# Hospital controllership: budget, costs and income statement in one place

> How BI supports hospital controllership: budgeting, cost centers, budget vs. actual income statements, contribution margin and variance analysis.

Page for people: https://clichealth.com.br/en/hospital-bi/hospital-controllership
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**Hospital controllership** is the function that organizes a hospital's accounting, cost and budget information to support executive decisions. It answers questions like "are we within budget?", "which cost center explains the variance?", "which payer is profitable?" and "how will the year close if nothing changes?". BI is the tool that makes it possible to answer those questions every month, with the same criteria, without rebuilding spreadsheets.

## The controllership cycle

- **Plan**: build the annual budget by income statement line and cost center, based on expected volume.
- **Record**: ensure accounting entries and costs are assigned to the right cost centers in the right period.
- **Compare**: set actual against budget and against last year, line by line.
- **Explain**: find the cause of variances (price, volume, payer mix, consumption).
- **Project**: estimate the year-end close (forecast) from actuals and trends.
- **Act**: bring to the board the variances that require a decision, with an owner and a deadline.

## What BI changes in controllership

Without BI, steps 3 to 5 take up most of the month: exporting reports, reconciling, building pivot tables. With BI connected to the information system, the comparison and the breakdown of variances are ready right after the close, and controllership spends its time explaining and proposing action.

Budget vs. actual income statement: budget, actual and the variances against last year and against budget, side by side.

## Controllership dashboards in Clic Health

| | Dashboard | What it is for

| Budget vs. actual income statement | See budget, actual and variances against last year and budget, line by line

| Budget variance | Find deviations by cost center, ledger account and cost group

| Management income statement and forecast | Follow the income statement by group and account, with month-by-month horizontal analysis and a simulation of the coming months

| Income statement analysis | Follow vertical analysis: how much each line represents of revenue

| Summary and SUS income statements | The main income statement groups and the result of SUS care

| Cost income statement table | Explore the cost income statement as a pivot table

| Department efficiency | Assess revenue-generating departments and support and administrative ones on cost and result criteria

| Consumption by department | See each department's consumption of supplies and drugs

Budget variance: each cost center's and expense group's deviation from budget.

## The concepts behind the analysis

- **Cost center**: the unit that accumulates costs (ICU, surgical center, laundry). They divide into productive (revenue-generating), support and administrative.
- **Variable and fixed cost**: what changes with patient volume (supplies, drugs, physician fees) and what does not (structure, fixed payroll).
- **Contribution margin**: revenue minus variable costs and deductions; it shows how much each payer or procedure contributes to covering fixed cost.
- **Accrual**: revenue and costs recorded in the month they occurred, not when they were paid.

The practical guides are in the articles on [how to analyze a hospital income statement](https://clichealth.com.br/en/blog/how-to-analyze-a-hospital-income-statement), [budget vs. actual](https://clichealth.com.br/en/blog/hospital-budget-vs-actual) and [costs by department](https://clichealth.com.br/en/blog/hospital-costs-by-department). For hospitals running Tasy, see [controllership and income statement with Tasy data](https://clichealth.com.br/en/tasy/controllership-and-income-statement).

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