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Health Care in the CPA’s Future Keith Kamperschroer, CPA, CHCC [email protected] Robert Denkert, CPA [email protected]

Health Care in the CPA’s Future

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Health Care in the CPA’s Future. Keith Kamperschroer, CPA, CHCC [email protected] Robert Denkert, CPA [email protected]. Keith Kamperschroer, CPA, CHCC. Shareholder – Health Care Services - PowerPoint PPT Presentation

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Page 1: Health Care in the CPA’s Future

Health Care in the CPA’s Future

Keith Kamperschroer, CPA, [email protected]

Robert Denkert, [email protected]

Page 2: Health Care in the CPA’s Future

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.

Page 3: Health Care in the CPA’s Future

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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.

Page 4: Health Care in the CPA’s Future

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

Page 5: Health Care in the CPA’s Future

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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

Page 6: Health Care in the CPA’s Future

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

Page 7: Health Care in the CPA’s Future

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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

Page 8: Health Care in the CPA’s Future

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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

Page 9: Health Care in the CPA’s Future

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The Business of Medicine

• Specialized Services and Revenue Generating Activities– Financial Statement formats specific to health care and

agreement to profit distribution schedules

Page 10: Health Care in the CPA’s Future

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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

Page 11: Health Care in the CPA’s Future

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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

Page 12: Health Care in the CPA’s Future

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The Business of Medicine

– Industry statistics and benchmarking

Page 13: Health Care in the CPA’s Future

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Comparison to IndustryYear-ended 2012

Page 14: Health Care in the CPA’s Future

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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

Page 15: Health Care in the CPA’s Future

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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.

Page 16: Health Care in the CPA’s Future

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Comparison of Features of Various Qualified Retirement Plans

Page 17: Health Care in the CPA’s Future

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Page 18: Health Care in the CPA’s Future

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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

Page 19: Health Care in the CPA’s Future

www.KolbCo.com

Page 20: Health Care in the CPA’s Future

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Page 21: Health Care in the CPA’s Future

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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

Page 22: Health Care in the CPA’s Future

www.KolbCo.com

The Business of Medicine

• Specialized Services and Revenue Generating Activities– Revenue Cycle

Page 23: Health Care in the CPA’s Future

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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

Page 24: Health Care in the CPA’s Future

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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

Page 25: Health Care in the CPA’s Future

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The Business of Medicine

• Additional Specialized Services– There are organizations that can help you with

compliance plan development.– Separate certificates are also available

Page 26: Health Care in the CPA’s Future

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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

Page 27: Health Care in the CPA’s Future

www.KolbCo.com

The Business of Medicine

• Additional Specialized Services– Individual financial planning and wealth management– Risk management consulting – business and individual

insurance analysis

Page 28: Health Care in the CPA’s Future

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Page 29: Health Care in the CPA’s Future

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Page 30: Health Care in the CPA’s Future

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The Business of Medicine

• Additional Specialized Services– Retirement plan design and implementation

Page 31: Health Care in the CPA’s Future

www.KolbCo.com

Page 32: Health Care in the CPA’s Future

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The Business of Medicine

• Additional Specialized Services– Audit and assurance services– Technology advising

Page 33: Health Care in the CPA’s Future

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Page 34: Health Care in the CPA’s Future

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Kolb+Co.’s Health Care Niche

• Development of the Health Care Industry Niche– Development of industry expertise and reputation– “Back office” for many practices

Page 35: Health Care in the CPA’s Future

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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

Page 36: Health Care in the CPA’s Future

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Health Care Today & Tomorrow

• Health Care Industry today– Obstacles– Opportunities

• Health Care Industry in the Future– Obstacles– Opportunities

Page 37: Health Care in the CPA’s Future

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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

Page 38: Health Care in the CPA’s Future

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Questions

Thank you!

Keith Kamperschroer, CPA, [email protected]

Robert Denkert, [email protected]