for Medical Practice Buy-Sell, Physician Recruitment, Mergers, Buy-ins, Pay-outs, Divorce, Second Opinions, Expert Witness Testimony.
including medical, optometric, chiropractic, podiatric, physical therapy, MRI/Xray, labs, etc.
Appraisals are performed on an hourly-fee basis, taking from 1-20+ hours depending on circumstances.
A verbal or written "Calculation" "Mini-report" can often be done in 3-5 hours, but it may not satisfy the other party, CPAs, litigants, courts, the IRS, or 2nd-opinion-reviews by other experts. Though reasonably accurate, it lacks a full narrative and detailed explanations, and is not meant to be fully educational and convincing. It may also be enough if you are seeking a 2nd opinion on an existing report by another appraiser wherein all the research has already been done and properly documented. It will usually not contain a detailed inventory of the tangible assets; using instead the company adjusted Balance Sheet or Tax Return Depreciation Schedule for a value. It does not include an aged AR valuation report. My Mini-report can be expanded to a Rebuttal-report, Full-report, or to include an inventory itemization or AR later if needed.
A full "IRS-Qualified" "USPAP-Compliant" "Conclusion Report" that is written, detailed, educational, & convincing; for a sale, buy-in, pay-out, partnership, merger, litigation or divorce –that will be satisfactory to most readers, their CPA, the IRS, and a bank for a loan- typically takes 10-20 hours depending on the specialty, size of the practice, complexity of the practice, and compliance of the financial records to practice accounting standards, excluding a visit. Visits are rarely required if you or a staff person can prepare an inventory of the office assets, computer & software, furnishings and instrumentation including brand & model number on the forms we send, and maybe send a few digital photos so that I can see the condition of the assets. It uses the official Income Approach, Market Approach, and Asset Approach. My Full IRS-Qualified report typically is 80-100+ pages long and generally leaves no question unanswered for the reader; with all assumptions clearly spelled out, referenced & footnoted; and all the math transparent & replicable. My reports have been commended by doctors, lawyers, judges, banks, executors, insurance companies, hospitals, administrators, and others as being "very readable and understandable". Hundreds of references are available at https://www.medicalpracticeappraisal.com/client.html
Second Opinion Review and Rebuttal Reports on other appraisers' reports can take 1-20 hours depending on the quality of the other appraiser's report.
If the appraisal is for purposes of divorce or other litigation, please first discuss with your attorney, mediator, or arbitrator, whether they want you to engage me directly, or if they want to do it for you to protect the report under their confidentiality "privilege". They might wish to interview me first, for which there is usually no charge. I am available to testify at arbitration, deposition or trial to support my report opinions. Many attorney references to my work are on my website under Client Comments. https://www.medicalpracticeappraisal.com/client.html
I am expert at the valuation of healthcare equipment and instrumentation, and was President of a medical-supply company vending many thousands of products. My valuation services have been used by many hospitals and foundations for acquisition of physician practices' assets.
All equity transactions, divorces, estates and gifting have IRS tax-return reporting requirements and implications, at least for capital-gains versus ordinary-income allocations between tangible assets and goodwill value. Practice transactions are reported in both the buyer's and seller's tax returns and investigated by the IRS for up to 7 years, and can impact both parties. I am a “Qualified Appraiser” per IRS Sec. 170(f)(11)(E)(ii) available to write "Qualified Appraisals" per IRS Regulations. That means my Full-appraisal reports can be used with your income tax returns. Not all appraisers (and not all CPAs) are Qualified, and fewer-yet are Qualified in healthcare valuation. The IRS is getting more serious about the quality and reliability of appraisals submitted with tax returns, as can be seen by Ruling Sec. 6695A. The IRS states: "It behooves taxpayers and tax practitioners to pay attention to the quality and reliability of the appraisers selected to prepare these appraisals". You can find those IRS-Qualified standards here: https://www.irs.gov/irb/2008-40_IRB/ar13.html and https://www.thetaxadviser.com/issues/2013/nov/gregory-nov2013.html
If Medicare, Medicaid, ObamaCare, or Tricare patients have been treated, or if the buyer is a hospital or other not-for-profit entity, my Full report might also provide some protection in case of Federal OIG scrutiny of the transaction for Stark II, Fee-Splitting, Anti-Kickback or other transaction-compliance issues. I don't give legal advice, but can refer you to specialist attorneys if needed. Details at https://corporate.findlaw.com/law-library/oig-issues-ten-new-safe-harbors-and-clarifies-six-existing-safe.html
Appraisal reports should follow national standards. Here are the Uniform Standards of Professional Appraisal Practice, as approved by Congress, in case you are curious https://www.appraisalfoundation.org
My Fair Market Value appraisals are never biased in favor of who pays me. Bias is unethical in Fair Market Value appraisals. I am an advocate only for my opinion, not for who pays me, and I find the same result in an appraisal no matter who pays me.
Appraisal reports are typically delivered within 30 days of receipt of data, depending on the number and complexity of appraisals in line ahead of you, holidays, and my faculty & expert witness schedules. The sooner I get your data, the sooner you get a place in line, and the sooner I can prepare and deliver a report. It takes most clients only 1-2 hours to complete my Questionnaire and assemble and send the required documents.
Appraisals for Marital Dissolution, rending an opinion of value within the specific guidelines of the courts of the state. Testimony at deposition, medication, arbitration or trial is often available.
Practice Appraisal for Sale Purposes, identifying a monetary value for a practice being sold from one physician to another.
Confidential Intermediary Services, wherein we represent a practice for sale, and field inquiries from prospective purchasers, keeping confidential the identity and location of the seller until the potential buyer has been pre-qualified and signed a Confidentiality, Non-Competition and Non-Disclosure Agreement.
Merger Appraisal for Equity Balancing, wherein multiple physicians are merging their practices, or when one practice or group is acquiring another practice by merger rather than purchase.
Practice Appraisal for Buy-in or Pay-out, identifying a monetary value for an associate buying into a practice, or an existing owner exiting a practice, or both.
Second Opinion Appraisals, wherein we review the work of another appraiser and render an opinion thereupon.
Expert Witness, Consulting and Support, to attorneys representing physicians in business valuation and business ethics disputes.
Pre-employment Practice Evaluations, investigating the business practice health and appropriateness of employment terms and/or buy-in terms on behalf of the employment candidate.
Physician Employee Candidate Evaluations, facilitating determination of the appropriateness of a candidate-physician-employee on behalf of the prospective employer.
Practice Start-up One-day Consults are available at your location or ours. Most solo physicians come to our offices, most groups have us come to them. You receive virtually everything necessary to start a practice, including confidence.
Group Formation One-day Consults lead you through the majority of issues and decisions needed to merge or form a group practice or IPA, ending with a structure that clearly defines how the group will look and feel, with a defined implementation plan and calendar.
Seminars and Workshops are often requested by medical societies, IPAs or hospitals for their member physicians on particular topics. Improving Profitability in Your Practice and Managing Your Managed Care Practice are current popular topics. Seminars can be customized to almost any degree. (Sorry: no "a la carte" attendance for individuals is available. Seminars must be sponsored by an organization that invites you, such as AAFP, ACP/ASIM, ACS, etc.)
Medical Practice Broker, assisting a seller
with valuation, setting terms of sale, promoting the practice for sale, introducing 100% bank financing to a buyer, and supporting legal counsel in guiding both parties through the myriad
and complex issues involved. Giving advice on ownership transfer
is a licensed activity in
many states. PMM is licensed since 1983.
(You wouldn't refer to an unlicensed doctor; don't use an unlicensed consultant!)
Click here for more info on Medical Practice Broker services.