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Fractional CFO for healthcare practices

Cash-flow forecasting, provider compensation modeling, expansion analysis, and a quarterly strategy conversation with a CPA who knows your numbers cold.

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CPA-led · Nationwide & fully remote · Flat monthly fees
A fractional CFO reviewing financial statements at a desk overlooking the city

Works with the tools you already use

13-week cash forecastKPI dashboardsBenchmarkingScenario modelsBoard-ready reporting
The Problem

The decisions that change your practice are not accounting decisions

Hire or wait. Open the second location or pay down debt. Take the offer or grow another two years. These are CFO questions, and most practice owners answer them alone.

No forward view of cash

Historical statements tell you what happened. A rolling 13-week forecast tells you whether payroll clears in March, which is the question you actually lose sleep over.

Hiring decisions made on instinct

A new provider is a six-figure commitment. We model the ramp, the breakeven month, and what happens if they underperform, before you sign.

Growth without a model

Second locations fail on working capital, not demand. We build the expansion model with the capital requirement made explicit.

What You Get

Everything your practice needs behind the front desk

One integrated, CPA-led team handles the entire business side, so your energy stays on care.

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  • ✓ Rolling 13-week cash-flow forecast
  • ✓ KPI dashboard built for your specialty
  • ✓ Provider compensation and productivity modeling
  • ✓ Hiring and capacity analysis with breakeven timing
  • ✓ Expansion and second-location modeling
  • ✓ Quarterly strategy sessions with a partner
  • ✓ Benchmarking against practices of your size
  • ✓ Lender and investor-ready reporting packages
What You Get

What fractional CFO includes

Senior financial leadership at a fraction of the cost of hiring it, engaged continuously rather than in emergencies.

01

Assess

A free deep-dive into your books, entity, comp, and pain points.

02

Build

We clean up the books, set your chart of accounts, and stand up the compliance calendar.

03

Run

Monthly financials, payroll, and tax filings delivered like clockwork.

04

Grow

Quarterly strategy, benchmarking, and proactive tax planning.

A worked example

The forecast that changes a hiring decision

A thirteen-week cash view is the difference between hiring a clinician and hoping.

Thirteen-week cash forecast, condensedIllustrative
Cash on hand at week zero$142,000
Average weekly collections$71,000
Average weekly operating outflow$66,400
Weekly net before the hire+$4,600
New clinician, fully loaded, weekly($3,750)
Ramp shortfall while the schedule fills, weeks 1–8($2,900)
Weekly net during the ramp($2,050)
Trough cash at week 8$125,600
Weekly net once the clinician is at full schedule+$850

What this tells you

  • What the trough tells youThe lowest point decides whether a hire is safe, not the average. Cash never drops below $125,600 here, and the practice turns cash-positive again in week 9 — so the hire is affordable, provided collections hold.
  • What would change the answerA payer slowing from 21 to 35 days pushes the trough materially lower and moves break-even out. That is why days-in-AR sits on the same page as the forecast.
  • What you get monthlyThe forecast rebuilt on actuals, the variance explained, and a clear read on whether the decision still holds.

Illustrative example built to show the structure of the analysis. Figures are not those of any client and are not a projection.

Questions

How a CFO engagement runs

Accounting reports the past accurately. A CFO uses it to make the next decision. If your current relationship is a tax return once a year and silence in between, that is the gap this fills.
Below roughly a million in collections, usually not. The honest answer is that most practices should get accounting right first. We will tell you if you are not ready rather than sell you a service you cannot use.
Monthly reporting, quarterly strategy sessions, and availability in between when a decision comes up. You get a partner, not a ticketing system.
The Difference

No equity. No percentage of your growth.

Most management services organizations charge for your back office by taking ownership or a share of every dollar you collect. One costs you control. The other costs you more each year you succeed.

Equity MSOs take ownership

A DSO or private-equity group provides the back office in exchange for a stake. You get infrastructure. You also get a board, a budget you no longer set, and an exit on their timeline.

Percentage MSOs tax your growth

A fee set as a share of collections does not stay flat. Running your back office is not twice the work when revenue doubles, but the fee is. Every good year costs you more.

We take neither

A flat monthly fee for a defined scope. No equity, no share of collections, no right of first refusal if you sell. Grow the practice and the upside stays with you.

Why our model is different →

Get Started

Ready to stop guessing on the big decisions?

Book a free assessment. We will build a first-pass cash forecast and show you what a CFO conversation about your practice actually looks like.

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