Proprietorships & Partnerships: Pros & Cons ✔️Ans - Pros: Ease of
Information, Subject to a few regulations, no corporation income taxes.
Cons: Limited life, difficult to transfer, unlimited life, difficult to raise capital.
Corporations: Pros & Cons ✔️Ans - Pros: Unlimited life, easy transfer of
ownership, limited liability, ease of raising capital.
Cons: Cost of formation and reporting, double or triple taxes must be paid.
Non-profit Organization ✔️Ans - Exempt from taxes. Goal is to improve
community.
For-profit Organizations ✔️Ans - (Investor Owned) Goal is to maximize
shareholder return. Owe taxes.
Agency Problem ✔️Ans - the possibility of conflict of interest between the
stockholders and management of a firm.
Example: Hire someone to carry out a job function, but they go out of their
interests instead of best interests of company/organization.
Third-party payor system in the US (i.e. private vs public) ✔️Ans - Private:
Blue Cross Blue Shield, Commercial Insurers, Self-Insurers. (AETNA)
Public: Medicare and Medicaid-both offer services to different levels. "Safety
net" Lowest reimbursement rates.
Reimbursement methods (fee-for-service vs. capitation) ✔️Ans - Fee for
Service: payment is tied to amount of services provided. (Decades ago)
*Dental industry*
Capitation: payment is tied to the size of the covered population (number of
enrollees) Payment is based on per # per month. *Decreasing utilization*
Population is healthier.
, Medicare reimbursement for different types of providers ✔️Ans - Medicare
parts A, B & C.
Medicare Part A (aka Hospital Insurance or HI) ✔️Ans - Provides hospital
insurance automatically at age 65 (if FICA qualified) at no fee but may have
deductible & co-pay.
Medicare Part B ✔️Ans - The part of the Medicare program that pays for
physician services, outpatient hospital services, durable medical equipment,
and other services and supplies.
Medicare Part C (Medicare Advantage) ✔️Ans - •Replaces and covers
expenses found in Part A and B
•Medicare private fee-for-service plans (PFFS)
•Medicare managed care plans (HMOs and PPOs)
•Medicare specialty plans
Medicare—Part D Prescription Drug Coverage ✔️Ans - a United States
federal-government program to subsidize the costs of prescription drugs and
prescription drug insurance premiums for Medicare beneficiaries.
Impact of the Affordable Care Act (what the bill changed about the healthcare
environment) ✔️Ans - Created new standards, individual mandates,
exchanges, and Medicaid expansion.
Focused on quality through clinical compensation, bundled payment, value-
based purchasing.
Regulations and standards of financial accounting (e.g. SEC, GAAP, FASB)
✔️Ans - -Securities and Exchange Commission (SEC): has the legal authority
to regulate the form and content of financial statements.
-Financial Accounting Standards Board (FASB)
-Generally Accepted Accounting Principles (GAAP): the conventions that have
evolved from the pronouncements and rulings of the implementing
organizations constitute a set of guidelines for the preparation of financial
accounting statements. -ONLY applies only to financial accounting statements.
Does NOT remain STATIC.
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