Table 1. HealthWays Clinic, Monthly Expense Budget Report, June 2018.
Item
June 2018
May 2018
2018 YTD
Budget Actual Variance Actual
Budget
1.0
1.0
1.0
1.0
3.0
3.0
3.0
3.0
Physician FTE
Nurse PractitionerFTE
Encounters:
Established patients
275
291
New patients
25
18
Total encounters
Expenses:
Physician Salaries & Benefits
$10,500 $10,502
NP Salaries & Benefits
$20,000 $20,992
Clerical (2 FTE) Salaries & Benefits $6,667 $6,771
Total personnel expense
Medical supplies
$7,500 $8,136
Office supplies
$583
$623
Rent
$2,917 $2,917
Depreciation
$333
$346
Capital Expenses
$3,333 $3,480
Overhead
$167
$167
Total non-personnel expense
Total health center expense
286
27
1650
150
$10,509
$20,191
$6,683
$63,000
$120,000
$40,000
$7,994
$508
$2,917
$346
$3,480
$167
$45,000
$3,498
$17,502
$1,998
$19,998
$1,002
Interpretation:
Providers:
The FTEs have not changed, at least for the first 6 months of 2018.
Encounters:
The number of encounters, both new and established, is increasing over the year.
Personnel expense:
Although the FTEs are not changing, the personnel budget is somewhat more than budgeted, particularly the NP and
Non-personnel expense:
Medical supplies are over budget. Office supplies are under budget. Depreciation and capital expenses (new equipm
Total expenses:
The clinic must carefully control expenses as its profitability is very low. Possible strategies might include improvin
2018 YTD
Actual
1.0
3.0
1671
164
$63,149
$122,001
$41,978
$47,883
$3,407
$17,502
$2,050
$20,439
$1,002
budgeted, particularly the NP and clerical budgets. The management should investigate why this is the case, and better control th
and capital expenses (new equipment) increased over the budget year. Rent and overhead remain stable, but might be expected to
strategies might include improving staff productivity, reducing the cost of medical supplies, and postponing further capital purch
e, and better control the personnel budget.
ut might be expected to increase next year.
Nurse-Run Clinic Scenario
Patient Encounters
Established patients
New patients
Total Encounters
FY 2018
3,348
331
3,679
Cash
$5,675
FY 2017
3,204
287
3,491
$12,098
Financial Ratios:
Expense per Encounter = Total Operating Expenses / Total Encounters
Total Operating Revenue per Encounter = Total Operating Revenue / Total Encounters
Operating Margin = Net Income/Total Operating Revenue
Days Cash On Hand = (Cash + Cash Equivalents) / (Operating Expenses / Days in Time Period)
Table 2. HealthWays Clinic, Income Statement, FY 2018.
Gross Revenue (charges)
Less write-offs & adjustments
Net Patient Revenue (collected)
+Other Revenue
Total Operating Revenue
FY 2018
$558,520
117,254
$441,266
209,671
FY 2017
$497,221
104,332
$392,889
234,953
$ 650,937 $
627,842
459,171
97,627
7,471
39,148
43,762
445,396
92,418
7,302
37,023
47,009
Total Operating Expenses
$ 647,179 $
629,148
Net Income
$
($1,307)
Operating Expenses
Salaries & Benefits
Medical Supplies
Office Supplies
Rent & Depreciation
Other
3,758
Return on Assets
Financial Reports: Quick Tips for Interpretation
Horizontal
Analysis
•income statement: positive net income indicates profitability
•balance sheet: positive equity indicates that there is a positive net worth, representing the amount remaining if a
•compare changes in reports from prior year(s) to identify trends in financial performance, and with industry stand
Financial Ratios
FY 2018
FY 2017
Expense per Encounter
$ 175.91 $
180.22
Total Operating Revenue per Encounter $ 176.93 $
179.85
Operating Margin
0.58%
-0.21%
Days Cash On Hand
3.2
7.0
Interpretation
Income Statement
The clinic operated at a loss the prior year, this reporting year the clinic made a small profit.
One thought is about collections. The collection rate should be as high as possible, ideally 90-95 percent. It is likel
Balance sheet
The current liabilities are greater than the current assets, so the ability of the clinic to pay its short-term obligation
Expense per Encounter:
In the prior year, the expense per encounter (patient visit) exceeded the revenue per encounter, so that the opera
Total Operating Revenue per Encounter:
In the current year, operating revenue is greater than expenses per encounter, but the two amounts are very simil
The clinic’s financial health is at risk if it cannot generate adequate profits that cover increases in costs and unexpe
Operating Margin:
The prior year’s net income was negative, thus leading to a negative operating margin. The current year’s operatin
As stated before, the clinic managers should consider how to improve the collection rate, how to negotiate higher
Days Cash On Hand
The clinic’s days cash on hand is very low, with only three days of ability to pay short-term expenses.
Concerns about meeting short-term obligations are more serious because current liabilities exceed current assets,
Table 3. HealthWays Clinic, Balance Sheet, December 31, 2018.
December 31,
December 31,
Current Assets
2018
2017
Cash
5,032
9,877
Short-term Investments
40,389
34,181
Accounts Receivable
63,392
59,359
Supply Inventories, at Cost
16,029
14,918
Prepaid Expenses & Other
2,104
1,876
Total Current Assets $
126,946 $
120,211
Property, Plant & Equipment (Fixed Assets)
Cost of PP&E
Less Accumulated Depreciation
Net PP&E (Net Fixed Assets) $
Other Assets
$
Total Assets
$
56,047
4,194
51,853 $
1,289
180,088 $
55,701
3,943
51,758
1289
173,258
, ideally 90-95 percent. It is likely that a lot of the write-offs and adjustments represent uncollected patient fees. More analy
per encounter, so that the operations of the clinic operated at a loss. It is important that the clinic carefully manages its costs
on rate, how to negotiate higher reimbursement, and how to better control costs. Another possible strategy is grant writing an
liabilities exceed current assets, so it might not be possible for the clinic to meet short-term obligations if there is an interrupt
Current Liabilities
Notes Payable
Accounts Payable
Accrued Expenses:
Salaries & Benefits
Taxes
Interest Payable
Total Current Liabilities
December 31, December
2018
31, 2017
27,449
50,000
78,702
69,412
$
Long-Term Liabilities
Net Assets
Unrestricted
Restricted
Total Net Assets $
Total Liabilities & Net Assets
$
38,265
28,274
1,419
1,398
3,294
500
149,129 $ 149,584
$0
$0
28,541
2,418
20,569
3,105
30,959 $
23,674
180,088 $ 173,258
nic carefully manages its costs because if revenue is not greater than cost, the clinic is not profitable and might not be able to r
and might not be able to remain solvent.
ESTIMATED EXPENSES and ROI (US Dollars $)
This worksheet presents the estimated expenses for the development, launch and maintenance of Nursing Shortage and the Cost of Recruitment. Also presented is a Return on investment (ROI) analysis.
Expenses/Cost
2020
2021
2022
2023
2024
2025
230,400.00
81,920.00
65,536.00
52,428.80
41,943.04
64,800.00
23,040.00
18,432.00
14,745.60
11,796.48
Start up expenses
Office Space
88,542.72
Equipement
132,814.08
Advertising
147,571.20
Payroll
472,227.84
Website
177,085.44
Total start up expenses ($)
1,018,241.28
Operating Expenses
Personnel
Equipement
Supplies
7,200.00
2,560.00
2,048.00
1,638.40
1,310.72
Marketing
28,800.00
10,240.00
8,192.00
6,553.60
5,242.88
Training
43,200.00
15,360.00
12,288.00
9,830.40
7,864.32
374,400.00
133,120.00
106,496.00
85,196.80
68,157.44
374,400.00
133,120.00
106,496.00
85,196.80
68,157.44
300,000.00
300,000.00
542,000.00
300,000.00
68,000.00
Technology advancement
16,000.00
16,000.00
16,000.00
16,000.00
16,000.00
Attrition
34,000.00
34,000.00
34,000.00
34,000.00
34,000.00
Reduction in work space
40,000.00
10,000.00
8,000.00
8,000.00
9,000.00
Total Revenue/savings ($)
390,000.00
360,000.00
600,000.00
358,000.00
127,000.00
Return on Investment (%)
4.17%
1.704326923
4.634014423
3.202035757
0.863332895
Total operating expenses ($)
Total Expenses ($)
1,018,241.28
Revenue/Savings
Appropriated funds
d is a Return on investment (ROI) analysis.
Grand Total
472,227.84
132,814.08
14,757.12
59,028.48
88,542.72
767,370.24
1,785,611.52
1510000
80000
170000
75000
1835000
0.027659141
Budget Development
This worksheet presents the budget for the development, launch and maintenance of Nursing Shortage and the Cost of Recruitment. Also presented is cash fl
Expenses/Cost
2020
2021
2022
2023
230,400.00
81,920.00
65,536.00
64,800.00
23,040.00
18,432.00
Start up expenses
Office Space
88,542.72
Equipement
132,814.08
Advertising
147,571.20
Payroll
472,227.84
Website
177,085.44
Total start up expenses ($)
1,018,241.28
Operating Expenses
Personnel
Equipement
Supplies
7,200.00
2,560.00
2,048.00
Marketing
28,800.00
10,240.00
8,192.00
Training
43,200.00
15,360.00
12,288.00
374,400.00
133,120.00
106,496.00
374,400.00
133,120.00
106,496.00
300,000.00
300,000.00
542,000.00
Technology advancement
16,000.00
16,000.00
16,000.00
Attrition
34,000.00
34,000.00
34,000.00
Reduction in work space
40,000.00
10,000.00
8,000.00
Total Revenue/savings ($)
390,000.00
360,000.00
600,000.00
Return on Investment (%)
4.17%
1.704326923
4.634014423
15,600.00
226,880.00
503,504.00
Total operating expenses ($)
Total Expenses ($)
1,018,241.28
Revenue/Savings
Appropriated funds
Cash flow
-1,018,241.28
Payback Period*
2.00
*Payback Period Calculation
Year
Cash Flow ($)
Net Cash Flow
($)
2020
-1,018,241.28
-1,018,241.28
2021
15,600.00
-1,002,641.28
2022
226,880.00
-775,761.28
2023
503,504.00
-272,257.28
2024
272,803.20
545.92
2025
38,842.56
39,388.48
t of Recruitment. Also presented is cash flow and pay
2024
2025 Grand Total
52,428.80
41,943.04
472,227.84
14,745.60
11,796.48
132,814.08
1,638.40
1,310.72
14,757.12
6,553.60
5,242.88
59,028.48
9,830.40
7,864.32
88,542.72
85,196.80
68,157.44
767,370.24
85,196.80
68,157.44
1,785,611.52
300,000.00
68,000.00
1510000
16,000.00
16,000.00
80000
34,000.00
34,000.00
170000
8,000.00
9,000.00
75000
358,000.00
127,000.00
1835000
3.202035757
0.863332895
0.027659141
272,803.20
38,842.56
49,388.48
Ratio Analysis
This worksheet presents the budget for the development, launch and maintenance of Nursing Shortage and the Cost of Recruitment. Also presented is cash flow and pay
Expenses/Cost
2020
2021
2022
2023
2024
2025
230,400.00
81,920.00
65,536.00
52,428.80
41,943.04
64,800.00
23,040.00
18,432.00
14,745.60
11,796.48
Start up expenses
Office Space
88,542.72
Equipement
132,814.08
Advertising
147,571.20
Payroll
472,227.84
Website
177,085.44
Total start up expenses ($)
1,018,241.28
Operating Expenses
Personnel
Equipement
Supplies
7,200.00
2,560.00
2,048.00
1,638.40
1,310.72
Marketing
28,800.00
10,240.00
8,192.00
6,553.60
5,242.88
Training
43,200.00
15,360.00
12,288.00
9,830.40
7,864.32
374,400.00
133,120.00
106,496.00
85,196.80
68,157.44
374,400.00
133,120.00
106,496.00
85,196.80
68,157.44
300,000.00
300,000.00
542,000.00
300,000.00
68,000.00
Technology advancement
16,000.00
16,000.00
16,000.00
16,000.00
16,000.00
Attrition
34,000.00
34,000.00
34,000.00
34,000.00
34,000.00
Reduction in work space
40,000.00
10,000.00
8,000.00
8,000.00
9,000.00
Total Revenue/savings ($)
390,000.00
360,000.00
600,000.00
358,000.00
127,000.00
Return on Investment (%)
4.17%
1.704326923
4.634014423
3.202035757
0.863332895
15,600.00
226,880.00
503,504.00
272,803.20
38,842.56
Total operating expenses ($)
Total Expenses ($)
1,018,241.28
Revenue/Savings
Appropriated funds
Cash flow
Payback Period*
-1,018,241.28
2.00
Ratio Anaylsis
Total Estimated Startup Expenses
1,018,241.28
Break-Even Point
2024
Paypack Period
2.00
pay
Grand Total
472,227.84
132,814.08
14,757.12
59,028.48
88,542.72
767,370.24
1,785,611.52
1510000
80000
170000
75000
1835000
0.027659141
49,388.48
*Payback Period Calculation
Net Cash Flow
Year
Cash Flow ($)
($)
2020
-1,018,241.28
-1,018,241.28
2021
15,600.00
-1,002,641.28
2022
226,880.00
-775,761.28
2023
503,504.00
-272,257.28
2024
272,803.20
545.92
2025
38,842.56
39,388.48
UnitedHealth Group
Statements of Comprehensive income
Horizontal analysis
For the year ended Dec 31
(In millions)
2018
2017
Change in amount
Revenues
Premiums
178,087.00
158,453.00
Products
29,601.00
26,366.00
Services
17,183.00
15,317.00
1,376.00
1,023.00
226,247.00
201,159.00
25,088.00
145,403.00
130,036.00
15,367.00
Operating costs
34,074.00
29,557.00
4517.00
Cost of products sold
26,998.00
24,112.00
2886.00
2,428.00
2,245.00
183.00
208,903.00
185,950.00
22953.00
17,344.00
15,209.00
2135.00
Investment and other income
Total revenues
19,634.00
3235.00
1,866.00
353.00
Operating costs
Medical costs
Depreciation and amortization
Total operating costs
Earnings from operations
Interest expense
–
Earnings before income taxes
Provision for income taxes
Net earnings
–
1,186.00
-214.00
15,944.00
1,400.00 –
14,023.00
1921.00
3,562.00 12,382.00
3,200.00
10,823.00
-362.00
1559.00
UnitedHealth Group
Consolidated Balance Sheets
(In millions)
December 31, 2018
December 31, 2017
Assets
Current assets
Cash and cash equivalents
10,866.00
11,981.00
Short-term investments
3,458.00
3,509.00
11,388.00
9,568.00
Other current receivables,net of allowances
6,862.00
6,262.00
Assets under management
3,032.00
3,101.00
Prepaid expenses & other current assets
3,086.00
2,663.00
Total current assets
38,692.00
37,084.00
Long-term investments
32,510.00
28,341.00
8,458.00
7,013.00
58,910.00
54,556.00
9,325.00
8,489.00
4,326.00
152,221.00
3,575.00
139,058.00
Accounts receivables,net of allowances
Property,equipment and capitalized software
Goodwill
Other intangible assets
Other assets
Total assets
Liabilities, redeemable noncontrolling interests and equity
Current liabilities
Medical costs payable
19,891.00
17,871.00
Accounts payable and accrued liabilities
16,705.00
15,180.00
Commercial paper & Current maturities of long-term
1,973.00
debts
2,857.00
Unearned revenues
2,396.00
2,269.00
Other current liabilities
12,244.00
12,286.00
Total current liabilities
53,209.00
50,463.00
Long-term debts
34,581.00
28,835.00
2,474.00
2,182.00
Deferred income taxes
Other liabilities
Total liabilities
5730.00
95,994.00
Commitments & Contigencies
5556.00
87,036.00
1908.00
2189.00
10.00
10.00
Equity
Common stock issued & Outstanding
Additional paid-in capital
–
1,703.00
Retained earnings
55,846.00
48,730.00
Accumulated other comprehensive loss-
4,160.00 –
2,667.00
Nonredeemable noncontrolling interests
2,623.00
2,057.00
Total equity
54,319.00
49,833.00
Total liabilities, redeemable noncontrolling interests
152,221.00
& equity 139,058.00
Return on asset(ROA)=Net income/average total assets
Average total assets=
ROA
145,639.50
8.50%
https://www.unitedhealthgroup.com/content/dam/UHG/PDF/investors/2018/UNH-Q4-2018-Form-10-K.pdf
Percentage change
12.39%
12.27%
12.18%
34.51%
12.47%
11.82%
15.28%
11.97%
8.15%
12.34%
14.04%
18.04%
13.70%
11.31%
14.40%

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