health care in the cpa’s future
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Health Care in the CPA’s Future
Keith Kamperschroer, CPA, CHCCkkamperschroer@KolbCo.com
Robert Denkert, CPArdenkert@KolbCo.com
www.KolbCo.com
Keith Kamperschroer, CPA, CHCC
• Shareholder – Health Care Services• As Managing Director of Health Care
Services at Kolb+Co., Keith works extensively with small and medium-sized medical practices providing assistance in all areas of accounting and practice management.
www.KolbCo.com
Robert Denkert, CPA
• Accounting Senior Manager• Bob works extensively with small and
medium-sized medical practices providing assistance in all areas of accounting, payroll and practice management.
www.KolbCo.com
In Addition to Physicians…
• Expand your definition of Health Care owners/stakeholders– MDs, DOs, Behavioral Health Practitioners– Advanced Level Practitioners (NPs and PAs)– Dentists– Veterinarians
www.KolbCo.com
The Value of a CPA from the Client Perspective
• Current on upcoming Health Care reform issues• Proactive planning ideas included with financial
statements not just historical financial data• What are the numbers telling me?• Value of service demonstrated
www.KolbCo.com
How to Enhance My Services to New or Existing Medical Clients?• Add value to existing services
• Understand their Revenue Cycle challenges; be proactive
• Additional “Specialty Services” to consider for building on your health care niche
www.KolbCo.com
Current Services• Change Management
– 2012-2013 substantial changes occurring in health care
• SGR - No Medicare reduction in reimbursement rates again for 2013
– How will practices be able to absorb a 30% reduction in Medicare reimbursement in 2014
– Commercial payers fee schedules at less than 100% of Medicare reimbursements
• Implementation of electronic medical records– How practices meet 1st stage meaningful use in
2012 or 2013
www.KolbCo.com
Current Services
• Look for other ways to add value– Do you review the financial reports with your
clients in person?– Are your statements presented in a format
specific to medical practices?– Is a production analysis report part of your
business analysis?• Example: provide gross and net collection rates
globally and by provider
www.KolbCo.com
The Business of Medicine
• Specialized Services and Revenue Generating Activities– Financial Statement formats specific to health care and
agreement to profit distribution schedules
www.KolbCo.com
Statements of Revenue and Expenses – Income Tax Basis(With the accountant’s compilation report of September 18, 2012)
For the months ended August 31, 2012
www.KolbCo.com
Profit Distribution and Physician Productivity – Income Tax Basis(With the accountant’s compilation report of September 18, 2012)
For the one month ended August 31, 2012
www.KolbCo.com
The Business of Medicine
– Industry statistics and benchmarking
www.KolbCo.com
Comparison to IndustryYear-ended 2012
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The Business of Medicine
– Tax preparation and planning• Corporate, Partnership and Individual• Not Too Soon to Plan for 2013 Tax Changes by Keith
Kamperschroer and Jim Brandenburg in Physicians Money Digest
– http://www.physiciansmoneydigest.com/personal-finance/Not-Too-Soon-to-Plan-for-2013-Tax-Changes
www.KolbCo.com
The Business of Medicine
• Specialized Services and Revenue Generating Activities– Retirement Plans
• The owner of a small business has two choices to consider when setting up a retirement plan: a qualified retirement plan or s Simplified Employee Pension (SEP). A qualified plan is any plan that is subject to the ERISA rules, such as a profit-sharing or money purchase plan or a defined benefit pension plan. An SEP is a simplified alternative to a qualified plan, in essence a group IRA with individual accounts.
www.KolbCo.com
Comparison of Features of Various Qualified Retirement Plans
www.KolbCo.com
www.KolbCo.com
The Business of Medicine
• Specialized Services and Revenue Generating Activities– Practice management
• operations review• CPA prepared reports
– A/R analysis– Provider analysis– Service line revenue/cost analysis
– Analysis of month-end reports• Accounts receivable
www.KolbCo.com
www.KolbCo.com
www.KolbCo.com
The Business of Medicine
• Specialized Services and Revenue Generating Activities– Internal controls
• Separation of Duties– Controls in systems
» Dual access and management» Limitations on access» Time off requirements; require staff to take vacations
– Workflow analysis and access» Determine weak areas in controls
– Work with CPA to monitor and provide business physical
www.KolbCo.com
The Business of Medicine
• Specialized Services and Revenue Generating Activities– Revenue Cycle
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The Business of Medicine
• Specialized Services and Revenue Generating Activities– Employment agreements– Buy/sell agreements– Structuring buy-in/buy-out– Merger and acquisition analysis and facilitation– Practice valuations– Accountable Care Organizations– Managed Service Organizations– Healthcare cooperatives
www.KolbCo.com
The Business of Medicine
• Additional Specialized Services– Practice start-ups– On-going practice management– Accounts receivable management– Coding and documentation review– EMR strategic planning and implementation
www.KolbCo.com
The Business of Medicine
• Additional Specialized Services– There are organizations that can help you with
compliance plan development.– Separate certificates are also available
www.KolbCo.com
The Business of Medicine
• Additional Specialized Services– HIPAA – privacy and security risk assessment– Fee reimbursement and utilization assessment– OSHA internal control plan development and training– Business/malpractice insurance evaluation– Personnel and human resource management– Employee benefit costs– Recruiting assistance
www.KolbCo.com
The Business of Medicine
• Additional Specialized Services– Individual financial planning and wealth management– Risk management consulting – business and individual
insurance analysis
www.KolbCo.com
www.KolbCo.com
www.KolbCo.com
The Business of Medicine
• Additional Specialized Services– Retirement plan design and implementation
www.KolbCo.com
www.KolbCo.com
The Business of Medicine
• Additional Specialized Services– Audit and assurance services– Technology advising
www.KolbCo.com
www.KolbCo.com
Kolb+Co.’s Health Care Niche
• Development of the Health Care Industry Niche– Development of industry expertise and reputation– “Back office” for many practices
www.KolbCo.com
Keys to Success
• Look for ways to add value– Go beyond the numbers
• Look for opportunities that can be replicated in other practices– Compliance plan
• Make your health care niche known– LinkedIn, Twitter, Facebook page etc.– Form an advisory group of professionals for
your area – quarterly meetings
www.KolbCo.com
Health Care Today & Tomorrow
• Health Care Industry today– Obstacles– Opportunities
• Health Care Industry in the Future– Obstacles– Opportunities
www.KolbCo.com
Organizations to Join• HCAA (National CPA Health Care Advisors
Association)
• PVN (Physician’s Viewpoint Network)
• MGMA (Medical Group Management Association)
• State MGMA associations
• HIMSS (Health Information and Management Systems Society)
• Compliance Resources
www.KolbCo.com
Questions
Thank you!
Keith Kamperschroer, CPA, CHCCkkamperschroer@KolbCo.com
Robert Denkert, CPArdenkert@KolbCo.com
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