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hello this is dr eric bricker and thank you for watching a healthcare z today were going to be discussing the hidden war for patients and dollars so before we get started we have to talk about two euphemisms that are used on the hospital business side that first one is service line so for a hospital a service line is a clinical department so a service line might be ob gyn or cancer or orthopedics okay youth was number two profitable payer mix so hospitals receive payment from a variety of payers right so you have commercially insured patients medicare medicaid self-pay which is the uninsured folks and so a profitable payer mix is a payments with more commercially insured patients because those are the ones that the hospital can actually make a profit on and fewer medicare medicaid and self-insured patients because those are the folks that they make less over they lose money on okay so with that there are departments within a hospital system theyre either business development or their