ACC 201 SNHU Wk 6 Professional Relevance of Financial Accounting Discussion In this week’s discussion, you will make connections between your chosen field and what you have learned about financial accounting up to this point. This discussion is important practice for the second part of your final project, in which you will analyze the practical applications of financial accounting in terms of how relevant it is to your own professional aspirations.
In your initial post, describe your current or aspiring professional identity, including your career and the field in which you work or hope to work. What sort of transactions would you encounter in that field? What are the impacts of those transactions on the business? List and describe several examples.
Then, review your peers’ initial posts to find out who is working or plans to work in the fields or professions most closely related to your own. In your responses to those peers, compare and contrast your responses. Specifically, comment on how important financial accounting is within that field or profession. Before taking this course, would you have held the same view? Why or why not?
Homework for Week 6
The 6-1 discussion assignment requires connecting your career goal with what you have learned in Acc-201 so far. Examples are the most powerful way to get your points across. People remember stories (examples) much better than they remember abstract principles.
Helpful hints and strategies for success
Please be sure to proofread your discussion posting to reduce grammatical and spelling errors. It’s amazing how many of our own errors we can spot when we re-read it the next day.
This is what I posted for the first post what all the comments I received.This will help with this post.
Hello Everyone,
My name is Aimee Darwin, and I am a landlord for properties I own with my husband here in North Central Florida. I was laid off back in 2016 from Kmart. I decided then with my husband that I am not going to count on earning a paycheck from a place of business and living paycheck to paycheck. My husband and I currently own four properties, and two of the three features are rent to own properties, one we are currently working on to fix it up, and the other one is where we live. We own everything free and clear. My husband is retired from construction and can build anything from the ground up, so he does all the fixing up. I am currently doing my bachelor’s degree in Business Administration with specialization Entrepreneurship. Below are some of the expenses that are encored by our current investment.
Expenses for maintenance
Monthly payments on properties
Property taxes
Lawyer
Interest made on properties
Advertising
Shortly, my target is to be one of the most significant entrepreneurs in Florida. To archive this goal, I am putting efforts to ensure that everything I do will help in archiving my set goals. On considering financial accounting, my future goal will highly depend on the finances that I will be getting from different institutions, which will be depending on my services. However, I will have to invest a lot to ensure that I am on a competitive level. The above outlined identifies must be financed for smooth learning of my current business and my plan. After finishing my degree, I will endure the total implementation of what I have acquired in classwork, which will help in ensuring that I have attained my goals.
George Angus
Hi, Aimee,Your work as a landlord is so important because you’re providing good housing to people, and being responsible to their needs. It’s great that your husband can do repairs; this saves lots of money and probably makes the enterprise more profitable, overall. I think you’re making a good decision to get a business degree and obtain an understanding of accounting. As you indicated, your lenders and suppliers will want to see financial statements of your business. So whether you prepare your own financial statements of have someone else do it, you will be able to interpret and discuss the statements in detail. Answering a lender’s questions about your financial condition will be important as you expand your operations. I like the list of accounts and transactions that you will be encountering in your enterprise. This shows that you have analyzed what will be needed as you move forward. Thanks for the helpful discussion of rental properties. Welcome to Acc-201!George Angus, SNHU Accounting Faculty
Christina Alex
Hi Aimee,I am also from Central Florida in the Orlando area. I find what you do very interesting and something that is a great source of income. Having your husband and the construction person sounds like a great plan to help keep things going. You know it’s getting done right when you do it yourself! I wish you luck on reaching your goals!Christina
Then need 2 responses done on classmates. I will have post the first response and will post the second response when tutor is selected.
Professional Relevance of Financial Accounting
Durango Pasch posted Jun 9, 2020 8:50 PM
Initially I aspire to be a certified public accountant (CPA) as I see it as a step on the path to other potential careers in financial management or in the government or non-profit sectors. I haven’t specifically narrowed in on one particular career field yet because I want to get deeper into my coursework and see which aspects of accounting that I find most compelling, but currently I’m aiming to be an accountant for a financial firm or a bank with my degree in accounting and finance. This could develop into a career as a financial planner eventually. I’ll need to go beyond my bachelor’s degree to attain these goals by earning 150 credits to qualify as a certified public accountant. I’ll also need to complete an internship to gain experience, complete the AICPA ethics course and exam, pass the uniform CPA exam, and then apply for a license in order to become a CPA in the state of Minnesota (Masters in Accounting, 2020).
If I were a financial accountant for a bank, I would have to deal with Notes Payable transactions from the opposite perspective as companies often need to borrow cash from banks to finance investments with the aim of improving their profitability. Below are examples of 3 transactions:
From the bank’s or the lender’s perspective, the transaction would debit Notes Receivable and that account would be considered an asset from their point of view rather than a liability, and then Cash would be credited.
Another related transaction would be collecting the interest on the Notes Payable. When the bank first extends the loan, they create a current assets account called Interest Receivable for the total amount of interest to be collected on the note.
When the interest payment is received from the borrower at the time that they pay the balance of the note, Cash is debited, and the Interest Receivable account is credited (Bragg, 2018).
The impact this has on the bank as a company is that the interest collected from loans is greater than what they pay to customers with savings accounts which results in the bank making a profit on the transaction (Zhen, 2019).
References
Bragg, S. (2018, September 29). Interest receivable. AccountingTools. Retrieved from https://www.accountingtools.com/articles/2017/5/10/interest-receivable
Masters in Accounting. (2020). Accounting schools in Minnesota. Retrieved from https://www.mastersinaccounting.info/minnesota/
Zhen, S. (2019, April 11). Finance 101: How do banks make money? Moneyunder30.com. Retrieved from https://www.moneyunder30.com/how-banks-make-money#:~:text=It%20all%20ties%20back%20to,difference%20is%20the%20banks’%20profit. Contraception 87 (2013) 154 – 161
Original research article
Burden of unintended pregnancy in the United States: potential savings
with increased use of long-acting reversible contraception☆
James Trussell a, b , Nathaniel Henry c , Fareen Hassan c , Alexander Prezioso d ,
Amy Law d , Anna Filonenko e,⁎
a
Office of Population Research, Princeton University, Princeton, NJ 08540, USA
b
The Hull York Medical School, University of Hull, Hull, HU6 7RX, UK
c
IMS Health, London, N1 9JY, UK
d
Bayer HealthCare Pharmaceuticals, Inc., Wayne, NJ 07470, USA
e
Bayer Pharma AG, Berlin, 13553, Germany
Received 25 April 2012; revised 16 July 2012; accepted 26 July 2012
Abstract
Background: This study evaluated the total costs of unintended pregnancy (UP) in the United States (US) from a third-party health care
payer perspective and explored the potential role for long-acting reversible contraception (LARC) in reducing UP and resulting health
care expenditure.
Study Design: An economic model was constructed to estimate direct costs of UP as well as the proportion of UP costs that could be
attributed to imperfect contraceptive adherence. The model considered all women requiring reversible contraception in the US: the pattern of
contraceptive use and the rates of UP were derived from published sources. The costs of UP in the United States and the proportion of total
cost that might be avoided by improved adherence through increased use of LARC were estimated.
Results: Annual medical costs of UP in the United States were estimated to be $4.6 billion, and 53% of these were attributed to imperfect
contraceptive adherence. If 10% of women aged 20–29 years switched from oral contraception to LARC, total costs would be reduced by
$288 million per year.
Conclusions: Imperfect contraceptive adherence leads to substantial UP and high, avoidable costs. Improved uptake of LARC may generate
health care cost savings by reducing contraceptive non-adherence.
© 2013 Elsevier Inc. All rights reserved.
Keywords: Unintended pregnancy; Long-acting reversible contraception; Intrauterine system; Contraception; Cost savings; Medication adherence
1. Introduction
Despite intense focus on reducing unintended pregnancies (UPs) in the United States (US) in recent years, nearly
half (49%) of all pregnancies are unintended [1]. UPs are
☆
Anna Filonenko is a full-time employee of Bayer Pharma AG. Amy
Law and Alexander Prezioso are full-time employees of Bayer Healthcare
Pharmaceuticals Inc. Nathaniel Henry and Fareen Hassan are full-time
employees of IMS Health and served as paid consultants to Bayer Healthcare
Pharmaceuticals Inc. for the development of this study and manuscript.
James Trussell is a full-time professor of economics and public affairs at
Princeton University and received a consultancy fee from Bayer Pharma AG
for his contribution to this work.
⁎ Corresponding author. Bayer Pharma AG, Berlin, 13553, Germany.
Tel.: +49 30 468 18534.
E-mail address: anna.filonenko@bayer.com (A. Filonenko).
0010-7824/$ – see front matter © 2013 Elsevier Inc. All rights reserved.
http://dx.doi.org/10.1016/j.contraception.2012.07.016
associated with adverse consequences for both mother and
child [2] and with a high rate of abortion [3,4]. Total costs to
US taxpayers from UP have been estimated to range from
$9.6 to $12.6 billion a year [5], whilst annual direct medical
costs have been estimated to be $5 billion [6]. These costs are
theoretically avoidable.
Available methods of contraception are effective when
adherence is high [7–9], but during real-world usage,
imperfect adherence contributes to contraceptive failure,
with an estimated 48% of all UPs in the United States
occurring in women who are using contraception [4].
Long-acting reversible contraception (LARC), which
includes implants and intrauterine contraceptives, is the
most effective type of reversible contraception [8]
because adherence is not required. In this analysis, an
economic model was used to estimate the cost to third-
J. Trussell et al. / Contraception 87 (2013) 154–161
party payers associated with UP and to estimate the
proportion of this cost attributable to imperfect contraceptive adherence. The model also estimated cost savings
that might be generated by women switching to LARC
from other contraceptive methods.
2. Materials and methods
2.1. Model design and population
A cost model was constructed as follows: first, the annual
number of UP-related events and the associated cost were
estimated; next, utilization and cost of contraceptive methods
in the United States were evaluated, and the proportion of UP
events in the United States associated with imperfect
adherence was estimated; finally, the change in UP and the
cost impact that might result from increased use of LARC
were derived. The framework follows the structure of an
earlier analysis [6].
The model considered women aged 15–44 years who are
sexually active and of child-bearing age but who currently
neither seek pregnancy nor wish to be permanently sterilized.
Separate calculations were performed by 5-year age groups.
The analysis represents an average 1-year period of use to
allow comparability between reversible methods that are
short acting (SARC) and long acting (LARC).
2.2. UP-related events
Four possible pregnancy outcomes were considered: live
birth, induced abortion, spontaneous abortion and ectopic
pregnancy. The annual number of these events (resulting
from both planned and unplanned pregnancy) occurring in
each age group was obtained from the National Survey of
Family Growth (NSFG), a large survey conducted by the US
Centers for Disease Control and Prevention which collects
data on pregnancy, childbearing, men’s and women’s health,
and parenting from a national sample of women and men
15–44 years of age in the United States [10]. Spontaneous
abortions and ectopic pregnancies were reported together in
a single category of fetal losses. Consequently, ectopic
pregnancy rates were taken from an analysis of a large
administrative claims database of US commercial health
plans [11] and applied to the total number of pregnancies in
each age group [10] to estimate ectopic pregnancy numbers.
Subtracting ectopic pregnancies from all fetal losses in each
age group then provided an estimate of the number of
spontaneous abortions.
The total numbers of live births and induced abortions
that result from UP only were estimated by multiplying the
total numbers of these events by the estimated proportions of
these events that result from UP [4,12]. No data were
identified to estimate the proportion of ectopic pregnancies
and spontaneous abortions that result from UP; we assumed
that 50% resulted from UP in the United States, in line with
the proportion of all pregnancies that are unintended [1].
155
2.3. Costs of UP-related events
Costs associated with UP outcomes in the US within the
inpatient, outpatient and non-hospital settings were obtained
from the Medicare Fee Schedule 2011 [13], and a weighted
average cost for each UP outcome was derived.
A proportion of live births resulting from UP in the
United States are mistimed rather than unwanted; costs were
adjusted downward as in prior work [6]. This adjustment is
described in full in the Technical Appendix.
The cost of each event was multiplied by the annual
number of events to generate an estimate of total UP costs.
2.4. Utilization of contraceptive methods
In addition to no method, 10 reversible contraceptive
methods were considered in this analysis. SARC included the
oral contraceptive pill (OC), male condom, patch, injectables
and vaginal ring. LARC included implant, intrauterine device
(IUD) and hormonal intrauterine system (IUS). Other
methods were withdrawal and periodic abstinence. Permanent contraceptive methods were not considered.
The distribution of use of the various contraceptive
methods was determined from the NSFG [14] and
multiplied by the total population in each age group to
estimate the number of women using each method.
Contraceptive discontinuation or switching was not considered; women allocated to a contraceptive method were
assumed to stay on the intervention for the full duration of
product efficacy. In reality, given their changing preferences
and situations, individuals do switch between different
methods. There are, however, no nationally representative
data from which to estimate probabilities of switching
among all methods. Moreover, allowing switches precludes
a pure comparison of different contraceptive methods; if all
switches are assigned an average cost of a mix of
contraceptive methods, then the costs of the different
methods will converge over time.
2.5. Costs of contraceptives
Contraceptive costs included both product costs and
associated health care resources (e.g., consultation, device
insertion/removal). For product costs, IMS Multinational
Integrated Data Analysis System (MIDAS) [15] market
share data were used in conjunction with price data from the
Medi-Span Master Drug Database [16] to construct weighted
average costs for each contraceptive method.
Medical consultation costs were obtained from the
Medicare Fee Schedule [13]; consultation frequency was
assumed for each method in the absence of literature estimates.
To permit comparability between contraceptives with
varying durations of use, product costs incurred over an
average 1-year period were calculated. For products with a
duration of product efficacy exceeding 1 year (implant, IUD
and IUS), total costs incurred over the product duration of
efficacy were divided by this duration to derive average
156
J. Trussell et al. / Contraception 87 (2013) 154–161
Table 1
Annual number of UP outcomes in the United States
Pregnancy outcome
15–19 years
20–24 years
25–29 years
30–34 years
35–39 years
40–44 years
All ages
Live births [10]
Proportion due to UP [12]
Live births resulting from UP
Induced abortion [10]
Proportion due to UP [4]
Induced abortion resulting from UP
Ectopic pregnancyb [10,11]
Proportion due to UP c
Ectopic pregnancy resulting from UP
Spontaneous abortion and ectopic pregnancy [10]
Spontaneous abortion d
Proportion due to UP c
Spontaneous abortion resulting from UP
435,000
0.71 a
310,590
192,000
0.92
176,640
2111
0.5
1056
128,000
125,889
0.5
62,944
1,052,000
0.44
464,984
397,000
0.92
365,240
7414
0.5
3707
237,000
229,586
0.5
114,793
1,196,000
0.27
322,920
298,000
0.92
274,160
9249
0.5
4624
251,000
241,752
0.5
120,876
957,000
0.22 a
208,626
177,000
0.92
162,840
10,057
0.5
5028
225,000
214,943
0.5
107,472
489,000
0.22 a
106,602
10,6000
0.92
97,520
8108
0.5
4054
224,000
215,892
0.5
107,946
114,000
0.22 a
24,852
370,00
0.92
34,040
1980
0.5
990
52,000
50,020
0.5
25,010
4,230,000
1,438,574
1,207,000
1,110,440
38,918
19,459
1,117,000
1,078,082
539,041
a
The values reported were for the age groups 18–19 years, 20–24 years, 25–29 years and 30–44 years; therefore, those reported for 18–19 years were
applied to the 15–19-year group in this model, and similarly, those reported for the aggregate age group of 30–44 years were applied to the individual age groups
of 30–34 years, 35–39 years and 40–44 years [12].
b
Calculated by applying the ectopic pregnancy rate reported in Hoover et al. (2012) [11] to the total number of pregnancies reported by Ventura et al.
(2008) [10].
c
Assumption, see text.
d
Calculated by subtracting the number of ectopic pregnancies from the number of spontaneous abortions.
annual costs. For all other contraceptives, average annual
costs were assumed equivalent to the first year of product
use. A more detailed description of cost annualization may
be found in the Technical Appendix.
2.6. UP due to imperfect adherence
For each contraceptive method, pregnancy rates for
‘perfect use’ (efficacy during correct and consistent use)
and ‘typical use’ (effectiveness during actual ‘real-world’
use including inconsistent or incorrect use) were taken
from the literature [8]: the difference between them was
assumed to represent UP attributable to imperfect adherence for each contraceptive method. The percentage of UP
attributable to imperfect adherence was determined in this
way for each method.
2.7. Effects of increased use of LARC
The potential cost impact of increased uptake of LARC
methods was examined among a subset of women aged
20–29 years. Our analysis focused on this cohort as it
contributes the major portion of annual UP [17]. Three
scenarios were explored:
1. Ten percent of women aged 20–29 who are currently
using OC switched to LARC.
2. Ten percent of women aged 20–29 who are currently
using any SARC method switched to LARC.
3. Ten percent of women aged 20–29 who are currently
using either SARC or no method switched to LARC.
Note that the population switching within the three
scenarios differs; the OC switch analysis represents the
smallest cohort of women switching because only those
women currently using OC are included in the calculation;
the SARC plus no method analysis represents the largest
cohort as 10% of all SARC and no method users switch. The
projected cost of UP and contraception in each scenario was
compared to the estimated current cost. The calculation is
described in detail in the Technical Appendix.
2.8. Sensitivity analysis
Sensitivity analysis explored the impact of increased use
of LARC on potential savings when costs of implant, IUD
and IUS were not annualized. Full first-year contraceptive
costs were applied in the model, and the change in cost was
estimated based on a 1-year time horizon.
Table 2
Costs of pregnancy outcomes in the United States by setting
Pregnancy outcome
Hospital Hospital
Non-hospital Weighted
inpatient outpatient
average
Live birth, cost per
event ($) [13]
Proportions by setting
of care (%) a
Induced abortion, cost
per event ($) [13]
Proportions by setting
of care (%) [3]
Spontaneous abortion,
cost per event ($) [13]
Proportions by setting
of care (%) a
Ectopic pregnancy, cost
per event ($) [13]
Proportions by setting
of care (%) a
$4729
–
–
100
0
0
$3524
$1712
$303
0
30
70
$2869
$1765
$365
10
20
70
$4511
–
–
100
0
0
a
b
Assumption.
See Technical Appendix and Table A1.
$4729 b
$725
$895
$4511
J. Trussell et al. / Contraception 87 (2013) 154–161
157
Table 3
Annual cost of contraceptive methods in the United States
Contraceptive method per
woman per year, $, annualized
SARC methods
Pill
Male condom
Patch
Ring
Injection
LARC methods
Implant
IUD
IUS
Others
Product cost
[15,16] (A)
Initial consultation &
procedure [13] (B)
Follow-up
consultation [13] (C)
Removal consultation &
procedure [13] (D)
Total annual
cost (A+B+C+D)
$612.85
$21.77
$982.41
$945.49
$223.84
$41.45
$0.00
$41.45
$41.45
$41.45
$0.00
$0.00
$0.00
$0.00
$125.24
$0.00
$0.00
$0.00
$0.00
$0.00
$654.30
$21.77
$1023.86
$986.94
$390.53
$219.81
$59.80
$140.61
None
$55.61
$14.10
$28.20
$0.00
$6.90
$13.79
$61.84
$16.55
$33.09
$337.25
$97.34
$215.70
Note: numbers may not sum due to rounding.
See Technical Appendix for derivation of cost components.
An additional sensitivity analysis estimated the duration
of time that LARC methods would need to be used following
a switch to achieve cost neutrality, defined as a net cost
impact to the payer of zero. This analysis was undertaken to
address concerns that LARC methods may not be used for
the full duration of product efficacy and hence may not be
able to realize the potential cost savings arising from low
annualized costs.
3. Results
3.1. UP-related events and costs
The estimated annual number of UPs is 3.11 million,
resulting in 1.44 million live births, 1.11 million induced
abortions, 539,000 spontaneous abortions and 19,000
ectopic pregnancies. Over half (53%) of UPs in the United
States occurred in women 20–29 years of age (Table 1).
The weighted average cost for each UP in the US outcome
is shown in Table 2. The estimated annual cost of UP
outcomes is $4.6 billion.
3.2. Contraceptive costs and effectiveness
Annual contraceptive costs ranged from $22 for condoms
to more than $1000 for the patch (Table 3). Pregnancy rates
for perfect use and typical use are shown in Table 4. All
SARC and LARC methods considered are associated with
UP rates of 2 or less per 100 women within the first year of
perfect use. SARC methods are, however, associated with
higher rates of UP in typical use, with a high proportion of
UP attributable to imperfect adherence.
3.3. Implications of imperfect adherence
We estimate that 1.64 million UPs in the United States
occur due to imperfect adherence. The highest number of UP
events occur in women aged 20–24 and 25–29 years. The
total cost of UP due to imperfect adherence is $2.47 billion
(Table 5), 53% of the total cost of UP. Estimated costs due to
imperfect adherence are $762 million in women aged 20–24
years, the highest in all age groups assessed.
3.4. Impact of increased LARC utilization
In all three scenarios examined in women aged 20–29,
higher LARC uptake generated cost savings. The largest
savings were achieved when 10% of the cohort currently
using any SARC or no method switched to LARC, reaching
$436 million (Table 6).
3.5. Non-annualized costs and cost-neutrality analysis
When costs are not annualized, in the 20–29-year age
group, switching from non-LARC to LARC methods
results in net cost increases, rather than the savings
observed in the base case. Ten percent of women switching
to LARC from OCs, SARC, and SARC and no method
Table 4
Contraceptive failure rates and proportion of pregnancies due to imperfect
adherence in the United States
Contraceptive
method
SARC methods
Pill [8]
Male condom
[8]
Patch [8]
Ring [8]
Injection [8]
LARC methods
Implant [8]
IUD [8]
IUS [8]
Other
Withdrawal [8]
Periodic
abstinence [8]
No method [9]
UPs per woman UPs per woman Proportion of UP
per 100 years in per 100 years in rate attributable to
perfect use (A) typical use (B) imperfect adherence
(B−A)/B
0.3
2.0
9.0
18.0
0.967
0.889
0.3
0.3
0.2
9.0
9.0
6.0
0.967
0.967
0.967
0.05
0.6
0.2
0.05
0.8
0.2
0.000
0.250
0.000
4.0
5.0
22
24
0.818
0.792
46
46
NA
158
J. Trussell et al. / Contraception 87 (2013) 154–161
Table 5
Annual number and cost of UPs and proportion attributable to imperfect adherence in the United States
Results
15–19 years
20–24 years
25–29 years
30–34 years
35–39 years
40–44 years
All ages
Number of UPs
Number UPs due to imperfect adherence
Cost of UP ($ millions)
Cost of UP due to imperfect adherence ($ millions)
As a % of total UP
551,230
255,887
$754
$350
46%
948,724
510,993
$1,415
$762
54%
722,580
396,488
$1,006
$552
55%
483,966
294,798
$846
$515
61%
316,122
148,786
$497
$234
47%
84,892
36,332
$124
$53
43%
3,107,514
1,643,283
$4642
$2466
53%
results in net cost increases of $52 million, $273 million
and $334 million, respectively.
Among women currently using OC, assuming a 10%
switch to LARC, cost neutrality is achieved after 1.33
years in women aged 20–24 and after 1.39 years in
women aged 25–29; among women currently using any
SARC, cost neutrality is achieved after 1.62 years (aged
20–24) and 1.82 years (aged 25–29); among women
currently using any SARC or using no method, cost
neutrality is achieved after 1.63 years (aged 20–24) and
1.90 years (aged 25–29).
4. Discussion
The total direct medical cost of UP was estimated to
be greater than $4.6 billion annually, consistent with
previous estimates [6]. Our results suggest that greater
than half of UP costs in the US may be attributed to
imperfect contraceptive adherence, with a particularly high
cost in women aged under 35 years. Our analysis also
indicates that significant cost savings may be generated
among women aged 20–29 years by switching from
SARC to LARC.
There are several limitations to the analysis. Only firstyear failure rates were available for contraceptive methods;
these may be higher th…
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