About military healthcare system


Assignment:

Are you or your immediate supervisor involved with staffing decisions?

No, I am not involved with staffing decisions, but my supervisor is. Forecast are prepared by using the staffing measurement known as the full-time equivalent (FTE). The text states that there are two different methods how to compute the FTE the annualizing method, and the scheduled - position method FTE is a measure equivalent to the employee annualized, or staffed for the full-time employment Baker & Baker (2014). Human resources could benefit by using both methods, all they would need to do is complete a trend analysis to review past employment needs to predict future needs. This can be completed two ways by computing the number of employees at the end of a certain numbers of years, the second way is the number of employees in a certain function research shows it's best to use both methods to cover all bases.
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In the military healthcare system, there are our civilian population that are hired through the civilian office on base via an ad that ask for specific experiences and criteria. If it looks like we may need additional positions due to an increase in the population in a certain area or a new mission is added to the base, the Surgeon General's office will forecast for a new position for that particular base through the main civilian personnel office. Our civilian positions do not fluctuate often and stay consistent in how many exist. The civilian hires are come in the form of contractors or government GS positions. The Active Duty hires are also completed based on the needs of the Air Force. It is predetermined by the Air Force pentagon staff based on the number of servicemen and woman as well as their families how many technicians and physicians are needed. Once the members are staffed there are higher ranking personnel who are called Major Command Functional Managers who oversee their specific specialty in that particular command. I am the Aerospace Physiology Air Combat Command Functional Manager. In that position, I am able to forecast if the number of hires from the Pentagon are accurate for the mission tempo and ask for an adjustment or a movement of a position from one base to the other. The best way to describe forecasting in the military is a system of checks and balances of personnel based on the mission, resources, and operations tempo.
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I am a supervisor in a company that is a third party claims administrator. My team manages FMLA and short term disability claims for a national health care organization. I do not make decisions about the number of positions budgeted to the office or team. My office VP advises me the number of approved FTE's for our client and I do the interviewing and hiring. I do know that the number of FTE's for our client is based on the number of average claims filed for our client per year and then is broken down to individual caseload per examiner.

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I am not involved with staffing decisions in my current position. However, I think it's very important to take into account internal and external changes and must integrate HR planning with the company's business plan. Once all relevant information has been collected, the HR Department should forecast its staffing and recruitment needs. Developing a detailed and useful set of job requirements is key.

This information can help determine whether qualified candidates already exist or whether they can be developed within the company before recruiting externally. I Also think that documenting turnover trends to help predict how many people will leave an organization will prepare an organization for peak recruitment times.

My organization uses a flexible budget which is a budget that adjusts or flexes for changes in the volume of activity Baker & Baker (2014). Companies prepare flexible budgets at the end of an accounting period to compare how they spent their money with how they had planned to spend their money. The flexible budgets show how they truly spent their funds. The original budgets, and the static budgets, show how they had expected to spend their funds. For example, Flexible budgets also allow companies to model how they might allocate their funds in lieu of particular changes. A company can prepare an array of flexible budgets that each reflect a different scenario. This is termed pro forma analysis. For example, a mental health facility would create a budget showing what its profits and expenses would be if it had 800 (imaginary numbers) admissions that year. The mental health facility might also create a budget showing profits and expenses for filling 80 rooms and 50 rooms that year, causing each version to adjust certain items in the budget, not just earnings. For example, if the weather conditions changed the homeless population may seek the facility for shelter and food alone, because of that the facility might need to hire new employees or pay overtime to meet the patient's needs.

Does your organization use a flexible or a static budget? Explain and provide examples.

I believe it would make sense that my organization uses both budgets. I think that specifically for staffing in healthcare, it is based on both budgeting principles. The organization budgets for staffing based on staffing grid for the year. However, when there are shortages in staff due to heavy census, terminations, suspensions, promotions or even individuals quitting, there are temporary periods of time when the staffing budget needs to be flexible and allow for travel nurses to fill in the gaps or allow for bonus pay for nurses to pick up extra shifts. Additionally, as the professor pointed out in last week's discussion, there has to be flexibility in the budget to pay for orientation of new staff, meetings, professional training, etc. Staffing budgets are probably the biggest example of an area where both budgets are required in healthcare due to the need for an organization to try to keep costs down but also try to fill in the gaps when necessary.

Does your organization use a flexible or a static budget? Explain and provide examples.

The military uses a static budget because, according to Baker and Baker (2014) it is based on a single level of operations and has been approved, finalized and never adjusted.

This is the operating budget that the government gives each facility every fiscal year. It is based off the previous year and how much was spent and adjusted accordingly for the next year. If a particular facility was consistent in not spending their entire budget for several years, their budget will be decreased and redistributed towards the areas that need it the most. The budget for the employee salaries are the same because it is based on rank and those in the same rank category make the same and if you are in a specialty position you get more but that is predetermined as well based on the position. Something else that is static is the Government Purchasing Cards that are used to purchase local apparel that is not office supplies but unique to a particular job or mission. Flights are usually given $3,000 each month for these types of supplies. For instance, oxygen bottles for a high altitude jump or gear to fly on the back of Airplanes. Additionally, a static budget is also used for conferences and schools which comes out of a separate account but is fixed and projected each year.

I used to work in Finance a couple of years ago and reporting has changed a little bit within my organization. I talked to a couple of people that currently work in finance and they told me that for official financial statements, the organization still uses static budget. When month-end close takes place, financial teams meet together to analyze and discuss the actual numbers compared to the static budget.

In addition, the decision support system has developed Responsibility Reports for responsibility centers use. Actual numbers are displayed along flexible budget numbers, allowing managers to have a better handle of their operating expenses.

Responsibility centers mainly flex their budgets on labor and supply items. Each responsibility center has a primary productivity stat that is used in order to flex labor and supply line items. For example, nursing floors would use equivalent patient days, OR would use surgery minutes, imaging would use number of test or scans, etc.

 

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