Healthcare finance insights
Real numbers, real case studies, real advice for clinic owners.
2026 Medicare Final Rule: What Outpatient Clinics Must Know
CMS finalized the CY 2026 Physician Fee Schedule (CMS-1832-F) in October 2025, with effects that carry through the 2027 payment year. Behind the headline pay bump are an efficiency adjustment, a split conversion factor, and a skin substitute reset that change the math for most outpatient clinics.
Clinic Valuation Guide 2026: How to Price Your Practice
Most clinic owners value their practice with a back-of-napkin number that bears no relation to what a sophisticated buyer will pay. Here is how valuation actually works in 2026, and where owners leave the most money on the table.
The hidden cost of switching EHRs: a 24-month financial reality check
The vendor quote is the smallest number in an EHR switch. The real cost shows up in productivity loss, data migration, training, and the second year of optimization. Here is the 24-month financial picture.
AI billing tools: what they save, what they miss, what your CFO should watch
AI coding assistants and billing automation are showing up everywhere. Some save real money. Others create expensive new problems. Here is what we are seeing.
Med Spa Operating Costs 2026: Where the Margin Leaks
Med spa cost breakdown: 25–35% injectables, 20–25% staff, 8–15% marketing, 8–12% rent. Where the 20–30% margin actually leaks — and how to fix it.
Medicare reimbursement is down 33% since 2001. The math gets worse from here.
Adjusted for inflation, Medicare pays physicians 33% less than it did in 2001. For a clinic with 30% Medicare patients, that is a slow-motion financial crisis.
Healthcare staffing costs in 2026: the biggest line item keeps growing
Staffing is 45-55% of clinic overhead and it went up again this year. Here is what the numbers look like by specialty and what clinics are doing about it.
Where most dental practices leak money: six patterns I see over and over
After working with dozens of dental practices, the same financial mistakes show up over and over. Lab costs, PPO write-offs, associate comp — here is what to watch.
The prior authorization API mandate hits January 2027. Here is what to do.
By January 2027, payers must support electronic prior auth via API. This changes how your practice handles authorizations and how fast you get paid.
MIPS reporting for 2026: the checklist your practice manager needs
MIPS performance in 2026 determines your Medicare payments in 2028. Here is what to track and when to track it.
Tax deductions your clinic accountant probably misses
Most clinic accountants handle compliance. Few proactively look for deductions. Here are the ones we find most often.
Selling your practice in 2027? Start the financial cleanup now.
Practice sales take 12-18 months. If you want to sell in 2027, the financial prep starts today. Here is the timeline.
The financial case for staying independent vs selling to PE
Private equity is buying clinics aggressively. Before you take the call, know what your practice is actually worth and what you are giving up.
The highest-revenue provider was barely profitable. Here is why.
Revenue is not profit. Without provider-level P&Ls, you are guessing which providers make you money and which ones cost you.
Location-level P&Ls: why you need to know which clinic subsidizes the others
Most multi-location clinics run one consolidated P&L. That means your profitable location is hiding the losses at your other one.
When your clinic hits $3M, your QuickBooks setup stops working
QuickBooks got you here. But once you have multiple providers, two locations, and a billing company, you need financial infrastructure that actually scales.
Your accountant sees bank deposits. Do they see your billing data?
At most outpatient clinics we review, the accountant has never seen the billing data. They reconcile bank deposits. That is like reading half the story.
Insurance reimbursement keeps dropping. What smart clinics do about it.
Medicare payments are down 33% since 2001 in real terms. Commercial payers follow. Here is how profitable clinics adapt their financial model.
The 6-12% gap between billing and collections that most clinics ignore
Based on the practices we've reviewed, the average multi-location clinic loses 6-12% of revenue between what gets billed and what hits the bank. At your scale, that is not a rounding error.
65% of denied claims never get resubmitted. Here is what that costs you.
The healthcare industry average is brutal: most denied claims die in a pile on someone's desk. At a 3-location clinic, that is $50K-$200K per year.
Your billing team says everything is fine. Your bank account disagrees.
Most clinic owners trust their billing team's numbers. But when billing data and bank deposits tell different stories, somebody is wrong.
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