AKUNTANSI MANAJEMEN:
PIRANTI PENYEIMBANG
TRILOGI AKSES–MUTU–BIAYA
PADA MANAJEMEN RUMAH SAKIT
Agenda
1. Esensi dari Peran Manajemen RS
4. Keterbatasan Praktek
Pengelolaan Keuangan RS yang Masih Berlaku
8. Pendekatan Pengembangan
Sistem Akuntansi Manajemen RS
• Pendapatan
• Volume
• Mix
• Biaya (UC)
PRODUK • Margin
• Remunerasi
• Kapasitas
• Modal Kerja
• Utilisasi
• Logistik
• Aset
• Investasi, dst. Catatan:
HOSPITAL SUSTAINABILITY Misi RS = Produk RS
AND GROWTH
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RS MEMILIKI 2 PRODUK
Strategies and Tactics
Cheap/Controlled BPJS – Regulation-Driven Product
Products Hospital Unit Cost Accounting–
Driven Cost Reduction
Capacity Management
Waste/NVA Elimination
Uniform Medical Process
Inventory Control System
Maximum Customer Value
Premium/ Minimum Waiting Time
Customer–Focused Maximum Quality Clues
Products Maximum CRM
Cost Management
Financial Management System
1. Direct Labor
1.1. Jasa Medis Per Product Remuneration System At Cost Negotiation
1.2. Jasa Keperawatan Per Product Remuneration System At Cost Budgetary Planning
1.3. Insentif Pelayanan Per Product Remuneration System At Cost Budgetary Planning
2. Direct Service
2.1. Jasa Gizi Per Product Distribution Journal At Cost Budgetary Planning
2.2. Jasa Laundry Per Product Distribution Journal At Cost Budgetary Planning
2.3. Jasa CSSD Per Product Distribution Journal At Cost Budgetary Planning
2.4. Sewa Alat/Kamar/Fasilitas Per Product Distribution Journal At Cost Budgetary Planning
3. Direct Material
3.1. Obat-Obatan Per Product Logistic Report & Opname Simple Average Logistics Planning
3.2. Barang Medik Habis Pakai Per Product Logistic Report & Opname Simple Average Logistics Planning
3.3. Barang Non Medik Per Product Logistic Report & Opname Simple Average Logistics Planning
4. Biaya Overhead Rumah Sakit
4.1. Jasa Sarana Per Dept Distribution Journal At Cost Budgetary Planning
4.2. Biaya SDM Medik Per Dept Distribution Journal At Cost Budgetary Planning
4.3. Biaya SDM Non Medik Per Dept Distribution Journal At Cost Budgetary Planning
4.4. Biaya Outsourcing Per Dept Distribution Journal At Cost Budgetary Planning
4.5. Biaya Overhead Pemasaran Per Dept Distribution Journal At Cost Budgetary Planning
4.6. Biaya Overhead Adm & Umum Per Dept Distribution Journal At Cost Budgetary Planning
4.7. Biaya Overhead Penunjang Lingk. Per Dept Distribution Journal At Cost Budgetary Planning
4.8. Biaya Overhead Penunjang Fasilitas Per Dept Distribution Journal At Cost Budgetary Planning
4.9. Biaya Overhead Penunj. Non Medis Per Dept Distribution Journal At Cost Budgetary Planning
4.10. Biaya Overhead Penunjang Medis Per Dept Distribution Journal At Cost Budgetary Planning
4.11. Biaya Overhead Pelayanan Medis Per Dept Distribution Journal At Cost Budgetary Planning
Hospital
Level
Distribution Kalkulasi UC
Tindakan Medis ROLL–UP
Allocation Cost Cascading
Department (Penjabaran Biaya)
Level Assignment
Cost Roll–Up
Inter–Depart (Penggabungan
Level Biaya)
Product Level:
Epidemiology Pool/
(Diagnostic Related
Grouping)
Diagnose Pool/
Product Pool/
DRG (INA–CBG) Customer Pool
Clinical = MPRG
Pathways (Medical Procedure Medical Procedure
Related Grouping) Level (PPK/PDT):
Paket Pelayanan Clinical Procedures
(Reguler, Seasonal, dsb)
(Marketing & Target Market
Related Grouping) Cost Structure &
Behavior Level:
Komponen UC
PPK = Panduan Praktek Klinis
Direct Labor
PDT = Pedoman Diagnosa dan Terapi Direct Service
Unit Cost Direct Material
Components Overhead Cost
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PENGGUNAAN INFORMASI UNIT COST
No Dukungan ke Akuntansi Fokus Penggunaan Rincian Penggunaan
1. Akuntansi Keuangan External Reporting Kalkulasi Cost of Good Sold (HPP)
Inventory Valuation
2. Akuntansi Manajemen Planning Penerjemahan Renstra RS
Penjabaran Renstra dengan Budgeting Berbasis Produk
Integrated Logistics Planning
Integrating Remuneration Planning
Processing Time Planning
Financial Planning and Projection
Decision Support Unit Cost Structuring (Full Costing)
Normal Costing
Variable Costing
Cash Costing
Cost-Based Monitoring (BE Monitoring)
Cost-Based Operation Adapting (CPV Adapting)
Cost-Based Optimizing
Performance Budgetary Control
Analysis Logistics Performance Variance & Analysis
Sales Volume and Mix Variance & Analysis
Alkes Capacity Utilization Variance & Analysis
Overhead Cost Variance & Analysis
Processing Time Variance & Analysis
Performance Product Profitability Evaluation
Evaluation Customer Profitability Evaluation
Renstra Execution Evaluation
Evaluasi Kelayakan Renstra
KEUANGAN Direktur
Keuangan
Prioritizing among conflicting objectives
Navigating Top Management with Proper
DI RUMAH SAKIT Financial Considerations
Making the Use of Money at Optimum Value
Using of Generating of
Financial Information Financial Information
Balancing Akses–Kualitas–Biaya
Mengimplementasikan SAMRS
2. Pendekatan
OLAP/
Intermediate
Bookkeeping
Harga: Rp 350 Jt. sd. Rp 650 Jt.
Waktu: 2 sd. 6 Bulan
INTERMEDIATE
BOOKKEEPING Back Office System Front Office System
Information Processing System Transaction Processing System
Lebih Efektif menggunakan Excel Harus menggunakan DBMS
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ARSITEKTUR SIKRS
BSC–Based–Strategic Management System
Programming System
dengan
Budgeting System (Product–Based)
Remuneration Planning System
PENDEKATAN OLAP
Unit Cost Accounting System
(Product–Based & ABC System–Based) Performance Evaluation System
Insentive System
OLAP
(OFF–LINE ANALYTICAL PROCESSING)
DATA WAREHOUSE
SIKRS = Sistem Informasi
Keuangan Rumah Sakit
Billing System
Inventory System
Cash System
OLTP A/P & A/R
Ledgerless Bookkeeping
(ONLINE TRANSACTION PROCESSING)
Payroll System
Sistem Programming
Variance Analysis Budgeting RS Berbasis Produk
Rumah Sakit
COST SESUNGGUH- Remunerasi Personel
NYA dengan Sistem dengan Sistem
Akuntansi Unit Cost RS Budgeting RS Berbasis
Realisasi Produk
10.
PENGAWASAN 4. Perencanaan
Biaya Bahan Sistem Akt. Persediaan SISTEM AKUNTANSI Sistem Budgeting RS
Logistik Terpadu
dengan Sistem Rumah Sakit MANAJEMEN dengan Sistem
Berbasis Produk Budgeting RS
Akuntansi RUMAH SAKIT Berbasis Produk
Persediaan RS
9. PELAPORAN 5. Perencanaan Beban
CPV Analysis
Berbasis Produk dan
Sistem Budgeting RS
KINERJA Unit Kerja dan Kapasitas
Pelayanan dengan dengan Sistem
Sistem Akuntansi Budgeting Rumah
Pertanggungjawaban Sakit Berbasis Produk
Rumah Sakit
8. PEMANTAUAN Pelaksanaan 6. Perencanaan & Simulasi Keu.
Budget dengan Sistem Budgeting dg Sistem Budgeting RS Berbasis
RS & Analisis Impas Produk untuk Cost Reduction, etc.
7. KOORDINASI Pelaksanaan Budget dengan Sistem
Budgeting RS Berbasis Produk & CPV Analysis
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Thank You
Thank You
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