Your accountant tells you what happened. This tells you what to do.
Most practices have a bookkeeper and an accountant, and both do their jobs. You get a P&L in the second week of the following month, it is accurate, and it does not tell you whether your Tuesday afternoon schedule is losing money or which provider is carrying the practice.
Operating financials are a different artifact from tax financials. Most practices have never had them.
What you get
- Monthly close
- books closed on a schedule, not when someone gets to it, and reviewed with you in a meeting in the first week of the following month.
- P&L by provider and service line
- where margin actually comes from, which is rarely where owners assume.
- Cost per visit and revenue per provider
- the two numbers that tell you whether growth is worth having.
- Payer mix and yield analysis
- what each payer actually pays you per visit after adjustments, versus what the contract says.
- Benchmarking
- your numbers against comparable practices by specialty and size, so you know whether 4% is good or bad in your context.
- Cash flow forecasting
- 13-week rolling, because payroll is the problem practices see coming least often.
One document, monthly, same format.
| $ thousands | Apr | May | Jun | Jul | Aug | Sep |
|---|---|---|---|---|---|---|
| Revenue | 196 | 188 | 205 | 199 | 212 | 221 |
| Expenses | 171 | 168 | 174 | 172 | 176 | 179 |
| Net margin | 12.8% | 10.6% | 15.1% | 13.6% | 17.0% | 19.0% |
| Net income | 25 | 20 | 31 | 27 | 36 | 42 |
Four pillars, the same definitions every month, direction rather than snapshots. Three things flagged as needing your decision — not thirty.
Most practice metrics are unfalsifiable.
Ask two people in a practice what the no-show rate is and you will get two numbers, because one counts same-day cancellations and the other does not. Same for days in AR, which can be calculated three defensible ways that differ by 20%.
We publish the definition of every metric we report and do not change them. A number that moves because the definition moved is worse than no number, because you will act on it.
What this is not
We are not your accountant and we do not file your taxes. We work alongside whoever does that, and the operating financials should reconcile to their statements.
If they do not reconcile, that is a finding worth having.
