“You will always know where your practice stands — and you will never have to chase us to find out.”
Every owner assumes there is a firm out there that knows their business, watches the numbers all year, and helps them build and grow — rather than appearing in April with a return and an invoice. Most never find it.
We built this firm to be that partner, and to still be it in year five.
Independent healthcare is consolidating, and the groups doing the consolidating arrived with something owners genuinely need: real financial infrastructure. Books that close on time. A forecast that answers whether payroll clears. A model behind every hire. Records that hold up in diligence.
The price is ownership. Sell a stake and the board sets the budget, approves the hires, and decides when you exit. Pay a percentage of collections instead, and the arrangement quietly worsens every year you grow.
Practice Partner CPAs exists to separate the infrastructure from the claim — services, strategy, and support at the standard a private-equity-backed group would bring, for a flat monthly fee, with no stake in your practice and no share of what you collect.
| Equity MSO or DSO | Percentage-fee MSO | Practice PartnerFlat fee | |
|---|---|---|---|
| Ownership of your practice | They take a stake | You keep it | You keep it |
| Hiring and clinical decisions | Subject to the group | Yours | Yours |
| What growth costs you | Upside is shared | Fee rises with revenue | Fee stays flat |
| What it costs at $1.2M in collections | A share of every future dollar, permanently | $72,000 a year at 6%, and more every year you grow | $36,000 a year, flat |
| If you ever sell | On their timeline | Often a right of first refusal | No claim, no right of refusal |
| Who you actually call | Assigned support | An account manager | The partner |
The dollar figures are illustration, not an offer — they use the same assumptions as the flat-fee calculator on our home page, where you can put in your own collections and your own percentage. Your actual fee is set after we scope the work.
It is the right question, and the one nobody selling a flat fee volunteers. Here is the honest answer, including the part that is a genuine limitation.
A percentage MSO earns more when you grow, so at least its incentive points at your revenue. A flat fee is the opposite: once it is set, every additional hour we spend on you costs us. On paper the incentive is to do the minimum and keep collecting.
Because the fee is not fixed forever — it is fixed between scoping conversations. When your practice adds an entity, a location, or thirty percent more transaction volume, we come to you and re-scope openly, with the reasons written down. You are never surprised by an invoice, and we are never quietly absorbing work by cutting corners on the close.
Not our good intentions. A published cadence you can hold us to — books by the 15th, a reply inside one business day, a strategy call each quarter. A partner review on every engagement. And an exit that costs you nothing after the initial term, with your data leaving with you. If we underserve you, it is visible within one close, and you can leave.
A flat fee means we have to be selective about who we take on. If your practice needs more than the engagement scopes — a genuine turnaround, litigation support, a year of forensic reconstruction — we will price that separately or tell you we are not the firm for it. We would rather say that at the start than discover it in month four.
Plenty of firms will tell you that private-equity-grade infrastructure can be delivered without private-equity terms. Very few of them have built that infrastructure inside a portfolio and watched what the terms actually do to an owner.
We can say that with confidence because our founder spent his early career as financial controller for a private-equity healthcare portfolio, then oversaw the general ledgers behind roughly $500 million in revenue across about 100 partnerships. We have run the back office inside the model that buys practices.
Controller work inside a portfolio is a different job from public accounting, and it is the more useful one here. You sit on the other side of the table: building the budget a practice has to live inside, modeling the clinician it wants to hire, and preparing the numbers a buyer will pull apart in diligence. You learn quickly which reports get a practice funded and which ones get its budget cut.
What comes attached to that infrastructure in a portfolio is a board — one that sets the budget, approves the hires, and decides the timing of your exit. The infrastructure and the board are separable. This firm is the argument that they should be separated.
On your engagement that is not a name on a letterhead. He reviews your close, sets and defends your tax position, and takes the quarterly call himself. When a question actually matters, you get the partner rather than a queue.
So we built the same infrastructure — services, strategy, and support — and priced it as a flat monthly fee. You keep control, you keep ownership, and you stop losing sleep over the business side.
The fair question to ask a firm with a founder’s photograph on its About page is whether the founder is the firm. Here is how an engagement is actually staffed, and what happens when someone on it is unavailable.
Not values. Values are unfalsifiable. These are specific enough that you would notice immediately if we stopped doing them.
A firm that claims to be right for everyone has not thought about it. If you are in one of these situations, we will say so on the first call rather than three months into an engagement.
A management services organization is a legal structure, not a marketing word. These are the terms that define ours, stated plainly so your attorney does not have to go looking for them.
The prior month is closed. Reconciled books and financial statements are in your hands, with a plain-English read on what they say.
Our reply window on anything you send us. Not a ticket number and not a queue — an answer from the people who know your file.
A scheduled strategy call within thirty days of quarter close: results reviewed, tax position updated, next moves agreed.
Typical onboarding, start to finished: books current, systems connected, compliance calendar built, and your first full close delivered.
Filing deadlines are worked ahead of the due date, not on it. And if a date is ever at risk, you hear it from us before it passes rather than after — which is the part most practice owners have learned not to expect.
Nothing on this page is a contract or an offer of one. Specific terms are set out in the management services agreement and the engagement letter for your practice.
A free assessment is a working session, not a sales call: we review your books, entity structure, payroll setup and tax posture, and come back with what we would change, what it is worth, and what it would cost. If the honest answer is that you do not need us yet, that is what you will hear.