Which statement best describes the difference between accrual accounting and cash accounting in healthcare finance?

• A. Accrual recognizes revenues and expenses when earned or incurred, regardless of cash; cash accounting recognizes cash when received or paid.
• B. Accrual recognizes cash when received; cash accounting recognizes revenue when earned.
• C. Accrual ignores expenses; cash accounting ignores revenue.
• D. Accrual records only assets; cash accounting records only liabilities.

Answer: (D)

The main idea being tested is when revenues and expenses are recognized. Accrual accounting records revenues when they are earned and expenses when they are incurred, regardless of when cash actually moves. This follows the matching principle and gives a fuller picture of performance and obligations. Cash accounting, on the other hand, records revenue when cash is received and expenses when cash is paid, which can misrepresent timing if there are outstanding receivables or payables.

The statement that accrual records only assets and cash records only liabilities is not accurate. Accrual accounting involves recognizing all types of accounts—assets, liabilities, revenues, and expenses—based on when the economic event occurs, not when cash changes hands.