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Sr. Jaime Ponce , Managing Director of the non-governmental organization Asociación para la Salud Familiar (ASF) surveyed the group of managers he had invited to this meeting: his chief accountant, the director of clinical staff, the marketing director, a representative from the governing board, and the managers of the organizations' 10 clinics."Welcome," began Sr. Ponce. "I know you are probably wondering why I have called together such important representatives of our organization. As many of you know, the top organizational priority we developed during our recent strategic planning exercise is to increase our financial independence. Our first step is to take stock of where we are and determine what actions to take to improve our financial situation. "We provide maternal and child health care services to a sizable segment of the population, and more than 40 percent of the women who use family planning in this country come to us for services. Last year when one of our donors analyzed our financial situation, they told us that our cost recovery rate is about 55 percent. Our objective now is to conduct a cost and revenue analysis ourselves and use the results to make decisions that will improve our cost recovery rate and reduce our reliance on outside funding." "What do we hope to learn by doing this analysis?" asked Sra. Cruz, manager of a clinic in a northern province. "The analysis will tell us how much it costs us to deliver each of our services, our rate of cost recovery for each service, and our rate of cost recovery clinic by clinic and for the organization overall," said Sr. Ponce. "The analysis will help us determine which services, categories of services, and clinics are subsidizing others. It will also help us identify cost-efficient standard practices for providing quality services. "And finally, the analysis results will give us a clearer understanding of how we might adjust our staff utilization patterns to use our human resources more efficiently, where we may be able to increase our fees, and what services we might promote more intensively in order to bring in more revenue." "I would like to know what kind of effort this analysis requires from me and my staff," commented Sr. Fuente, manager of ASF's largest clinic. "I can understand your concern," said Sr. Ponce. "I would like you to be part of our overall management team for the analysis, which will require your participation in these team meetings. At your clinic, you will first need to inform your staff that we are doing this analysis. You will also explain the steps involved and how it will benefit them, the organization, and our clients. "Then, you will need to assign one of your clinical staff and one of your financial staff to work with the data collection team for one week each to gather the necessary service delivery and financial data. Once the data have been gathered and entered into the spreadsheets here at our headquarters, you will need to review the results, and meet with the rest of the management team to review them and adjust the data, where needed." "How long will the analysis take?" asked Sra. Cruz. "All in all," Sr. Ponce continued, "we expect that gathering the data for all our clinics and inputting them into a cost and revenue analysis spreadsheet will take about four months. Once we have completed the spreadsheets, we will analyze the results, and ask "What if" questions about our service mix, staff utilization, procurement, and fees. "I expect that within six months we will feel secure in making decisions about how to increase our efficiency, reduce our costs, and increase our revenues. A year from now, we will update our analysis and look at the impact of the decisions we have made." Sr. Ponce paused and smiled at his colleagues. "We have set a challenging objective for ourselves. Some people might say that we should simply close some of our clinics and keep open the ones that bring in more revenue. But I know that most of you believe as I do that we provide important services for our clients. Doing this cost and revenue analysis will allow us to continue our mandate. "I look forward to working with you in using our new knowledge to make the decisions that will strengthen our organization overall."
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