When cash flow starts to pinch, most practice owners look outward—new marketing campaigns, new devices, even expansion plans. But the fastest way to boost cash flow isn’t out there. It’s inside your existing patient flow. The key is your Average Patient Charge (APC)—the amount you actually collect per visit.

All adjustments fall into two categories. Knowing which is which helps you separate what’s normal from what’s fixable. Contractual Adjustments These are the discounts you’ve agreed to with insurance companies. They’re built into your payer contracts and are part of the cost of doing business. They can’t be avoided—and they shouldn’t be feared. Think of them as the difference between your retail price and your contracted price. Write-Offs Write-offs are different

Many small healthcare practices run at or near break-even once you account for the fair cost of the owner’s work. On paper, it might look like a solid operation: Years of service to the community Loyal staff and steady patients A history of “profitability” But once you normalize expenses—especially provider compensation—the math often changes.

Many medical offices glance at their billed charges and assume that’s their income. It’s not. The real measure of your financial health is your Average Patient Charge (APC). Average Patient Charge tells you how much money you actually collect per patient visit, not what you billed. It’s the difference between thinking your practice is profitable and actually knowing it is.

Debt in medicine often carries stigma. Many providers view it as a sign of overreach or mismanagement. In truth, debt itself is neutral—it’s the structure of that debt that determines whether it becomes a burden or a catalyst. Smart financing doesn’t weaken a practice; it strengthens it—when guided by strategy and discipline. That’s the essence of a debt detox: not avoidance, but alignment.

When you hand over your practice, you’re not just transferring assets—you’re transferring identity.Your successor inherits more than a patient roster and a revenue stream. They inherit your name on the door, your standards of care, and the trust your community has placed in you. That inheritance is sacred—and one wrong hire can erode it faster than any market downturn or billing error. Finding the right successor isn’t just a business decision; it’s the hardest hire you’ll e

When your “visit” metric mixes provider work with ancillary services, your data stops reflecting reality. Staffing plans, clinician compensation, and even hiring decisions all become distorted.

When most healthcare owners hear “debt consolidation,” their first thought is usually more paperwork. In reality, smart consolidation is one of the most powerful cash-flow tools a practice can use. It turns scattered obligations into a single, predictable payment—freeing up time, capital, and mental bandwidth.

Great CFOs are not just data collectors; they are energy allocators. They design reporting systems that are efficient, not exhaustive. For example: Track payroll by department, because it’s significant and actionable. Estimate rent by square footage, because precision there adds little insight.

Too often, practices treat accounting like a project with a finish line: set up QuickBooks, build a few reports, and call it done. But six months later, the questions have changed — and the numbers no longer tell the full story. Your business has evolved. Your accounting should too.

Therapy, psychiatry, assessments, and telehealth all depend on the same space and staff, yet contribute differently to the bottom line. And here’s the hard truth: there’s no perfect way to allocate shared costs. Every method has tradeoffs. That’s okay. Because the goal of cost allocation isn’t mathematical perfection—it’s managerial clarity. The moment you chase “perfect,” you risk making your finances so complex that they stop being useful.

Revenue growth should never come at the cost of morale or exhaustion. If average patient charge improvements are working, resist the temptation to also add days. Let one driver land before pulling the next. Clear cancellation policies and simple scripts turn chaos into just another variable to manage. Growth without burnout isn’t slow—it’s stable. That stability fuels a stronger team, happier patients, and a practice built to last.

You can rebuild pricing for any procedure in under fifteen minutes using four building blocks: Consumables – List items consumed per case and calculate true per-unit cost, including wastage. Labor – Convert provider and staff minutes (including setup and documentation) into cost. Commission/Performance Pay – Factor in any incentives or case-level bonuses. Overhead Spread – Allocate the fair share of rent, admin, marketing, and software costs. Once the math is done, add your t

When growth stalls, the reflex is usually: “We just need more customers.” Sometimes that’s true. More often, it’s not. Most businesses don’t grow by piling on volume—they grow by pulling one of three levers: Capacity, Price, or Patient Mix. The real challenge is identifying which lever matters right now, then focusing relentlessly on it for the next 30–90 days.

CFOs help you make better decisions about the future: pricing, capacity, cash, and risk. Both are essential. They’re just not the same. Think about it like a vehicle. A CPA is the licensed mechanic who ensures your car is safe and road-legal. The CFO is your crew chief and navigator—choosing routes, pit stops, and race strategy. If you keep asking the mechanic why your lap times are slow, you’ll get great maintenance…and no improvement plan.

Every multi-location practice eventually faces the same question: do we keep separate tax IDs, or merge into one? A common mistake: merge first, figure out reporting later. Revenue and costs pool together, and suddenly managers don’t trust their P&Ls. Without guardrails, every “why is this site underperforming?” conversation turns into guesswork. The good news: this is fixable with the right design up front.

Most practices chase growth by doing “more of everything”—more hours, more patients, more services. It feels busy but rarely produces sustained results. Instead, think of your practice as a dashboard with three levers of revenue. If you learn to separate them—and pull one at a time—you’ll grow faster, with less stress and greater clarity.

Consistency is what turns good habits into reliable numbers. Build a checklist so nothing slips through the cracks.

Ancillary and supportive services often decrease blended APC but still boost overall profit. These services tend to have steadier schedules, fewer payer hurdles, and higher staff-time leverage.

Owner Shield is a practical mindset and toolkit for reducing risk without dulling your leadership edge.