Practical Management for Independent Practices

Practical Management for Independent Practices

This excellent post is from Pacific Northwest Healthcare Practice Consultant Lonnie Hirsch of Hirsch Healthcare Consulting. Lonnie has identified top 10 challenges that face physician-owned independent practices. The list includes financial and profitability challenges, the emotional states of being overwhelmed and confused, time and resource constraints, physiological barriers to success, and more. For each example, Mr. Hirsch includes solutions for the challenges that are plaguing independent practices. This post is an engaging and insightful look at problem/solution for physicians, practice managers and staff working in clinics that are fighting to stay independent. Read the full blog post: ...
Potential Strategies for Physicians When Considering The New 20% Pass-Through Deduction

Potential Strategies for Physicians When Considering The New 20% Pass-Through Deduction

Tax reform, commonly referred to as the Tax Cut and Jobs Act, has many new provisions that became effective for tax years beginning January 1st, 2018. One provision in particular created a deduction up to 20% of “qualified business income” earned from pass-thru entities and sole proprietors. The deduction will be claimed on individual owners’ tax return Form 1040 and is commonly being referred to as the Section 199A deduction (referencing the Internal Revenue Code), or the 20% qualified business income deduction (QBID). Business income is eligible if the company is structured as a Sole proprietorship, a Partnership, or an S-corporation. C corporations are not eligible to take this deduction. Personal taxable income must be less than $315,000 for a married filer or $157,500 for a single filer to avoid the deduction being phased out. The deduction is fully phased out at taxable income of $415,000 for a married filer and $207,500 for a single filer. The deduction is subject to a host of qualifications and limitations. Taking advantage of this new tax savings opportunity requires careful strategic tax planning. We have listed our top 5 strategies to be considered for healthcare practice owners. 1. Increased Retirement Plan Contributions Increasing retirement plan contributions can reduce taxable income. Consider increasing contributions to an existing plan and consider if establishing a cash balance plan might be an additional vehicle for increasing contributions. 2. Employing Children in Your Practice You may have an opportunity to employ your children and pay them the highest reasonable rate for their work. Now each child can earn up to $12,000 per year free of federal income tax. 3. Review Personal & Business Expenses Consider whether...
Jones & Roth to Present “Optimizing Revenue Cycle & Cash Flow” at OMGMA Fall Conference

Jones & Roth to Present “Optimizing Revenue Cycle & Cash Flow” at OMGMA Fall Conference

Jones & Roth Healthcare Advisors Nicole McOmber, CPA & Elliott Tracy, CPAhave been selected to present a breakout session at the 2018 OMGMA Fall Conference. Healthcare is in a state of volatility and it is important that your practice is optimizing cash flow. Learn the things that the most successful practices are doing to optimize their cash flow, and what you could do to improve your revenue cycle management. 2018 OMGMA Fall Conference Breakout Session 1C: “Optimizing Your Revenue Cycle & Cash Flow” Thursday, Sept. 20th 11:15 a.m. – 12:30pm Attendees who participate in this session will: • Learn the best practices to increase collections • Understand which factors impact your revenue cycle • Calculate, benchmark, and analyze key revenue cycle performance indicators The annual OMGMA Fall Conference is a highly anticipated event by healthcare executives throughout Oregon. The conference is of the highest educational quality, featuring nationally distinguished keynote speakers and experts in the field for each and every session. In a professional but fun environment, this conference provides timely education for management of your practice and professional development. The conference offers plenty of face-to-face interaction with OMGMA members and Partners to strengthen your business relationships and build your network in...
Depreciation Tips for Small Healthcare Clinics

Depreciation Tips for Small Healthcare Clinics

Growing your practice by investing in new high-technology medical equipment is one of the best strategies for the success of your business. Interest rates are still very low and business loan interest is still 100% tax deductible. The newest technology gives you an advantage over your competition, both in marketing and quality of care. There’s no denying that investing in new medical equipment is an investment in your success. Taking a big tax deduction on equipment in the year of purchase can be a huge benefit to your practice. Unfortunately, it’s also very common for it to become a five-year financial burden that some practices never recover from. The cookie-cutter approach to accelerated depreciation can hamstring the growth of your practice. How is this possible? Accountants love to talk about the time value of money, and it’s true that a deduction today is worth more than the same deduction next year. But what happens in three years when you are still paying off the equipment loans, your taxes have gone through the roof, and the loan principal payments are not tax deductible? Will you have had enough growth by then to sustain that kind of cash outflow? Does it make sense to save fifteen cents on the dollar today when you could be in the 35% tax bracket next year? The answer is maybe. It is not a simple question, and careful consideration and planning is the key. Your personal cash flow needs, business loan payments, projected practice growth, and many other factors all play into determining the best strategy for your new equipment or practice purchase. Avoid the...
Oregon Legislature Update for Healthcare Practices

Oregon Legislature Update for Healthcare Practices

The Oregon Legislature voted and passed a tax bill in February in response to the federal tax reform enacted in December 2017. In planning for 2018 taxes, the following are a few of the key Oregon provisions to take into consideration: Addition of Oregon tax credit for certified contributions to the Oregon Opportunity Grant Fund. Oregon disconnected from federal tax law that allows specified pass-through entities a deduction of up to 20% of qualified pass-through business income on the federal return. As a result, the amount will be an addition to taxable income on Oregon tax returns. Oregon Pass-Through Entity reduced rates: For 2018, an addition of sole proprietorships for eligibility of preferential tax rates on business income. Limits preferential tax rates available to sole proprietorships and nonpassive income of partnerships or S corporations to first $250,000 of qualified taxable income. Limits use of preferential rates to businesses not classified in certain North American Industry Classification System industries. For tax years 2018 – 2025, increases Oregon personal exemption credit from $90 to $113. As you are planning for 2018, it is important to include changes from both federal and Oregon tax laws to ensure you are effectively optimizing your cash flow and minimizing your tax liabilities.   Nicole McOmber, CPA is a Healthcare CPA and the leader of the Jones & Roth Healthcare Team. She specializes in practice management, advisory services, and tax & accounting services for medical practices and clinics across Oregon & Southwest...
MIPS/MACRA Update

MIPS/MACRA Update

Happy New Year. I hope your new year is off to a great start. Every year practices face various challenges and 2018 is no different. In planning for success, you will want to start early. In our recent webinar featuring Elizabeth Woodcock, we navigated through MIPS/MACRA: Gearing up for 2018. As we enter our second year of the government’s Quality Payment Program we find many still confused along with continued changes to the program. For 2018 it is important not only to understand which quality payment program pathway you will follow, but also how you are scored so you can ensure you are armed for success in meeting minimum thresholds to optimize practice cash flow. With the deadline to send in your performance data quickly approaching, by March 31, 2018, make sure you are ready. If you missed our webinar, we encourage you to watch the recording as Elizabeth presents some great tips and tools on how your practice can prepare.   Nicole McOmber, CPA is a Healthcare CPA and the leader of the Jones & Roth Healthcare Team. She specializes in practice management, advisory services, and tax & accounting services for medical practices and clinics across Oregon & Southwest...