Elaborate on the implications of a Health Services Department moving from a cost center to a profit center.
Four required elements, and the fourth decides the essay. If your staff cannot bill, a profit centre has no revenue to be measured on, which is where the mission conflict actually bites.
Editorial process
Last reviewed · August 22, 2026
A profit centre needs revenue, and some staff cannot generate it
Get the accounting right in a few sentences and then spend the essay on what it does to behaviour. A cost centre is a unit whose manager is accountable for expenses only, and it is measured against budget. A profit centre is accountable for revenue as well, so its manager is measured on margin and gains authority over decisions that generate revenue: service mix, pricing where it applies, volume and payer mix. That reclassification is why the decentralisation question sits in the brief. Making a department a profit centre pushes decision rights down to it, which improves responsiveness and accountability but fragments purchasing, duplicates overhead and can pull the department's strategy away from the organisation's. Say which way you would go and on what evidence, because the brief asks you to weigh the two rather than to define them, and a health services department sitting inside a larger system is exactly the case where the answer is genuinely contested.
The fourth element is where the essay earns its grade, because it exposes a structural problem rather than a preference. If a substantial part of the workforce cannot bill and holds no reimbursable codes, then work that is genuinely valuable produces no recorded revenue, and a profit centre measured on margin will systematically undervalue it. Health education, outreach, case finding, immunisation campaigns and community assessment all fall in that gap. The predictable consequence is that services to the uninsured and the underserved shrink first, which is precisely the mission the third element asks you to protect. So answer the mission question with mechanisms rather than intentions: cross-subsidy from billable services, grant and public health funding streams, contracts with an insurer or health system that pay for population outcomes, and a scorecard that counts population measures alongside margin. Then use the biblical integration on stewardship or care for the poor, and connect it to a mechanism rather than leaving it decorative.
Likely learning objectives
- Define cost and profit centres by what their managers are accountable for.
- Connect the reclassification to decentralised decision rights.
- Identify unbillable work as a structural undervaluation problem.
- Propose mechanisms that protect a safety-net mission under margin pressure.
Assignment instructions
Read the full question
Review every instruction before using the planning guidance that follows.
Financial Analysis and decision making in healthcare Elaborate on the implications of a Health Services Department moving from a cost center to a profit center. Information discussed must include: The difference between a cost and a profit center. Decentralization versus centralization within the health service business. How the health service department can stick to its historic mission of serving those without insurance and/or those that are historically under served. The implications of having public health professionals that are not permitted to bill or have reimbursable codes. 600 words and must contain at least 2 references and 1 instance of biblical integration. Current APA format must be used. Harrington, Michael K. Health care finance and the mechanics of insurance and reimbursement. Burlington, MA: Jones & Bartlett, 2016. ISBN: 9781284026122
Course-wide instructions that accompany this question
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes. Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages. Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor. The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
Turn the brief into deliverables
- 01The accounting difference stated in terms of accountability.
- 02Decentralisation and centralisation, with the trade-off named.
- 03Mechanisms for protecting the historic mission.
- 04The consequence of employing staff who cannot bill.
- 05One instance of biblical integration connected to a mechanism.
- 06600 words with at least two references in APA format.
The accounting change, then decentralisation, then the mission
What changes in the accounting
Define both centre types by what the manager is measured on.
What the assessor is likely looking for
Accountability for revenue identified as the actual change.
Decision rights move too
Explain decentralisation and what the organisation gives up for it.
What the assessor is likely looking for
A specific cost of decentralisation, such as duplicated overhead.
Work that generates no revenue
Show what happens to unbillable services under margin measurement.
What the assessor is likely looking for
A named public health activity with no reimbursement route.
Protecting the mission
Give cross-subsidy, grants, contracts and a broader scorecard as mechanisms.
What the assessor is likely looking for
A funding mechanism rather than a statement of commitment.
Stewardship and the underserved
Integrate the biblical element with the mechanism you proposed.
What the assessor is likely looking for
A connection to the argument rather than a decorative citation.
Where reimbursement and safety-net financing are documented
Recommended databases
- CMS
- KFF
- PubMed Central
- University Library
Search sequence
- 1.Confirm which public health roles have no reimbursement pathway.
- 2.Look up how safety-net services are funded outside fee-for-service.
- 3.Find evidence on value-based contracts paying for population outcomes.
- 4.Check the textbook's own definitions before writing the accounting section.
Reference shortlist
These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.
Original Medicare Providers Information Center
Centers for Medicare & Medicaid Services · 2024
Fee-for-service payment, for what billing requires and who may do it.
Hospital Readmissions Reduction Program
Centers for Medicare & Medicaid Services · 2025
A programme paying on outcomes, as a model for the population contract mechanism.
Access to Health Services
Healthy People 2030, Office of Disease Prevention and Health Promotion · 2024
Access evidence, for the consequence of shrinking safety-net services.
Cost-Effectiveness Analysis in Disease Control Priorities, Third Edition
StatPearls, NCBI Bookshelf · 2023
Cost-effectiveness analysis, for valuing services that produce no revenue.
Before you submit this essay
Common mistakes
- Defining the two centre types and never applying the definition.
- Treating decentralisation as straightforwardly good.
- Answering the mission question with a statement of values rather than a funding mechanism.
- Missing that unbillable work becomes invisible under margin accounting.
- Adding the biblical reference as a closing sentence unconnected to the argument.
Submission checklist
- Is the difference stated as accountability rather than as terminology?
- Have you given both sides of the decentralisation trade-off?
- Are your mission protections funding mechanisms?
- Have you drawn the consequence of unbillable staff explicitly?
- Is the biblical integration connected to something in the argument?
Use this guide to plan and review your own work. Follow your institution's rules and read Brinevia's academic-integrity policy.
Written by
Maren Caldwell
MSN, RN, CNE
Medical-surgical nursing, pharmacology and NCLEX preparation
Maren is a registered nurse with over 15 years of clinical and educational experience in medical-surgical nursing. She writes on NCLEX preparation, patient care fundamentals, pharmacology and evidence-based practice.
Reviewed by
Dr. Tessa Redmond
DNP, RN, CNE
Evidence-based practice and clinical education
Tessa is a doctorally-prepared nurse educator. She reviews Brinevia content for clinical accuracy and alignment with current evidence-based guidelines.