This study aims to examine the effects of factors related to management accounting systems and managerial performance. The factors include budgetary participation, decentralization, and management style. Furthermore, this research investigates the consequences of the management accounting systems on managerial performance and the direct effect between management style and budgetary participation on managerial performance. Survey questionnaires were distributed to both public and private hospitals in Palembang, the South Sumatera region, Indonesia. The sample consisted of 62 respondents from 15 hospitals Target respondents were all managers in hospitals, including financial managers, service managers, human resource managers, quality managers, and other managers. The questionnaire was distributed online to each hospital, and approximately five or more questionnaires were hardcopies. This research was conducted over less than six months. The data obtained were processed via excel files, then checked for conformity, and analyzed by partial least square (PLS) software with descriptive statistics. This study uses path analysis, which that is structural equation modeling (SEM). The findings show that management style, decentralization, and budgetary participation significantly affect management accounting systems. However, management style and budgetary participation did not influence managerial performance. Finally, the findings indicate that management accounting systems are positively affected by managerial performance.