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9780683302547

Managerial and Supervisory Principles for Physical Therapists

by ; ; ;
  • ISBN13:

    9780683302547

  • ISBN10:

    068330254X

  • Format: Hardcover
  • Copyright: 1998-10-01
  • Publisher: Williams & Wilkins
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Summary

Now more than a complete introduction to the business side of physical therapy, the new Second Edition has been greatly expanded to reflect the many legislative, economic, and educational events that have affected the physical therapy profession in recent years. Nineteen new chapters and fifteen fully revised chapters provide an up-to-date, expanded view of the needs of today's and tomorrow's physical therapists. Business concepts covered include healthcare economics, payment sources, accounting, billing, human resource management, marketing, outcomes measurement, and legal concepts. This edition is consistent with the American Physical Therapy Association's Section on Health Care Policy and Administration.

Table of Contents

The Health Care Delivery System
1(20)
Preview
1(1)
Introduction
2(1)
Health Care Delivery System
3(3)
Providers by Type of Care
3(1)
Preventive Care
3(1)
Primary Care
4(1)
Specialty Care
4(1)
Type of Setting
4(1)
Ambulatory Care
4(1)
Inpatient Care
4(1)
Home Care
4(1)
Continuum of Care
5(1)
Health Care Social Philosophy and Public Policy
6(9)
Period 1965 through 1980
8(1)
Medicare
8(1)
Medicaid
9(1)
The Blues
9(1)
Cost: The Impetus for Change
10(1)
Period 1980 to 1990
10(1)
The Move to Managed Care
10(1)
Limiting and Shifting Financial Risk
11(1)
Utilization Management
12(1)
Provider Accountability for Performance Outcomes
13(1)
Restrictive Guidelines for Provider Participation
13(1)
Health Reform in the 1990s
14(1)
The Seal Of Approval: External Oversight
15(1)
Governmental Regulation and Review
15(1)
Accreditation and Quality Review
15(1)
Professional Associations
15(1)
The Health Care Industry Responds
16(2)
Period 1965 through 1980
16(1)
Period 1981 to 1990
16(1)
The 1990s
17(1)
The Health Care Professional Must Also Respond
18(1)
New Skills for a New Time
18(1)
Accountability for Patient Outcomes
18(1)
Hard Times for the Independent Practitioner
18(1)
Generalists, Specialists and the Use of Professional Extenders
19(1)
Impact on the Practice of Physical Therapy
19(1)
Summary
19(2)
Values and Motivations
21(22)
Preview
21(1)
Introduction
22(1)
Personal Guidance: Understanding Personal Values
23(1)
Values Theory
23(3)
Generalizable Values Theory
24(1)
Continuum of Motivational Types of Values
24(2)
Exploring Personal Values
26(1)
Hard Questions: What is Right?
27(1)
Changing the Focus from Valuation to Obligation
27(1)
Dealing with Moral Issues
28(3)
A Process to Deal with Moral Issues
28(1)
Making Moral Decisions
28(2)
A Quantification Method
30(1)
A Quick Screen
30(1)
A Role Playing Method
31(1)
Summarizing Personal Guidance: A Model
31(1)
Professional Guidance: More on Ethics
32(1)
Code of Ethics
33(1)
1997 APTA Code of Ethics and Guide for Professional Conduct
33(2)
Analysis of APTA Code and Guide
34(1)
Summary of the APTA Code and Guide
35(1)
Professional Guidance: A Model
35(1)
Organizational Guidance
36(1)
Conflicting Values Equals Conflicting Motivations
36(1)
Conceptual Model: Organizational, Personal and Professional Guiding Influences
36(4)
Organizational Self-View
38(1)
Fundamental Documents
38(1)
Values Statement
38(1)
Vision Statement
38(1)
Mission Statement
39(1)
Reality
39(1)
Strategic Plans
40(1)
Summary
41(2)
Marketing
43(17)
Preview
43(1)
Introduction
44(1)
Market Orientation
44(15)
Market Orientation: The Road to Success?
45(1)
Market-Oriented Planning and Information
46(1)
Internal Information
46(1)
External Information
46(1)
What is a Market?
46(1)
Special Customer Considerations in Health Care Marketing
46(2)
Expectations and Relationships in the Third Party Payer System
48(1)
Market Segmentation
49(1)
Niche Markets
49(1)
Basics of Marketing---The Marketing Mix
49(1)
Products and Services
50(3)
Pricing
53(1)
Forecasting
53(2)
Sources of Forecasting Information
55(2)
Using Marketing Dollars Wisely
57(1)
The Promotional Mix
57(1)
Communication Methods and Media
57(1)
The Marketing Campaign
58(1)
Summary
59(1)
Organizing and Engaging People in the Work Setting
60(17)
Preview
60(1)
Introduction
61(1)
Achieving the Organizational Vision Through People
61(1)
The Concept of Productivity
62(1)
Leadership
62(1)
Formal and Informal Leaders
62(1)
Leadership: Art, Science or Both?
63(1)
Organizational Leadership: Roles, Responsibilities and Competencies
63(1)
Leadership Roles
63(1)
The Interpersonal Role
63(1)
The Informational Role
63(1)
The Decisional Role
64(1)
Leadership Roles and Organizational Position
64(1)
Theories About Managing People: Past To Present
64(2)
The Traditional Model
64(1)
The Human Relations Model
65(1)
The Human Resource Model
65(1)
A Continuum of Management Styles: Push, Pull or Lead
66(3)
The Contingency Model
66(3)
Achieving Maximum Productivity Through Work Teams
69(4)
Why Work Teams?
69(1)
Team Formation
69(1)
Transformation: Work Group To Work Team
69(1)
Performance Expectations
69(1)
Performance Constraints
69(1)
Work Rules
70(1)
Team Structure
70(1)
Information
71(1)
Stages of Team Development
71(1)
A Performing Work Team: Would You Know It If You Saw It?
72(1)
Work Teams and Productivity
72(1)
Self-Directed Work Teams
72(1)
Practice Implications for Health Care Management
73(1)
Know Yourself and Prepare for the Future
73(1)
Have the Right People and Prepare Them Well
73(1)
Keep Good Employees
74(1)
Know Your Business
74(1)
Organizational Performance Improvement
74(2)
Quality Improvement/Service Improvement
75(1)
Summary
76(1)
Dealing with Differences
77(11)
Preview
77(1)
Introduction
78(1)
Values
78(1)
Diversity
79(7)
How and Why Do Organizations Choose Diversity as a Goal?
80(1)
Quality and Fairness Paradigm
80(1)
Access and Legitimacy Paradigm
81(1)
Learning and Effectiveness Paradigm
81(1)
Elements of Culture
82(1)
Conflict
82(1)
Role and Importance of Language
83(1)
Sources of Conflict
84(1)
The Conflict Partnership Process
85(1)
Alternate Methods for Conflict Resolution
85(1)
Managing Change
86(1)
Summary
86(2)
Organizational Structure and Control For Business Success
88(25)
Preview
88(1)
Introduction
89(1)
Characteristics of Business Structures
90(8)
Legal Structure
90(1)
Sole Proprietorship
90(1)
Partnership
91(1)
The Corporation
91(1)
Tax Status
92(1)
The For-Profit Business
92(1)
The Not-For-Profit Business
93(1)
Operating Structure
93(1)
Work Coordination
93(1)
Internal Factors Influencing Operating Structure
94(3)
External Factors Influencing Operating Structure
97(1)
Common Organizational Structures
98(5)
The Organizational Chart
99(1)
Operating Structure At Progressive Stages of Organizational Development
99(1)
The Craft Stage
99(1)
The Entrepreneurial Stage
100(1)
The Bureaucratic Stage
100(2)
The Divisional Stage
102(1)
Additional Structural Models
102(1)
Organizational Structure and Product Strategy Decisions
103(1)
Process Approach to Organizational Design
103(2)
Reasons to Reorganize
103(1)
Reorganization: Part of the Strategic Planning Process
104(1)
Reaffirm the Vision
104(1)
Complete an Organizational Assessment
104(1)
Determine Strategic Directions and Set Performance
104(1)
Human Resource Management In Relation to the Operating Structure
105(6)
Work Design Elements
105(1)
Work Design Parameters
105(1)
Job Specialization
105(1)
Behavior Formalization
106(1)
Training and Professional Socialization
106(1)
The Job Description
107(1)
Performance Standards and Appraisal
107(1)
Performance Management
107(2)
Coaching
109(1)
Mentoring
109(1)
Employee Retention
109(2)
Can Management Control Employee Turnover?
111(1)
Summary
111(2)
Money Matters: Health Care Financial Management
113(35)
Preview
113(1)
Introduction
114(1)
Financial Management
115(8)
Financial Management Services
115(1)
Financial Reporting
116(1)
Financial Accounting Principles
116(1)
Entity
116(1)
Transactions
116(1)
Cost Valuation
116(1)
Double Entry
116(1)
Accrual
116(1)
Matching
117(1)
Accrual Method Of Accounting
117(1)
Cash Method Of Accounting
117(1)
Accounting Conventions
117(1)
Financial Statements
118(1)
Balance Sheet
118(2)
Income Statement
120(3)
Cash Flow Statement
123(1)
Financial Analysis
123(5)
Comparative and Common-Size Financial Statements
123(1)
Financial Ratios
124(2)
Liquidity Ratios
126(1)
Capital Ratios
126(1)
Activity Ratios
127(1)
Performance Indicators
127(1)
Keeping the Books
128(1)
Chart of Accounts
128(1)
Accounts Receivable Management
128(7)
Charge Master (Fee Schedule)
129(2)
Operating Revenue
131(1)
Case Mix and Service Utilization Projections
131(1)
Payer Mix and Deductions From Revenue
131(1)
Charge and Payment Methodology
131(4)
Non-Operating Revenue
135(1)
Accounts Payable Management
135(1)
Expense Management
135(7)
Types of Expenses
135(1)
Calculation of Operating Expenses
136(1)
Capital Expenses
137(5)
Control of Expenses
142(2)
Direct and Indirect Expenses
142(1)
Expense Classification
143(1)
Fixed Cost
143(1)
Variable Cost
143(1)
Semi-Variable Cost
143(1)
Total Cost
144(1)
Cost-Volume-Profit Analysis
144(2)
Cost-Volume-Profit Analysis Under Variable Reimbursement Methods
146(1)
Summary
146(2)
Money Matters: Maximizing Financial Performance
148(37)
Preview
148(2)
Introduction
150(2)
No Margin, No Mission
150(1)
Should Businesses Profit From Health Care Delivery?
150(1)
Separating Ethical From Legal Issues
151(1)
Managing Financial Performance
152(11)
A Four-Part Process
152(1)
Long-range Financial Plan
152(1)
The Use of Financial Modeling
153(1)
Revenue Management
153(2)
Cost Management
155(1)
A Multi-Year Financial Plan
155(4)
The Annual Budget: Setting Performance Targets
159(2)
Using Outcome Targets to Monitor Performance
161(1)
Financial Variance Analysis
161(2)
Getting Paid For What You Do
163(10)
Who Pays For Health Care Services?
164(1)
Patients and Their Families
164(1)
Health Care Providers
165(1)
Charitable Groups and Individuals
165(1)
Employers
165(1)
Insurance Companies
165(2)
Government Programs
167(1)
What Do Third Party Payers Pay For?
168(1)
Insurance Plan Coverage Guidelines
168(1)
Coverage Guidelines for Government-Sponsored Health Insurance Programs
168(1)
Medicare Coverage of Physical Therapy Services
169(1)
Responsibilities of a Health Care Provider Operating Under Contract With a Health Care Insurance Plan
169(1)
Third Party Payment For Administrative Services
170(1)
Performance Incentive Payments
170(1)
Maximizing Net Income Under Third Party Payment Methods
170(1)
Managing Under a Cost-Based Payment Method
170(1)
Managing Under Fee-For-Service and Discounted Fee-For-Service Payment Method
171(1)
Managing Under a Per Diem Payment Method
171(1)
Managing Under a Case Rate Payment Method
172(1)
Managing Under a Capitation Payment Method
172(1)
Payment Related Practices That May Impact Net Income
173(1)
Getting Paid: Things To Do
173(6)
Participation Agreements
174(1)
Services and Equipment For Sale
175(1)
Price Setting
176(1)
Credit Policy
177(1)
The Patient Registration Process
177(1)
The Billing Process
177(1)
Charge Recording
178(1)
Invoicing, Payment Tracking and Collections
178(1)
Making the Most of What You Get Paid
179(4)
Managing Operating Expenses
179(1)
Resource Productivity
179(2)
Labor Costs
181(2)
Nonlabor Operating Costs
183(1)
Summary
183(2)
Facility Planning
185(20)
Preview
185(1)
Introduction
186(1)
Designing Values Based Facility
186(1)
Facility Planning As a Marketing Task
187(1)
Facility Planning As a Project Management Task
187(1)
Planning: The Key To Developing a Usable Economic Facility
187(12)
There Are No Boundless Projects
188(1)
Room Space Requirements
189(4)
Contingency Planning
193(1)
Design Decisions
193(2)
Structural Systems
195(1)
Communication Systems
195(1)
Lighting
196(1)
Electrical
196(1)
Safety Systems
196(1)
Plumbing Systems
197(1)
Sound Abatement Systems
197(1)
Heating, Ventilation, Air Conditioning Systems (HVAC)
197(1)
Storage Systems
198(1)
Regulatory Compliance
198(1)
Interior Design
199(1)
Planning Steps
199(1)
Detailed Planning Process for Physical Plant Development and Alteration
199(4)
Predesign
199(1)
Planning Team Selection
199(1)
Pre-planning
199(1)
Construction Design
200(1)
Detailed Planning
200(1)
Final Planning and Checks
200(1)
Keeping Track of the Project and Adjusting Work In Progress
201(1)
Construction
202(1)
Construction and Equipment Procurement
202(1)
Preoperations
202(1)
Final Check Out
202(1)
Occupancy and Operations Startup
202(1)
Occupancy
202(1)
Revision and Critique
203(1)
Mistakes Happen
203(1)
Summary
203(2)
Information Management
205(16)
Preview
205(2)
Introduction
207(1)
Values
208(1)
The Information Crunch
208(1)
The Management and Flow of Information in an Organization
209(7)
Traditional Areas of Information Management
210(1)
Differences in Typical Information Needs in Private Practice Compared to Organization-Based Clinical Services
211(1)
Information Systems at a Community Hospital
211(1)
Organization
211(1)
Management Structure
212(1)
Information Systems
212(1)
Patient Information Systems at ABC Community Hospital
212(1)
Human Resource Information at ABC Community Hospital
213(1)
Organizational Information at ABC Community Hospital
213(1)
Information Systems at a Private Therapy Practice
214(1)
Organization and Management Structure
214(1)
Information Systems
214(1)
Patient Information at XYZ Rehab, Inc.
214(1)
Human Resource Information
215(1)
Organizational Information
215(1)
Information Systems in Large and Small Organizations
216(1)
Use of Data
216(1)
Expert Systems in Medicine
217(1)
Documentation as an Example of a Complex Information System
218(2)
Personnel Considerations in Documentation Management Systems
218(1)
Technology Considerations in Documentation Management Systems
219(1)
Financial Considerations in Documentation Management Systems
219(1)
Realistic Expectations in Documentation Management Systems
220(1)
Nontraditional Areas of Information Management
220(1)
Summary
220(1)
Outcomes: What to Collect and What Does the Information Mean
221(26)
Preview
221(1)
Introduction
222(1)
The Outcomes Imperative: Values
223(2)
Defining Acceptable Quality And Quantity Of Services
225(1)
Uses Of Outcome Management
226(2)
Measuring Performance To Develop and Maintain Accountability
226(1)
Clinical Performance
226(1)
Financial Performance
227(1)
Customer Satisfaction
227(1)
Using Outcome Information
228(1)
How to Measure and Manage Outcomes
228(5)
Nine Steps To Outcome Management
228(1)
Identify The Population To Be Studied
228(1)
Choose An Outcome Measurement Tool
229(1)
Collect Admission Data
230(1)
Clinical Intervention
230(1)
Collect Discharge Data
231(1)
Collect Followup Data
231(1)
Analyze The Collected Data
232(1)
Develop Actions Based On Data Analysis
232(1)
Evaluate The Outcomes Program
232(1)
Quality Improvement
233(9)
Variation
236(1)
Tools Of Continuous Quality Improvement
236(5)
Tools Are Just Tools
241(1)
Regulatory Compliance
242(4)
CARF, The Rehabilitation Commission (CARF)
242(2)
The Joint Commission on Accreditation of Health Care Organizations (JCAHO)
244(1)
National Committee for Quality Assurance
244(1)
Health Plan Employer Data and Information Set
244(2)
Summary
246(1)
Playing It Safe: Managing Risk
247(20)
Preview
247(1)
Introduction
248(1)
General Concepts
248(11)
Responsibilities
249(1)
Risk Management Process in Health Care Organizations
249(1)
Identification of Exposure to Risk
249(2)
Information Is Needed To Manage Risk
251(3)
Occurrence Screening
254(1)
Walking the Beat
255(2)
Analysis
257(1)
General Risk Management Options
257(2)
Risk Management Concerns in Physical Therapy
259(5)
Abuse, Assault and Harassment
259(1)
Abuse Considerations and Risk Management
260(1)
External Sources of Abuse
260(1)
Internal Sources of Abuse
260(1)
Assault Considerations and Risk Management
261(1)
Assault and Battery
261(2)
Sexual Harassment and Risk Management in Physical Therapy
263(1)
Summary
264(3)
Getting Advice: Consultants
267(11)
Preview
267(1)
Introduction
268(1)
Consultant, Contractor Or Temporary Employee?
268(1)
Services Available
269(4)
Financial Services
269(1)
Legal Services
270(1)
Human Resources
271(1)
Real Estate
271(1)
Equipment And Technology
272(1)
Operations Management
272(1)
When And When Not To Use A Consultant
273(1)
Ask The Right Questions
273(1)
Supporting The Consultation Process
274(1)
How To Select A Consultant
274(1)
The Goals And Objectives Of The Engagement
274(1)
Ground Rules
274(1)
Selection Criteria
274(1)
The Request For Proposal (RFP)
274(1)
General Guidelines
275(1)
The Consultation Agreement
275(1)
The Potential For Internal Controversy And Resistance
276(1)
Summary
276(2)
Enterpreneurship: Ownership and Private Practice Physical Therapy
278(21)
Donald Olsen
Preview
278(1)
Introduction
279(1)
Entrepreneurial Characteristics
279(2)
What It Takes
280(1)
Tangible and Intangible Benefits
280(1)
Financial
280(1)
Self-Expression
280(1)
Opportunities to Lead
280(1)
Community Contribution
280(1)
Contributions of Small Business
281(1)
Threats to Private Practice Physical Therapy
281(2)
Few Women
281(1)
Large Versus Small Private Practice
282(1)
Increasing Numbers of Physicians
282(1)
Balancing Demands
283(1)
Getting Started
283(3)
Direct Experience
283(1)
Other Experience
283(1)
Planning Is a Must
284(1)
Know Yourself: Self Assessment
284(1)
Philosophy and Values
285(1)
Goals
285(1)
Business Plan: ``Failing to Plan is Planning To Fail''
286(1)
Process of Business Planning
286(1)
Dream
286(1)
Talk and Listen
287(1)
Do Your Homework
287(1)
Write
287(1)
Business Planning Format
287(6)
Transmittal Letter
289(1)
Elements of A Business Plan
289(1)
Cover Letter
289(1)
Executive Summary
289(1)
Table of Contents
289(1)
The Business Description
289(4)
Financial Information
293(1)
Supporting Information
293(1)
Multiple Uses of A Business Plan
293(1)
Additional Private Practice Physical Therapy Considerations
294(2)
Contracting to Provide Services
294(1)
Participation in the Medicare Program
294(1)
From an Agency
295(1)
Home Health Services
295(1)
Joint Ventures
295(1)
Network Participation
296(1)
Changing Environment for Private Practice Physical Therapy
296(1)
Summary
297(2)
Future
299(12)
Preview
299(1)
Introduction
299(1)
Futures Model
300(1)
External Environment
301(1)
Internal Environment
301(1)
Created Future
301(1)
Using the Model to Create A Vision of The Future
301(6)
National Scenarios For the Near Future in Seven Categories
302(1)
Patients
302(1)
Third Party Payment
302(1)
Institutional Providers
303(1)
Gate Keepers and Case Managers
304(1)
Physicians
304(1)
Physical Therapy Practice
305(1)
Physical Therapy Education
306(1)
Thinking About the Preparing For the Future
307(2)
Supply and Demand
308(1)
Background
308(1)
Vector Report
308(1)
Threats and Opportunities
309(1)
Summary
309(2)
Appendix A: Role Plays for Chapters 1 through 14 311(26)
Appendix B: Guide for Professional Conduct 337(5)
Appendix C: Code of Ethics 342(1)
Glossary 343(10)
Index 353

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