As I've mentioned, in my day job I am a marketing director.  One of the things this means is that I fairly regularly have to learn about and understand a new product, a new service, or a new customer type.  This involves a lot of fairly unsystematic research, because the intersection between customer needs and product is hard to define.

It's always a pleasure to find someone who can explain the customers needs in some clear, easily understood way.  And, as it happens, finding someone like that is fairly rare.

Right now, I am planning to market a physical capital planning product to healthcare clients--hospitals, skilled nursing facilities, continuing care retirement communities, and others with complex buildings and physical systems.  Where their money comes from, where it goes, how they plan, what they worry about most--these are the issues I'm struggling with.

So I was happy to find a useful introductory document from The Access Project at the Harvard School of Public Health:  A Community Leader's Guide to Hospital Finance, Evaluating How a Hospital Gets and Spends Its Money, by Sarah Gunther Lane, Elizabeth Longstreth, and Victoria Nixon.  I certainly could have used this in my days at the Medicaid health plan, where various abstruse issues like Disproportionate Share Hospital or “DSH” payments were a constant conundrum.  Thank you, Lane, Longstreth, and Nixon.

Now, as it happens, this piece did not answer a single one of my questions about how healthcare facilities spend, plan, and budget for fixed equipment and building costs.  Not their fault, that's not what they were after.

So I'm still looking for a similar document about that unsexy and essential feature of hospital facilities:  the actual real estate.  Side point: you can't understand health care finance by looking only at the provision of actual care and reimbursement for it.  That's most important, certainly.  But look at jobs, and look at the value of the real estate, and some seemingly perverse decisions and practices will become, if not clear, at least somewhat less contradictory seeming.

But that's for another time.