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This chapter demonstrates (1) divergence between spending based upon a budget ratcheting model and a benchmark spending model, (2) that this divergence affects organizational performance, and (3) that internal benchmarking enables unit-to-unit performance comparisons, despite claims of organizational or unit uniqueness. We contrast two spending models to examine whether the divergence, or cost estimation gap, affects operating performance across inpatient (n=4,536) and outpatient departments (n=8,438) in 23 U.S. Army hospitals. Using a fixed-effects panel data methodology for fiscal years 2004–2006, we find that unit managers’ spending in this setting is more closely approximated by budget ratcheting. Using multiple performance metrics measured via a DuPont-like decomposition, we find that, within a specified range, operating performance generally improves as resources become constrained. Outside that range, however, we find nonlinear performance effects that approximate a quadratic loss function. Our benchmark model enables clinical department comparisons while controlling for facility, clinical specialty, and case mix severity. The resulting departmental comparability facilitates identification and communication of best practices across the entire Army hospital system. These results should be of interest to corporate executives, government officials, and agency managers who have responsibility for establishing funding mechanisms that include performance-based components.

Hospital costs in the USA are a large part of the national GDP. Medical billing and supplies processes are significant and growing contributors to hospital operations costs in the USA. This article aims to identify cost drivers associated with these processes and to suggest improvements to reduce hospital costs.

A Monte Carlo simulation model that uses @Risk software facilitates cost analysis and captures variability associated with the medical billing process (administrative) and medical supplies process (variable). The model produces estimated savings for implementing new processes.

Significant waste exists across the entire medical supply process that needs to be eliminated. Annual savings, by implementing the improved process, have the potential to save several billion dollars annually in US hospitals. The other analysis in this study is related to hospital billing processes. Increased spending on hospital billing processes is not entirely due to hospital inefficiency.

The study lacks concrete data for accurately measuring cost savings, but there is obviously room for improvement in the two US healthcare processes. This article only looks at two specific costs associated with medical supply and medical billing processes, respectively.

This study facilitates awareness of escalating US hospital expenditures. Cost categories, namely, fixed, variable and administrative, are presented to identify the greatest areas for improvement.

The study will be valuable to US Congress policy makers and US healthcare industry decision makers. Medical billing process, part of a hospital's administrative costs, and hospital supplies management processes are part of variable costs. These are the two major cost drivers of US hospitals' expenditures that were examined and analyzed.

The purpose of this paper is to propose a conceptual approach to determining an optimal strategy development process and controlling of the defence spending, by utilizing the decision‐making system adopted in the Republic of Estonia.

The author offers a part of the Balanced Scorecard model named “Management and Control Perspective” as one of the improvement tools for the system of planning military expenditures and effective utilization of budgetary funds.

The results show that the Balanced Scorecard application, using the “utility function”, will allow the Estonian Defence Forces to overcome important barriers to strategy implementation by interrelation of military planning and budgeting processes.

One suggestion for further research might be established as a way of improvement and development of methods directed to application of the utility function in the decision‐making process. This approach will improve calculations of strategic perspective plans and will reveal the essence of the budgetary policy on the whole by taking into consideration expenses features of the business and non‐profit organizations.

By using the Balanced Scorecard the paper offers a new strategic method of planning and controlling the military expenditure in the Estonian Defence Forces.

The present paper provides direct evidence of the alternative methods forecast measures and the possibility of using mathematical models in the strategic planning process.

The purpose of this paper is to describe a methodology for measuring “cost of poor quality” within an administrative process. The methodology provides primarily a process analysis tool, but it can also be used as a quality measurement technique and a platform for activity based costing. The methodology was developed in the Scottish Legal Aid Board ‐ a non‐departmental public body ‐ addressing the key administrative process of invoice payment. An initial pilot study was enlarged into a full evaluation which combined the quantification of “quality costs” using a novel cost model with the identification of process weaknesses as part of the “analysis” phase of a new computer system development. The paper addresses some of the general practical considerations in launching cost of poor quality measurement schemes.

The study develops a structure for procurement digitalisation by identifying its context drivers, technology interventions and performance-inducing mechanisms and exploring the linkages between these variables.

The study draws on rich interview and workshop data on 48 digital intervention projects, as reflected by mental models of managers from 12 case organisations in manufacturing, retail and service sectors. Supported by an a priori structure, the study employs an abductive cross-case analysis approach.

Results suggest several categories within the elements of context, intervention and mechanism to structure procurement digitalisation and the linkages between them. Seven propositions that reflect digitalisation strategy options in procurement are developed regarding the linkages. Internal complexity dominantly drives procurement digitalisation, motivating communication support and process structuring interventions, which in turn aim at procurement coordination and control as well as process improvement. External coercive pressure and external dynamism also drive interventions for information processing and decision aiding, which appear to be linked with supply market knowledge, strategic alignment and supplier capability assessment. Therefore, an internal–external dichotomy is observed as the main thrust of procurement digitalisation.

The study supports decision makers in developing digitalisation strategy options for different procurement contexts. The results also raise awareness of a possible bias in existing strategies for procurement digitalisation.

A novel forward-looking approach is employed to enable the design and construction of systems that do not yet exist by focusing on the mental models of managers in a systematic way.

This study describes the Illinois State capital budget process and explains why traditional capital planning has not been adopted in Illinois. The state uses non-accounting techniques and multi-attribute judgment criteria, including political and social values, to make decisions. The case suggests that regardless of their sophistication, accounting methods are, relatively, not useful in ranking capital projects across functions. The methods compare "pples" and "oranges." A comparison of capital projects across functions may be impossible with any set of methods. Intelligent sub-optimization within given functions may be the best academics and practitioners can hope for in rationalizing project choice and maintenance, particularly in large cities or state governments. Public capital-budgeting educators might shift their focus in training prospective public budgeters, from accounting methods to critical thinking, through multi-attribute analysis methods.

The Asia‐Pacific region has enjoyed robust economic growth in the last two decades and a substantial manufacturing network has been established in the region. The manufacturers in this region are now able to offer very good quality products cost‐effectively in the low‐end product category. But the recent regional financial turmoil, besides the increasingly integrated global economy and the emergence of regional trade pacts, has had an impact on the whole region and also presented many new challenges for businesses. Under this condition, manufacturers have to consider seriously how to win competition as they move into the new millennium. This paper applies axiomatic design to develop the guidelines for high value‐added activities. Manufacturers may discover their own weak points and develop their own core competencies or competitive priorities to drive change according to these guidelines.

The Profit Impact of Marketing Strategy (PIMS) database was used to test the relationship between production process type (small batch, large batch/assembly, and continuous) and eight organizational policy decisions (new products, new plant and equipment, finished goods inventory, raw materials/work‐in‐process inventory, capacity utilization, fixed capital assets, manufacturing costs, gross margin). In addition, the effect of six broad industry types on the proposed relationships was also investigated. Overall industries, raw materials/work‐in‐progress, capacity utilization, manufacturing costs, fixed assets, and gross margin varied with production process type while new products, new plant and equipment, and finished goods inventory did not vary. Within each industry, the findings showed less support for the relationships between production process type and the eight organizational policy decisions. Further analysis showed that most of the industries are dominated by a production process type. Suggests a movement away from the traditional differentiation of production process technologies and a shift of research emphasis to the differing uses of a particular production process technology within an industry.