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Organizations across industries are constantly seeking ways to enhance efficiency, streamline operations, and maximize value. However, outdated processes, unnecessary complexity, and organizational inertia can hinder progress, slowing innovation and impacting productivity. The good news? Businesses and institutions can adopt proven methods to become more agile, responsive, and effective—with the right mindset and leadership. 

Change can be daunting. Leaders may worry about disrupting established workflows, employees may fear efficiency initiatives could threaten job security, and stakeholders may hesitate to embrace new approaches. But the reality is this: Lean thinking isn't about cutting corners—it's about optimizing value. It's about refining processes so that employees can focus on what truly matters: delivering results. 

This approach reduces bottlenecks, eliminates redundant steps, and ensures that every action aligns with broader organizational goals. By adopting Lean methodologies, businesses can unlock new opportunities for innovation and productivity. 

The lean methodology 

Lean is all about working smarter, not harder. Originally developed from Toyota’s production system, Lean principles now extend beyond manufacturing into industries such as healthcare, technology, and finance. The core goal? Remove inefficiencies—whether excessive paperwork, outdated procedures, or unnecessary handoffs—so that teams can operate at peak performance. 

Rather than disruptive, large-scale changes, Lean focuses on continuous, incremental improvements that refine workflows over time. This approach enables organizations to optimize resources, simplify processes, and eliminate barriers to success. 

Identifying and reducing waste 

Lean methodology centers around eliminating waste in seven key areas: 

Transportation: Unnecessary movement of materials, information, or people slows down operations. Organizations should assess whether digital alternatives can replace physical movement, optimizing accessibility and minimizing disruptions. 

Inventory: Excess resources, whether unused equipment or redundant data, increase costs and complexity. Streamlining assets ensures that every resource serves a clear purpose. 

Motion: Inefficient physical movements or cumbersome digital workflows slow down productivity. Identifying friction points—whether unnecessary clicks or outdated storage practices—helps refine efficiency. 

Waiting: Bottlenecks occur when approvals, materials, or decisions are stalled in a queue. Empowering teams with clearer processes and real-time visibility reduces delays. 

Overprocessing: Adding unnecessary steps to a task makes it more time-consuming than necessary. Simplifying workflows ensures essential tasks remain streamlined without sacrificing quality. 

Overproduction: Producing more than needed creates inefficiencies. Whether it’s excessive documentation or redundant reporting, cutting down on excess work optimizes time and resources. 

Defects: Errors in processes lead to rework and wasted effort. Investing in clear instructions, automation, and proactive checks reduces mistakes and ensures smoother operations. 

Taking the next step toward operational excellence 

Lean methodology provides a powerful framework for enhancing efficiency, reducing waste, and driving meaningful improvements. By embracing continuous innovation, organizations can work smarter—not harder—delivering better results while optimizing resources. Whether streamlining workflows, eliminating unnecessary steps, or fostering a culture of improvement, Lean helps businesses operate at their best. 

Embracing smarter processes unlocks new potential for agility, productivity, and innovation. Organizations that invest in efficiency don’t just survive—they thrive. Ready to explore Lean principles further? Download our ebook to learn more details and explore common myths about Lean. 

On July 18, 2025, the United States took a historic step in digital finance when President Donald Trump signed the Guiding and Establishing National Innovation for US Stablecoins (GENIUS) Act into law. This legislation introduces the first comprehensive federal framework for payment stablecoins, aiming to balance innovation with consumer protection and financial stability while strengthening the US dollar’s global dominance. 

What are payment stablecoins? 

Payment stablecoins are digital assets pegged to a fixed monetary value (such as the US dollar) and designed for payments. Unlike volatile cryptocurrencies, they maintain price stability, making them attractive for everyday transactions and financial services. 

Key provisions of the GENIUS Act 

• Only permitted payment stablecoin issuers can issue stablecoins in the US, with the three main categories being: 

  1. A subsidiary of an insured depository institution 

  2. A federal qualified payment stablecoin issuer (can include nonbank entities but must be approved by the Office of the Comptroller of the Currency) 

  3. An entity established under state law and approved by a state payment stablecoin regulator 

• Stablecoins must be 100% backed with high-quality liquid assets (US dollars, short-term Treasuries). 

• Issuers must provide monthly disclosures of reserve composition. These disclosures must be reviewed by a Public Company Accounting Oversight Board (PCAOB)-registered accounting firm. 

• Issuers are prohibited from paying interest or yield to stablecoin holders. 

• Issuers are subject to the Bank Secrecy Act, requiring anti-money laundering and sanctions compliance programs. 

• In insolvency, stablecoin holders’ claims take priority over other creditors. 

• Issuers must have the technical ability to freeze or seize assets when legally required. 

• Stablecoins are not federally insured and may not be marketed as having such insurance. 

Why would companies issue stablecoins? 

Given that stablecoins must be backed 1:1 with highly liquid assets and they cannot pay interest, it begs the question of why a company would want to issue its own stablecoin, especially given the regulatory requirements. Furthermore, why would one want to invest in a stablecoin? 

Let’s use Starbucks as an example: 

Starbucks could issue its own stablecoin, let’s call it “Star Bucks” (pretty clever, right?) Starbucks customers could purchase Star Bucks and then use those Star Bucks when making purchases at Starbucks. To encourage the use of Star Bucks, Starbucks could offer incentives, such as lower prices and exclusive deals. But again, why would Starbucks want to encourage the use of Star Bucks? Think of it as free financing. Starbucks is taking customers’ money in exchange for Star Bucks. Sure, these Star Bucks must be backed 1:1 with highly liquid assets, but Starbucks will earn interest on these highly liquid assets. In a way, it’s like purchasing a gift card—the customer is giving a company money in exchange for a future product/service from that company. The company can then invest that cash. Starbucks could possibly even offer its employees Star Bucks in lieu of a paycheck, further increasing the amount of cash (or highly liquid assets) Starbucks has on hand. 

Impact on community banks 

One of the benefits of stablecoins is the ability to make real-time payments, thus increasing the chances of businesses and consumers circumventing the banking system. There are also concerns that if stablecoins become popular, it could cause a decrease in deposit balances held at financial institutions. Although stablecoins must be backed 1:1, the assets backing stablecoins don’t necessarily have to be in cash. Thus, it is not a guarantee that stablecoin issuers will back these assets with deposits at financial institutions. This isn’t entirely a new problem for financial institutions, as Starbucks reported stored card value at $1.78 billion at the end of 2024. This is cash that is sitting on gift cards instead of in a bank. Although some of this cash may still find its way into financial institutions, it’s likely not all of it will. 

There’s also concern that stablecoins may cause US Treasury market instability. US Treasuries are one of the permissible investments for backing stablecoins. Thus, there may be companies that have historically not been interested in US Treasuries that now will be. This increased demand could drive up US Treasury prices, which would lower their yields. Alternatively, there are also concerns as to what would happen if there were a “run” on the stablecoin market. For instance, stablecoins are built on blockchain technology and there are concerns that the safety of this technology could be compromised with advances in quantum computing. If stablecoin holders lose confidence in the system, it could cause them to dump their stablecoins rapidly, causing the stablecoin issuers to fulfill these redemptions, selling off large quantities of US Treasuries and possibly withdrawing large sums of cash from financial institutions.  

In a way, think of stablecoin issuers, especially those that are not financial institutions, as an added layer to the financial ecosystem. And, with each new layer, there is often an added level of market instability. However, community banks cannot ignore the GENIUS Act and the stablecoin market.  

Community banks will have a significant strategic decision to make:  

1. Issue its own stablecoin 

2. Partner with a fintech to issue a stablecoin 

3. Stay out of the stablecoin space 

Community banks will also need to decide if they’re willing to hold assets meant to back stablecoins for other stablecoin issuers. 

The stablecoin market will be an evolving landscape, and there is much to still be learned as to how the GENIUS Act will work in practice. The GENIUS Act becomes effective on the earlier of 18 months after enactment (so, January 18, 2027) or 120 days after federal agencies issue final regulations. Community banks should start discussing internally now how they plan to approach the GENIUS Act. If you plan to issue your own stablecoin, please reach out to the BerryDunn team. As a PCAOB-registered accounting firm, we are fully equipped to review your monthly reserve composition disclosures. 

This article is for CFOs, controllers, and directors of finance at companies that are owned by Employee Stock Ownership Plans, particularly recently established plans. 

Employee Stock Ownership Plans (ESOPs) are an attractive employee benefit, giving employees ownership interest in the company through shares of stock and an appealing exit strategy for founders. However, accounting for ESOP transactions can be confusing and cause frustrations for accountants. Understanding the basics of accounting for ESOP transactions is essential to avoiding inaccurate financial statements and ensuring compliance with US Generally Accepted Accounting Principles.  

Financing the ESOP 

ESOPs can be financed with internal or external loans. For an internal loan, the company provides the financing to the ESOP trust, essentially lending money directly to the trust for the purchase of shares. This type of loan is not recognized on the company’s General Ledger (GL), meaning it doesn’t appear as a liability or asset in financial statements. The ESOP trust receives contributions from the company, including the amounts required to repay the internal loan. If the company were to report the internal loan in its GL, it would artificially inflate the total assets on the company’s financial statements. An internal loan provides the company with greater control over provisions of the loan, such as interest rate and repayment terms. 

With external loans, funds are borrowed from either the selling shareholders, a financial institution, or both, and are reported on the company’s balance sheet. External loans are legal obligations of the ESOP trust. However, the company has an obligation to provide the trust with sufficient capital to service the loans and therefore must reflect the liability on the balance sheet.  

Unearned ESOP shares 

Unearned ESOP shares, sometimes referred to as unreleased shares, are shares that have been contributed to the trust but have not yet been allocated to individual employees. On the balance sheet, these shares are reported as a contra-equity account at the original transaction cost of the acquired shares, less the annual amount of shares, which are released for allocation to ESOP participants. Unearned ESOP shares are released at historical cost when repayment of the internal loan occurs.  

Commonly, companies will inappropriately report an ESOP note receivable rather than unearned ESOP shares, resulting in an overstatement of assets.  

ESOP compensation expense 

ESOP compensation expense is recorded annually based on the average fair value of the ESOP shares released for allocation to participants during the year. Shares are deemed to be released ratably throughout the year despite the fact that they are generally allocated at one time. The actual share allocation typically occurs several months after the financial statement date. However, an accrual is generally not required.  

ESOP compensation expense may be presented as a component of the cost of sales or selling, or general and administrative expenses. It is also permissible to present ESOP compensation expense as a component of other income and expense on the statement of income.  

About BerryDunn 

Whether your ESOP is newly established or mature, proper accounting is critical to accurate financial reporting. BerryDunn’s ESOP experts are excited to partner with employee-owners to help address any technical accounting or compliance matters. Learn more about our team and services. 

In recent years, the public health workforce has faced unprecedented challenges—from responding to the COVID-19 pandemic to addressing the impact of social determinants of health on communities to stark changes in policy at the federal level. These pressures have led to poorer quality of care, reduced access to services, diminished preparedness, and a decline in public trust in the public health system. As political tensions deepen and workplace stress intensifies, public health employees are reporting increased mental health concerns, including burnout and moral injury. 

To address this crisis, government and non-governmental agencies are implementing actionable strategies to support workforce wellness. These include trauma-informed leadership, peer support networks, flexible work policies, and regular wellness check-ins. By creating supportive environments and promoting resilience, organizations can strengthen the public health infrastructure and ensure the workforce is equipped to meet both current and future demands. 

Mental health and stigma 

The Public Health Workforce Interests and Needs Survey (PH WINS) reveals alarming levels of burnout among public health professionals. In 2021, nearly half of respondents reported frequent feelings of burnout—up from 32% in 2017. Similarly, nearly half expressed intentions to seek new employment, compared to 33% in 2017. 

These findings underscore the need for proactive measures such as open dialogue around mental health, access to resources, and flexible work arrangements. 

Read our previous article to explore PH WINS data and the evolving landscape of public health transformation. 

Understanding burnout and moral injury 

Burnout is closely linked to mental health conditions such as anxiety, depression, and trauma. It often manifests as exhaustion, reduced motivation, and cynicism. According to the National Center for PTSD, moral injury was initially identified in military veterans exposed to events that violated their deeply held moral beliefs. In the context of clinical health workers, moral injury is described as “knowing what your patients need and being unable to provide it due to external constraints.” 

These issues are increasingly prevalent across the public health workforce—from community health workers to epidemiologists—and affect both governmental and non-governmental organizations. The de Beaumont Foundation defines burnout as an occupational syndrome caused by chronic workplace stress, leading to emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment. Key contributors include excessive workloads, moral injury, and insufficient support. 

To mitigate these effects, agencies are encouraged to implement peer support programs, conduct interviews to understand retention drivers, and explore alternative support models such as the Critical Incident Peer Support Model used in emergency response sectors. 

Real-world impact 

The strain on public health workers is evident in crisis situations. For example, in January 2023, over 653,000 people—roughly 20 per 10,000—experienced homelessness in the U.S. As emergency shelters reached capacity, public health workers faced increased workloads with limited staffing and resources. The emotional toll of turning away individuals in need further deepens moral injury and burnout. 

These scenarios highlight the importance of building a dynamic public health emergency response infrastructure and reinforcing core public health functions to better support both the workforce and the communities they serve. 

Trauma-informed public health practice 

To support recovery and resilience, agencies are increasingly adopting trauma-informed approaches. These frameworks recognize the impact of trauma on both the workforce and the communities served. Trauma-responsive leadership can empower public health professionals to perform effectively while fostering healing. 

A trauma-informed organizational change model is built on four core assumptions—known as the “Four Rs”: 

1. Realization of the widespread impact of trauma 
2. Recognition of trauma symptoms 
3. Response through integrated policies and practices 
4. Resisting re-traumatization 

These are supported by six guiding principles that promote safety, trust, collaboration, empowerment, and cultural sensitivity. Agencies can use these principles to create trauma-informed environments that support healing and resilience. 

Key recommendations for agencies 

To champion mental wellness and build a resilient public health workforce, agencies can: 

• Create supportive environments: Encourage open dialogue around mental health, provide access to supportive resources, and implement flexible work policies. 
• Promote work-life balance: Support boundary-setting and offer flexible schedules to reduce overload. 
• Establish peer support networks: Create safe spaces for sharing experiences and mutual encouragement. 
• Conduct regular wellness checks: Use surveys and check-ins to detect early signs of burnout. 
• Build leadership pathways: Review promotion practices and policies to help assure accessible career ladders within the public health agency 
• Strengthen emergency response infrastructure: Develop dynamic systems to handle public health crises. 
• Reinforce core public health functions: Invest in foundational capabilities. 
• Foster trauma-responsive environments: Ensure organizational practices support healing and resilience. 

BerryDunn's public health team is comprised of former state and local health agency leaders and public health professionals with assessment and planning, accreditation readiness, technology solution planning and procurement, policy and program development, project management, health information exchange, and data modernization expertise. Learn more about our team and services. 

Most healthcare organizations conduct internal or external Evaluation and Management (E/M) audits on a monthly, quarterly, or annual basis to stay ahead of compliance risks and optimize reimbursement. While these audits can be stressful, given their association with risk, penalties, and payer scrutiny, when executed effectively, they can uncover significant opportunities within a practice. A well-structured E/M audit, combined with a strategic audit plan and targeted education, can shift the focus from apprehension to opportunity. Instead of asking, "Did we do something wrong?" the conversation transforms to, "What can we improve, clarify, or claim with greater confidence?" 

Audits frequently reveal consistent issues such as under-coding, vague documentation, or inconsistent use of templates. Addressing these concerns can lead to more accurate coding and enhanced revenue integrity. Implementing a strategic audit plan allows practices to proactively identify and correct such issues. By doing so, practices can not only avoid potential penalties but also optimize their revenue streams. Keep these things in mind during your next E/M audit:  

Involve certified coders for the most accurate and compliant E/M audit 

Certified coders help ensure that coding is precise and compliant with current regulations. Trained in CPT®, ICD-10-CM, and payer-specific E/M guidelines, coders apply their expertise to help ensure proper audits. They examine documentation and coding for issues. Coders also provide educational feedback to providers by looking at audit insights and then illustrating a finding for providers with examples from the provider’s notes. The improved documentation and corrected coding errors that result from the certified coder’s work help providers boost revenue through accurate reimbursements and reducing denials. 

Tie your E/M audit to physician education

The true advantage of audits emerges when findings are tied to education—specifically, sessions tailored to the provider’s specialty and utilizing examples from their own documentation. When providers comprehend the rationale behind the feedback, their engagement, confidence, and ability to improve increase significantly.  Comprehensive physician education remains critical, equipping providers with insights into intricate coding requirements and the necessity of detailed documentation. E/M audits extend beyond mere compliance checks. They are essential tools for continuous quality improvement, operational efficiency, and financial sustainability.  

Think strategically 

A strategic E/M audit plan is designed to continuously improve accuracy, compliance, and revenue integrity. By integrating certified coders and focused physician education into the audit process, practices can enhance their revenue integrity and ensure long-term success. A strategic audit plan, therefore, creates opportunities for improvement, turning potential apprehensions into avenues for advancement. 

BerryDunn’s healthcare compliance team incorporates deep, hands-on knowledge with industry best practices to help your organization manage compliance and revenue integrity risks. Learn more about BerryDunn’s team and services.