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Medical Practices

You built this practice to see patients. Not to chase insurance payments at midnight.

Running a physician-owned practice means you're equal parts clinician, CEO, and collections manager. Northstar runs the financial side of your practice, from monthly close to payer negotiations, so your only job is the one you actually trained for.

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You're making million-dollar decisions with a shoebox full of data.

We're producing more and taking home less.

Production and patient volume are up, but overhead keeps creeping. Staff costs have jumped 20% since 2020, and after rent, malpractice, and billing fees, there's less left for partners than three years ago. Your financials don't break it down well enough to pinpoint where the money is going.

My partners can't agree on compensation.

One partner sees 30 patients a day; another sees 18 but generates twice the ancillary revenue. Your current formula doesn't account for this fairly, and nobody has modeled a production-based comp plan benchmarked against MGMA data. So the conversation never gets resolved.

I have no idea which payers are worth keeping.

You've never calculated your true reimbursement rate by payer, adjusted for denials, write-offs, and time-to-payment. Some contracts haven't been renegotiated in five years. You suspect a few are costing you money, but you don't have the data to prove it.

My accountant has no idea what a wRVU is.

Your CPA gets the returns done. But when you ask about compensation restructuring, the economics of adding a procedure room, or whether your overhead ratio aligns with MGMA benchmarks, they stare blankly. They understand accounting, not medical practice economics.

What your finance team looks like with Northstar.

We deploy a dedicated finance pod, your outsourced accounting department, controller, and CFO, built around the financial rhythms of a physician-owned practice.

Monthly close and management reporting

Books closed by the 15th. You get a P&L, balance sheet, cash flow statement, and a plain-English management summary explaining what the numbers mean.

Payer mix and reimbursement analysis

Effective reimbursement rate by payer, adjusted for denials, appeals, and write-offs. See which contracts are performing and which to renegotiate or drop.

Provider-level productivity and profitability

Production tracked by provider (encounters, wRVUs, collections) with overhead allocated to show each physician's true bottom-line contribution.

Overhead benchmarking

Your staffing, supply, occupancy, and total overhead compared against MGMA benchmarks for your specialty and practice size, with a plan to close any gaps.

Compensation modeling and restructuring

Financial models for equal-split, production-based, or hybrid comp plans benchmarked against regional MGMA data. We present the numbers so the partner conversation is about data.

Buy-in, buy-out, and partnership structuring

Economics of partner buy-ins and buy-outs: valuation methodology, payment terms, financing options, and impact on existing partner distributions.

Practice valuation

Detailed valuation based on financial performance, provider productivity, payer contracts, and growth trajectory. A real analysis you can negotiate from.

Cash flow forecasting

Rolling forecasts that account for reimbursement cycles, seasonal volume shifts (January deductible resets, elective procedure timing), and the service-to-payment lag.

Tax strategy and entity optimization

S-corp election timing, reasonable compensation analysis, qualified retirement plans, and year-end distribution planning tailored to multi-provider practices.

Growth and expansion modeling

Full financial projections for adding a provider, location, or service line: capital required, ramp timeline, breakeven analysis, and projected return.

What this looks like in practice.

The Situation

A five-provider orthopedic surgery group was splitting income equally despite widening production gaps. The highest-producing surgeon generated nearly twice the wRVUs of the lowest, yet both took the same draw. Two partners were discussing leaving, and a health system had made an acquisition offer they couldn't evaluate.

What We Did

Within 60 days we completed a per-provider profitability analysis, a practice valuation, and a compensation restructure model. We designed a hybrid comp plan weighting 70% on wRVU production and 30% on a base component for administrative duties and call coverage, benchmarked against MGMA 50th percentile data.

The Result

Partners unanimously adopted the new model, and both physicians considering departure stayed. Collections increased 14% the following year. When they explored the health system acquisition, the detailed valuation package resulted in a purchase price $1.2M above the system's initial offer.

Our partner compensation meetings used to be the worst day of my quarter. Northstar gave us financial models that turned arguments into conversations. We restructured our comp plan in two months, and for the first time in five years, every partner feels the system is fair.

Managing Partner

Orthopedic Surgery Group

Take the First Step

Let's talk about your practice.

We'll discuss your practice size, biggest financial frustrations, and what your ideal finance function looks like. If we're a fit, we'll map out your finance pod and what it costs.

Free 30-minute strategy call
No contracts or commitments
Custom roadmap for your business

Or call us directly: 888.999.0280

Schedule a Medical Practice Finance Consultation

Tell us about your business and we'll reach out within 24 hours.

No obligation, no jargon. Just a conversation with someone who understands physician-owned practice economics.