Explore our outsourcing services
Wipfli’s outsourcing services provide a cost-effective way to gain the experienced staff you need. Our team brings a depth of knowledge to guide your organization in key areas, including technology, cybersecurity, financial management and talent. We also scale our services to your needs, so that you get a tailored level of support that lets you focus on growing your organization and enhancing patient care.
Our outsourced services include:
In our fractional CFO service, your outsourced CFO from Wipfli partners with your CEO to provide insights, strategy and best practices for managing your revenue cycle while helping your organization work toward its budgeted goals.
Wipfli’s outsourced CIO services help your organization with strategy and execution for all your technology needs, including key systems like ERPs and EHRs.
Data breaches can hurt your organization’s reputation and bottom line. Our vCISO services help your organization keep patient data secure by working with you on HIPAA compliance, incident response and managing an effective information security plan.
Attract and retain high-performing talent with Wipfli’s outsourced CHRO services. We can help you strategize around physician compensation, leadership development, succession planning and other key areas in talent management.
Insights and resources
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Senior living providers are missing out on valuable revenue opportunities. Here’s how to change that.
Faced with growing financial pressures, more senior living providers are looking to generate new revenue growth. But what many providers don’t realize is that some of the most valuable revenue opportunities may not involve adding new patients, but simply running your existing business more effectively. What should you do to create more cash flow for your senior living business? Keep reading to find out. Low reimbursement rates and Medicaid cuts are pushing more senior living providers to search for new revenue Senior living providers across the country are feeling more financial urgency this year. In addition to rising costs and staffing constraints , one of the biggest drivers is that it’s simply harder to get paid enough for your work. Many providers are noticing lower reimbursement rates than in the past. Complex billing and reimbursement processes and procedures are also increasingly hard to navigate, demanding more people, better processes and help from AI to do so. Meanwhile, some senior living providers will also be affected by the roughly $1 trillion in Medicaid cuts that begin taking effect at the end of 2026. States with budget deficits, especially, may struggle to make up for the cutback in federal dollars and choose to move funding away from nursing homes. All of the above makes finding new revenue even more valuable for many senior living providers. But where should you look? What are the top missed revenue opportunities for senior living providers? Most senior living providers have clear revenue opportunities they are currently missing out on. Crucially, this hidden revenue doesn’t involve adding more patients, but improving revenue cycle management, billing processes, clinical management and other process-related improvements that may be fairly simple to implement. Key missed revenue opportunities include: Ineffective billing and revenue cycle management: Many senior living providers lack sufficient experience with billing and revenue cycle management, in part because there are no formal training programs that teach nursing home billing. This can result in slow collections due to ineffective internal processes or team members getting overwhelmed by trying to navigate complex insurance regulations without sufficient experience. Slow reporting: Nursing homes may also struggle with slow financial reporting, with financial statements frequently up to three months out of date. This makes it difficult to understand what’s happening inside your business and easier to miss that you’re leaving money on the table. Commingling adjustments and write-offs: Adjustments often get classified as write-offs, which means you miss out on any possibility of collecting on the adjustment balances. Any remaining payer balance needs to be evaluated to determine whether the payer made an error before adjusting off. Poor clinical documentation: Effective clinical management involves both accurately determining what a patient needs and fully documenting that care so you get paid for all of the services you provide. However, too many senior providers don’t properly document, which means not getting reimbursed for work that you’ve already done. Underbilling: Providers also may not always know what they are eligible to bill for, especially under Managed Medicare contracts and Medicaid. As a result, you could be paying out of pocket for costs like oxygen or transport that you should be getting reimbursed for. However, many of these revenue opportunities can be unlocked with relatively little effort, boosting your cash flow and softening the financial pressure on your business. Here’s how to start. How should senior living providers start taking advantage of more missed revenue opportunities? Senior living providers can often notably increase revenue by taking action to shore up holes in procedures, processes, systems or training. While some of this work takes time, there is often low-hanging fruit you can implement fairly quickly. Key actions include: 1. Train your team to use your systems more effectively Whether you run your business on new or legacy systems matters less than whether your team knows how to use them effectively. Even a simple change like training your team to no longer commingle adjustments and write-offs in your accounts receivable system can generate more revenue at very little cost to implement. 2. Strengthen team communication Make sure your team understands the billing opportunities that are available to you, as well as the importance of documenting everything for billing purposes. If you get everyone on the same page, less revenue will fall through the cracks. 3. Make targeted tech upgrades Use new tech tools where an investment makes sense from an ROI perspective . For example, could you implement an AI tool that helps you discover new revenue opportunities in your EMR, like areas where you’re not currently billing that you could be? 4. Explore automation Can you automate aspects of your billing process? This can exponentially reduce the amount of time you spend on billing work, while also speeding up your collections. 5. Increase your posted rates Managed Medicare contracts typically state that they will pay out the lower of either your posted rates or their reimbursement rates. This means if your posted rates are less than the managed care reimbursement rate, you can quickly generate new revenue simply by raising your posted rates to more than the reimbursement rate. 6. Build up your strategic financial capabilities Your accounting team may understand the day-to-day financial operations of your business, but many senior living providers lack higher-level financial awareness from a CFO or controller. You need someone on your team who understands the business of making money from a nursing home: Strategic planning, cost reporting, revenue cycle management, cash flow, KPIs and how it all fits together. 7. Seek advisory support An advisory firm that knows the senior living business can help you identify specific ways to generate more revenue. The right advisor will understand both operations and revenue cycle management and be able to point to areas of improvement within your business where a change could deliver results. 8. Consider outsourced billing or financial leadership An advisory firm can also deliver additional support in the form of an outsourced biller. This can be valuable because so few people really understand the ins and outs of nursing home billing, so an outsourced biller can often generate more cash simply by billing more effectively for the work you are already doing. Using an outsourced biller also eliminates the risk of making a significant investment in training an in-house biller, only to watch them quickly leave for a better offer. For higher-level financial leadership, you can also lean on an outsourced CFO or controller. Someone in this role will understand how your business works and be able to figure out how to more efficiently grow your revenue. Read more How demographic changes are impacting the senior living industry | Wipfli Innovation in the senior living industry — a key for growth | Wipfli 6 strategic planning imperatives for senior living organizations - Wipfli
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2026 healthcare industry outlook: Get ready for seismic disruption
The healthcare industry is headed into an era of disruption greater than any in living memory. Fifty-four percent of healthcare revenue comes from the federal government — but nearly $1 trillion of that funding is disappearing, with more cuts looming on the horizon. To survive, healthcare will have to change in a big way . Organizations will need to radically transform how they operate and rethink what it means to serve patients, providers and communities. The time to start that transformation process is right now. Keep reading to learn more about key trends for the healthcare industry in 2026 and what your organization can do to meet the moment. What’s coming for healthcare in 2026? Massive Medicaid funding cuts. In 2026, healthcare will face massive funding cuts. For decades, healthcare organizations have heavily relied on federal money to keep their doors open, and now, much of that revenue is gone or sunsetting. The One Big Beautiful Bill (OBBB) Act, which the Trump administration pushed through Congress in July, will cut an estimated $911 billion from Medicaid over the next 10 years. The nonpartisan Congressional Budget Office (CBO) also estimates that the bill will trigger nearly $500 billion in future Medicare cuts beginning in 2027 to offset lower federal tax revenue, although Congress could still act to prevent this from happening. Hospitals, which serve all comers, will feel the effects first, with a significant amount of revenue now likely to become bad debt. Rural hospitals will take an especially large hit, and while Congress did create a $50 billion fund to help rural hospitals affected by Medicaid cuts, it’s not nearly enough. Three hundred rural hospitals are already at immediate risk of closure . Along with funding cuts, Medicaid is also imposing burdensome work requirements , which will likely dramatically reduce the number of people insured by the program. Unless Congress makes a last-minute deal to extend the Affordable Care Act (ACA) subsidies set to expire at the end of 2025, the number of people covered under the ACA will likely fall significantly as premiums are expected to more than double — with the average premium rising by 114% . Finally, the OBBB also cut $187 billion in food stamp funding over 10 years, which will worsen patient health outcomes just as organizations are struggling to find the resources to provide care. If this sounds dramatic, that’s because it is. No one alive has witnessed such a major level of change in the healthcare sector. This understandably creates tremendous uncertainty. Healthcare leaders are losing sleep trying to figure out how to fill seemingly unfillable budget gaps. It’s a hard time, and as an industry, we need to give each other grace. But don’t despair. Every crisis also contains the seeds of a new beginning. And for organizations willing to evolve, that beginning can start right now. To survive 2026, healthcare must transform to meet the moment The current U.S. healthcare system can work miracles, but it is also deeply flawed. For every remarkable advancement in medicine or life transformed, there are still too many glaring inefficiencies, short-changed patients and exhausted providers. And the economics of healthcare just don’t add up. Both organizations and patients have long struggled to manage ballooning costs, even with vast sums of federal money to prop up the system. As an industry, we can’t sugarcoat how brutal this new era of change will be. However, as transformation becomes a survival necessity, healthcare should also take it as an equally rare opportunity to rethink and rebuild from the ground up: 1. Completely reassess funding Federal money isn’t gone completely, but hospitals and other healthcare organizations can no longer count on it. This means it’s time to reevaluate your funding from the ground up and find new revenue streams. Private philanthropy will be useful here. Look to cultivate relationships with donors or foundations that could help make up for at least some of your budget shortfall. But private money alone likely won’t be enough, so you’ll also need to get more creative. Most hospitals provide only acute care. Is it time to rethink that model? What about offering continuing education services for healthcare professionals or renting out unused facilities? More than ever, you also need to get what you can from insurance. Work with your billing team to maximize insurance reimbursements to keep that revenue going strong. As a longer-term trend, look for more hospitals to become government-sponsored entities capable of receiving tax dollars. This used to be common: Decades ago, many hospitals were county-operated and largely funded by local tax dollars, and a return to this approach may make increasing sense in the coming years. 2. Reengage with your local community Hospitals and healthcare organizations make a huge impact on their local communities. Besides providing medical care, a hospital is usually among the largest employers in a town or neighborhood. Now, more than ever, you need to lean on and deepen those community relationships. As you’re rethinking funding, consider how you can provide additional value to your community. For example, can your organization evolve beyond acute care into a gathering place or hub for local wellness? Imagine, for a moment, a hospital that hosts cooking and yoga classes, offers performance spaces and creates other opportunities to not just treat disease but actively promote the physical, social and emotional well-being of the people who live nearby. No, this isn’t what hospitals or healthcare centers usually do, but the time for usual is over. More community engagement can provide revenue opportunities, volunteers and a general sense of goodwill that healthcare organizations could really use right now. It can also bolster political support for additional state or local funding to help stabilize your organization. 3. Reevaluate how you run your organization To survive, healthcare organizations are going to need to reevaluate longstanding systems and practices. This means asking uncomfortable questions and leaving no stone unturned in pursuit of greater efficiency. Look to AI and automation to see what’s possible. Can you automate back-office functions to save on costs? Some doctors are now using AI notetakers to record patient visits so the doctor can focus on the person in front of them, which can make patients happier and improve treatment outcomes. Outsourcing can also be a useful tool. Organizations that need effective financial management can save money by hiring a CFO or controller fractionally rather than full-time. 4. Work with an advisor Don’t try to tackle huge organizational change on your own. Work with an outside advisory firm to evaluate your specific needs and figure out an action plan to navigate the challenges before you. An advisor can help you navigate funding difficulties, find opportunities to make your organization more efficient and evaluate new revenue opportunities. If you need new tools or systems to accomplish your goals, an advisor can also recommend and implement them. Look for an advisor with deep healthcare experience. This will allow you to benefit from what other hospitals and healthcare organizations are learning and avoid pitfalls along the way. 5. Embrace change for what it is This is not an easy moment for healthcare. But change is inevitable — and people and organizations who embrace that reality will have a smoother journey than those that don’t. Communicate honestly with your team about what’s happening. Share your frustrations and your fears. And then start taking action to move forward. It may be winter now, but spring will come again. Read more Healthcare Medicaid cuts 2025: Rural hospitals and senior living adapt Strategies to navigate the OBBB FQHC impact Senior living at a crossroads: Navigating financial and demographic shifts
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What is a cash balance plan, and how does it benefit physicians?
Does your medical practice have a 401(k) plan in place? Are you maxing out your contributions to your 401(k) plan and still desire to save additional contributions for retirement on a pre-tax basis? If so, then your practice could benefit from implementing a cash balance plan. What is a cash balance plan? A cash balance plan is a hybrid retirement plan with characteristics of both a defined benefit pension plan and a defined contribution (profit-sharing) plan, with contributions funded exclusively by the employer. While a cash balance plan may operate as the sole employer-sponsored plan, it is most commonly sponsored in combination with a 401(k) plan. Medical practices typically make good candidates for cash balance plans because most practices are consistently profitable, enabling them to fund the mandatory annual contribution. If the goal is to maximize the percentage of total contributions to the physician-owners, cash balance plans work best for smaller businesses with fewer employees, as it maximizes a larger percentage of the total contribution to the owners. As the business grows in size, the percentage of the total allocable to the physician owners will generally decline as the contribution is divided among a larger group of employees. What are the benefits of a cash balance plan? There are three primary benefits to physician-owners: Retirement savings, tax savings and an increased physician owner-share of the total contributions . Retirement savings: A cash balance plan provides physician-owners the ability to greatly accelerate their retirement savings. Contribution maximums are determined by the age of the participant. For example, annual contributions for a physician owner can exceed $250,000 for those approaching retirement age. Conversely, younger physicians at the beginning of their career (early 30s) may be limited to contributions of $50,000 annually, depending on age. Thus, age demographics are key in determining overall contributions for each physician-owner. When compared to the maximum contribution limits in a 401(k) plan ($61,000 and $67,500 [for those age 50 or older] for 2022 plan years), it can provide for significant increases in retirement savings. This alone can make implementing a cash balance plan well worth the effort. Tax savings: As contributions to the cash balance and 401(k) plans increase, incremental tax savings are realized. As with other retirement plan contributions, each dollar contributed to the cash balance plan offers a tax deduction. For example, if your medical practice has an annual profit of $500,000 and has a combined federal and state marginal tax rate of 40%, the corresponding tax liability would be $200,000. But if you design a cash balance plan with $300,000 of annual contributions, the medical practice can deduct the $300,000 and only pay taxes on $200,000 of profits ($80,000 tax bill). Not only do you increase retirement savings, but you have now lowered your current tax liability bill by $120,000. It’s important to understand that retirement plans provide a deferral of taxation benefit over a period of time, which may span decades. In other words, the tax benefit realized is based on current tax rates at the time the contribution is made, whereas the tax liability generated from a distribution of the original contributions plus associated earnings to the participant is based on future, unknown tax rates. For most physicians, deferring income through pre-tax contributions during higher earning working years allows them to realize it at expected lower tax rates in their retirement years. Increased physician-owner share of contributions: While increased retirement and tax savings can be beneficial for physician-owners, the benefits don’t stop there. Often, cash balance plans can also significantly increase the percentage of employer contributions going to the physician-owners. Depending on how much your practice is contributing to employee 401(k) accounts, there may be little to no increase in contributions to employees via the cash balance plan. You’re also not required to offer the plan to every employee so long as you’re meeting minimum coverage tests. While results vary based on employee demographics, amongst other items, the below example shows the power of the three benefits. A medical practice was able to optimize a 401(k)-only structure by moving to a combination 401(k) and cash balance plan, utilizing the same 10% of compensation, employer contribution structure. By shifting a portion of their existing 10% contribution to the new cash balance plan, the physicians were able to realize the entire incremental contribution of $400,000. The additional contributions generated a six-figure current year annual tax deferral, and increased the total allocable contribution to the physician-owners. How does a cash balance plan work? Cash balance plans can be more simply explained by dividing them into two parts: pay credits and interest credits. Pay credits: Pay credits are synonymous with contributions. They are expressed as either a percentage of compensation, or a fixed dollar amount. Cash balance plans have an annual, minimum funding requirement. This is computed by an actuary, and employers have some flexibility in contributing a range of contributions each year within acceptable limits. Unlike 401(k) plans, contributions to cash balance plans are not discretionary. Generally, the goal is to keep the plans as close to fully funded as possible, especially in situations where physician-owners are entering and exiting the practice. Pay credits may differ for employees vs. physician-owners. For employees, the medical practice can set a percentage of compensation to be contributed to the plan, such as 3% of each employee’s salary. For owners, contributions may vary based on the owner’s personal cash flow and desired savings, but are restricted based on nondiscrimination testing and the overall employee age demographics of the organization. The pay credits may be amended periodically, but typically no more than once every three years. Interest credits: Once you have dollars in the plan, it’s time to grow them. Unlike a 401(k), in which the employee can direct their investments and assumes the risk of doing so, a cash balance plan places the investment risk on the employer. All plan assets are placed into a single, pooled account, which is invested according to a stock-to-bond allocation determined by the investment committee appointed by the medical practice, with guidance from an investment advisor (such as Wipfli Financial Advisors). Not only do you decide this important allocation, but your medical practice is also required to guarantee a specific rate of return for participants, known as the interest crediting rate. Typically, this is 3-5% (and is based on long-term Treasury yields). Because of this, the expected future returns for the stock-to-bond risk allocation should align with the interest crediting rate. However, it is unlikely the underlying investment return from the portfolio will earn a return identical to the interest crediting rate. Any over/under-performance impacts the physician-owners’ cash flow. For example, let’s assume your plan’s crediting rate is 4%. This means your practice is required to provide each account with a guaranteed fixed rate of return, similar to a 4% certificate of deposit, regardless of the actual investment return of the portfolio. If your investments earn a 7% return, for example, the additional 3% return earned in excess of the 4% interest crediting rate can be used to offset future contributions into the plan. If your investments earn 1% and thus underperform the interest crediting rate by 3%, the physician-owners must contribute additional contributions to make up the shortfall. Due to these nuances, it is important to be thoughtful about investment risk and strategy so that it properly aligns with the interest crediting rate to avoid large swings in over/underperformance of the interest crediting rate. Are you ready for a cash balance plan? From managing recruiting and onboarding, to payroll compliance, to navigating employee benefits and succession, our specialists will help you develop a full-service human capital program that ensures employee engagement, gives you competitive leverage and allows you to focus on what you do best — running your business. Learn more on our human capital management services web page . Sign up to receive additional retirement plan content and information in your inbox, or continue reading on: 3 big reasons why physicians should consider life insurance Cash-flow planning for soon-to-be retired physicians Top changes the SECURE Act and CARES Act make to retirement plans Why now is the time for physicians to consider a variable universal life insurance policy 3 budgeting strategies for new physicians
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