When budgets are submitted, the financial department must determine if expected revenues meet expected expenses. The cost of implementing new programs, capital purchases, and operating budget should be less than the overall revenue. If it is not, the manager must reduce the budgets. The manager identifies ways to reduce the supply costs and options for changing practice and systems. Collaborative effort is involved when physician practice must change to meet the budget reduction needs. A reduction in overall expenses is needed to initiate new programs and purchase requested equipment. To prepare and finalize the operating expense budget, the manager needs to foster quality improvement in services, employ negotiation skills, justify budget proposals, redistribute funds, and seek cost-saving methods.