With hospitals facing financial struggle, they must determine ways to cut costs without compromising quality care. This articles states “Strong financial performance is associated with improved patient reported experience of care, the strongest component distinguishing quality and safety” (Akinleye, McNutt, Lazariu, & McLaughlin, 2019, para. 1).  For this week’s discussion, please review this article: Akinleye, D. D., McNutt, L.-A., Lazariu, V., & McLaughlin, C. C. (2019). Correlation between hospital finances and quality and safety of patient care. PLoS ONE, 14(8), 1–19. Respond to the following: Briefly summarize the article. Describe and discuss two pressures hospitals struggle with and how this impacts them financially? What hospital financial measures/indicators were used within the article to determine results? Describe three of them in-depth and how they helped in defining results (e.g. operating profit or loss, net profit margin, return on total assets, cash flow margin, working capital, current ratio, days cash on hand, net asset position, equity financing, fixed asset financing, debt coverage, total debt ratio, long term debt ratio, salary ratio, total asset turnover, or average operating margin and average total margin).

1-2 Case Study Analysis: Audit of Claims and Charges Instructions Before completing this audit, carefully review the following resources. You will refer to this information throughout the course for your final project, which is due in Module 7. To complete this assignment, refer to the following resources: Module One Case Study Guidelines and Rubric Internal Medicine 2019 Hospital Clinic Claims for Audit 2019 Family Practice Charges Claims for Audit 2019 Template Audit of Claims and Charges Tutorial (2:17) 

Case Study Overview Sourcing of a new sub-component Your company, based near Wilmington, N.C., needs to source a new sub-component that will be a key element in a new product that is due to start production next year. Your boss contacted three producers of the sub-component and obtained the cost information below. Your boss has asked you to provide a detailed spreadsheet of the cost and provide a recommendation on which firm would be able to provide the sub-component at the best price. She needs to brief the CEO next week. Since your firm has worked with all three of the producers before, and all have a good record of providing sub-components, the decision will be solely based on the lowest cost. Additional Shipping Information 10,000 units of the sub-component will fit into a 40-foot shipping container, so to keep the shipping cost down; all three firms will ship full containers each time an order is placed. Details on the Producer Firms Producer A Producer A is located in Nashville, Tennessee, and can provide the sub-component for $3.25 each. The producer’s warehouse is 600 miles from your production facility, and truck transportation will cost $1.25 per mile. There is a container-handling fee of 1% of the total product cost that is assessed by the shipping company, as well as a required $200 insurance policy. Producer B Producer B is located in Europe and can provide the sub-component for $2.00 each. The producer’s warehouse is 100 KMs from the port and the truck transportation will be $1.50 per kilometers. The trucking cost from the United States port to your production facility is 35 miles and the transportation will cost $1.25/mile. From Europe to the United States, the sea shipping will run $2,000 with a handling fee of 1.25% of the total product cost. Since the sub-component must be imported into the United States, there is a 10% import duty assessed on the total cost of the product. Finally, there will be a fee of $850 for sea and surface transportation insurance. Producer C Producer C is located in Asia, the furthest away from your facility however; their cost per unit is the lowest at $1.50. The factory for Producer C is located 150 kilometers from the closest port and costs $0.20 per KM to move the container to the port. Sea shipping runs $2,500, with a handling cost of 1.25% of the total cost of the product. As with Producer B, once the container reaches the United States, it will be assessed import duties of 10%. Final transportation to your facility will run $43.75. Finally, there will be a fee of $900 for sea and surface transportation insurance. Considerations Additional information to Consider While both Producer B and C have a lower cost per unit, they have a higher shipping cost. Also, since both Producer B and C are so far away, and delivery time is uncertain, then your firm will want to hold $3,000 worth of safety stock. Finally, part of the reason that Producers B and C sub-components are cheaper is that some additional work will be needed on their components once they are received. Your production office has determined that it will cost $.50 each to finish off the sub-component for Production B and $1.10 each to finish the sub-component from Producer C. Deliverables Include the following in your submission Provide a professional looking detailed spreadsheet with all of the costs outlined. Provide a professional looking (not APA formatted), one-page summary (double-spaced) of your findings that your boss can give to the CEO. In your initial task, you were told that the lowest cost would be the winner, but oftentimes the lowest price is not always the best solution. Therefore, in your memo, provide some information on sourcing that you would want your boss and the CEO to consider before making the final decision.