ACCOUNTING INFORMATION & MANAGEMENT; HEALTH ENTERPRISE MANAGEMENT
Professor Emeritus of Accounting Information & Management
Prince is the author of ten books. Extension of the Boundaries of Accounting Theory, Information Systems for Management Planning and Control, Financial Reporting and Cost Control for Health Care Entities, and Strategic Management for Health Care Entities: Creative Frameworks for Financial and Operational Analysis are his most referenced books. Professional papers include publications in Accounting Review, Health Care Management Review, Journal of Health Care Finance, Health Services Research, Commercial Lending Review, Municipal Finance Journal, American Bankruptcy Institute Law Review, Journal of Health Administration Education, Hospital & Health Services Administration, Journal of Ambulatory Care Management, and Hospital Progress. He is the co-author of many healthcare reports sponsored by foundations, state and local governments, and federal agencies. Prince directed the Patient Friendly Billing Project for the American Hospital Association and the Healthcare Financial Management Association in 2000 and 2001.
Prince joined Northwestern University immediately upon completion of his doctorate at the University of Illinois at Champaign-Urbana. His undergraduate degrees were from Mississippi State University, and his military service was at the U. S. Army Finance School. He is a certified public accountant and has served on the Illinois CPA Society's Committee on Health Care Institutions - Hospital Section. He is a faculty associate of the American College of Healthcare Executives and his memberships include the Financial Executives International, American Hospital Association, the American Institute of Certified Public Accountants, and Association of University Programs in Health Administration.
Healthcare Accounting
Managed Care Systems
Nonprofit Accounting
Technology has made great strides in healthcare, but has been slow in reaching a Senior's home or residence. At 35 million and growing, the Senior population is making it known that home is where they want to stay. Technology advancements in devices, communications, and wireless capability are now making possible the delivery of customized telehealth solutions to provide Seniors with "enabled independence," allowing them to confidently "age in place" at home or residence for much longer, with improved health outcomes and quality of life. Combined with traditional ambulatory care services, integrating telehealth technology services now allows delivery of "virtual asisted living" services at home that can more efficiently meet Senior health requirements, and can simplify other aspects of a Senior's life that can play a role in extending time at home. To be successful, an integrated service must be able to usefully address a range of activities of daily living - instrumental activities of daily living, and enhanced activities of daily living - requirements. Already proven in other areas such as radiology, intensive care units, prisons, and rural communities, companies are working to develop practical telehealth service offerings designed for the home or residence. These services must be (a) packged to meet individual Senior needs and (b) reviewed and revised regularly to match changes in Senior requirements over time. A core element of this service is the use of regular "virtual visits" between healthcare professionals and a Senior at home or residence, which have been shown to both increase efficiency and Senior health out-comes. Another important element is centralizing key data from the telehealth technoloy into a single database to improve information delivered to a Senior's doctor, family, and other ambulatory care provides. North Shore eCare and other companies are conducting extensive market tests and pilot efforts to make sure service offerings meet Senior needs, and can be delivered cost-effectively.
Corporate purchasers of healthcare benefits for employees and their dependents are beginning to demand the use of information technology in healthcare for purposes of improving quality. Level of investment in information technology is directly related to net income for hospitals. The proper choice of investment in information technology is associated with financial stability and supporting patient-centered care in medical groups. Empirical studies of healthcare services in outpatient facilities and clinics indicate opportunities for significant improvements in quality by focusing on a very small set of treatment protocols.
Informed investments in medical technology and information systems are associated with financial viability of community hospitals. Financially distressed facilities are 3 to 4 years behind proactive hospitals in supporting high-speed, voice, and image transmissions to physicians in various locations. Impact of the Balance Budget Act of 1997, fraud and abuse activities, Y2K issues, and lack of information systems suport for physicians will result in 800 hospital closures and mergers of distressed hospitals over the next 60 months. These findings are based on the application of an eight-step framework for classifying information systems in healthcare entities. This framework is validated by survey instruments, site visits, interviews with senior management in 44 healthcare entities containing 576 hospitals, and judgments on the financial status of the healthcare entities
Strategic investments in information and medical technology are changing the financial viability of community hospitals. An electronic medical record with interfaces with all major medical devices is a prerequisite for supporting physicians at various remote locations. High-speed access by physicians to voice, pictures, and data in the hospital information system is becoming a common characteristics of proactive community hospitals. Financial pressures from timing differences, delays in collection, supporting transition periods for new technology, payment reductions with the Balance Budget Act of 1997, fraud and abuse activities, and lack of information systems support for physicians will result in 800 hospital closures and mergers of distressed community hospitals over the next 60 months.
Information technology permits revised patient management activities for high-quality, cost-effective care in ambulatory clinics. The electronic medical record is financially feasible for very small physician groups. Disease management for chronic and terminal care patients represents an expanding area of service in medical group management. The Internet provides access to healthcare information that has empowered patients, and their families to approach patient-physician office visits from a new relationship. Data provided by this information technology permit benchmarking of activities by ambulatory care service, treatment modalities, specialty group, and physician.
Significant financial reserves are required to support the day-to-day operations of nonprofit hospitals. For many years, the financial reserve requirements were partially accommodated by the period interim payment (PIP) procedure under the Medicare program. But, with the implementation of the Prospective Payment System (PPS) for Medicare inpatients, PIP was replaced with a delayed payment mechanism based on diagnosis-related groups (DRGs). Nonprofit hospitals must have their own financial reserves to support operations while waiting for payment from diverse third-party payers. Donations, contributions, gifts and transfers assist in establishing reserves, but a 5 percent return on net patient revenue is essential for maintaining a financially viable nonprofit hospital.
An Advisory Panel meeting focusing on the financial viability measures of hospital and healthcare systems hosted by the American Hospital Association in 1998, brought together 22 experts in healthcare finance, investment banking, investment rating, economics, public policy, quality measurement, and healthcare management. This report details the panel members' thoughts on which measures of financial viability are valid and may prove most useful, as well as their opinions regarding areas where measures ahve been lacking or subjective.
Study links enchanced electronic medical record and picture archiving and communications system with institutional financial health.
This article creates a medical technology index to serve as a benchmark in strategic assessment of community hospitals. An expert panel assigned weights to the six components in the index. Empirical validation of the medical technology index is accomplished by using it as a single factor in predicting bond ratings of hospitals with significant findings. The index is used with 8 other factors in projecting returns on operating revenue for a 4-year period in a sample of 490 hospitals.
The viability of a hospital can be revealed through not only financial but also clinical and patient satisfaction measures. This article describes some nonfinancial measures that lenders can use to predict net income and the viability of hospitals and health systems.
Catholic community hospitals are becomming more like nongovernment, not-for-profit community hospitals of a smilar bed size located in the same states. After controllling for state, urban-versus-rural location, and bed-size range, a matched set of 303 Catholic community hospitals are compared with nongovernment, not-for-profit community hospitals. This empirical study documents that the average 1992 Catholic hospital is less profitable, with older equipment, and treats more Medicare patients than the average matched community hospital.
In this study, the operating performances of not-for-profit community hospitals are compared among groups partitioned by bond ratings, level of debt insurance coverage, and number of bond rating services. The analysis indicates that hte performances of hospitals with full debt insurance coverage resulting in AAA ratings are significantly lower than those of hospitals with partial debt insurance and with AA ratings or better. Indeed, the hospitals will full debt insurance resemble those with partial insurance that are rated BBB to A. These findings have implications for managerial action choices. Hospitals seeking external funding to improve their operating performance may consider the costs and benefits of full insurance coverage.
This study documents many factors associated with differential operating performance of a sample of 235 Catholic community hospitals in the time period of 1986-89. A comparison of these hospitals indicates taht a panel of 78 facilities with relatively high returns on net patient revenue made significantly higher proportional investment in medical technology, equipment, and facilities compared to a panel of 78 low return hospitals, and were larger in size in many different ways.
Reviews the book "Development of Information Systems for Education," by Khateeb M. Hussain.
A professional paper recently examined some of the economic considerations of a statement prepared by the American Accounting Association's Committee on Basic Accounting Theory. It represented the accounting function by an information economic model embodying a utility function of a user. The article examines this Committee's statement from a more fundamental perspective with a focus on the particular statement that accounting is an information system. Specifically, the analysis consists of four parts. First, an overview of information theory is presented. Second, a concept of formal information systems is developed. This will include a differentiation between information theory and information systems and the identification of the critical elements in formal information systems. Third, two generalized models of accounting theory are presented which culminate with a model embodying the critical elements in formal information systems. Finally, the insights gained from the latter model are used to indicate research areas in accounting theory.
Reviews the book "Characteristics of an Effective Management Control System in an Industrial Organization," by Robert H. Demino.
Reviews the book "Financial Accounting Theory," by Harold Bierman.
The article focuses on the study of information systems for management control. During the past decade there have been many new approaches toward the study of the business entity. It is difficult to classify these approaches because each new approach usually overlaps previous approaches and is typically modified and strengthened by subsequent approaches. Recognizing the difficulty of any classification scheme, four developments are submitted as being the major movements in new approaches during the past decade. First, the psychological and sociological inquiries were combined to form the behavioral science approach toward studying the firm, with the human motivational aspects of each area given greatest emphasis. Second, advances were made in electronic data processing, and the electronic computer became a familiar expression throughout our society. Concurrent developments in electronic computers and communication equipment have provided the necessary means for rapid accumulation, calculation, processing, summarization, reporting, and transmission of data. Third, mathematical tools and techniques were applied to the study of business events. Fourth, scientific method has been applied to the study of the business entity, and applied models are frequently used in studying business situations
The article informs that profit motive has frequently been described as the "driving force" of capitalistic society, and some of the more ardent supporters of this belief hold the profit motive in the same high esteem as their most sacred beliefs. The profit motive is assumed to be the implicit expression of society's goal for the firm. Further more, the profit motive is ascribed as being the objective of enterprise management, and this objective is assumed to be explicitly stated by the stockholders for the corporate management. The changes in the socio-economic environment, since the concept of a profit motive was first advanced, do not mean, analogously, that the profit motive is no longer a reasonable assumption regarding corporate management's goal. This paper re-examines the "profit motive" in modem society and relates the "modified profit motive" assumption to accounting practice. Thus, the paper consists of two parts. The first part describes, compares, and contrasts three viewpoints on how the motivational assumption for accounting theory can be re-interpreted in the current socioeconomic environment. The second part suggests specific extensions, from the foregoing analysis, to accounting practice.
A study of 50,126 infrants between the ages of 3 months and 23 months who were given the wrong medication in 23 leading Pediatric Hospitals between 1992-2002.
Assessment of the Impact of Organizational, Legal and Structural Changes in Healthcare Delivery Because of Revised 2002-2003 Government Changes in Payment and Their Impact on Financial Performance
The average community hospital had a 5.1 percent return for 1997, but many hospitals were not so fortunate. There is large variation by census region and bed size. Cash flow to net patient revenue per certified financial statments indicates that 30.7 percent of community hospitals are in the distressed gorup of the reacting phase. Many distressed community hospitals will be coping with new challenges from the year 2000 compliance, resulting in an increase in the rate of insolvency. Some of the state laws for destroying medical records for an insolvent hospital do not protect the rights of former patients.
Yugoslavian translation of the third edition of this book was made in 1976. The second edition of the book was translated and printed in Japanese, 1973; in Portuguese, 1975; in Serbo-Croation, 1979; and in Russian, 1981. The first edition of this book was translated and printed in Italian in 1973.
This course counts toward the following majors: Accounting.
This course acquaints students with the process used to construct and understand the financial reports of organizations. The objective is to understand the decisions that must be made in the financial reporting process and to develop the ability to evaluate and use accounting data. Emphasis is placed on understanding the breadth of accounting measurement practices and on being able to make the adjustments necessary for careful analysis. The course highlights the linkages between accounting information and management planning, and decision making and control.
Information Technology In Healthcare Management (ACCT-432-0)
This course counts toward the following majors: Accounting,Health Enterprise Management, Health Industry Management, Technology Industry Management.
This course examines accounting concepts as they apply to planning and management control of healthcare institutions with current information technology in a connected world. Topics covered include cost accounting, hospital information systems, activity-based costing, clinical information systems, responsibility accounting, management control, product costing, financial reports, cost benefit analysis, performance assessment, computer-based medical records, medical clinic information systems and enterprise-wide information networks. Information technology in a connected world encompasses all healthcare relationships, which are examined with case studies.
Financial Assessment and Performance Evaluation of Healthcare Entities (ACCT-479-0)
This course counts toward the following majors: Accounting, Health Industry Management, Health Enterprise Management
This course focuses on accounting, operational, utilization and financial systems as they apply to the financial management of healthcare entities with current information technology. Topics include financial statements of different types of healthcare entities, financial viability, medical technology, hospital closures, physician performance, patient treatment profiles, short-term financing, management of patient accounts, payor analysis, long-term financing, issuance of tax-exempt securities and bond ratings. Students perform a strategic assessment of healthcare entities in a marketplace using published data provided by the instructor and make a class presentation of the findings.
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