Steven Finkler

Professor Emeritus of Public and Health Administration, Accounting, and Financial Management

Steven Finkler

Dr. Finkler is Professor Emeritus of Public and Health Administration, Accounting, and Financial Management. He served as Director of the Specialization in Healthcare Financial Management at Wagner for over twenty years. He is an award winning teacher and author.

He received a B.S. with joint majors in finance and accounting (Summa Cum Laude) and M.S. in Accounting (with Highest Distinction) from the Wharton School at the University of Pennsylvania. His M.A. in Economics and Ph.D. in Business Administration were awarded by Stanford University. Dr. Finkler, who is also a CPA, worked for several years as an auditor with Ernst and Young and was on the faculty of the Wharton School before joining NYU.

Among his publications are twenty-five books. Several of them are Financial Management for Public, Health, and Not-for-Profit Organizations, 4th Ed. (with Robert Purtell, Thad Calabrese, and Daniel Smith), Financial Management for Nurse Managers and Executives, 4th Ed. (with Cheryl Jones and Christine Kovner), Essentials of Cost Accounting for Health Care Organizations, 3rd Ed. (with David Ward and Judith Baker), and Accounting Fundamentals for Health Care Management, 2nd Ed. (with David Ward and Thad Calabrese).

He has published over 200 articles in Health Services ResearchThe New England Journal of MedicineAcademic MedicineHospitals and Health Services Administration, Healthcare Financial Management, Health Care Management Review, Nursing Economics, The Journal of Nursing Administration, Medical Care, and many other academic journals.

He is the former Editor of Hospital Cost Management and Accounting, and has served on the editorial boards of Health Services Research, Health Care Management Review and Research in Healthcare Financial Management. Dr. Finkler served four years as a national advisory council member at the National Institutes of Health (NIH), and is a former member of the Executive Committee of the International Society for Research in Healthcare Financial Management. He also served as a member of the Board of Governors and as Treasurer of Daughters of Israel Geriatric Center, in New Jersey.

Dr. Finkler was a full-time faculty member at Wagner from 1984 until his retirement in 2006.  He currently teaches online Budgeting courses at Wagner, and also teaches educational programs for the American College of Physician Executives (ACPE).

 

The focus of this course is on the budget process for health care organizations. Participants are exposed to specific techniques of health care budgeting and variance analysis. The objectives for this course are for participants to improve their understanding of the budget process as it applies to health care organizations and to learn valuable specific techniques of budgeting and variance analysis. This course accomplishes its objectives by covering a wide range of budgeting topics from introductory through advanced. The course is provided in an online format.

The course has six weeks of lessons. Each week there are approximately 3 hours of Lessons using video imaging, audio, and power point slides. Students watch and listen to these Lessons online at their convenience via a Blackboard website. During each week students participate in online discussions focusing on not only the Lessons, but also readings and homework problem sets that are assigned for that week. Students taking the course for Graduate credit are required to email homework assignments each week.

Topics covered include an introduction and overview of health care budgeting covering basic definitions, purposes, and uses of budgets in health care, the long range plan, programming, operating budgets, capital budgets, and fixed and variable costs. A nursing unit operating budget is examined in detail. Additional topics covered include zero based budgeting, cost estimation and forecasting, break-even analysis, performance budgeting, flexible budget variance analysis and capital budgeting. Health care examples and applications are used throughout all parts of the organization.

Another objective of the course is to provide a working knowledge of the Excel computer software program to class participants who are not already conversant in Excel. Tutorial lessons in Excel are provided covering the basic mechanics of Excel, Excel graphs (charts), and budgeting applications of Excel.

Download Syllabus

The focus of this course is on the budget process for health care organizations. Participants are exposed to specific techniques of health care budgeting and variance analysis. The objectives for this course are for participants to improve their understanding of the budget process as it applies to health care organizations and to learn valuable specific techniques of budgeting and variance analysis. This course accomplishes its objectives by covering a wide range of budgeting topics from introductory through advanced. The course is provided in an online format.

The course has six weeks of lessons. Each week there are approximately 3 hours of Lessons using video imaging, audio, and power point slides. Students watch and listen to these Lessons online at their convenience via a Blackboard website. During each week students participate in online discussions focusing on not only the Lessons, but also readings and homework problem sets that are assigned for that week. Students taking the course for Graduate credit are required to email homework assignments each week.

Topics covered include an introduction and overview of health care budgeting covering basic definitions, purposes, and uses of budgets in health care, the long range plan, programming, operating budgets, capital budgets, and fixed and variable costs. A nursing unit operating budget is examined in detail. Additional topics covered include zero based budgeting, cost estimation and forecasting, break-even analysis, performance budgeting, flexible budget variance analysis and capital budgeting. Health care examples and applications are used throughout all parts of the organization.

Another objective of the course is to provide a working knowledge of the Excel computer software program to class participants who are not already conversant in Excel. Tutorial lessons in Excel are provided covering the basic mechanics of Excel, Excel graphs (charts), and budgeting applications of Excel.

Download Syllabus

The focus of this course is on the budget process for health care organizations. Participants are exposed to specific techniques of health care budgeting and variance analysis. The objectives for this course are for participants to improve their understanding of the budget process as it applies to health care organizations and to learn valuable specific techniques of budgeting and variance analysis. This course accomplishes its objectives by covering a wide range of budgeting topics from introductory through advanced. The course is provided in an online format.

The course has six weeks of lessons. Each week there are approximately 3 hours of Lessons using video imaging, audio, and power point slides. Students watch and listen to these Lessons online at their convenience via a Blackboard website. During each week students participate in online discussions focusing on not only the Lessons, but also readings and homework problem sets that are assigned for that week. Students taking the course for Graduate credit are required to email homework assignments each week.

Topics covered include an introduction and overview of health care budgeting covering basic definitions, purposes, and uses of budgets in health care, the long range plan, programming, operating budgets, capital budgets, and fixed and variable costs. A nursing unit operating budget is examined in detail. Additional topics covered include zero based budgeting, cost estimation and forecasting, break-even analysis, performance budgeting, flexible budget variance analysis and capital budgeting. Health care examples and applications are used throughout all parts of the organization.

Another objective of the course is to provide a working knowledge of the Excel computer software program to class participants who are not already conversant in Excel. Tutorial lessons in Excel are provided covering the basic mechanics of Excel, Excel graphs (charts), and budgeting applications of Excel.

Download Syllabus
Abstract

Now in its Fifth Edition, Financial Management for Public, Health, and Not-for-Profit Organizationsis the leading textbook on financial management in the government, health, and not-for-profit sectors providing a comprehensive yet practical introduction to the financial decision-making and management skills required of students and practitioners in the field.  Assuming readers have no prior training in financial management, the authors artfully combine the principles and theory and analytics of accounting and finance.  Coverage includes cost analysis, budget preparation, budget and variance analysis, management control, and recording and reporting financial information, with an emphasis on preparing and analyzing financial statements. The authors detail the foundational principles of each of the methods introduced in the book, and through step-by-step equations, figures, and exhibits, they illustrate how to execute financial management in practice.

2012

Finkler, Steven A., Cheryl Jones and Christine T. Kovner. Financial Management for Nurse Managers and Executives 4th Edition, W.B. Saunders/Elsevier, St. Louis, 2012.

2011

Finkler, Steven A.. Finance & Accounting for Nonfinancial Managers 4th Edition with interactive CD, CCH, 2011.

2009

Finkler, S.A.. Financial Management for Public, Health, and Not-for-Profit Organizations, 3rd Edition Prentice Hall, Upper Saddle River, NJ.

2007

Abstract

Covering the financial topics all nurse managers need to know and use, this book explains how financial management fits into the healthcare organization. You'll study accounting principles, cost analysis, planning and control management of the organization's financial resources, and the use of management tools. In addition to current issues, this edition also addresses future directions in financial management.

Abstract

This book helps nurses develop and refine good budgeting skills - a necessity in today's economy-driven health care system. Clearly written and thoroughly understandable, this new edition shows first-line nurse managers and their immediate supervisors how to work effectively with financial staff and management, and how to develop, monitor, and maintain departmental and institutional budgets. It is written at a level that assumes no previous financial management experience or expertise on the part of the reader.

2006

Abstract

Accounting Fundamentals for Health Care Management is ideal for an introductory course in financial accounting in both undergraduate and graduate programs. This is the first book that focuses on basic accounting in health care management. This essential book contains the vocabulary of, and an introduction to, the tools and concepts employed by finance officers. It will help anyone assess financial information, ask the appropriate questions, and understand the jargon-laden answers. This book is indispensable for anyone who manages a department and a budget.

2005

Abstract

This is one of the only books available that addresses financial and managerial accounting within the framework of the three major areas of the public sector. Clear and comprehensive, Finkler's unique and accessible text provides the fundamentals of financial management for those who lack a financial background so that readers can access and apply financial information more effectively. Details the many aspects of strategic and budgetary planning. Outlines the processes involved in implementing and controlling results. Features aspects of accounting unique for Health Care, not-for-profit organizations and state and local governments. Explains balance sheets, operating and cash flow statements. Provides basic foundation for financial analysis. For managers and policy-makers in public service organizations who want to make more efficient use of their organization's financial information.

Abstract

How do we understand and also assess the health care of America? Where is health care provided? What are the characteristics of those institutions which provide it? Over the short term, how are changes in health care provisions affecting the health of the population, the cost of care, and access to care? These core issues regarding our health policy are answered in this text.This is a textbook for course work in health care, the handbook for administrators and policy makers, and the standard for in-service training programs

2003

Abstract

This article explores the current state of the creation and use of evidence by managers for cost containment in hospitals. We assert that hospitals do not know enough about what things cost, and until they get evidence on costs, it is not likely that much can be done to narrow the chasm between common practice and best practice. Part of the problem is that managers do not seek out available evidence that exists, and part of the problem is a lack of sufficient research efforts to generate evidence for managers to use. The article strives to help direct future efforts by researchers and managers in the area of evidence-based cost containment research by presenting a framework for priorities that managers and researchers can use to increase the amount of research done to generate evidence and to increase the use of evidence by health care managers.

Abstract

There is a growing movement toward evidence-based management in healthcare. This movement extends to healthcare financial management. However, there are barriers to the use of evidence by healthcare financial managers. These barriers are largely the result of culture (management culture is substantially different from clinical culture) and education. If healthcare financial managers are to become better at generating and using evidence, educators must do a better job of preparing them to do so. If we provide more education regarding the goals of research and about the different types of research methods, then healthcare financial managers can become educated consumers of evidence. If we provide more examples of evidence that has been generated by research in our classes, and if we give the students experience in gathering evidence, we have a chance of increasing the use of evidence-based management in healthcare.

2002

Abstract

For all entrepreneurs and nonfinancial professionals with budget and/or P&L responsibilities, Finance and Accounting for Nonfinancial Managers provides the basics necessary to make a solid contribution to the financial goals and success of their companies. This indispensable and easy-to-read primer gives all entrepreneurs and managers in nonfinancial areas--sales, marketing, production, and more--a complete understanding of financial terms, statements, and ratios and how they affect the operations of a business or corporation. With this information, financial managers will be able to understand: owners' equity, ratio analysis; balance sheets; income statements; LIFO liquidations; asset valuation; cash flow statements; capital leasing; liabilities; present value; operating leverage; breakeven analysis; and more. New to the third edition are chapters covering: basic tax concepts; capital structure; business plans; working capital management and banking relationships; personal finances; and accountability and controls.

Abstract

Discusses the challenges posed by incorporating Statement No. 34 of the U.S. Governmental Accounting Standards Board, Basic Financial Statements-and Management's Discussion and Analysis-for State and Local Governments (GASB 34) in the core curriculum of a school. Generally accepted accounting principles and GASB 34; Pedagogical issues in GASB 34; Dynamism in learning governmental accounting.

Abstract

To describe the development, testing, modification, and results of the Quality Cost Model of Advanced Practice Nurses (APNs) Transitional Care on patient outcomes and health care costs in the United States over 22 years, and to delineate what has been learned for nursing education, practice, and further research. ORGANIZING CONSTRUCT: The Quality Cost Model of APN Transitional Care. METHODS: Review of published results of seven randomized clinical trials with very low birth-weight (VLBW) infants; women with unplanned cesarean births, high risk pregnancies, and hysterectomy surgery; elders with cardiac medical and surgical diagnoses and common diagnostic related groups (DRGs); and women with high risk pregnancies in which half of physician prenatal care was substituted with APN care. Ongoing work with the model is linking the process of APN care with the outcomes and costs of care. FINDINGS: APN intervention has consistently resulted in improved patient outcomes and reduced health care costs across groups. Groups with APN providers were rehospitalized for less time at less cost, reflecting early detection and intervention. Optimal number and timing of postdischarge home visits and telephone contacts by the APNs and patterns of rehospitalizations and acute care visits varied by group. CONCLUSIONS: To keep people well over time, APNs must have depth of knowledge and excellent clinical and interpersonal skills that are the hallmark of specialist practice, an in-depth understanding of systems and how to work within them, and sufficient patient contact to effect positive outcomes at low cost.

2001

Abstract

OBJECTIVE: To examine prenatal, maternal, and infant outcomes and costs through 1 year after delivery using a model of prenatal care for women at high risk of delivering low-birthweight infants in which half of the prenatal care was provided in women’s homes by nurse specialists with master’s degrees. STUDY DESIGN: Randomized clinical trial. PATIENTS AND METHODS: A sample of 173 women (and 194 infants) with high-risk pregnancies (gestational or pregestational diabetes mellitus, chronic hypertension, preterm labor, or high risk of preterm labor) were randomly assigned to the intervention group (85 women and 94 infants) or the control group (88 women and 100 infants). Control women received usual prenatal care. Intervention women received half of their prenatal care in their homes, with teaching, counseling, telephone outreach, daily telephone availability, and a postpartum home visit by nurse specialists with physician backup. RESULTS:For the full sample, mean maternal age was 27 years; 85.5% of women were single mothers, 36.4% had less than a high school education, 93.6% were African American, and 93.6% had public health insurance, with no differences between groups on these variables. The intervention group had lower fetal/infant mortality vs the control group (2 vs 9), 11 fewer preterm infants, more twin pregnancies carried to term (77.7% vs 33.3%), fewer prenatal hospitalizations (41 vs 49), fewer infant rehospitalizations (18 vs 24), and a savings of more than 750 total hospital days and $2,880,000. CONCLUSION: This model of care provides a reasoned solution to improving pregnancy and infant outcomes while reducing healthcare costs.

Abstract

Managers of a healthcare organization have numerous demands on their time, their skills, their knowledge, and their budgets. They are responsible for adapting to change, managing their office, making effective decisions, among countless other tasks.

This book, newly revised to include readings, commentary, and cases, offers a bridge from management theory to the actual world of healthcare management. Throughout its past editions, Health Services Management has featured the best literature on health services management to help readers understand the role of the manager, organizational design and control, the blending of organization and health professionals, change (adaptation), and responsiveness (accountability). This edition continues that effort, and features new readings.

 

Abstract

This book helps nurses develop and refine good budgeting skills - a necessity in today's economy-driven health care system. Clearly written and thoroughly understandable, this new edition shows first-line nurse managers and their immediate supervisors how to work effectively with financial staff and management, and how to develop, monitor, and maintain departmental and institutional budgets. It is written at a level that assumes no previous financial management experience or expertise on the part of the reader.

Abstract

One of the few books that addresses financial and managerial accounting within the three major areas of the public sector � government, health, and not-for-profit�the Second Edition provides the fundamentals of financial management for those pursuing careers within these fields. With a unique presentation that explains the rules specific to the public sector, this book outlines the framework for readers to access and apply financial information more effectively. Employing an engaging and user-friendly approach, this book clearly defines essential vocabulary, concepts, methods, and basic tools of financial management and financial analysis that are imperative to achieving success in the field. This book is intended for financial managers and general managers who are required to obtain, understand, and use accounting information to improve the financial results of their organizations, specifically within the areas of government or public policy and management, not-for-profit management, and health policy and management.

2000

Abstract

In recent years, it has become common for physicians to become managers of new programs and ventures. In some cases, the physician is acting as a manager of a large organization, such as a hospital, nursing home, or integrated delivery system. In other cases, the physician my be acting as an owner of a sole or group practice. In all cases, the physician decision maker needs tools to ascertain the likely profitability of the new programs and ventures. Break-even analysis can be a helpful tool in such situations.

1999

Finkler, S.A. & Ward, D.M. (eds).. Issues in Cost Accounting for Health Care Organizations 2nd Edition, Aspen Publishers, Inc., Gaithersburg, MD.
Abstract

Essentials of Cost Accounting for Health Care Organizations, Second Edition is a comprehensive text that applies the tool and techniques of cost accounting to the health services field. It is an essential tools for all professionals who need to deal with the challenges of managing health facilities in a difficult economic environment.

Abstract

Cost Accounting for Health Care Organizations: Concepts and Applications and Essentials of Cost Accounting for Health Care Organizations (companion book) provide a thorough coverage of cost accounting from a health care perspective. They cover all of the basic tools of cost accounting common to all industries, and use health care examples. Cost Accounting for Health Care Organizations: Concepts and Applications and Essentials of Cost Accounting for Health Care Organizations focus on costing issues and concepts peculiar to the health care field. The tools covered are all practical, although they are not all commonly used. Some approaches, such as learning curves, are commonly used in other industries but not in health care. It is our hope that readers of these books will see the value of some of these less frequently used techniques and adopt them for use in their organizations.

1998

1997

Abstract

In a randomised clinical trial, quality of health care as reflected in patient outcomes and cost of health care was compared between two groups of high-risk childbearing women: women diagnosed with diabetes or hypertension in pregnancy. The control group was discharged routinely from the hospital. The intervention group was discharged early using a model of clinical nurse specialist transitional follow-up care. During pregnancy, the intervention group had significantly fewer rehospitalisations than the control group. For infants of diabetic women enrolled in the study during their pregnancy, low birth weight was three times more prevalent in the control group than in the intervention group. The postpartum hospital charges for the intervention group were also significantly less than for the control group. The mean total hospital charges for the intervention group were 44 percent less than for the control group. The mean cost of the clinical specialist follow-up care was two percent of the total hospital charges for the control group. A net savings of $13,327 was realised for each mother-infant dyad discharged early from the hospital.

Schwartzben, Dov & Finkler, S.A.. The Financial Impact of Increased Managed Care Penetration - A Large Teaching Hospital's Experience Healthcare Financial Management, July .
Brown, L., Finkler, S., et al.. Resubmission of a Grant Application: Breastfeeding Services for LBW Infants Nursing Research, March/April 1997, Vol. 46, No. 2, pp. 119-122.

1996

Brooten, D., Knapp, H., Borucki, L., Jacobsen, B., Finkler, S. et al.. Early Discharge and Home Care of Women Following Unplanned Cesarean Birth: A Report of Nurse Care Time Journal of Gynecological and Neonatal Nursing, September, pp. 595-600.

1995

Finkler, S.A.. The Financial Impact of Management Innovations by Health Centers Journal of Ambulatory Care Management, April 1995, Vol. 18, No. 2, pp. 15-32.
Brooten, D., Naylor, M., York, R., Brown, L., Roncoli, M., Hollingsworth, R. & Jacobsen, B.. Effects of Nurse Specialist Transitional Care on Patient Outcomes and Cost: Results of Five Randomized Trials The American Journal of Managed Care, Vol. 1, No. 1, September, pp. 45-51.
Hanson, K.L. & Finkler, S.A.. Case Studies of Management Innovation at Primary Care Health Centers Journal of Ambulatory Care Management, Vol. 18, No 2., April 1995, pp. 54-65.
Finkler, S.A. & Hanson, K.L. (eds).. Lessons from the Program to Strengthen Primary Care Health Centers The Journal of Ambulatory Care Management, Vol. 18, No. 2.
Finkler, S.A. & Hanson, K.L.. Innovations by Primary Care Health Centers: Management and Policy Lessons for the Future Journal of Ambulatory Care Management, Vol. 18, No 2., April 1995, pp. 74-80.
Hendrikson, G., Kovner, C.T., Knickman, J.R. & Finkler, S.A.. Implementation of a Variety of Bedside Nursing Information Systems in Seventeen New Jersey Hospitals Computers in Nursing, Vol. 13, No. 3, pp. 96-102.
Finkler, S.A.. Management Techniques at Primary Care Health Centers: The Impact of Management Innovation Journal of Ambulatory Care Management, Vol. 18, No 2., April 1995, pp. 47-53.