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Variance Analysis Project 6. You have been asked to explain the causes for a cha

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Question

Variance Analysis Project

6.      You have been asked to explain the causes for a change in the charges for MS-DRG 445 from 2006 to 2011. Charge profiles are presented below:

                                              Units Provided      Charge/Unit           Total Charge

                                                2006      2011       2006    2011          2006       2011

                  Routine Care            10          7          $200    $400         $2,000    $2,800

                  Special Care               2          1            400      560              800         560

                  Pharmacy                   1          1              95      125                95         125

                  Radiology                  9          1              65      585              585         585

                  CT Scan                     0          1            300      300                  0         300

                  Lab                            1          1            185      185              185         185

                                                                                                         $3,665    $4,555

           

      Compute price and efficiency variances for all departments.

Use the following data to calculate the variances in problems 7–10.

You have been asked by management to explain the variances in costs under your inpatient capitated contract. The following data is provided.

                                                                      Budget              Actual

                        Inpatient Costs                 $12,568,500    $16,618,350

                        Members                                   42,000             42,000

                        Admission Rate                          0.070               0.095

                        Case Mix Index                            0.90                 0.85

                        Cost per Case (CMI = 1.0)        $4,750             $4,900

                                   

7. What dollar amount of the total variance is attributed to Enrollment Variance?

8. What dollar effect did the increased admission rate have on cost?

9. The intensity of care delivered dropped from a budgeted case mix of 0.90 to an actual case mix of 0.85. What dollar effect did this have on actual costs?

10. Costs per case increased to $4,900 from a budgeted value of $4,750. This increased actual total costs by what amount?

Use the following data to calculate the variances in problems 11–13.

The following information has been prepared for a home health agency:

                                                          Budget             Actual

            Wage Rate per Hour                          $16.00            $17.00

            Fixed Hours                                            320                 320

            Variable Hours per Relative

                  Value Unit (RVU)                             1.0                  1.1

            Relative Value Units (RVUs)             1,000              1,200

            Total Labor Hours                               1,320              1,640

            Labor Costs                                     $21,120          $27,880

            Cost per RVU                                    $21.12            $23.23

           

Budgeted costs at actual volume would be $25,344 ($21.12 × 1,200), and the total variance to be explained is $2,536 Unfavorable ($27,880 – $25,344). Be sure to specify whether the variance is favorable or unfavorable.

11. What is the amount of variance that is attributed to the difference between the budgeted and actual wage rate per hour?

12. What is the amount of variance that is attributed to the change in labor productivity?

13. What is the amount of variance that can be attributed to the difference between budgeted and actual volume?

Use the following information for problems 14–16.

The administrator of Appomattox Nursing Home is very aware of needing to keep his cost down since he just negotiated a new arrangement with a large insurance company that will pay him a fixed amount per patient day. Listed below are budgeted and actual expenses for the previous month.

Actual patient days were 30,000 compared to budgeted patient days of 24,000.

Budgeted Costs @ 24,000 Patient Days

Budgeted Cost Per Unit

Actual Costs @ 30,000 Patient Days

Pharmacy Costs Variable

$100,000

$4.167

$140,000

Misc Supplies Costs Variable

$56,000

$2.333

$67,500

Fixed Overhead Costs

$708,000

$29.50

$780,000

Total

$864,0000

$36.00

$987,500

14. Determine the total variance associated with the planned and actual expenses.

15. Prepare a flexible budget of expense at 30,000 patient days.

16. Determine the “Spending Variance” which is defined as Actual costs less costs budgeted at actual volume.

Use the following information for problems 17–19.

A dermatology clinic expects to contract with an HMO for an estimated 80,000 enrollees. The HMO expects 1 in 4 of its enrolled members to use the dermatology services per month.

At the end of the year, the dermatology clinic’s business manager looked at her monthly figures and saw that the number of enrolled members had increased by 5% over the budgeted amount, and that 1 in 3 of the total HMO members had used the dermatology services per month.

Actual and budgeted statistics are presented below. The total variance is $70,000 and is unfavorable:

Budgeted

Actual

Enrollees

80,000

84,000

Usage Rate

0.25

0.3333

Visits

20,000

28,000

Cost

$200,000

$270,000

Cost Per Visit

$10.00

$9.643

17. Determine the enrollment variance for the month.

18. Determine the utilization variance for the month.

19. Determine the efficiency variance for the month.

Budgeted Costs @ 24,000 Patient Days

Budgeted Cost Per Unit

Actual Costs @ 30,000 Patient Days

Pharmacy Costs Variable

$100,000

$4.167

$140,000

Misc Supplies Costs Variable

$56,000

$2.333

$67,500

Fixed Overhead Costs

$708,000

$29.50

$780,000

Total

$864,0000

$36.00

$987,500

Explanation / Answer

Answer (6)

Price Variance = Actual Units * (Actual Price – Budgeted Price)

Routine Care = 7 * (400 – 200) = 7 * 200 = $ 1,400

Special Care = 1 * (560 – 400) = $ 160

Pharmacy = 1 * (125 - 95) = $ 30

Radiology = No Variance as it appears to be a fixed charge

CT Scan    = No variance on account of price because of fixed charge

Lab = No variance

Efficiency Variance = (Actual Units – Budgeted Units) * Budgeted Price

Routine Care = (7 – 10) * 200 = -$ 600

Special Care = (1-2) * 400 = - $560

Pharmacy = (1-1) * 95 = 0

Radiology = No variance as it appears a fixed charge

CT Scan = $ 300 due to one unit processed though it appears to be a fixed charge

Lab = No Variance

Answer (7)

Actual Members &Budgeted Members = 42000

Actual Admission Rate = 0.095

Budgeted Admission Rate = 0.070

Variance attributable to Enrollment = Actual Members (Actual Admission Rate – Budgeted Admission rate)

Variance = 42000 * (0.095 – 0.070) = 42000 * 0.025 = 1,050

Answer (8)

$ Budgeted cost = Members * Budgeted admission rate * budgeted case mix ratio * budgeted cost

                             = 42000 * 0.070 * 0.90 * 4750 = $ 12,568,500

$ Actual Cost = Members *Actual Admission rate * budgeted case mix ratio * budgeted cost

                        = 42000 * 0.095 * 0.90 * 4750 = $ 17,057,250

Effect of increased admission rate = $ 17,057,250 - $ 12,568,500 = $ 4,488,750

Answer (9)

Changed Case Mix ratio from 0.90 to 0.85

$ Budgeted Cost = Members * Budgeted admission rate * budgeted case mix ratio * budgeted cost

                               = 42000 * 0.070 * 0.90 * 4750 = $ 12,568,500

$ Actual Cost = Members *Budgeted Admission rate * actual case mix ratio * budgeted cost

                         =   42000 * 0.070 * 0.85 * 4750 = $ 11,870,250

Effect of decreased Case Mix Ratio = $ 11,870,250 - $ 12,568,500 = ($ 698,250)   ( negative value)

Answer (10)

Cost per case increased from $ 4750 to $ 4900

$ Budgeted cost = Members * Budgeted admission rate * budgeted case mix ratio * budgeted cost

                               = 42000 * 0.070 * 0.90 * 4750 = $ 12,568,500

$ Actual Cost = Members *Budgeted Admission rate * budgeted case mix ratio * actual cost

                         =   42000 * 0.070 * 0.90 * 4900 = $ 12,965,400

Effect of increased patient cost = $ 12,965,400 - $ 12,568,500 = $ 396,900

Answer (11)

Budgeted Wage Rate = $ 16

Actual Wage Rate = $ 17

Variance attributable to budgeted and actual wage rate = Actual labour hours * (budgeted wage rate – actual wage rate)

Variance = 1640* (16 – 17) = 1640 * -1 = ($ 1,640) (negative value)

Answer (12)

Actual Labour hours = 1640

Budgeted Labour hours = 1320

Budgeted Labour cost = 16

Variance Attributable to Labour Productivity = (Actual Labour Hours – Budgeted Labour Hours) * Budgeted labour cost

Variance = (1640 – 1320) * 16 = 320 * 16 = $ 5,120

Answer (13)

Variance attributable to volume = (Actual No of Units - Budgeted No of Units) * Budgeted cost

No of units here indicates Relative Value Units

Variance attributable to Volume = (1200 – 1000) * 21.12 = 200 * 21.12 = $ 4,224

Answer (14)

Total Planned Expenses = Budgeted patients * budgeted cost = 24000 * 36 = $ 864,000       

Actual Expenses = $ 987,500

Variance = Actual Expenses – Planned Expenses = 987500 – 864000 = $ 123,500

Answer (15)

Budget of Expenses at 30000 patient days

Pharmacy Costs = patient days * Budgeted cost = 30000 * 4.167      = $ 125,010

Misc Supplies cost = Patient days * Budgeted cost = 30000 * 2.333 = $   69,990

Fixed Overhead Costs                                                                                   = $ 708,000

Total Budget of Expenses at 30000 patient days                                    = $ 903,000

Answer (16)

Spending Variance = Actual Costs – Costs Budgeted at Actual Volume

                                  = $ 987,500 - $ 903,000 = $ 84,500

Answer (17)

Budgeted Enrollees = 80000

Actual Enrollees       = 84000

Enrollment Variance = 84000 – 80000 = 4000

Answer (18)

Actual Utilization at standard (estimated) usage rate = Actual enrollees * standard usage rate

                                                                                               = 84000 * 0.25 = 21000

Actual Utilization at Actual usage rate = Actual enrolees * actual usage rate

                                                                    = 84000 * 0.3333 = 28000 (rounded off)

Utilization Variance = Actual Utilization at Actual rate – Actual Utilization at Standard rate

Utilization Variance = 28000 – 21000 = 7000

Answer (19)

Efficiency Variance = Actual Visits * Actual Cost - Actual Visits * standard cost

Efficiency Variance = 28000 * 9.643 – 28000 * 10   = 270000 – 280000 = - 10,000