Discuss two positives and two negatives regarding retirementplanning and deferred compensation. Please write 2-3 paragraphs . . .
Case Study – Background Reading – Strategic Management – Banks
The CEO of St. Sebastian Health System, a moderate-sized hospital system in a mid-sized, Midwest city
has hired you to help turn things around. The CFO is projecting an $8.9 million operating loss this year,
which will be more than offset by non-operating income. However, the board has made it clear that the
situation must improve. If the system cannot produce a positive operating margin in 2017, someone else
is going to be the CEO. The CEO and CFO have asked you to recommend strategic approaches to selling
their services in the community that will help turn the financial ship around.
Your Health System
St. Sebastian is a community-based health system. The senior management team has an average tenure
of 17 years. The exception is the Chief Medical Officer (CMO). She has been in her position for two years
and is the fourth CMO in that role in the past ten years. The CEO and COO have each been in their
current roles for ten years. The system is comprised of the following:
1. Two large, acute care hospitals
2. Two long term care facilities
3. Two skilled nursing facilities
4. One long-term acute-care hospital (LTAC)
5. Four geographically distributed outpatient centers
6. Four Urgent Care Centers
7. Two free-standing ambulatory surgery centers (ASCs)
8. A 400 member employed physician group that includes 180 Primary Care Providers (PCPs). All 28
PCP practices are certified Level III Patient Centered Medical Homes by NCQA.
The remainder of the 1,000 member medical staff is generally comprised of large, independent groups
who have varying degrees of ‘loyalty’ to the system. The Radiology and Emergency groups, for example
do 100% of their work at St. Sebastian and have no ownership of any outside facilities. The
Gastroenterology group, on the other hand, does work at the hospital, but also owns their own,
freestanding endoscopy center. The orthopedic group does 75% of their work at St. Sebastian, but
maintains privileges at other facilities. They do not own their own ASC.
In the current year, St. Sebastian is projecting 221,700 patient visits (combined IP and OP) with an
average cost per visit of $1,727. They have an average charge per visit of $4,600.
Over the past ten years, St. Sebastian has been active in pursuing a number of different strategic
projectsincluding:
1. They have established ‘clinical institutes’ in cardiovascular, orthopedic, oncology, maternity and
neurologic care. Each of these has been built through a co-management agreement between
the system and the internal or external physician group who would be most logical. Each
institute is led by a dyad of an administrator and medical director.
2. Five years ago, they consolidated maternity programs to one facility, a move that justified
investing in a Level III Neonatal Intensive Care Unit (NICU)
3. They have established a research division in the hopes of working with national pharmaceutical
companies and/or tertiary care hospitals in the Midwest.
4. They have established a Physician Hospital Organization (PHO) and intend to become an
Accountable Care Organization (ACO) that can participate in the Medicare Shared Savings
Program (MSSP) and/or enter into global risk contracts with third party payers. The PHO is
currently evaluating whether or not they should purchase an insurance license so that they
could offer commercial, Medicare Advantage and Managed Medicaid insurance products.
5. They have established a Business Health division to service the corporate health needs of the
employers in the region. This would include things like EAP programs, on-site wellness, drug
screening, on-site clinics, etc. This division also recently built two large, full-service fitness
centers.
Attachments:
could you please reply this two comments to my last discussion homework? Just a short answer. One paragrafh each could be ok.
Kelly M.
Hi J, I think you hit the nail on the head. Simple costing systems are much easier to use and much more cost effective than ABC systems. However, ABC systems are able to produce much more accurate data than simple costing systems which can be extremely beneficial to a company, especially when making decisions based on the cost of products (Horngren et al., 2012, p. 148). With simple costing systems, there is a much higher probability that products will be over or undercoated (Horngren et al., 2012, p. 140). I think that it all depends on the individual company and how they are planning to use the information for if a simple or ABC system will be best.
I had a very similar viewpoint on the article, “Rethinking Activity-Based Costing”. This new concept of a “time-driven ABC” is very innovative and cost-effective take on an ABC system (“Rethinking”). I also think that this new take on an ABC system will be the most beneficial for larger organizations with a large amount of activities and products. They would find this new approach much more cost-effective and possibly even more accurate than their current system.
____________________________________________________________________________________
ROBERT D.
Hi J,
I think you did a great job explaining the pros and cons of the ABC system. I would agree too that updating the system would require detailed and accurate judgments of costs or improper assigning of these costs would play a negative role in this system. As for the updated version of the ABC system, I too think that it would be beneficial for many businesses. The key factor is making sure to assign costs to the right products and when updating the system make sure the right managers are involved to maintain these accurate costs.
-Bob
1. The individual amounts in the sales journal are posted to the accounts receivable subsidiary ledger
yearly.
daily.
weekly.
monthly.
2. In which journal would a cash purchase of merchandise inventory be recorded?
Purchase journal
General journal
Cash payments journal
None of these.
3. During July, the following purchases and sales were made by James Company. There was no beginning inventory. James Company uses a perpetual inventory system.
Purchases Sales
July 3 20 units @ $12 July 13 25 units
11 20 units @ $13 22 10 units
20 10 units @ $15
Under the FIFO method, the cost of goods sold for each sale is:
July 13 July 22
375 150
$300 $120
325 130
305 130
4. In large companies, the independent internal verification procedure is often assigned to
management.
computer operators.
outside CPAs.
internal auditors.
3. Five identical 2-microcoulomb charges are located on an xy-coordinate system such that one charge is at the origin and the other four are located at (1,0), (0,1), (- 1,0), and (0,-1) respectively. (This problem illustrates the concept of symmetry.)
(a) (10 points) Draw a diagram illustrating this situation.
(b) (10 points) Determine the force on the charge at the origin.
(c) (10 pts) Remove the charge at (1,0) and determine the force on the charge at the origin.
4. (10 points) Consider the system of charges described in Problem 3. Determine the difference in voltage between point a (6,0) and point b (-6,0).
(Does the concept of symmetry provide any help here?)
Biomedical measurements show that the arms and hands togethertypically make up 13.0 % of a person’s mass, while the legs andfeet together account for 37.0 % . For a rough (but reasonable)calculation, we can model the arms and legs as thin uniform barspivoting about the shoulder and hip, respectively. Let us considera 74.0 kg person having arms 70.0 cm long and legs 90.0 cm long.The person is running at 12.0 km/h , with his arms and legs eachswinging through ±30∘ in 12s. Assume that the arms and legs arekept straight. a) what is the average angular velocity of his armsand legs? b)Using the average angular velocity from part A,calculate the amount of rotational kinetic energy in this person’sarms and legs as he walks. c)What is the total kinetic energy dueto both his forward motion and his rotation? d) What percentage ofhis kinetic energy is due to the rotation of his legs and arms? . . .
Take the Ethics Awareness Inventory and Ethical Choices in the Workplace assessments to assess your values. Using vocabulary and ideas developed from the survey instrument and the results that you obtained, complete the following assignment:
Write a paper of approximately 750 words in which you do the following:
1. Explain the purpose of the ISO-OSI model and TCP/IP and the
significance to real-world networks such as LANS and the Internet
2. Explain in detail the architecture of LANS, the IEEE 802 standards for
station addresses and frame format, and the operation of LAN switches, and
outline shortcomings in LANS such as security and broadcasts
3. Describe in detail the architecture of the Internet, the operation of
routing tables, routers and the operation of dynamic routing protocols and
explain the purpose of layer 3 protocols and IP in particular, and the main fields
in the IP packet header
5. Describe in detail the features and protocol formats for presentation and
Application layers and outline the basic architecture of the World Wide Web
and Internet email systems
Attachments:
Finc 340:
1. The PowerBall Lottery
Last week’s reading included a section on the time value of money.
How would you advise a friend if they won the $400,000,000 PowerBall Lottery, and had the choice of equal payments for 30 years, or a $224M lump sum payment up front?
For this problem let’s assume an inflation rate of 3% and that taxes have no impact since the winner will pay the maximum rate each year in either case.
2. Does it make sense to own a stock if it does not outperform the S&P500 index? Why or why not?
3. What is the difference between diversifiable risk and undiversifiable risk? (in your own words only)
4. What % of managed mutual fund portfolios have outperformed the S&P500 index over the past 5 years? Is this what you expected?
5. What is the risk premium of Tesla stock (TSLA) if the beta is 1.28 and the market return (based on the last 12 months of the S&P500 index) is 20%. Please calculate then explain this to a non-finance person.
…….
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Strategy-Case….pdf