CFO services for allied health practices.
Physical, occupational, and speech therapy, chiropractic, and related practices run on visits: how many, how well reimbursed, and how much therapist time each one consumes. We bring finance leadership that measures the visit and manages the practice around it.
The finance problems that define this segment.
Visit economics are averaged across very different payers.
Commercial, Medicare with its multiple-procedure reductions, workers' compensation, auto-liability, and cash reimburse at wide ranges; the practice sees one blended number.
Therapist productivity is unmanaged.
Visits per therapist-day, units billed per visit, and cancellation rates vary widely and are seldom reported against a break-even.
Plan-of-care and authorization limits leak revenue.
Visits delivered beyond authorized counts or without recertification become write-offs.
Aides and assistants are used inconsistently.
The mix of therapists, assistants, and aides drives cost per visit and, under some payers, reimbursement — and is rarely optimized.
Cash-pay and wellness lines are launched without a model.
Performance, dry needling, and wellness memberships added for demand, without margin or capacity analysis.
Referral dependence is unmeasured.
Physician and employer referral concentration determines volume risk; few practices track it.
Multi-site growth outruns reporting.
Clinics added on a lease and a lead therapist, without their own profit and loss statement or a ramp model.
How we run finance here.
- Visit-level economics — net revenue per visit by payer, therapist cost per visit including assistants and aides, allocated overhead, contribution per visit.
- Productivity reporting — visits per therapist-day, units per visit, cancellation and no-show rates, against a break-even per compensation model.
- Authorization and plan-of-care controls measured; unbillable visit rate tracked by reason.
- Staffing mix optimization — therapist, assistant, and aide ratios modeled for cost and reimbursement.
- Cash-pay line reporting — each line with its own margin and capacity effect.
- Referral source analytics — volume, conversion, and concentration by source.
- Clinic profit and loss with allocation; de novo model with therapist ramp and cash requirement.
- Accrual close, 13-week cash, and owner or sponsor pack.
Key metrics we build and report.
| Metric | What it tells you |
|---|---|
| Contribution per visit by payer and clinic | Where the practice earns |
| Visits per therapist-day and units per visit | Productivity |
| Net revenue per visit by payer | Reimbursement reality |
| Cancellation and no-show rate | Capacity leakage |
| Unbillable visit rate by reason | Authorization and documentation control |
| Therapist / assistant / aide mix and cost per visit | Staffing efficiency |
| Referral concentration (top 5 sources) | Volume risk |
| Arrival-to-discharge visits per episode | Plan-of-care adherence and revenue per case |
| Clinic contribution margin | Site performance |
Worked example.
A five-clinic physical and occupational therapy group, $7.8M revenue, 26 therapists.
The plan: schedule templates and cancellation policy to lift visits per day; payer-mix targets and a case for the lowest commercial contract; authorization tracking in the front-end workflow; staffing mix redesign; referral development to reduce concentration.
Where we’ve done this.
Founder practices growing to multi-clinic groups; pediatric therapy providers with school and Medicaid contracts; groups adding cash-pay performance lines; sponsor-backed therapy platforms. Pattern-level only.
How do we know if a payer is worth keeping?
Contribution per visit after therapist cost and overhead, plus authorization burden and days to cash — measured, not assumed.
Can you help with school district or employer contracts?
Yes — pricing models, utilization risk, and contract terms for organizational contracts.
Do you replace our practice manager?
No; we add the finance layer above operations and give the manager the numbers to run the clinics.
Do you work with sponsor-backed groups?
Yes: sponsor pack, covenant model, clinic integration, exit preparation.
Further reading.
Clinician Utilization: The Number That Decides Whether a Practice Is Profitable
How to define, measure, and manage clinician utilization in a behavioral health practice, with a worked break-even example — and why it matters more than reimbursement rates.
Read article → InsightEmployer, School, and Employee Assistance Program Contracts: Business-to-Business Revenue for a Behavioral Health Group
How direct contracts with employers, school districts, and employee assistance programs work financially — pricing models, utilization risk, cash timing, a worked contract comparison, and what to negotiate.
Read article → InsightNegotiating Payer Contracts With Data: A Behavioral Health Playbook
How behavioral health groups should prepare for payer rate negotiations — cost per session, network need, quality data, alternatives, and a worked example of the business case.
Read article →Insights for this vertical.
Tell us about the organization.
One conversation about where the numbers stand and what the next stage needs from finance. We will tell you where we can help, where you need someone else, and what it would cost.
The information on this page is provided for general informational purposes and does not constitute accounting, tax, legal, or investment advice. Reimbursement, licensing, and compliance matters in healthcare depend on payer contracts, state rules, and the specific facts of the organization and change frequently. Figures in examples are illustrative. See our full Legal Disclaimer.