In the Netherlands, like in many other developed countries, the care sector is facing challenges in a dynamic environment. Regulation is increasing, patients are becoming more critical, budget responsibility will be transferred from country- to municipality level in association with cuts in funding, and more and more emphasis is put on transparent execution of medical treatment procedures and protocols (cf. ActiZ, 2012; Zorgvisie, 2014). In this challenging environment also small healthcare organizations are urged to professionalize their management accounting and control practices (ActiZ, 2012). This paper describes, using the problem solving research approach derived from Mitroff et al. (1974), the introduction of a Management Accounting and Control System (MACS) and its effect in a young, fast growing, small care organization in the Netherlands. The MACS for this company consists of four components: cost and margin calculation per product; time registration facilities; budgeting and variance analysis; and ICT support. The introduction of the MACS has led to accurate, structurally available, and visible financial information for accounting and controlling, thus providing insight in the organization's current situation and into how to move the organization forward in its challenging environment. It is finally argued that similar care organizations may benefit as well from a comparable MACS.
