Annis R J, Holton J W
Health Prog. 1986 Apr;67(3):26-8.
While hospitals are implementing case-mix accounting systems, they also may be negotiating prices with health maintenance organizations (HMOs) and preferred provider organizations (PPOs). To aid decision makers in their evaluation of HMO/PPO bids, a matrix that projects the bottom-line effect of various rate and volume options may be useful. Identifying incremental cost--the additional cost incurred if one patient day were added--is the key to this type of matrix analysis. Knowing incremental cost, financial managers can project the effect of a potential loss of current patient volume if a bid is rejected, as well as the effect of a potential shift of patients to HMO/PPO status if a bid is accepted. Although the incremental per diem cost is of chief importance in evaluating bid alternatives, other factors, such as the hospital's potential for growth, opportunity to increase its competitive position, and the impact on community relations and on the medical staff, also must be considered.
医院在实施病例组合计费系统的同时，可能也在与健康维护组织（HMO）和优先提供者组织（PPO）协商价格。为帮助决策者评估HMO/PPO的投标，一个能预测各种费率和数量选项底线效应的矩阵可能会很有用。确定增量成本——增加一个病人日所产生的额外成本——是这类矩阵分析的关键。了解增量成本后，财务经理可以预测如果投标被拒绝，当前病人数量潜在损失的影响，以及如果投标被接受，病人转向HMO/PPO状态的潜在影响。虽然每日增量成本在评估投标方案时最为重要，但其他因素，如医院的增长潜力、提升其竞争地位的机会以及对社区关系和医务人员的影响，也必须予以考虑。
