1、本科毕业论文（设计）外文翻译原文HOSPITALREVENUECYCLEMANAGEMENTANDPAYERMIXDOMEDICAREANDMEDICAIDUNDERMINEHOSPITALSABILITYTOGENERATEANDCOLLECTPATIENTCAREREVENUEINRECENTYEARS,BUDGETPRESSURESCOMBINEDWITHTHEACCELERATIONINTHEGROWTHOFHOSPITALCOSTSHAVEFORCEDPOLICYMAKERSATBOTHFEDERALANDSTATELEVELSTOLIMITFUTUREINCREASESINGOVE
2、RNMENTPAYERSREIMBURSEMENTRATESOREVENCUTTHERATESTHEYCURRENTLYPAYPROVIDERSTHESECOSTCONTAINMENTEFFORTSHAVERESULTEDINSUBSTANTIALPAYMENTSHORTFALLSFORHOSPITALSACCORDINGTOTHEAMERICANHOSPITALASSOCIATION,BETWEEN2000AND2007,THEAVERAGEPAYMENTTOCOSTRATIOSFORMEDICAREANDMEDICAIDPATIENTSFELLFROM99TO91PERCENTANDFRO
3、M95TO88PERCENT,RESPECTIVELY,WHILETHEAVERAGEPAYMENTTOCOSTRATIOFORPRIVATELYINSUREDPATIENTSROSEFROM116TO132PERCENT1HOSPITALPARTICIPATIONINMEDICAREANDMEDICAIDISVOLUNTARY,YETGIVENTHATTHESETWOPROGRAMSACCOUNTFOR55PERCENTOFCAREPROVIDEDBYHOSPITALSVERYFEWHOSPITALSCANAFFORDNOTTOSERVEPUBLICLYINSUREDPATIENTSCONS
4、EQUENTLY,MOSTHOSPITALSHAVENOCHOICEBUTTOACCEPTTHEPAYMENTRATESANDTERMSTHATLAWMAKERSSETFORTHETREATMENTOFMEDICAREANDMEDICAIDPATIENTSHOWEVER,GIVENGOVERNMENTPAYERSCONTINUEDEFFORTSTOCONTAINHEALTHCARECOSTS,HOSPITALMANAGERSHAVEBECOMEINCREASINGLYCONCERNEDTHATSERVINGMEDICAREANDMEDICAIDPATIENTSCOULDSERIOUSLYUND
5、ERMINETHEIRPERFORMANCETHECONTINUINGEFFORTSOFGOVERNMENTPAYERSTOCONTAINHOSPITALCOSTSHAVERAISEDCONCERNSAMONGHOSPITALMANAGERSTHATSERVINGPUBLICLYINSUREDPATIENTSMAYUNDERMINETHEIRABILITYTOMANAGETHEREVENUECYCLESUCCESSFULLYTHISSTUDYUSESFINANCIALINFORMATIONFROMTWOSOURCESMEDICARECOSTREPORTSFORALLUSHOSPITALSFOR
6、2002TO2007ANDAUDITEDFINANCIALSTATEMENTSFORALLBONDISSUING,NOTFORPROFITHOSPITALSFOR2000TO2006TOEXAMINETHERELATIONSHIPBETWEENHOSPITALSSHARESOFMEDICAREANDMEDICAIDPATIENTSANDTHEAMOUNTOFPATIENTCAREREVENUETHEYGENERATEASWELLASTHESPEEDWITHWHICHTHEYCOLLECTTHEIRREVENUEHOSPITALLEVELFIXEDEFFECTSREGRESSIONANALYSI
7、SFINDSTHATHOSPITALSWITHHIGHERMEDICAREANDMEDICAIDPAYERMIXCOLLECTSOMEWHATHIGHERAVERAGEPATIENTCAREREVENUESTHANHOSPITALSWITHMOREPRIVATELYINSUREDANDSELFPAYPATIENTSHOSPITALSWITHMOREMEDICAREPATIENTSALSOCOLLECTONTHISREVENUEFASTERSERVINGMOREMEDICAIDPATIENTSISNOTASSOCIATEDWITHTHESPEEDOFPATIENTREVENUECOLLECTIO
8、NFORHOSPITALMANAGERS,THESEFINDINGSMAYREPRESENTGOODNEWSTHEYSUGGESTTHAT,DESPITEINCREASESINTHENUMBEROFPUBLICLYINSUREDPATIENTSSERVED,MANAGERSHAVEFREQUENTLYBEENABLETOGENERATEADEQUATEAMOUNTSOFPATIENTREVENUEANDCOLLECTITINATIMELYFASHIONKEYWORDSPAYERMIX,PATIENTCAREREVENUE,AVERAGECOLLECTIONTIMES,REVENUECYCLEM
9、ANAGEMENTSIMONERAUSCHER,PHD,ISASSISTANTPROFESSOROFHEALTHSYSTEMSADMINISTRATION,GEORGETOWNUNIVERSITYSCHOOLOFNURSINGANDHEALTHSTUDIESSHECANBEREACHEDATSR468GEORGETOWNEDUJOHNRCWHEELER,PHD,ISPROFESSOROFHEALTHMANAGEMENTANDPOLICY,UNIVERSITYOFMICHIGANSCHOOLOFPUBLICHEALTHHECANBEREACHEDATJACKWHEEUMICHEDUJHEALTH
10、CAREFINANCE201037281962010ASPENPUBLISHERS82JOURNALOFHEALTHCAREFINANCE/WINTER2010ATREVENUECYCLEMANAGEMENT,IE,THEIRABILITYTOGENERATEADEQUATEAMOUNTSOFPATIENTCAREREVENUEANDTOCOLLECTONTHISREVENUEINATIMELYFASHIONTHISARTICLEEXPLORESTHERELATIONSHIPBETWEENHOSPITALSGOVERNMENTPAYERMIX,IE,THEIRPROPORTIONSOFMEDI
11、CAREANDMEDICAIDPATIENTS,ANDTHEAMOUNTOFPATIENTCAREREVENUEHOSPITALSGENERATEASWELLASTHESPEEDWITHWHICHHOSPITALSCOLLECTTHEIRREVENUEWEFINDTHATSERVINGLARGERNUMBERSOFMEDICAREANDMEDICAIDPATIENTSDOESNOTNECESSARILYUNDERMINEHOSPITALSREVENUECYCLEMANAGEMENTPERFORMANCEFORHOSPITALMANAGERS,THESEFINDINGSMAYREPRESENTG
12、OODNEWSTHEYSHOWTHAT,DESPITEINCREASESINTHENUMBEROFPUBLICLYINSUREDPATIENTSSERVED,MANAGERSHAVEFREQUENTLYBEENABLETOGENERATEADEQUATEAMOUNTSOFPATIENTREVENUEANDCOLLECTITINATIMELYFASHIONLITERATUREREVIEWDESPITEFREQUENTLYVOICEDCONCERNSBYHOSPITALPRACTITIONERSTHATSERVINGMEDICAREANDMEDICAIDPATIENTSMAYUNDERMINETH
13、EIRABILITYTOGENERATEANDCOLLECTPATIENTCAREREVENUE,ONLYAFEWSTUDIESHAVEEXPLOREDEMPIRICALLYTHERELATIONSHIPBETWEENGOVERNMENTPAYERMIXANDHOSPITALSPERFORMANCEATMANAGINGTHEREVENUECYCLENONEOFTHESESTUDIESHASFOUNDEVIDENCETHATGOVERNMENTPAYERSUNDERMINEHOSPITALSABILITYTOGENERATEANDCOLLECTPATIENTCAREREVENUEINASTUDY
14、OFUSHOSPITALSINTHE1990S,MEDICAREANDMEDICAIDPAYERMIXWASNOTASSOCIATEDWITHTHEAVERAGEAMOUNTOFNETREVENUEHOSPITALSGENERATEDPERPATIENT2ADDITIONALEVIDENCEFORTHISLACKOFARELATIONSHIPBETWEENGOVERNMENTPAYERMIXANDHOSPITALSABILITYTOGENERATEPATIENTREVENUEWASPROVIDEDBYASTUDYOFHOSPITALSINTHESTATEOFWASHINGTONIN1987,W
15、HICHFOUNDTHATHOSPITALSPROVISIONOFCHARITYCARE,AREVENUEDEDUCTIONANDTHUSANIMPORTANTDETERMINANTOFHOSPITALSNETREVENUEPERPATIENT,WASNOTASSOCIATEDWITHTHEPROPORTIONOFPUBLICLYINSUREDPATIENTSSERVED3MOREOVER,WITHRESPECTTOHOSPITALSABILITYTOCOLLECTPATIENTCAREREVENUEINATIMELYFASHION,ASTUDYOFNOTFORPROFITHOSPITALSI
16、NTHELATE1980SFOUNDTHATHOSPITALSGOVERNMENTPAYERMIXDIDNOTUNDERMINETHEIRCOLLECTIONPERFORMANCE4ONTHECONTRARY,FORSEVERALSUBSETSOFHOSPITALSANALYZED,HOSPITALSSHARESOFMEDICAREANDMEDICAIDPATIENTSWEREINVERSELYRELATEDTOTHEIRAVERAGECOLLECTIONPERIODS,IMPLYINGTHATSERVINGMOREPUBLICLYINSUREDPATIENTSALLOWEDHOSPITALS
17、TOCOLLECTONTHEIRPATIENTREVENUESFASTERWHILEEMPIRICALSTUDIESOFHOSPITALSINTHE1980SAND1990SFOUNDNOEVIDENCETHATGOVERNMENTPAYERMIXUNDERMINEDHOSPITALSABILITYTOEFFECTIVELYMANAGETHEREVENUECYCLE,THECONTINUINGEFFORTSOFPUBLICPAYERSTOCONTAINHOSPITALCOSTSMAYLIMITTHEAPPLICABILITYOFPRIOREMPIRICALFINDINGSTOHOSPITALS
18、OPERATINGINTODAYSBUSINESSENVIRONMENTUSINGFINANCIALINFORMATIONFROMTWONATIONALDATASETSFORTHEYEARS2000TO2007,OURSTUDYEXPANDSONPREVIOUSWORKBY1ANALYZINGTHERELATIONSHIPBETWEENHOSPITALSGOVERNMENTPAYERMIXANDTHEIRPERFORMANCEATREVENUECYCLEMANAGEMENTINTODAYSBUSINESSENVIRONMENTAND2EMPLOYINGAMORECOMPREHENSIVESET
19、OFFINANCIALINDICATORSOFREVENUECYCLEMANAGEMENTPERFORMANCETAKINGINTOACCOUNTBOTHTHEAMOUNTANDTHESPEEDOFHOSPITALSPATIENTREVENUECOLLECTIONHOSPITALREVENUECYCLEMANAGEMENTANDPAYERMIX83CONCEPTUALFRAMEWORKPAYMENTPOLICIESANDPRACTICESVARYSUBSTANTIALLYACROSSTHIRDPARTYPAYERSANDCANBEMOREORLESSGENEROUSWITHRESPECTTOH
20、OWMUCHANDHOWFASTHOSPITALSAREREIMBURSEDFORTHESERVICESTHEYPROVIDE5AHOSPITALSPAYERMIX,IE,ITSRELATIVEPROPORTIONSOFMEDICARE,MEDICAID,PRIVATELYINSURED,ANDUNINSUREDPATIENTS,MAYTHUSPLAYANIMPORTANTROLEINITSABILITYTOGENERATEADEQUATEAMOUNTSOFPATIENTCAREREVENUEANDCOLLECTONTHISREVENUEINATIMELYFASHIONINGENERAL,TH
21、EAMOUNTOFPATIENTREVENUEAHOSPITALCOLLECTSISAFUNCTIONOFTHEPRICETHEHOSPITALRECEIVESFORITSSERVICESANDTHEVOLUMEOFSERVICESPROVIDEDTHECOMPOSITIONOFAHOSPITALSPAYERMIXHASAPERVASIVEINFLUENCEONBOTHPAYERMIXLARGELYDETERMINESTHEAVERAGENETREVENUEAHOSPITALISABLETOGENERATEFORANYGIVENSERVICE6UNLIKEFIRMSINMOSTOTHERIND
22、USTRIES,WHICHUSEBILLEDCHARGESASTHEONLYTYPEOFPAYMENTANAVERAGEHOSPITALMAYHAVESEVERALHUNDREDDIFFERENTCONTRACTUALRELATIONSHIPSWITHTHIRDPARTYPAYERS,ALLOFWHICHSPECIFYDIFFERENTRATESOFREIMBURSEMENTFORANYGIVENSERVICEWHILEMEDICAREANDMEDICAIDPAYHOSPITALSACCORDINGTOPREDETERMINEDPAYMENTSCHEDULESMOSTFREQUENTLYINT
23、HEFORMOFFIXEDPEREPISODEPAYMENTSBASEDONDIAGNOSISRELATEDGROUPSPRIVATETHIRDPARTYPAYERSMAYNEGOTIATEREIMBURSEMENTRATESINDIVIDUALLYWITHEACHHOSPITALONAVERAGE,BECAUSEOFTHEIRMARKETPOWER,MEDICAREANDMEDICAIDPAYHOSPITALSASUBSTANTIALLYLOWERPERCENTAGEOFBILLEDCHARGESTHANMOSTPRIVATEINSURERS,RESULTINGINPAYMENTSHORTF
24、ALLS7UNLESSHOSPITALSAREABLETOOFFSETSOMEOFTHEUNDERPAYMENTSFROMMEDICAREANDMEDICAIDBYNEGOTIATINGHIGHERPRICESFROMPRIVATEHEALTHINSURERS,HOSPITALSSERVINGMOREPUBLICLYINSUREDPATIENTSLIKELYCOLLECTREDUCEDAMOUNTSOFPATIENTREVENUEAHOSPITALSPAYERMIX,HOWEVER,NOTONLYINFLUENCESTHEAVERAGEPRICETHEHOSPITALCANCHARGEFORE
25、ACHSERVICEBUTALSOTHEVOLUMEOFSERVICESBEFOREAPATIENTCANBEADMITTEDTOTHEHOSPITAL,MANYTHIRDPARTYPAYERSREQUIREPREAUTHORIZATIONOFSERVICESONCEAPATIENTHASBEENADMITTED,PAYERSFREQUENTLYINFLUENCETHENUMBEROFSERVICESANDTHEINTENSITYOFCAREPROVIDEDTHROUGHCASEMANAGEMENTANDUTILIZATIONREVIEWSOMEPAYERS,SUCHASMANAGEDCARE
26、ORGANIZATIONS,MANAGETHEVOLUMEOFSERVICESPROVIDEDTOTHEIRINSUREDMORETHANOTHERS8ASARESULT,HOSPITALSWITHHIGHERSHARESOFMANAGEDCAREPATIENTS,INCLUDINGMEDICAREPATIENTSENROLLEDINMEDICAREADVANTAGEPLANSANDMEDICAIDPATIENTSENROLLEDINHEALTHMAINTENANCEORGANIZATIONSHMOS,MAYEXPERIENCEREDUCTIONSINTHEIRVOLUMEOFSERVICES
27、ANDTHUSCOLLECTLOWERAMOUNTSOFPATIENTREVENUEWHENCOMPAREDTOHOSPITALSWITHMOREPATIENTSCOVEREDUNDERFEEFORSERVICEHEALTHINSURANCEPLANSEQUALLYIMPORTANT,BUTRARELYDISCUSSEDINTHESAMECONTEXT,AHOSPITALSPAYERMIXALSOINFLUENCESITSSPEEDOFREVENUECOLLECTIONALONGTIMEBETWEENSERVICEPROVISIONANDRECEIPTOFPAYMENTPLACESACASHF
28、LOWBURDENONTHEHOSPITAL,PERHAPSNECESSITATINGTHATTHEHOSPITALACCESSSHORTTERMFINANCINGTOMEETPAYROLLORDEBTSERVICEFURTHER,ALONGCOLLECTIONPERIODMEANSTHEHOSPITALWILLCARRYRELATIVELYHIGHLEVELSOFACCOUNTSRECEIVABLEONITSBALANCESHEETACCOUNTSRECEIVABLEISOBVIOUSLYANASSETWHICHMUSTBEFINANCEDATCONSIDERABLECOSTTOTHEHOS
29、PITALHOSPITALSAVERAGECOLLECTIONPERIODSVARYGREATLYBYPAYERWHILESOMETHIRDPARTYPAYERS,SUCHASMEDICAREANDMANY84JOURNALOFHEALTHCAREFINANCE/WINTER2010MANAGEDCAREORGANIZATIONSINCLUDINGMEDICAIDHMOS,AREBOUNDBYFEDERALORSTATELAWSTOREIMBURSEPROVIDERSWITHINSPECIFIEDPERIODSOFTIME,9OTHERPAYERS,SUCHASPRIVATEINDEMNITY
30、INSURERS,FREQUENTLYTAKECONSIDERABLEAMOUNTSOFTIMETOREIMBURSEHOSPITALSBECAUSEOFDISPUTESOVERCOVERAGEORREASONABLENESS10COLLECTIONSFROMINDIGENTANDSELFPAYPATIENTSOFTENPROVETOBEPARTICULARLYDIFFICULT,RESULTINGINSUBSTANTIALPAYMENTDELAYS11ASARESULT,HOSPITALSWITHHIGHERSHARESOFMEDICAREANDMANAGEDCAREPATIENTS,INC
31、LUDINGMEDICAIDPATIENTSINSTATESWHEREMEDICAIDISMAINLYADMINISTEREDTHROUGHPRIVATEHMOS,MAYCOLLECTTHEIRPATIENTREVENUEFASTERTHANHOSPITALSSERVINGMOREPATIENTSWITHTRADITIONALFEEFORSERVICEINSURANCECOVERAGEASWELLASMOREINDIGENTANDSELFPAYPATIENTSMETHODSANALYTICMODELFOLLOWINGPREVIOUSEMPIRICALSTUDIES,12WEMODELEDHOS
32、PITALREVENUECYCLEMANAGEMENTPERFORMANCE,RCMIT,ASAFUNCTIONOFPAYERMIX,PAYERMIXIT,ANDASETOFCONTROLVARIABLES,REPRESENTEDASXIT,WHEREBYTHESUBSCRIPTSIANDTREFERTOHOSPITALIINYEARTBECAUSEOFTHEPOTENTIALFORHOSPITALLEVELVARIATIONINTHEWAYHOSPITALSMANAGETHEREVENUECYCLE,WEINCLUDEDAHOSPITALSPECIFICERRORTERM,I,WHICHRE
33、PRESENTSTHEUNOBSERVEDHETEROGENEITYACROSSHOSPITALSREVENUECYCLEMANAGEMENTHASBEENFOUNDTOVARYSUBSTANTIALLYACROSSHOSPITALSWHILESOMEHOSPITALSHAVEAHIGHLYINTEGRATED,WELLMANAGEDREVENUECYCLEENCOMPASSINGEVERYSTEPFROMPATIENTREGISTRATIONTOTHECOLLECTIONANDPOSTINGOFCASH,13OTHERHOSPITALSARECHARACTERIZEDBYASILOSTRUC
34、TUREOFMANAGINGTHEREVENUECYCLEWITHLITTLEINTEGRATIONOFTHEFUNCTIONSOFDIFFERENTDEPARTMENTS14INGENERAL,HOSPITALLEVELHETEROGENEITYCANBEMODELEDUSINGEITHERFIXEDORRANDOMEFFECTSHAUSMANTESTSOFTHENULLHYPOTHESISTHATTHEHOSPITALLEVELEFFECTSARERANDOM,HOWEVER,INDICATEDTHATFIXEDEFFECTSREGRESSIONWASPREFERREDOVERRANDOM
35、EFFECTSFORALLREGRESSIONS,WEEMPLOYEDHETEROSKEDASTICITYROBUSTWHITESTANDARDERRORSTOACCOUNTFORTHECLUSTERINGOFOBSERVATIONSWITHINHOSPITALSOVERTIMEMEASURESHOSPITALREVENUECYCLEMANAGEMENTPERFORMANCE,THEDEPENDENTVARIABLE,WASMEASUREDUSINGTHREEFINANCIALINDICATORSOFHOSPITALSABILITYTOGENERATEANDCOLLECTPATIENTCARE
36、REVENUE,DAYSINNETACCOUNTSRECEIVABLE,NETPATIENTREVENUEPERADJUSTEDDISCHARGE,ANDNETPATIENTREVENUEPERTOTALASSETSSEEFIGURE1THEMOSTFREQUENTLYUSEDINDICATOROFHOSPITALREVENUECYCLEMANAGEMENTPERFORMANCEISDAYSINNETACCOUNTSRECEIVABLE,ORTHEAVERAGECOLLECTIONPERIOD,AMEASUREOFHOSPITALSABILITYTOCOLLECTPATIENTREVENUEI
37、NATIMELYFASHION15DAYSINNETACCOUNTSRECEIVABLEISDEFINEDASNETACCOUNTSRECEIVABLETIMES365DAYSDIVIDEDBYNETPATIENTREVENUEANDREPRESENTSTHENUMBEROFDAYSOFNETPATIENTREVENUETHATAHOSPITALHASDUEFROMPATIENTBILLINGSAFTERALLREVENUEDEDUCTIONSWHENEVERPOSSIBLEWEUSEDNETPATIENTREVENUEPERADJUSTEDDISCHARGEASANINDICATOROFTH
38、EAMOUNTOFPATIENTREVENUEGENERATED,WHICHADJUSTSNETPATIENTREVENUESFORAHOSPITALSWAGEINDEX,CASEMIXINDEX,ANDPROPORTIONOFOUTPATIENTBUSINESSANDTHUSHOSPITALREVENUECYCLEMANAGEMENTANDPAYERMIX85SOURCERAUSCHERSIMONEWHEELERJOHNRC,2010HOSPITALREVENUECYCLEMANAGEMENTANDPAYERMIXDOMEDICAREANDMEDICAIDUNDERMINEHOSPITALS
39、ABILITYTOGENERATEANDCOLLECTPATIENTCAREREVENUEJOURNALOFHEALTHCAREFINANCE,VOL37,NO2,PP8196译文医院管理和付款方收入周期混合近年来，预算压力结合的增长提速医疗费用迫使决策者在联邦和州水平，以限制在政府纳税人的未来增加的费用加在供应商身上。这些费用的努力导致实际支付给医院不足，根据美国医院协会统计，2000年至2007年间,医疗补助方案的病人就从9991,从95到88。因此，大部分医院别无选择只有接受支付利率和立法者通过治疗医疗保险和医疗补助的病人。然而,考虑到政府纳税人的持续的努力来控制医疗卫生护理成本，医院管
40、理者越来越担心，为医疗保险和医疗补助的病人服务，表现可能会严重破坏他们的政府对医院的管理。纳税人的医疗费用造成了医院管理者的担忧，这是因为公开保险患者可能破坏他们的管理能力。研究财政金融中间人的信息成本报告，对我们这些医院审计到2007年，2002年的财政金融中间人的言论。2000年到2006年到检查医院之间的关系，医院股票和医疗保险和医疗补助患者的治疗量，影响着产生收入的速度，根据他们收集收入的情况判断。医院医疗保险患者也收集更多收入更快；服务于更多的医疗补助方案的病人是不相关病人的速度收入的收集。对医院管理者,这些可能是好消息。他们建议，尽管越来越多的患者的公开被保险人的服事，管理者经常被
41、能够产生足够数量的病人收入和珍藏它的方式前行。关键词付款混合，病人保健，收入，平均收集次，收入周期管理。本文探讨了医院的政府之间的关系，即付款人混合比例。医疗保险和医疗补助的患者，患者的治疗量的影响和产生收入的医院速度,医院增加他们的收入，我们的目的就是即使医院收入了大量的有医疗保险和医疗补助方案的病人，而并不破坏医院的收入周期管理绩效。对医院管理者，这些可能是好消息。这些数据表明，尽管越来越多的患者的公开被保险人的服事，管理者经常被能够产生足够数量的病人收入和珍藏它的方式前行。尽管医院的从业人员经常表达了忧虑就是收入医疗保险和医疗补助病人可能破坏他们能够的医疗收入，只有很少有研究探讨政府之间
42、的关系，进行研究实证付款人混合和医院的绩效管理收入周期。所有这些研究已经发现证据表明政府纳税人破坏医院的能够生成并收集病人的保健费用。在一项我们医院在20世纪90年代，医疗保险和医疗补助付款。1、平均收入的净量产生。2、每位患者医院没有进一步说明政府之间的关系付款人混合和。医院的能够得到病人身上的收入来作为医院的研究经费。1987年华盛顿的国家而言，该试验发现，医院的提供慈善关怀，收入扣除之重要决定因素,因此医院的病人，每收入的比例不相关保险服务。3、公开病人对医院而且通过收集病人护理的能力得到及时的收入，研究中的医院在80年代后期发现医院的政府没有破坏其付款人混合收集性能。4、相反，几个子集
43、的医院进行了分析，医院的医疗保险和医疗补助的股票呈负相关的患者平均收集时期，这意味着服务于更多的公开保险患者医院允许更快收集病人收入在实证研究医院。5、20世纪80年代和90年代政府发现，没有证据表明付款人破坏了医院和有效管理收入不断周期内，公共纳税人含有医疗费用可能会限制实证金融中间人的适用性，前医院操作在当今的商业环境使用财政信息从两个国家的数据集，2000年到2007年,我们的研究进行了拓展此前的研究分析医院的政府之间的关系和他们的表现和付款人收入周期管理在当今的商业环境。6、使用一种更全面的财政金融中间人的收入周期管理绩效指标同时考虑的金额和速度的医院病人收入的收集。一般来说,患者的数
44、量对于医院收入收集是一个函数，为其服务和医院接受提供服务的体积。医院的组成一个普遍的比例也付款人的家族影响力点将两者兼具。付款人混合很大程度上决定了平均净收益医院能够产生对于任意给定的服务。不像有效值的大多数其他行业,使用宣传的指控是唯一的一种付款，平均医院可能会有数百个不同合同关系,所有这些第三方指定的速度是不同的报销任何服务。平均来说，因为他们的市场优势,医疗保险和医疗补助支付医院实质性的比率较低比大多数私人保险公司被指控,导致短缺。7、除非医院付款能弥补一些的，从医疗保险和医疗补助通过谈判更高的价格从私人健康保险公司、医院服务于更多的公开保险患者很可能收集病人后年确认收入医院的混合，然而
45、，付款人不仅影响医院的平均价格的每一个服务，也负责大量的服务。在病人能住院,许多第三方要求特殊的服务。一旦病人已经承认，纳税人的数量影响服务的护理和强度，通过个案管理和利用审查。一些纳税人，如管理医疗组织、管理大量的服务提供给他们的保险多于别人。8、结果，医院护理管理的股票高医疗保险的病人年龄患者，包括医疗保险覆盖优势计划和医疗补助方案的病人就读于健康维护组织健康，可经验减少体积的服务和因此收集低得多，相比病人收入在发票上，医院在精神上给人的健康保险。同样重要的是,但却很少有人讨论在同一个问题，一个医院的付款融合了影响它的速度应收帐款的收款很长一段时间，收到服务提供之间支付现金外语现在地方上医
46、院负担，也许需要医院满足短期金融中间人工资或债务服务。进一步，久的采集时间意味着医院将把应收帐款在其资产负债表显示出较高数据。应收帐款的资产是很明显的。医院的平均收集有很大不同时期付款。虽然一些第三方的纳税人，如医疗保险医疗机构，包括医疗补助被束缚在联邦偿还供应商在指定时段。9、纳税人，如列兵赔偿保险公司，经常拖延很长时间来偿还医院，难以确定纠纷范围和合理性。10、病人病情疑难导致实际支付的延迟。11、因此，医院医疗保险和股票的高医疗保健患者，包括患者主要医疗补助的国家里,在通过私人健康管理，可以收集病人的收入，很多的病人有医院保险，也更有贫困患者和自费病人。出处美西蒙尼惠勒，约翰，医院管理和付款方收入周期混合，关注健康期刊，第37卷,2010（3）8196
