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Healthcare Financial Management,May,1996 by Donald Hayers, Timothy.Kincaid
PATIENT ACCOUNTS MANAGEMENT
Accounts receivable financing is a potential tool for managing a provider organization's working capital needs. But before entering into a financing agreement, organizations need to consider and take steps to avoid serious problems that can arise from participation in an accounts receivable financing program.
For example, the purchaser may cease purchasing the receivables, leaving the organization without funding needed for operations. Or, the financing program may be inordinately complex and unnecessarily costly to the organization. Sometimes the organization itself may fail to comply with the terms of the agreement under which the accounts receivable were sold, thus necessitating that restitution be made to the purchaser or provoking charges of fraud.
These potential problems should be addressed as early as possible - before an organization enters into an accounts receivable financing program - in order to minimize time, effort, and expense and maximize the benefits of the financing agreement.
Prior to the late 1980s, accounts receivable purchase programs were of limited use and availability to provider organizations because retrospective reimbursement practices dominated the healthcare industry. Accounts receivable financing programs began to appear when prospective reimbursement policies forced provider organizations to become more adept at managing their financial resources. The drive toward managed care only has accelerated the need for creative financing mechanisms to improve cash flow as well as fund asset acquisitions and joint ventures.
The growth of accounts receivable purchase programs initially was slow, in part because executives believed the sale of accounts receivable would be perceived as a sign of financial weakness in their organizations, and in part because this type of financing mechanism was not well understood in the industry. Since 1990, however, there has been a market for accounts receivable purchase programs among healthcare providers that recognize the need for a vehicle for improving cash flow. An increasing number of nursing homes, home health care providers, psychiatric/alcohol and substance abuse facilities, and acute care hospitals are entering into receivables purchasing programs.
Benefits for providers
The objective of an accounts receivable purchase program is to provide immediate funds to healthcare providers so they do not have to wait to obtain capital until receivables are collected. The resulting acceleration of cash flow allows the provider to reduce payables, prepay accounts to obtain discounts, or pay off tax liens and other debts that threaten the financial stability of the business. It also improves the balance sheet. With a properly structured sale of accounts receivable, a provider can remove from its balance sheet the receivables that have been sold and substitute cash without recording any significant liability other than the liabilities that may arise as a result of 939
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