Provider-level profitability
Practice-wide numbers hide almost everything that matters. Two physicians producing similar collections can have very different economics once you allocate their share of staff time, space, supplies and malpractice coverage.
We build the P&L so that each provider's contribution is visible, which is what compensation formulas, partnership decisions and recruitment models all depend on.
Revenue cycle in the ledger
- Gross charges, contractual adjustments and net collections tracked separately
- Collection rate by payer and days in accounts receivable
- Payer mix analysis and the margin implication of shifting it
- Denial and write-off tracking as a cost rather than an invisible leak
- Reconciliation between the practice management system and the general ledger
The gap between what is billed and what is collected is where practice profitability is decided, and it cannot be managed if the ledger only sees deposits.
Structure and physician tax planning
Most states require professional entities for medical practice, which constrains but does not eliminate structuring choices. Beyond the entity itself, the substantial planning levers for high-income physicians are retirement plan design, equipment and buildout depreciation, and the treatment of the real estate if the practice owns its premises.
A defined benefit or cash balance plan alongside a 401(k) can shelter a materially larger amount than a 401(k) alone for an established practice with stable profit and the right age profile among the owners. It is worth modelling properly.
Practice transitions
Buying into a practice, buying one outright, or selling to a group are all events where the accounting quality determines the price. We prepare the financials for diligence, model the transaction from both sides, and structure the purchase price allocation with the tax consequences in view.
Frequently asked questions
Do you work with dental and veterinary practices too?
Yes. The economics are structurally similar: provider production, payer or client mix, high fixed cost in space and equipment.
Can you work alongside our billing company?
Yes, and we generally recommend it. We take their output, reconcile it to the ledger, and hold the reporting on collection performance.
Should the practice own its building?
Often, held in a separate entity that leases to the practice. That separates operating risk from the appreciating asset and opens depreciation planning on the property. The right answer depends on your position.