatment. This study examines the cost of providing substance abuse treatment coordination through probation agencies. We used Activity Based Costing (ABC) to examine the cost of probation with and without treatment coordination in one probation agency. Agency budget was analyzed and allocated to various programs. A questionnaire was developed to assess probation officer's activities. The cost of coordinating treatment for one offender was calculated by dividing the total cost of the program by units of various activities done by the probation officers. Preliminary test of reliability of the instrument showed that it was accurately portraying the probation officers time allocation. Probation officers spent 6.9% of their time in seamless supervision and 83.3% time in traditional supervision (83.83%). The seamless probation officers had more group meetings and more phone contact with their offenders than traditional probation officers. The average cost per offender per day was 12 dollars for seamless probation and 7 dollars for traditional probation. This study is limited because it focuses on one agency at one point in time. Results may not be relevant to other agencies or to the same agency as it makes its operation more efficient. This study provides a method of allocating budget cost to per client costs using survey of probation officer's activities -- a tool developed in this study. Comparison of seamless and traditional supervision activities

75 FR 34283 - Federal Acquisition Regulation; FAR Case 2009-025, Disclosure and Consistency of Cost Accounting...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-16

... Regulation (FAR) to align the FAR with the revised Cost Accounting Standards (CAS) Board clause, Disclosure....230-4 is replaced in its entirety and re-titled ``Disclosure and Consistency of Cost Accounting...) Disclosure and Consistency of Cost Accounting Practices-- Foreign Concerns. (1) The contracting officer shall...

Using Time-Driven Activity-Based Costing to Implement Change.

PubMed

Sayed, Ellen N; Laws, Sa'ad; Uthman, Basim

2017-01-01

Academic medical libraries have responded to changes in technology, evolving professional roles, reduced budgets, and declining traditional services. Libraries that have taken a proactive role to change have seen their librarians emerge as collaborators and partners with faculty and researchers, while para-professional staff is increasingly overseeing traditional services. This article addresses shifting staff and schedules at a single-service-point information desk by using time-driven activity-based costing to determine the utilization of resources available to provide traditional library services. Opening hours and schedules were changed, allowing librarians to focus on patrons' information needs in their own environment.

Challenges in Building Disease-Based National Health Accounts

PubMed Central

Rosen, Allison B.; Cutler, David M.

2012-01-01

Background Measuring spending on diseases is critical to assessing the value of medical care. Objective To review the current state of cost of illness (COI) estimation methods, identifying their strengths, limitations and uses. We briefly describe the current National Health Expenditure Accounts (NHEA), and then go on to discuss the addition of COI estimation to the NHEA. Conclusion Recommendations are made for future research aimed at identifying the best methods for developing and using disease-based national health accounts to optimize the information available to policymakers as they struggle with difficult resource allocation decisions. PMID:19536017

Defining the value of magnetic resonance imaging in prostate brachytherapy using time-driven activity-based costing.

PubMed

Thaker, Nikhil G; Orio, Peter F; Potters, Louis

Magnetic resonance imaging (MRI) simulation and planning for prostate brachytherapy (PBT) may deliver potential clinical benefits but at an unknown cost to the provider and healthcare system. Time-driven activity-based costing (TDABC) is an innovative bottom-up costing tool in healthcare that can be used to measure the actual consumption of resources required over the full cycle of care. TDABC analysis was conducted to compare patient-level costs for an MRI-based versus traditional PBT workflow. TDABC cost was only 1% higher for the MRI-based workflow, and utilization of MRI allowed for cost shifting from other imaging modalities, such as CT and ultrasound, to MRI during the PBT process. Future initiatives will be required to follow the costs of care over longer periods of time to determine if improvements in outcomes and toxicities with an MRI-based approach lead to lower resource utilization and spending over the long-term. Understanding provider costs will become important as healthcare reform transitions to value-based purchasing and other alternative payment models. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Policy-driven development of cost-effective, risk-based surveillance strategies.

PubMed

Reist, M; Jemmi, T; Stärk, K D C

2012-07-01

Animal health and residue surveillance verifies the good health status of the animal population, thereby supporting international free trade of animals and animal products. However, active surveillance is costly and time-consuming. The development of cost-effective tools for animal health and food hazard surveillance is therefore a priority for decision-makers in the field of veterinary public health. The assumption of this paper is that outcome-based formulation of standards, legislation leaving room for risk-based approaches and close collaboration and a mutual understanding and exchange between scientists and policy makers are essential for cost-effective surveillance. We illustrate this using the following examples: (i) a risk-based sample size calculation for surveys to substantiate freedom from diseases/infection, (ii) a cost-effective national surveillance system for Bluetongue using scenario tree modelling and (iii) a framework for risk-based residue monitoring. Surveys to substantiate freedom from infectious bovine rhinotracheitis and enzootic bovine leucosis between 2002 and 2009 saved over 6 million € by applying a risk-based sample size calculation approach, and by taking into account prior information from repeated surveys. An open, progressive policy making process stimulates research and science to develop risk-based and cost-efficient survey methodologies. Early involvement of policy makers in scientific developments facilitates implementation of new findings and full exploitation of benefits for producers and consumers. Copyright © 2012 Elsevier B.V. All rights reserved.

Activity Fund Accounting.

ERIC Educational Resources Information Center

Cool, David W.

1983-01-01

Addresses the need of school districts in many states to decide on an appropriate mingling of centralization and decentralization in the operation of activity funds. Argues for analysis of activity fund operation through a breakdown into such major components as policy, the accounting system, and reporting and auditing. (JBM)

Cost-effectiveness of a community-based physical activity programme for adults (Be Active) in the UK: an economic analysis within a natural experiment.

PubMed

Frew, Emma J; Bhatti, Mobeen; Win, Khine; Sitch, Alice; Lyon, Anna; Pallan, Miranda; Adab, Peymane

2014-02-01

To determine the cost-effectiveness of a physical activity programme (Be Active) aimed at city-dwelling adults living in Birmingham, UK. Very little is known about the cost-effectiveness of public health programmes to improve city-wide physical activity rates. This paper presents a cost-effectiveness analysis that compares a physical activity intervention (Be Active) with no intervention (usual care) using an economic model to quantify the reduction in disease risk over a lifetime. Metabolic equivalent minutes achieved per week, quality-adjusted life years (QALYs) gained and healthcare costs were all included as the main outcome measures in the model. A cost-benefit analysis was also conducted using 'willingness-to-pay' as a measure of value. Under base-case assumptions-that is, assuming that the benefits of increased physical activity are sustained over 5 years, participation in the Be Active programme increased quality-adjusted life expectancy by 0.06 years, at an expected discounted cost of £3552, and thus the cost-effectiveness of Be Active is £400 per QALY. When the start-up costs of the programme are removed from the economic model, the cost-effectiveness is further improved to £16 per QALY. The societal value placed on the Be Active programme was greater than the operation cost therefore the Be Active physical activity intervention results in a net benefit to society. Participation in Be Active appeared to be cost-effective and cost-beneficial. These results support the use of Be Active as part of a public health programme to improve physical activity levels within the Birmingham-wide population.

Performance measurement: integrating quality management and activity-based cost management.

PubMed

McKeon, T

1996-04-01

The development of an activity-based management system provides a framework for developing performance measures integral to quality and cost management. Performance measures that cross operational boundaries and embrace core processes provide a mechanism to evaluate operational results related to strategic intention and internal and external customers. The author discusses this measurement process that allows managers to evaluate where they are and where they want to be, and to set a course of action that closes the gap between the two.

Cost-Effective Control of Infectious Disease Outbreaks Accounting for Societal Reaction.

PubMed

Fast, Shannon M; González, Marta C; Markuzon, Natasha

2015-01-01

Studies of cost-effective disease prevention have typically focused on the tradeoff between the cost of disease transmission and the cost of applying control measures. We present a novel approach that also accounts for the cost of social disruptions resulting from the spread of disease. These disruptions, which we call social response, can include heightened anxiety, strain on healthcare infrastructure, economic losses, or violence. The spread of disease and social response are simulated under several different intervention strategies. The modeled social response depends upon the perceived risk of the disease, the extent of disease spread, and the media involvement. Using Monte Carlo simulation, we estimate the total number of infections and total social response for each strategy. We then identify the strategy that minimizes the expected total cost of the disease, which includes the cost of the disease itself, the cost of control measures, and the cost of social response. The model-based simulations suggest that the least-cost disease control strategy depends upon the perceived risk of the disease, as well as media intervention. The most cost-effective solution for diseases with low perceived risk was to implement moderate control measures. For diseases with higher perceived severity, such as SARS or Ebola, the most cost-effective strategy shifted toward intervening earlier in the outbreak, with greater resources. When intervention elicited increased media involvement, it remained important to control high severity diseases quickly. For moderate severity diseases, however, it became most cost-effective to implement no intervention and allow the disease to run its course. Our simulation results imply that, when diseases are perceived as severe, the costs of social response have a significant influence on selecting the most cost-effective strategy.

Cost-Effective Control of Infectious Disease Outbreaks Accounting for Societal Reaction

PubMed Central

Fast, Shannon M.; González, Marta C.; Markuzon, Natasha

2015-01-01

Background Studies of cost-effective disease prevention have typically focused on the tradeoff between the cost of disease transmission and the cost of applying control measures. We present a novel approach that also accounts for the cost of social disruptions resulting from the spread of disease. These disruptions, which we call social response, can include heightened anxiety, strain on healthcare infrastructure, economic losses, or violence. Methodology The spread of disease and social response are simulated under several different intervention strategies. The modeled social response depends upon the perceived risk of the disease, the extent of disease spread, and the media involvement. Using Monte Carlo simulation, we estimate the total number of infections and total social response for each strategy. We then identify the strategy that minimizes the expected total cost of the disease, which includes the cost of the disease itself, the cost of control measures, and the cost of social response. Conclusions The model-based simulations suggest that the least-cost disease control strategy depends upon the perceived risk of the disease, as well as media intervention. The most cost-effective solution for diseases with low perceived risk was to implement moderate control measures. For diseases with higher perceived severity, such as SARS or Ebola, the most cost-effective strategy shifted toward intervening earlier in the outbreak, with greater resources. When intervention elicited increased media involvement, it remained important to control high severity diseases quickly. For moderate severity diseases, however, it became most cost-effective to implement no intervention and allow the disease to run its course. Our simulation results imply that, when diseases are perceived as severe, the costs of social response have a significant influence on selecting the most cost-effective strategy. PMID:26288274

Accounting for the costs of quality.

PubMed

Suver, J D; Neumann, B R; Boles, K E

1992-09-01

Total quality management (TQM) represents a paradigm shift in the organizational values that shape every aspect of a healthcare provider's activities. The TQM approach to quality management subscribes to the theory that it is not the work of employees of an organization that leads to poor quality; rather, it is the poor design of systems and procedures. In a book recently published by HFMA, Management Accounting for Healthcare Organizations, third edition, authors Suver, Neumann and Boles point out that the changes in behavioral focus and organizational climate brought about by TQM will have a major impact on management accounting function in healthcare organizations. TQM will require new methods of accounting that will enable the effects of declining quality to be recognized and evaluated. It also will require new types of management accounting reports that will identify opportunities for quality improvement and will monitor the effectiveness of quality management endeavors. The following article has been adapted from the book cited above.

41 CFR 102-33.190 - What are the aircraft operations and ownership costs for which we must account?

Code of Federal Regulations, 2010 CFR

2010-07-01

... operations and ownership costs for which we must account? 102-33.190 Section 102-33.190 Public Contracts and... Parts Accounting for the Cost of Government Aircraft § 102-33.190 What are the aircraft operations and ownership costs for which we must account? You must account for the operations and ownership costs of your...

Full cost accounting in the analysis of separated waste collection efficiency: A methodological proposal.

PubMed

D'Onza, Giuseppe; Greco, Giulio; Allegrini, Marco

2016-02-01

Recycling implies additional costs for separated municipal solid waste (MSW) collection. The aim of the present study is to propose and implement a management tool - the full cost accounting (FCA) method - to calculate the full collection costs of different types of waste. Our analysis aims for a better understanding of the difficulties of putting FCA into practice in the MSW sector. We propose a FCA methodology that uses standard cost and actual quantities to calculate the collection costs of separate and undifferentiated waste. Our methodology allows cost efficiency analysis and benchmarking, overcoming problems related to firm-specific accounting choices, earnings management policies and purchase policies. Our methodology allows benchmarking and variance analysis that can be used to identify the causes of off-standards performance and guide managers to deploy resources more efficiently. Our methodology can be implemented by companies lacking a sophisticated management accounting system. Copyright © 2015 Elsevier Ltd. All rights reserved.

The association between physical activity and healthcare costs in children--results from the GINIplus and LISAplus cohort studies.

PubMed

Idler, Nadja; Teuner, Christina M; Hunger, Matthias; Holle, Rolf; Ortlieb, Sandra; Schulz, Holger; Bauer, Carl-Peter; Hoffmann, Ute; Koletzko, Sibylle; Lehmann, Irina; von Berg, Andrea; Berdel, Dietrich; Hoffmann, Barbara; Schaaf, Beate; Heinrich, Joachim; Wolfenstetter, Silke B

2015-04-29

Physical inactivity in children is an important risk factor for the development of various morbidities and mortality in adulthood, physical activity already has preventive effects during childhood. The objective of this study is to estimate the association between physical activity, healthcare utilization and costs in children. Cross-sectional data of 3356 children aged 9 to 12 years were taken from the 10-year follow-up of the birth cohort studies GINIplus and LISAplus, including information on healthcare utilization and physical activity given by parents via self-administered questionnaires. Using a bottom-up approach, direct costs due to healthcare utilization and indirect costs resulting from parental work absence were estimated for the base year 2007. A two-step regression model compared effects on healthcare utilization and costs for a higher (≥ 7 h/week) versus a lower (<7 h/week) level of moderate-to-vigorous physical activity (MVPA) adjusted for age, gender, BMI, education and income of parents, single parenthood and study region. Recycled predictions estimated adjusted mean costs per child and activity group. The analyses for the association between physical activity, healthcare utilization and costs showed no statistically significant results. Different directions of estimates were noticeable throughout cost components in the first step as well as the second step of the regression model. For higher MVPA (≥ 7 h/week) compared with lower MVPA (< 7 h/week) total direct costs accounted for 392 EUR (95% CI: 342-449 EUR) versus 398 EUR (95% CI: 309-480 EUR) and indirect costs accounted for 138 EUR (95% CI: 124-153 EUR) versus 127 EUR (95% CI: 111-146 EUR). The results indicate that childhood might be too early in life, to detect significant preventive effects of physical activity on healthcare utilization and costs, as diseases attributable to lacking physical activity might first occur later in life. This underpins the importance of clarifying the long

Cost evaluation to optimise radiation therapy implementation in different income settings: A time-driven activity-based analysis.

PubMed

Van Dyk, Jacob; Zubizarreta, Eduardo; Lievens, Yolande

2017-11-01

With increasing recognition of growing cancer incidence globally, efficient means of expanding radiotherapy capacity is imperative, and understanding the factors impacting human and financial needs is valuable. A time-driven activity-based costing analysis was performed, using a base case of 2-machine departments, with defined cost inputs and operating parameters. Four income groups were analysed, ranging from low to high income. Scenario analyses included department size, operating hours, fractionation, treatment complexity, efficiency, and centralised versus decentralised care. The base case cost/course is US$5,368 in HICs, US$2,028 in LICs; the annual operating cost is US$4,595,000 and US$1,736,000, respectively. Economies of scale show cost/course decreasing with increasing department size, mainly related to the equipment cost and most prominent up to 3 linacs. The cost in HICs is two or three times as high as in U-MICs or LICs, respectively. Decreasing operating hours below 8h/day has a dramatic impact on the cost/course. IMRT increases the cost/course by 22%. Centralising preparatory activities has a moderate impact on the costs. The results indicate trends that are useful for optimising local and regional circumstances. This methodology can provide input into a uniform and accepted approach to evaluating the cost of radiotherapy. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Managerial innovation in the hospital: an analysis of the diffusion of hospital cost-accounting systems.

PubMed

Counte, M A; Glandon, G L

1988-01-01

Currently much interest is focused on the uses of cost-accounting systems within the hospital industry. Proponents frequently contend that such systems will help hospitals successfully adapt to new methods of financial reimbursement because they are essential to a number of major management functions, including competitive bidding, cost management, pricing, and profitability assessment. This article reports the results of a study conducted to examine the extent to which hospitals in a major market are actually beginning to use standard cost-accounting systems and identify factors that either aid or hinder the diffusion of these methods. Chief financial officers from 94 hospitals (83 percent response rate) participated in the study during the summer of 1986 where less than half of the hospitals (43 percent) had recently purchased a cost-accounting system. Detailed information about the interface of cost-accounting systems with other application systems and their specific management uses is reported.

Activity-based costing for pathology examinations and comparison with the current pricing system in Turkey.

PubMed

Ergün, Ferda A K; Ağirbaş, Ismail; Kuzu, Işınsu

2013-01-01

To demonstrate the real cost data of the pathology examinations by using the activity-based costing method and to contribute to the financial planning of the departments, health managers and also the social security institution. Forty-four examinations selected from the Healthcare Implementation Notification system list and performed at the Ankara University Faculty of Medicine Pathology Department during September 2010 were studied. The analysis and the real cost calculations were done according to the duration of the procedures. Calculated costs were compared with the Healthcare Implementation Notification system and Medicare price lists. The costs of the pathology tests listed within the same pricing levels in the Healthcare Implementation Notification system list showed great differences. The minimum and maximum costs in level 1, 2, 3, and 4 were 15,98-80,15 TL, 15,95-258,59 TL, 42,38- 236,87 TL, and 124,42-406,76 TL, respectively. Medicare price levels were more consistent with the real costs of the examinations compared to the Healthcare Implementation Notification system price list. The prices of the pathology examination listed at different levels in the Healthcare Implementation Notification system lists do not cover the real costs of the work done. The principal parameters of Activity-Based Costing system are more suitable for making the most realistic cost categorization. Although the prices could differ between countries, the Medicare system categories are more realistic than the Healthcare Implementation Notification system. The Healthcare Implementation Notification system list needs to be revised in order to reflect the real costs of the pathology examinations.

Procuring Contracting Officers’ Perceptions of the Contributions Made to Defense Cost Accounting Practices by CAS 401-416.

DTIC Science & Technology

1981-09-01

8217 PERCEPTIONS OF THE CONTRIBUTIONS MADE TO DEFENSE COST ACCOUNTING PRACTICES BY CAS 401-416 Captain Bruce E. Simpson, USA LSSR 70-81 The contents of...CONTRIBUTIONS MADE TO DEFENSE MastersThesis COST ACCOUNTING PRACTICES BY CAS 401-416 6. PEROR ING OG. REPORT NUMBER 7. AUTHOR(e) S. CONTRACT OR GRANT...SUPPLEMENTARY NOTES 19. KEY WORDS (Con~tiue, on revere side it naoeaaeuy and Identify by block nuffler) Accounting Cost Accounting Cost Accounting Standards

48 CFR 52.230-4 - Disclosure and Consistency of Cost Accounting Practices-Foreign Concerns.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CONTRACT CLAUSES Text of Provisions and Clauses 52.230-4 Disclosure and Consistency of Cost Accounting... Disclosure Statement, disclose in writing its cost accounting practices as required by 48 CFR 9903.202-1... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Disclosure and Consistency...

Opportunities and challenges for implementing cost accounting systems in the Kenyan health system

PubMed Central

Kihuba, Elesban; Gheorghe, Adrian; Bozzani, Fiammetta; English, Mike; Griffiths, Ulla K.

2016-01-01

Background Low- and middle-income countries need to sustain efficiency and equity in health financing on their way to universal health care coverage. However, systems meant to generate quality economic information are often deficient in such settings. We assessed the feasibility of streamlining cost accounting systems within the Kenyan health sector to illustrate the pragmatic challenges and opportunities. Design We reviewed policy documents, and conducted field observations and semi-structured interviews with key informants in the health sector. We used an adapted Human, Organization and Technology fit (HOT-fit) framework to analyze the components and standards of a cost accounting system. Results Among the opportunities for a viable cost accounting system, we identified a supportive broad policy environment, political will, presence of a national data reporting architecture, good implementation experience with electronic medical records systems, and the availability of patient clinical and resource use data. However, several practical issues need to be considered in the design of the system, including the lack of a framework to guide the costing process, the lack of long-term investment, the lack of appropriate incentives for ground-level staff, and a risk of overburdening the current health management information system. Conclusion To facilitate the implementation of cost accounting into the health sector, the design of any proposed system needs to remain simple and attuned to the local context. PMID:27357072

Opportunities and challenges for implementing cost accounting systems in the Kenyan health system.

PubMed

Kihuba, Elesban; Gheorghe, Adrian; Bozzani, Fiammetta; English, Mike; Griffiths, Ulla K

2016-01-01

Low- and middle-income countries need to sustain efficiency and equity in health financing on their way to universal health care coverage. However, systems meant to generate quality economic information are often deficient in such settings. We assessed the feasibility of streamlining cost accounting systems within the Kenyan health sector to illustrate the pragmatic challenges and opportunities. We reviewed policy documents, and conducted field observations and semi-structured interviews with key informants in the health sector. We used an adapted Human, Organization and Technology fit (HOT-fit) framework to analyze the components and standards of a cost accounting system. Among the opportunities for a viable cost accounting system, we identified a supportive broad policy environment, political will, presence of a national data reporting architecture, good implementation experience with electronic medical records systems, and the availability of patient clinical and resource use data. However, several practical issues need to be considered in the design of the system, including the lack of a framework to guide the costing process, the lack of long-term investment, the lack of appropriate incentives for ground-level staff, and a risk of overburdening the current health management information system. To facilitate the implementation of cost accounting into the health sector, the design of any proposed system needs to remain simple and attuned to the local context.

Cost accounting in a surgical unit in a teaching hospital--a pilot study.

PubMed

Malalasekera, A P; Ariyaratne, M H; Fernando, R; Perera, D; Deen, K I

2003-09-01

Economic constraints remain one of the major limitations on the quality of health care even in industrialised countries. Improvement of quality will require optimising facilities within available resources. Our objective was to determine costs of surgery and to identify areas where cost reduction is possible. 80 patients undergoing routine major and intermediate surgery during a period of 6 months were selected at random. All consumables used and procedures carried out were documented. A unit cost was assigned to each of these. Costing was based on 3 main categories: preoperative (investigations, blood product related costs), operative (anaesthetic charges, consumables and theatre charges) and post-operative (investigations, consumables, hospital stay). Theatre charges included two components: fixed (consumables) and variable (dependent on time per operation). The indirect costs (e.g. administration costs, 'hotel' costs), accounted for 30%, of the total and were lower than similar costs in industrialised nations. The largest contributory factors (median, range) towards total cost were, basic hospital charges (30%; 15 to 63%); theatre charges fixed (23%; 6 to 35%) and variable (14%; 8 to 27%); and anaesthetic charges (15%; 1 to 36%). Cost reduction in patients undergoing surgery should focus on decreasing hospital stay, operating theatre time and anaesthetic expenditure. Although definite measures can be suggested from the study, further studies on these variables are necessary to optimise cost effectiveness of surgical units.

The costs associated with adverse event procedures for an international HIV clinical trial determined by activity-based costing.

PubMed

Chou, Victoria B; Omer, Saad B; Hussain, Hamidah; Mugasha, Christine; Musisi, Maria; Mmiro, Francis; Musoke, Philippa; Jackson, J Brooks; Guay, Laura A

2007-12-01

To determine costs for adverse event (AE) procedures for a large HIV perinatal trial by analyzing actual resource consumption using activity-based costing (ABC) in an international research setting. The AE system for an ongoing clinical trial in Uganda was evaluated using ABC techniques to determine costs from the perspective of the study. Resources were organized into cost categories (eg, personnel, patient care expenses, laboratory testing, equipment). Cost drivers were quantified, and unit cost per AE was calculated. A subset of time and motion studies was performed prospectively to observe clinic personnel time required for AE identification. In 18 months, there were 9028 AEs, with 970 (11%) reported as serious adverse events. Unit cost per AE was $101.97. Overall, AE-related costs represented 32% ($920,581 of $2,834,692) of all study expenses. Personnel ($79.30) and patient care ($11.96) contributed the greatest proportion of component costs. Reported AEs were predominantly nonserious (mild or moderate severity) and unrelated to study drug(s) delivery. Intensive identification and management of AEs to conduct clinical trials ethically and protect human subjects require expenditure of substantial human and financial resources. Better understanding of these resource requirements should improve planning and funding of international HIV-related clinical trials.

76 FR 53377 - Cost Accounting Standards; Allocation of Home Office Expenses to Segments

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-26

... Accounting Standards; Allocation of Home Office Expenses to Segments AGENCY: Office of Management and Budget (OMB), Office of Federal Procurement Policy (OFPP), Cost Accounting Standards Board (Board). ACTION... Accounting Standards (CAS) Board, is providing public notification of the decision to discontinue the...

[Management accounting in hospital setting].

PubMed

Brzović, Z; Richter, D; Simunić, S; Bozić, R; Hadjina, N; Piacun, D; Harcet, B

1998-12-01

The periodic income and expenditure accounts produced at the hospital and departmental level enable successful short term management, but, in the long run do not help remove tensions between health care demand and limited resources, nor do they enable optimal medical planning within the limited financial resources. We are trying to estabilish disease category costs based on case mixing according to diagnostic categories (diagnosis related groups, DRG, or health care resource groups, HRG) and calculation of hospital standard product costs, e.g., radiology cost, preoperative nursing cost etc. The average DRG cost is composed of standard product costs plus any costs specific to a diagnostic category. As an example, current costing procedure for hip artheroplasty in the University Hospital Center Zagreb is compared to the management accounting approach based on British Health Care Resource experience. The knowledge of disease category costs based on management accounting requirements facilitates the implementation of medical programs within the given financial resources and devolves managerial responsibility closer to the clinical level where medical decisions take place.

A cost simulation for mammography examinations taking into account equipment failures and resource utilization characteristics.

PubMed

Coelli, Fernando C; Almeida, Renan M V R; Pereira, Wagner C A

2010-12-01

This work develops a cost analysis estimation for a mammography clinic, taking into account resource utilization and equipment failure rates. Two standard clinic models were simulated, the first with one mammography equipment, two technicians and one doctor, and the second (based on an actually functioning clinic) with two equipments, three technicians and one doctor. Cost data and model parameters were obtained by direct measurements, literature reviews and other hospital data. A discrete-event simulation model was developed, in order to estimate the unit cost (total costs/number of examinations in a defined period) of mammography examinations at those clinics. The cost analysis considered simulated changes in resource utilization rates and in examination failure probabilities (failures on the image acquisition system). In addition, a sensitivity analysis was performed, taking into account changes in the probabilities of equipment failure types. For the two clinic configurations, the estimated mammography unit costs were, respectively, US$ 41.31 and US$ 53.46 in the absence of examination failures. As the examination failures increased up to 10% of total examinations, unit costs approached US$ 54.53 and US$ 53.95, respectively. The sensitivity analysis showed that type 3 (the most serious) failure increases had a very large impact on the patient attendance, up to the point of actually making attendance unfeasible. Discrete-event simulation allowed for the definition of the more efficient clinic, contingent on the expected prevalence of resource utilization and equipment failures. © 2010 Blackwell Publishing Ltd.

[Cost-benefit analysis of mental health activities in the workplace].

PubMed

Tarumi, Kimio; Hagihara, Akihito

2013-01-01

In order to examine the cost-benefit of mental health care activities in the workplace, the total costs of the fiscal year 2005, during which the old-type mental health care was conducted, and those of the fiscal years from 2006 to 2008, during which the new-type mental health care was conducted according to the governmental guidelines of each year, were compared using about 3,000 workers in a particular workplace in 2005. The total cost comprised the sum of the medical fees, the payment compensation for sick absences, and expenditures for health care activities of mentally ill health workers. The total costs from 2006 to 2008 were not markedly different from those in 2005, and the benefit due to new-type activity was not shown. However, the following was found: payment compensation for sick absences accounted for 60% of the total cost; personnel expenses which were a large part of the expenditure of health care activities largely changed over the years because of the age structure of the staff in charge. The results show that a cost-benefit analysis may be a useful tool for examining health care activities in the workplace for various members in the workplace although health care issues usually tend to be solved by specialists.

Individual social security accounts: issues in assessing administrative feasibility and costs.

PubMed

Olsen, K A; Salisbury, D L

1998-11-01

Whether to add individual accounts (IAs) to the Social Security system is a highly political issue. But almost lost in the debate so far have been any practical considerations about how to administer such accounts. Any discussion of whether to create individual accounts must also address the basic but critical questions of how they would work: Who would run them? What would they cost? Logistically, are they even possible? This EBRI Issue Brief provides an overview of the most salient administrative issues facing the current Social Security reform debate--issues that challenge proponents to carefully think through how their proposals could be implemented so as to achieve their policy goals. The options and difficulties in administering IAs raise concerns that cut across ideology. The object of this report is neither to dissuade the advocates nor support the critics of individual accounts. Rather, it is to bring practical considerations to a political debate that has largely ignored the pragmatic challenges of whether IAs would be too complex for participants to understand or too difficult for record keepers to administer. The major findings in this analysis include: Adding individual accounts to Social Security could be the largest undertaking in the history of the U.S. financial market, and no system to date has the capacity to administer such a system. The number of workers currently covered by Social Security--the largest single entitlement program in the nation--is at least four times higher than the combined number of all tax-favored employment-based retirement accounts in the United States, which are administered by hundreds of entities. Direct comparisons between employment-based retirement savings plans and Social Security reform are tenuous at best. Social Security covers workers and businesses that are disproportionately excluded from employment-based plans. Because of these differences, a system of individual Social Security accounts would be more

Utilizing time-driven activity-based costing to understand the short- and long-term costs of treating localized, low-risk prostate cancer.

PubMed

Laviana, Aaron A; Ilg, Annette M; Veruttipong, Darlene; Tan, Hung-Jui; Burke, Michael A; Niedzwiecki, Douglas R; Kupelian, Patrick A; King, Chris R; Steinberg, Michael L; Kundavaram, Chandan R; Kamrava, Mitchell; Kaplan, Alan L; Moriarity, Andrew K; Hsu, William; Margolis, Daniel J A; Hu, Jim C; Saigal, Christopher S

2016-02-01

Given the costs of delivering care for men with prostate cancer remain poorly described, this article reports the results of time-driven activity-based costing (TDABC) for competing treatments of low-risk prostate cancer. Process maps were developed for each phase of care from the initial urologic visit through 12 years of follow-up for robotic-assisted laparoscopic prostatectomy (RALP), cryotherapy, high-dose rate (HDR) and low-dose rate (LDR) brachytherapy, intensity-modulated radiation therapy (IMRT), stereotactic body radiation therapy (SBRT), and active surveillance (AS). The last modality incorporated both traditional transrectal ultrasound (TRUS) biopsy and multiparametric-MRI/TRUS fusion biopsy. The costs of materials, equipment, personnel, and space were calculated per unit of time and based on the relative proportion of capacity used. TDABC for each treatment was defined as the sum of its resources. Substantial cost variation was observed at 5 years, with costs ranging from $7,298 for AS to $23,565 for IMRT, and they remained consistent through 12 years of follow-up. LDR brachytherapy ($8,978) was notably cheaper than HDR brachytherapy ($11,448), and SBRT ($11,665) was notably cheaper than IMRT, with the cost savings attributable to shorter procedure times and fewer visits required for treatment. Both equipment costs and an inpatient stay ($2,306) contributed to the high cost of RALP ($16,946). Cryotherapy ($11,215) was more costly than LDR brachytherapy, largely because of increased single-use equipment costs ($6,292 vs $1,921). AS reached cost equivalence with LDR brachytherapy after 7 years of follow-up. The use of TDABC is feasible for analyzing cancer services and provides insights into cost-reduction tactics in an era focused on emphasizing value. By detailing all steps from diagnosis and treatment through 12 years of follow-up for low-risk prostate cancer, this study has demonstrated significant cost variation between competing treatments. © 2015

Finance salaries. Account the cost.

PubMed

Robling, Andy

2003-02-06

Post-qualification salaries have increased by 4-7 per cent, a slowdown on last year's figures when increases were often more than 10 per cent. The highest increases this year tended to be in medium-sized trusts where newly qualified accountants' salaries rose 8.2 per cent. Directors of finance in large trusts earn about 20 per cent more than in medium trusts and about 40 per cent more than in small ones. Newly qualified accountants in large trusts earn 5 per cent more than in medium-sized trusts and 13 per cent more than in small ones. The survey is based on an analysis of salaries from Hays' jobs database, and salaries of registered candidates.

Predicting hospital accounting costs

PubMed Central

Newhouse, Joseph P.; Cretin, Shan; Witsberger, Christina J.

1989-01-01

Two alternative methods to Medicare Cost Reports that provide information about hospital costs more promptly but less accurately are investigated. Both employ utilization data from current-year bills. The first attaches costs to utilization data using cost-charge ratios from the previous year's cost report; the second uses charges from current year's bills. The first method is the more accurate of the two, but even using it, only 40 percent of hospitals had predicted costs within plus or minus 5 percent of actual costs. The feasibility and cost of obtaining cost reports from a small, fast-track sample of hospitals should be investigated. PMID:10313352

Comparative costs and activity from a sample of UK clinical trials units.

PubMed

Hind, Daniel; Reeves, Barnaby C; Bathers, Sarah; Bray, Christopher; Corkhill, Andrea; Hayward, Christopher; Harper, Lynda; Napp, Vicky; Norrie, John; Speed, Chris; Tremain, Liz; Keat, Nicola; Bradburn, Mike

2017-05-02

The costs of medical research are a concern. Clinical Trials Units (CTUs) need to better understand variations in the costs of their activities. Representatives of ten CTUs and two grant-awarding bodies pooled their experiences in discussions over 1.5 years. Five of the CTUs provided estimates of, and written justification for, costs associated with CTU activities required to implement an identical protocol. The protocol described a 5.5-year, nonpharmacological randomized controlled trial (RCT) conducted at 20 centres. Direct and indirect costs, the number of full time equivalents (FTEs) and the FTEs attracting overheads were compared and qualitative methods (unstructured interviews and thematic analysis) were used to interpret the results. Four members of the group (funding-body representatives or award panel members) reviewed the justification statements for transparency and information content. Separately, 163 activities common to trials were assigned to roles used by nine CTUs; the consistency of role delineation was assessed by Cohen's κ. Median full economic cost of CTU activities was £769,637 (range: £661,112 to £1,383,323). Indirect costs varied considerably, accounting for between 15% and 59% (median 35%) of the full economic cost of the grant. Excluding one CTU, which used external statisticians, the total number of FTEs ranged from 2.0 to 3.0; total FTEs attracting overheads ranged from 0.3 to 2.0. Variation in directly incurred staff costs depended on whether CTUs: supported particular roles from core funding rather than grants; opted not to cost certain activities into the grant; assigned clerical or data management tasks to research or administrative staff; employed extensive on-site monitoring strategies (also the main source of variation in non-staff costs). Funders preferred written justifications of costs that described both FTEs and indicative tasks for funded roles, with itemised non-staff costs. Consistency in role delineation was fair (κ�

Pesticide Environmental Accounting: a method for assessing the external costs of individual pesticide applications.

PubMed

Leach, A W; Mumford, J D

2008-01-01

The Pesticide Environmental Accounting (PEA) tool provides a monetary estimate of environmental and health impacts per hectare-application for any pesticide. The model combines the Environmental Impact Quotient method and a methodology for absolute estimates of external pesticide costs in UK, USA and Germany. For many countries resources are not available for intensive assessments of external pesticide costs. The model converts external costs of a pesticide in the UK, USA and Germany to Mediterranean countries. Economic and policy applications include estimating impacts of pesticide reduction policies or benefits from technologies replacing pesticides, such as sterile insect technique. The system integrates disparate data and approaches into a single logical method. The assumptions in the system provide transparency and consistency but at the cost of some specificity and precision, a reasonable trade-off for a method that provides both comparative estimates of pesticide impacts and area-based assessments of absolute impacts.

A Comparative Study of Activity-Based Costing vs. Current Pricing System for Pathology Examinations at Okmeydani Training and Research Hospital, Turkey.

PubMed

Yarikkaya, Enver; Özekinci, Selver; Sargan, Aytül; Durmuş, Şenay Erdoğan; Yildiz, Fetin Rüştü

2017-01-01

To provide real cost data for pathology examinations by using activity-based costing method, in order to provide means to departments, health administrators and the social security institution to achieve improvements in financial planning, quality and cost control. The cost of the histopathological examinations, which were accepted by the Department of Pathology at Okmeydanı Training and Research Hospital during August 2014, was calculated using the activity-based costing method. The costs were compared with the amounts specified in the Healthcare Implementation Notification Tariff and the conventional volume-based costing. Most pathology examinations listed within a given band in the Healthcare Implementation Notification Tariff show variations in unit costs. The study found that the costs of 77.4% of the examinations were higher than the prices listed in the Healthcare Implementation Notification Tariff. The pathology examination tariffs specified in the Healthcare Implementation Notification do not reflect the real costs of the examinations. The costs that are calculated using the activity-based costing system may vary according to the service types and levels of health care institutions. However, the main parameters of the method used in the study reflect the necessity of a more accurate banding of pathology examinations. The banding specified by the Healthcare Implementation Notification Tariff needs to be revised to reflect the real costs in Turkey.

Bias in Examination Test Banks that Accompany Cost Accounting Texts.

ERIC Educational Resources Information Center

Clute, Ronald C.; McGrail, George R.

1989-01-01

Eight text banks that accompany cost accounting textbooks were evaluated for the presence of bias in the distribution of correct responses. All but one were found to have considerable bias, and three of eight were found to have significant choice bias. (SK)

Accountability for Community-Based Programs for the Seriously Ill.

PubMed

Teno, Joan M; Montgomery, Russ; Valuck, Tom; Corrigan, Janet; Meier, Diane E; Kelley, Amy; Curtis, J Randall; Engelberg, Ruth

2018-03-01

Innovation is needed to improve care of the seriously ill, and there are important opportunities as we transition from a volume- to value-based payment system. Not all seriously ill are dying; some recover, while others are persistently functionally impaired. While we innovate in service delivery and payment models for the seriously ill, it is important that we concurrently develop accountability that ensures a focus on high-quality care rather than narrowly focusing on cost containment. The Gordon and Betty Moore Foundation convened a meeting of 45 experts to arrive at guiding principles for measurement, create a starter measurement set, specify a proposed definition of the denominator and its refinement, and identify research priorities for future implementation of the accountability system. A series of articles written by experts provided the basis for debate and guidance in formulating a path forward to develop an accountability system for community-based programs for the seriously ill, outlined in this article. As we innovate in existing population-based payment programs such as Medicare Advantage and develop new alternative payment models, it is important and urgent that we develop the foundation for accountability along with actionable measures so that the healthcare system ensures high-quality person- and family-centered care for persons who are seriously ill.

Accountability for Community-Based Programs for the Seriously Ill

PubMed Central

Montgomery, Russ; Valuck, Tom; Corrigan, Janet; Meier, Diane E.; Kelley, Amy; Curtis, J. Randall; Engelberg, Ruth

2018-01-01

Abstract Innovation is needed to improve care of the seriously ill, and there are important opportunities as we transition from a volume- to value-based payment system. Not all seriously ill are dying; some recover, while others are persistently functionally impaired. While we innovate in service delivery and payment models for the seriously ill, it is important that we concurrently develop accountability that ensures a focus on high-quality care rather than narrowly focusing on cost containment. The Gordon and Betty Moore Foundation convened a meeting of 45 experts to arrive at guiding principles for measurement, create a starter measurement set, specify a proposed definition of the denominator and its refinement, and identify research priorities for future implementation of the accountability system. A series of articles written by experts provided the basis for debate and guidance in formulating a path forward to develop an accountability system for community-based programs for the seriously ill, outlined in this article. As we innovate in existing population-based payment programs such as Medicare Advantage and develop new alternative payment models, it is important and urgent that we develop the foundation for accountability along with actionable measures so that the healthcare system ensures high-quality person- and family-centered care for persons who are seriously ill. PMID:29195052

ABC estimation of unit costs for emergency department services.

PubMed

Holmes, R L; Schroeder, R E

1996-04-01

Rapid evolution of the health care industry forces managers to make cost-effective decisions. Typical hospital cost accounting systems do not provide emergency department managers with the information needed, but emergency department settings are so complex and dynamic as to make the more accurate activity-based costing (ABC) system prohibitively expensive. Through judicious use of the available traditional cost accounting information and simple computer spreadsheets. managers may approximate the decision-guiding information that would result from the much more costly and time-consuming implementation of ABC.

41 CFR 102-33.190 - What are the aircraft operations and ownership costs for which we must account?

Code of Federal Regulations, 2011 CFR

2011-01-01

... Parts Accounting for the Cost of Government Aircraft § 102-33.190 What are the aircraft operations and... Government aircraft as described in the “Government Aircraft Cost Accounting Guide” (CAG), which follows OMB... operations and ownership costs for which we must account? 102-33.190 Section 102-33.190 Public Contracts and...

Cost and cost-effectiveness of nationwide school-based helminth control in Uganda

PubMed Central

BROOKER, SIMON; KABATEREINE, NARCIS B; FLEMING, FIONA; DEVLIN, NANCY

2009-01-01

Estimates of cost and cost-effectiveness are typically based on a limited number of small-scale studies with no investigation of the existence of economies to scale or intra-country variation in cost and cost-effectiveness. This information gap hinders the efficient allocation of health care resources and the ability to generalize estimates to other settings. The current study investigates the intra-country variation in the cost and cost-effectiveness of nationwide school-based treatment of helminth (worm) infection in Uganda. Programme cost data were collected through semi-structured interviews with districts officials and from accounting records in six of the 23 intervention districts. Both financial and economic costs were assessed. Costs were estimated on the basis of cost in US$ per schoolchild treated and an incremental cost effectiveness ratio (cost in US$ per case of anaemia averted) was used to evaluate programme cost-effectiveness. Sensitivity analysis was performed to assess the effect of discount rate and drug price. The overall economic cost per child treated in the six districts was US$ 0.54 and the cost-effectiveness was US$ 3.19 per case of anaemia averted. Analysis indicated that estimates of both cost and cost-effectiveness differ markedly with the total number of children which received treatment, indicating economies of scale. There was also substantial variation between districts in the cost per individual treated (US$ 0.41-0.91) and cost per anaemia case averted (US$ 1.70-9.51). Independent variables were shown to be statistically associated with both sets of estimates. This study highlights the potential bias in transferring data across settings without understanding the nature of observed variations. PMID:18024966

Government Accounting

DTIC Science & Technology

1999-06-22

Commercial Industry • Financial Standards Accounting Board (GAAP) • Internal Revenue Service - Tax Accounting • DoD - Cost Accounting Standards...internal management control systems, managers shall focus on results, not process” Government Accounting • Intent EVM Accounting Criteria : – Record costs ...consistent with established budgets – Insure control of indirect costs – Insure disciplined accumulation of cost – Insure proper material accounting and

A time-driven activity-based costing model to improve health-care resource use in Mirebalais, Haiti.

PubMed

Mandigo, Morgan; O'Neill, Kathleen; Mistry, Bipin; Mundy, Bryan; Millien, Christophe; Nazaire, Yolande; Damuse, Ruth; Pierre, Claire; Mugunga, Jean Claude; Gillies, Rowan; Lucien, Franciscka; Bertrand, Karla; Luo, Eva; Costas, Ainhoa; Greenberg, Sarah L M; Meara, John G; Kaplan, Robert

2015-04-27

In resource-limited settings, efficiency is crucial to maximise resources available for patient care. Time driven activity-based costing (TDABC) estimates costs directly from clinical and administrative processes used in patient care, thereby providing valuable information for process improvements. TDABC is more accurate and simpler than traditional activity-based costing because it assigns resource costs to patients based on the amount of time clinical and staff resources are used in patient encounters. Other costing approaches use somewhat arbitrary allocations that provide little transparency into the actual clinical processes used to treat medical conditions. TDABC has been successfully applied in European and US health-care settings to facilitate process improvements and new reimbursement approaches, but it has not been used in resource-limited settings. We aimed to optimise TDABC for use in a resource-limited setting to provide accurate procedure and service costs, reliably predict financing needs, inform quality improvement initiatives, and maximise efficiency. A multidisciplinary team used TDABC to map clinical processes for obstetric care (vaginal and caesarean deliveries, from triage to post-partum discharge) and breast cancer care (diagnosis, chemotherapy, surgery, and support services, such as pharmacy, radiology, laboratory, and counselling) at Hôpital Universitaire de Mirebalais (HUM) in Haiti. The team estimated the direct costs of personnel, equipment, and facilities used in patient care based on the amount of time each of these resources was used. We calculated inpatient personnel costs by allocating provider costs per staffed bed, and assigned indirect costs (administration, facility maintenance and operations, education, procurement and warehouse, bloodbank, and morgue) to various subgroups of the patient population. This study was approved by the Partners in Health/Zanmi Lasante Research Committee. The direct cost of an uncomplicated vaginal

Time-driven activity-based cost comparison of prostate cancer brachytherapy and intensity-modulated radiation therapy.

PubMed

Dutta, Sunil W; Bauer-Nilsen, Kristine; Sanders, Jason C; Trifiletti, Daniel M; Libby, Bruce; Lash, Donna H; Lain, Melody; Christodoulou, Deborah; Hodge, Constance; Showalter, Timothy N

To evaluate the delivery cost of frequently used radiotherapy options offered to patients with intermediate- to high-risk prostate cancer using time-driven activity-based costing and compare the results with Medicare reimbursement and relative value units (RVUs). Process maps were created to represent each step of prostate radiotherapy treatment at our institution. Salary data, equipment purchase costs, and consumable costs were factored into the cost analysis. The capacity cost rate was determined for each resource and calculated for each treatment option from initial consultation to its completion. Treatment options included low-dose-rate brachytherapy (LDR-BT), combined high-dose-rate brachytherapy single fraction boost with 25-fraction intensity-modulated radiotherapy (HDR-BT-IMRT), moderately hypofractionated 28-fraction IMRT, conventionally fractionated 39-fraction IMRT, and conventionally fractionated (2 Gy/fraction) 23-fraction pelvis irradiation with 16-fraction prostate boost. The total cost to deliver LDR-BT, HDR-BT-IMRT, moderately hypofractionated 28-fraction IMRT, conventionally fractionated 39-fraction IMRT, conventionally fractionated 39-fraction IMRT, and conventionally fractionated (2 Gy/fraction) 23-fraction pelvis irradiation with 16-fraction prostate boost was $2719, $6517, $4173, $5507, and $5663, respectively. Total reimbursement for each course was $3123, $10,156, $7862, $9725, and $10,377, respectively. Radiation oncology attending time was 1.5-2 times higher for treatment courses incorporating BT. Attending radiation oncologist's time consumed per RVU was higher with BT (4.83 and 2.56 minutes per RVU generated for LDR-BT and HDR-BT-IMRT, respectively) compared to without BT (1.41-1.62 minutes per RVU). Time-driven activity-based costing analysis identified higher delivery costs associated with prostate BT compared with IMRT alone. In light of recent guidelines promoting BT for intermediate- to high-risk disease, re-evaluation of payment

Cost-effectiveness of rotavirus immunization in Indonesia: taking breastfeeding patterns into account.

PubMed

Suwantika, Auliya A; Tu, Hong Anh T; Postma, Maarten J

2013-07-11

This study aims to assess the cost-effectiveness of rotavirus immunization in Indonesia, taking breastfeeding patterns explicitly into account. An age-structured cohort model was developed for the 2011 Indonesia birth cohort. Next, we compared two strategies, the current situation without rotavirus immunization versus the alternative of a national immunization program. The model applies a 5 year time horizon, with 1 monthly analytical cycles for children less than 1 year of age and annually thereafter. Three scenarios were compared to the base case reflecting the actual distribution over the different breastfeeding modes as present in Indonesia; i.e., the population under 2 years old with (i) 100% exclusive breastfeeding, (ii) 100% partial breastfeeding and (iii) 100% no breastfeeding. Monte Carlo simulations were used to examine the economic acceptability and affordability of the rotavirus vaccination. Rotavirus immunization would effectively reduce severe cases of rotavirus during the first 5 years of life of a child. Under the market vaccine price the total yearly vaccine cost would amount to US$ 65 million. The incremental cost per quality-adjusted-life-year (QALY) in the base case was US$ 174 from the societal perspective. Obviously, it was much lower than the 2011 Indonesian Gross Domestic Product (GDP) per capita of US$ 3495. Affordability results showed that at the Global Alliance for Vaccines and Immunization (GAVI)-subsidized vaccine price, rotavirus vaccination could be affordable for the Indonesian health system. Increased uptake of breastfeeding might slightly reduce cost-effectiveness results. Rotavirus immunization in Indonesia would be a highly cost-effective health intervention even under the market vaccine price. The results illustrate that rotavirus immunization would greatly reduce the burden of disease due to rotavirus infection. Even within increased uptake of breastfeeding, cost-effectiveness remains favorable. Crown Copyright © 2013

Revenue-based cost assignment: a potent but hidden threat to the survival of the multispecialty medical practice.

PubMed

Cooper, Robin; Kramer, Theresa R

2010-03-01

To demonstrate detrimental effects of revenue-based cost assignment (RBCA) in clinical practice and to compare that system with activity-based costing (ABC). Four cost-allocation methods including RBCA were applied to a comprehensive ophthalmology practice using typical accounting methods. Data were obtained by a survey of practitioners or practices and/or extracted from decision support and practice management systems. Inaccuracies and distortions in reported costs were enumerated. Accounting scenario analysis was used to predict resultant provider and managerial decisions. A sampling survey was used to analyze other specialties. ABC was applied to the practice. RBCA causes procedures with higher profitability to appear less profitable and those with lower profitability to appear more profitable. The distortion in reported costs, in medical settings, is often sufficient to incentivize providers with higher profitability to exit a practice and those with lower profitability to remain in it. The departure of providers causes the residual practice profits to decline. These detrimental effects occur in many subspecialties, which suggests a national effect on health care. ABC allocation can reduce cost distortions and eliminate detrimental effects. RBCA leads to fragmentation of health care and a reduction in the profitability of multispecialty practices. Its use may slow the updating of reimbursement and help eliminate low-profitability specialties.

How does accounting for worker productivity affect the measured cost-effectiveness of lumbar discectomy?

PubMed

Koenig, Lane; Dall, Timothy M; Gu, Qian; Saavoss, Josh; Schafer, Michael F

2014-04-01

Back pain attributable to lumbar disc herniation is a substantial cause of reduced workplace productivity. Disc herniation surgery is effective in reducing pain and improving function. However, few studies have examined the effects of surgery on worker productivity. We wished to determine the effect of disc herniation surgery on workers' earnings and missed workdays and how accounting for this effect influences the cost-effectiveness of surgery? Regression models were estimated using data from the National Health Interview Survey to assess the effects of lower back pain caused by disc herniation on earnings and missed workdays. The results were incorporated into Markov models to compare societal costs associated with surgical and nonsurgical treatments for privately insured, working patients. Clinical outcomes and utilities were based on results from the Spine Patient Outcomes Research Trial and additional clinical literature. We estimate average annual earnings of $47,619 with surgery and $45,694 with nonsurgical treatment. The increased earnings for patients receiving surgery as compared with nonsurgical treatment is equal to $1925 (95% CI, $1121-$2728). After surgery, we also estimate that workers receiving surgery miss, on average, 3 fewer days per year than if workers had received nonsurgical treatment (95% CI, 2.4-3.7 days). However, these fewer missed work days only partially offset the assumed 20 workdays missed to recover from surgery. More fully accounting for the effects of disc herniation surgery on productivity reduced the cost of surgery per quality-adjusted life year (QALY) from $52,416 to $35,146 using a 4-year time horizon and from $27,359 to $4186 using an 8-year time horizon. According to a sensitivity analysis, the 4-year cost per QALY varies between $27,921 and $49,787 depending on model assumptions. Increased worker earnings resulting from disc herniation surgery may offset the increased direct medical costs associated with surgery. After

Evaluation of Delivery Costs for External Beam Radiation Therapy and Brachytherapy for Locally Advanced Cervical Cancer Using Time-Driven Activity-Based Costing.

PubMed

Bauer-Nilsen, Kristine; Hill, Colin; Trifiletti, Daniel M; Libby, Bruce; Lash, Donna H; Lain, Melody; Christodoulou, Deborah; Hodge, Constance; Showalter, Timothy N

2018-01-01

To evaluate the delivery costs, using time-driven activity-based costing, and reimbursement for definitive radiation therapy for locally advanced cervical cancer. Process maps were created to represent each step of the radiation treatment process and included personnel, equipment, and consumable supplies used to deliver care. Personnel were interviewed to estimate time involved to deliver care. Salary data, equipment purchasing information, and facilities costs were also obtained. We defined the capacity cost rate (CCR) for each resource and then calculated the total cost of patient care according to CCR and time for each resource. Costs were compared with 2016 Medicare reimbursement and relative value units (RVUs). The total cost of radiation therapy for cervical cancer was $12,861.68, with personnel costs constituting 49.8%. Brachytherapy cost $8610.68 (66.9% of total) and consumed 423 minutes of attending radiation oncologist time (80.0% of total). External beam radiation therapy cost $4055.01 (31.5% of total). Personnel costs were higher for brachytherapy than for the sum of simulation and external beam radiation therapy delivery ($4798.73 vs $1404.72). A full radiation therapy course provides radiation oncologists 149.77 RVUs with intensity modulated radiation therapy or 135.90 RVUs with 3-dimensional conformal radiation therapy, with total reimbursement of $23,321.71 and $16,071.90, respectively. Attending time per RVU is approximately 4-fold higher for brachytherapy (5.68 minutes) than 3-dimensional conformal radiation therapy (1.63 minutes) or intensity modulated radiation therapy (1.32 minutes). Time-driven activity-based costing was used to calculate the total cost of definitive radiation therapy for cervical cancer, revealing that brachytherapy delivery and personnel resources constituted the majority of costs. However, current reimbursement policy does not reflect the increased attending physician effort and delivery costs of brachytherapy. We

Cost of outpatient endoscopic sinus surgery from the perspective of the Canadian government: a time-driven activity-based costing approach.

PubMed

Au, Jennifer; Rudmik, Luke

2013-09-01

The time-driven activity-based costing (TD-ABC) method is a novel approach to quantify the costs of a complex system. The aim of this study was to apply the TD-ABC technique to define the overall cost of a routine outpatient endoscopic sinus surgery (ESS) from the perspective of the Canadian government payer. Costing perspective was the Canadian government payer. All monetary values are in Canadian dollars as of December 2012. Costs were obtained by contacting staff unions, reviewing purchasing databases and provincial physician fee schedules. Practical capacity time values were collected from the College and Association of Registered Nurses of Alberta. Capacity cost rates ($/min) were calculated for all staff, capital equipment, and hospital space. The overall cost for routine outpatient ESS was $3510.31. The cost per ESS case for each clinical pathway encounter was as follows: preoperative holding ($49.19); intraoperative ($3296.60); sterilization ($90.20); postanesthesia care unit ($28.64); and postoperative day ward ($45.68). The 3 major cost drivers were physician fees, disposable equipment, and nursing costs. The intraoperative phase contributed to 94.5% of the overall cost. This study applied the TD-ABC method to evaluate the cost of outpatient ESS from the perspective of the Canadian government payer and defined the overall cost to be $3510.31 per case. © 2013 ARS-AAOA, LLC.

Comparison of the Ministry of Health's tariffs with the cost of radiology services using the activity-based costing method.

PubMed

Kalhor, Rohollah; Amini, Saeed; Emami, Majid; Kakasoltani, Keivan; Rhamani, Nasim; Kalhor, Leila

2016-02-01

Efficient use of resources in organizations is one of the most important duties of managers. Appropriate allocation of resources can help managers to do this well. The aim of this study was to determine the cost of radiology services and to compare it with governmental tariffs (introduced by the Ministry of Health in Iran). This was a descriptive and applied study that was conducted using the retrospective approach. First, activity centers were identified on the basis of five main groups of hospital activities. Then, resources and resource drivers, activities, and hospital activity drivers were identified. At the next step, the activities related to the delivery of radiology process were identified. Last, through allocation of activities cost to the cost objects, the cost price of 66 services that were delivered in the radiology department were calculated. The data were collected by making checklists, using the hospital's information system, observations, and interviews. Finally, the data were analyzed using the non-parametric Wilcoxon test, Microsoft Excel, and SPSS software, version 18. The findings showed that from the total cost of wages, materials, and overhead obtained, the unit cost of the 66 cost objects (delivered services) in the Radiology Department were calculated using the ABC method (Price of each unit of Nephrostogram obtained $15.8 and Cystogram obtained $18.4). The Kolmogorov-Smirnov test indicated that the distribution of data of cost price using the ABC method was not normal (p = 0.000). The Wilcoxon test showed that there was a significant difference between the cost of services and the tariff of radiology services (p = 0.000). The cost of delivered services in radiology departments was significantly higher than approved tariffs of the Ministry of Health, which can have a negative impact on the quality of services.

2 CFR 200.419 - Cost accounting standards and disclosure statement.

Code of Federal Regulations, 2014 CFR

2014-01-01

... million or more subject to this part during its most recently completed fiscal year must disclose their... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false Cost accounting standards and disclosure... receives aggregate Federal awards totaling $50 million or more in Federal awards subject to this part in...

Planning, budgeting, and controlling--one look at the future: case-mix cost accounting.

PubMed

Thompson, J D; Averill, R F; Fetter, R B

1979-01-01

This paper outlines the system for cost accounting and managerial control which is an extension of the usually accepted departmental costing systems and takes as its units the 383 Diagnosis Related Groups (DRGs) considered to be the hospital's products. It is held that such an approach offers hospital managers a more powerful, analytic, budgeting, and cost-finding tool and offers the opportunity to involve the medical staff in the issues of how their practice patterns are affecting hospital costs.

Current Developments in Cost Accounting/Performance Measuring Systems for Implementing Advanced Manufacturing Technology

DTIC Science & Technology

1989-11-01

incomplete accounting of benefits, few strategic projects will * be adopted. Nanni , et al [21], provide similar discussion regarding a benefit analysis in...management tends to ignore the fact that minimizing costs within departments does not guarantee minimization of overall costs ( Nanni (21]). Sullivan, et...changes in the manufacturing environment. The author also remarks that these cost systems need to be modified or replaced by entirely new systems

Cost Accounting Standards: An Overview of Compliance with These Complex Standards.

ERIC Educational Resources Information Center

Bruce, Janet D.

1993-01-01

A discussion of federal cost accounting standards (CAS) chronicles briefly the history of CAS, notes other pertinent regulations applicable to higher education, summarizes the initial standards drafted for colleges and universities, and examines disclosure statement requirements and implications of noncompliance. (MSE)

Costs of Providing Infusion Therapy for Rheumatoid Arthritis in a Hospital-based Infusion Center Setting.

PubMed

Schmier, Jordana; Ogden, Kristine; Nickman, Nancy; Halpern, Michael T; Cifaldi, Mary; Ganguli, Arijit; Bao, Yanjun; Garg, Vishvas

2017-08-01

Many hospital-based infusion centers treat patients with rheumatoid arthritis (RA) with intravenous biologic agents, yet may have a limited understanding of the overall costs of infusion in this setting. The purposes of this study were to conduct a microcosting analysis from a hospital perspective and to develop a model using an activity-based costing approach for estimating costs associated with the provision of hospital-based infusion services (preparation, administration, and follow-up) in the United States for maintenance treatment of moderate to severe RA. A spreadsheet-based model was developed. Inputs included hourly wages, time spent providing care, supply/overhead costs, laboratory testing, infusion center size, and practice pattern information. Base-case values were derived from data from surveys, published studies, standard cost sources, and expert opinion. Costs are presented in year-2017 US dollars. The base case modeled a hospital infusion center serving patients with RA treated with abatacept, tocilizumab, infliximab, or rituximab. Estimated overall costs of infusions per patient per year were $36,663 (rituximab), $36,821 (tocilizumab), $44,973 (infliximab), and $46,532 (abatacept). Of all therapies, the biologic agents represented the greatest share of overall costs, ranging from 87% to $91% of overall costs per year. Excluding infusion drug costs, labor accounted for 53% to 57% of infusion costs. Biologic agents represented the highest single cost associated with RA infusion care; however, personnel, supplies, and overhead costs also contributed substantially to overall costs (8%-16%). This model may provide a helpful and adaptable framework for use by hospitals in informing decision making about services offered and their associated financial implications. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Constrained Optimization Problems in Cost and Managerial Accounting--Spreadsheet Tools

ERIC Educational Resources Information Center

Amlie, Thomas T.

2009-01-01

A common problem addressed in Managerial and Cost Accounting classes is that of selecting an optimal production mix given scarce resources. That is, if a firm produces a number of different products, and is faced with scarce resources (e.g., limitations on labor, materials, or machine time), what combination of products yields the greatest profit…

Planning, budgeting, and controlling--one look at the future: case-mix cost accounting.

PubMed Central

Thompson, J D; Averill, R F; Fetter, R B

1979-01-01

This paper outlines the system for cost accounting and managerial control which is an extension of the usually accepted departmental costing systems and takes as its units the 383 Diagnosis Related Groups (DRGs) considered to be the hospital's products. It is held that such an approach offers hospital managers a more powerful, analytic, budgeting, and cost-finding tool and offers the opportunity to involve the medical staff in the issues of how their practice patterns are affecting hospital costs. PMID:511578

Integration of Mahalanobis-Taguchi system and traditional cost accounting for remanufacturing crankshaft

NASA Astrophysics Data System (ADS)

Abu, M. Y.; Norizan, N. S.; Rahman, M. S. Abd

2018-04-01

Remanufacturing is a sustainability strategic planning which transforming the end of life product to as new performance with their warranty is same or better than the original product. In order to quantify the advantages of this strategy, all the processes must implement the optimization to reach the ultimate goal and reduce the waste generated. The aim of this work is to evaluate the criticality of parameters on the end of life crankshaft based on Taguchi’s orthogonal array. Then, estimate the cost using traditional cost accounting by considering the critical parameters. By implementing the optimization, the remanufacturer obviously produced lower cost and waste during production with higher potential to gain the profit. Mahalanobis-Taguchi System was proven as a powerful method of optimization that revealed the criticality of parameters. When subjected the method to the MAN engine model, there was 5 out of 6 crankpins were critical which need for grinding process while no changes happened to the Caterpillar engine model. Meanwhile, the cost per unit for MAN engine model was changed from MYR1401.29 to RM1251.29 while for Caterpillar engine model have no changes due to the no changes on criticality of parameters consideration. Therefore, by integrating the optimization and costing through remanufacturing process, a better decision can be achieved after observing the potential profit will be gained. The significant of output demonstrated through promoting sustainability by reducing re-melting process of damaged parts to ensure consistent benefit of return cores.

48 CFR 9903.302 - Definitions, explanations, and illustrations of the terms, “cost accounting practice” and “change...

Code of Federal Regulations, 2010 CFR

2010-10-01

... ACCOUNTING STANDARDS CONTRACT COVERAGE CAS Rules and Regulations 9903.302 Definitions, explanations, and... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Definitions, explanations, and illustrations of the terms, âcost accounting practiceâ and âchange to a cost accounting practice.â...

The health, education, and social care costs of school-aged children with active epilepsy: A population-based study.

PubMed

Hunter, Rachael M; Reilly, Colin; Atkinson, Patricia; Das, Krishna B; Gillberg, Christopher; Chin, Richard F; Scott, Rod C; Neville, Brian G R; Morris, Stephen

2015-07-01

To provide data on the health, social care, and education costs of active childhood epilepsy and factors associated with these costs over an 18-month period in a population-based sample. The Children with Epilepsy in Sussex Schools (CHESS) study is a population-based study involving school-aged children (5-15 years) with active epilepsy (taking one or more antiepileptic drug and/or had a seizure in the last year) in a defined geographical area in England. Clinical data were collected on 85 children (74% of eligible population) who underwent comprehensive psychological assessment. Health, education, and social care resource use was collected retrospectively over an 18-month period. Regression analysis was used to identify variables associated these with costs. The mean (standard deviation) 18-month cost of health care for a child with active epilepsy was £3,635 (£5,339), with mean education and social care cost of £11,552 (£8,937) and £1,742 (£8,158), respectively, resulting in total mean costs per participant of £16,931 (£14,764). Health care costs were significantly associated with seizure frequency and etiology (all p-values < 0.05). Combined health care, social care, and education costs were significantly related to cognitive impairment (intelligence quotient [IQ] <85) and seizure frequency (p < 0.05). The mean cost of health care, social care, and education over 18 months for participants with cognitive impairment was £23,579 (95% confidence interval [CI] £16,489-£30,670) compared to £7,785 (95% CI £4,943-£10,627) for those without impairment. Active childhood epilepsy has significant health, social care, and education costs. This is the first study to comprehensively document the economic impact on these sectors as well as factors associated with these costs. When caring for children with epilepsy in England, costs incurred by education and social care sectors are approximately four times the costs incurred by the health care sector. Increased

The Cost of Joint Replacement: Comparing Two Approaches to Evaluating Costs of Total Hip and Knee Arthroplasty.

PubMed

Palsis, John A; Brehmer, Thomas S; Pellegrini, Vincent D; Drew, Jacob M; Sachs, Barton L

2018-02-21

In an era of mandatory bundled payments for total joint replacement, accurate analysis of the cost of procedures is essential for orthopaedic surgeons and their institutions to maintain viable practices. The purpose of this study was to compare traditional accounting and time-driven activity-based costing (TDABC) methods for estimating the total costs of total hip and knee arthroplasty care cycles. We calculated the overall costs of elective primary total hip and total knee replacement care cycles at our academic medical center using traditional and TDABC accounting methods. We compared the methods with respect to the overall costs of hip and knee replacement and the costs for each major cost category. The traditional accounting method resulted in higher cost estimates. The total cost per hip replacement was $22,076 (2014 USD) using traditional accounting and was $12,957 using TDABC. The total cost per knee replacement was $29,488 using traditional accounting and was $16,981 using TDABC. With respect to cost categories, estimates using traditional accounting were greater for hip and knee replacement, respectively, by $3,432 and $5,486 for personnel, by $3,398 and $3,664 for space and equipment, and by $2,289 and $3,357 for indirect costs. Implants and consumables were derived from the actual hospital purchase price; accordingly, both methods produced equivalent results. Substantial cost differences exist between accounting methods. The focus of TDABC only on resources used directly by the patient contrasts with the allocation of all operating costs, including all indirect costs and unused capacity, with traditional accounting. We expect that the true costs of hip and knee replacement care cycles are likely somewhere between estimates derived from traditional accounting methods and TDABC. TDABC offers patient-level granular cost information that better serves in the redesign of care pathways and may lead to more strategic resource-allocation decisions to optimize

Cost-Effectiveness and Cost-Utility of Internet-Based Computer Tailoring for Smoking Cessation

PubMed Central

Evers, Silvia MAA; de Vries, Hein; Hoving, Ciska

2013-01-01

Background Although effective smoking cessation interventions exist, information is limited about their cost-effectiveness and cost-utility. Objective To assess the cost-effectiveness and cost-utility of an Internet-based multiple computer-tailored smoking cessation program and tailored counseling by practice nurses working in Dutch general practices compared with an Internet-based multiple computer-tailored program only and care as usual. Methods The economic evaluation was embedded in a randomized controlled trial, for which 91 practice nurses recruited 414 eligible smokers. Smokers were randomized to receive multiple tailoring and counseling (n=163), multiple tailoring only (n=132), or usual care (n=119). Self-reported cost and quality of life were assessed during a 12-month follow-up period. Prolonged abstinence and 24-hour and 7-day point prevalence abstinence were assessed at 12-month follow-up. The trial-based economic evaluation was conducted from a societal perspective. Uncertainty was accounted for by bootstrapping (1000 times) and sensitivity analyses. Results No significant differences were found between the intervention arms with regard to baseline characteristics or effects on abstinence, quality of life, and addiction level. However, participants in the multiple tailoring and counseling group reported significantly more annual health care–related costs than participants in the usual care group. Cost-effectiveness analysis, using prolonged abstinence as the outcome measure, showed that the mere multiple computer-tailored program had the highest probability of being cost-effective. Compared with usual care, in this group €5100 had to be paid for each additional abstinent participant. With regard to cost-utility analyses, using quality of life as the outcome measure, usual care was probably most efficient. Conclusions To our knowledge, this was the first study to determine the cost-effectiveness and cost-utility of an Internet-based smoking

Effects of a Community-Based Fall Management Program on Medicare Cost Savings.

PubMed

Ghimire, Ekta; Colligan, Erin M; Howell, Benjamin; Perlroth, Daniella; Marrufo, Grecia; Rusev, Emil; Packard, Michael

2015-12-01

Fall-related injuries and health risks associated with reduced mobility or physical inactivity account for significant costs to the U.S. healthcare system. The widely disseminated lay-led A Matter of Balance (MOB) program aims to help older adults reduce their risk of falling and associated activity limitations. This study examined effects of MOB participation on health service utilization and costs for Medicare beneficiaries, as a part of a larger effort to understand the value of community-based prevention and wellness programs for Medicare. A controlled retrospective cohort study was conducted in 2012-2013, using 2007-2011 MOB program data and 2006-2013 Medicare data. It investigated program effects on falls and fall-related fractures, and health service utilization and costs (standardized to 2012 dollars), of 6,136 Medicare beneficiaries enrolled in MOB from 2007 through 2011. A difference-in-differences analysis was employed to compare outcomes of MOB participants with matched controls. MOB participation was associated with total medical cost savings of $938 per person (95% CI=$379, $1,498) at 1 year. Savings per person amounted to $517 (95% CI=$265, $769) for unplanned hospitalizations; $81 for home health care (95% CI=$20, $141); and $234 (95% CI=$55, $413) for skilled nursing facility care. Changes in the incidence of falls or fall-related fractures were not detected, suggesting that cost savings accrue through other mechanisms. This study suggests that MOB and similar prevention programs have the potential to reduce Medicare costs. Further research accounting for program delivery costs would help inform the development of Medicare-covered preventive benefits. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.

Defense Contract Audit Agency Audits of Contractor Compliance with Cost Accounting Standards

DTIC Science & Technology

1999-01-11

20301-1900. The identity of each writer and caller is fully protected. Acronyms ACO CAM CAS CO DCAA DCMC DFARS FAR FAO FMIS GAAP GAAS...Accounting Principles ( GAAP ) and accounting methods accepted for income tax purposes by the Internal Revenue Service. The purpose of GAAP is to report cost...information for financial statement purposes GAAP was developed primarily for stockholder use and protection, not to control expenditures on

The use of activity-based cost estimation as a management tool for cultural change

NASA Technical Reports Server (NTRS)

Mandell, Humboldt; Bilby, Curt

1991-01-01

It will be shown that the greatest barrier to American exploration of the planet Mars is not the development of the technology needed to deliver humans and return them safely to earth. Neither is it the cost of such an undertaking, as has been previously suggested, although certainly, such a venture may not be inexpensive by some measures. The predicted costs of exploration have discouraged serious political dialog on the subject. And, in fact, even optimistic projections of the NASA budget do not contain the resources required, under the existing development and management paradigm, for human space exploration programs. It will be demonstrated that the perception of the costs of such a venture, and the cultural responses to the perceptions are factors inhibiting American exploration of the moon and the planet Mars. Cost models employed in the aerospace industry today correctly mirror the history of past space programs, and as such, are representative of the existing management and development paradigms. However, if, under this current paradigm no major exploration programs are feasible, then cost analysis methods based in the past may not have great utility in exploring the needed cultural changes. This paper explores the use of a new type of model, the activity based cost model, which will treat management style as an input variable, in a sense providing a tool whereby a complete, affordable program might be designed, including both the technological and management aspects.

Comparison of the Ministry of Health’s tariffs with the cost of radiology services using the activity-based costing method