Describe the financial impact of a changing payer mix


Problem

The nurse manager in orthopedics has asked for your assistance with a finance project. She is being asked to estimate revenue for the next fiscal year based on the projected number of hip replacements increasing from 300 this year to 340 next year.

The nurse manager must also factor in the expected changes in sources of revenue by payer. It is estimated that the hospital will lose some contracted insurers due to local competition, and see an increase in Medicare and Medicaid patients due to area demographics and economic conditions. She has provided you with the numbers from this year's budget and the projections on numbers and payment amounts for next year.

Financial Forecasting Memo

i. Explain how the change in payer mix will impact the overall projected revenue of the unit.
ii. Describe the financial impact of a changing payer mix.
iii. Lists recommendations for the manager to consider in expenses, so that the budget will balance as neutral.

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