Son yıllarda ülkemizde yaşanan sağlık politikaları konusundaki yenilik ve değişimler sağlık işletmelerini maliyet odaklı çalışmaya zorlamaktadır. 2007 yılında Sosyal Güvenlik Kurumlarının (Sosyal Sigortalar Kurumu, Bağ-Kur ve Emekli Sandığı) tek çatı altında toplanması ile birlikte oluşturulan Sosyal Güvenlik Kurumu-SGK özel hastanelerle sözleşme yapmaya başladıktan sonra Paket İşlem Fiyat Uygulamasını başlatmıştır. Paket İşlem Fiyat Uygulaması çok karşılaşılan hastalıkların tanı ve tedavisi sırasında hizmet içeriği bakımından hasta bazında çok fazla değişiklik göstermeyen ve bu nedenle yaklaşık maliyeti önceden tahmin edilebilen tüm işlemler için tek bir fiyat belirlenmesi olarak tanımlanmıştır. Kısacası Paket İşlem Fiyat Uygulaması sağlık işletmelerinde üretilen hizmetin satış fiyatını önceden belirlemektedir. Bu uygulama aynı zamanda sağlık işletmelerinin aynı hizmetleri aynı satış fiyatıyla müşterilere sunma zorunluluğu doğurmaktadır. Bu noktada sağlık sektöründe rekabetin çok acımasız bir düzeye ulaştığı söylenebilir. Bu çalışmada sağlık işletmelerinin Paket İşlem Fiyat Uygulamasından hem kar hem de müşteri memnuniyeti sağlamak için Hedef Maliyetleme Yöntemi ve Stratejik Pazarlama Muhasebesi kavramlarından faydalanarak paket işlem fiyatını aşmayacak şekilde maliyetlerin belirlenmesine yönelik maliyet düşürme çalışmaları konusu incelenmiş ve bir diyaliz merkezinde uygulama yapılmıştır.

In health sector in which the competition is increasing day by day, to provide a better quality and better service, and so to achieve competitive advantage is possible by modern healthcare enterprises and also possible keeping the costs of health services with a reasonable level offered by these modern healthcare enterprises. The managers who give direction to the health sector and their enterprises to achieve competitive advantage, they must meet the expectations of patients in the best way, with the maximum level is required to perform quality service at minimal cost. Since healthcare enterprises’ one of main target is making profit so they must have a plan of income and expenses about estimations for future, business volume and other costs elements and get knowledge about the costs of services they offer, resources and market situation. Recent years the changes, innovations and developments in health policies in our country forces healthcare enterprises to work on cost-oriented. In this context, bundle pricing is an application reducing the costs of health care practises and to take the under the control of healthcare costs applied both private and public health institutions. In bundle pricing applications, sales prices of services are determined in advance but businesses can not determine the prices by themselves. Thus, the approximate cost of a single price will be determined for all the transactions that can be predicted, in terms of customers, they will be able to receive the same services at the same price. According to this application, health service businesses must keep servise prices under the control in the framework of bundle pricing and adjust their budget in accordance with not exceed the bundle pricing and plan their income and expenses. Accordingly, managers of health institutions must dominate the market and apply the strategic managemet techniques in line wtih the target cost in order to reduce regarding costs. In this regard, "Target Costing" is a method that provides cost management before they occur and achieving target profit by offering quality service. This method aims to protect the quality of the product as well as the costs before they happen so that management aims to achieve the planned profit. Since in bundle pricing application, prices are determined independently, to achieve target profit , costs should be reduced with target costing method. Also in highly competitive health sector, managers need to find most suitable markets for their goods and service and at this point the necessity of strategic marketing accounting is emerged. In another word, due to rapid increase in private healthcare enterprises and increasing fierce competition and incerase in the quality of services, to survive in this highly competitive environment, it is required strategic marketing accounting.”Strategic Marketin Accounting” is created with the partnership of marketing and accounting department in order to use as a tool to delivery suitable, valid, true and reliable information to marketing managers and to provide solutions to problems which can be emerged with the activities of marketing department and to take a decision related to marketing about strategic product and strategic price. Ministry of Health defined the purpose of enterprises as “patient care according to requirement of the modern era, suitable to country’s fact, fast, disciplined and highly quality and cost-efficient.” So taking these issues into consider, bundle pricing application has been demostrated in order to achieve economic patient care by Ministry of Health. At this point, to utilize the efficiency from this implementation by keeping the costs of healthcare services and s oto make profit, businesses will get the benefits of the target costing method and strategic marketing accounting method. In bundle pricing implementations, invoices sent to institutions which pay for different treatment and diagnosis services are examined and it is identified that the majority of patients who share the same diagnosis and the procedure was found to be certain services and material model. One of the healthcare enterprises, private dialysis centers get no patient share except bundle pricing. The aim of this paper, to put forth how health service enterprises utilize bundle pricing to get profit and satisfy customers with the concepts of target costing and strategic marketing accounting and how costs and prices are determined in bundle pricing implementation, what is the concepts of target costing method and strategic marketing accounting and their relationship between bundle pricing application and a field study in a dialysis center.