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H.R. 1—the “One Big Beautiful Bill Act”—enacts sweeping changes to Medicaid, the ACA Marketplaces, and Medicare, with major implications for state Medicaid offices. From new work requirements and shorter renewal cycles to reduced provider tax caps and tighter subsidy rules, the law shifts administrative burdens and financial risks to states. In this article, BerryDunn’s healthcare analytics experts break down the key health coverage provisions, highlights rural impacts, and what state agencies must consider as they prepare for implementation, coordination, and policy adaptation.

For a physician beginning a new clinical role, an efficient onboarding process is crucial. A seamless onboarding experience signals to clinicians that the organization values their time, expertise, and contribution to the care continuum. In today’s environment, where every dollar and every patient interaction count, the financial impact of a well-executed onboarding strategy is considerable. 

As public health evolves and new challenges emerge, both new and seasoned professionals need guidance to navigate their careers effectively. Whether guiding fresh graduates or supporting experienced employees, mentoring is a vital step in the workforce lifecycle. It bridges the gaps from academic learning and onboarding through career transitions to professional growth and expertise, helping individuals move from passion to practice and thrive in their respective areas. 

Starting January 1, 2025, a new individual tax benefit allows taxpayers to deduct certain interest paid on loans for qualified passenger vehicle purchases. This deduction is available through the end of 2028 and presents both opportunities and compliance responsibilities for lenders. 

Beginning January 1, 2026, significant changes will affect catch-up contributions to retirement plans for high-earning individuals, sometimes referred to as ‘highly paid participants.’ The new rules specifically target plan participants whose prior-year compensation exceeds a set threshold and require that their catch-up contributions to 401(k), 403(b), and governmental 457(b) plans be made on a Roth (after-tax) basis. This article provides an overview of these new requirements, focusing on the affected plan participants and discusses the pros and cons as well as key considerations for employers and affected individuals in advance of the transition deadline on December 31, 2025. 

In today's rapidly evolving business landscape, boards of directors are more than just stewards of governance—they are the strategic compass guiding an organization toward enduring success. For the latest installment of our corporate board leadership series, BerryDunn Financial Services Practice Group Senior Manager, Lindsay Francis, shares key insights on information security awareness and risk, including how to embed it in your organizational culture. 

For nonprofit organizations, every resource matters. Selecting the right Enterprise Resource Planning (ERP) system is no longer just a technology decision, it’s a strategic choice that impacts the entire organization. With so much at stake, it’s essential to approach ERP evaluation and implementation with careful planning and expert guidance. Follow these four steps for best practices to help you make informed decisions that support the mission and vision of your organization during the process. 

Local governments across the United States are facing a historic workforce transition. With nearly 38% of the local government workforce expected to retire within the next five years, the sector is confronting what experts have dubbed the “Silver Tsunami.” This wave of retirements, driven by an aging workforce and accelerated by post-pandemic burnout, is creating a perfect storm of staffing shortages, institutional knowledge loss, and increased pressure on remaining employees. 

Private foundations are vital players in the philanthropic landscape, channeling resources toward charitable, educational, and scientific causes. However, to maintain their tax-exempt status and avoid excise taxes, these organizations must comply with strict IRS rules—particularly those governing qualifying distributions. In the second installment of our trilogy, we will follow the McQueen Family Foundation to determine their qualifying distributions. As a non-operating foundation, this is a crucial step in their annual compliance requirements. 

Construction companies face distinct challenges that make them uniquely vulnerable to fraud. Multiple job sites, a mobile workforce, complex billing arrangements, and layers of subcontractors all increase the risks of misreporting, theft or even errors and require specific oversight. The good news? By understanding the three most common risks, owners can take practical steps to protect both their business and their bottom line. 

When utilities launch a Customer Information System (CIS) project, it can feel like game day—high stakes, fast decisions, and a lot riding on the outcome. Just like championship teams, successful CIS projects require vision, leadership, adaptability, and a playbook built for tough calls and last-minute pivots. 

No one likes to be caught off guard, especially when it comes to an audit. Being “audit ready” isn’t about checking a box; it’s about building confidence, protecting your reputation, and making sure your team can carry out its daily responsibilities with minimal disruption. It’s also important to know when to seek help. 

Today’s healthcare leaders are navigating a perfect storm of workforce shortages, financial strain, regulatory uncertainty, and more, creating unprecedented pressure across the industry. Meanwhile, leaders are being asked to innovate, improve operational efficiencies, and deliver exceptional care—all while remaining compliant and financially viable. Developing a strategy is key. 

In a move that has sparked widespread attention across higher education, the US Department of Education (ED) recently placed Harvard University on Heightened Cash Monitoring (HCM) status. This designation is typically reserved for institutions facing serious financial or administrative challenges. While Harvard’s inclusion may come as a surprise, the decision underscores the importance of understanding the HCM framework and its implications for colleges and universities nationwide. 

Assuring access to behavioral health services in rural communities remains one of the most persistent and critical challenges that state governments face today. Research shows that nearly 18% of large rural areas and over 40% of small or isolated rural areas are at least 30 minutes away from any mental health care facility. In comparison, fewer than 10% of urban areas face this issue. According to Rural Health Information Hub, over 70% of rural counties lack a psychiatrist, and many have no psychologists or licensed counselors. Rural communities often struggle to access behavioral health services, which can harm community well-being, economic stability, and family life. 

Your compliance policies should be living documents that guide daily activities for many staff members. To be effective, they must be clear, concise, and appropriately specific. How do your policies stack up? 

The FDIC's Quarterly Banking Profile for quarter two 2025 reports the performance for the 3,982 community banks evaluated.

When it comes to Medicare reimbursement, the hospital Area Wage Index (AWI) may be one of the most important and often overlooked factors influencing your bottom line. This article breaks down how the wage index is calculated and offers practical strategies to help hospitals avoid common pitfalls, support audit readiness, and take full advantage of this critical reimbursement mechanism.  

In an era defined by rapid technological advancement and constant innovation, one truth remains unchanged: the success of any organization depends on its people. Employee engagement is not a nice-to-have—it’s a strategic imperative. BerryDunn’s Valuable Organizational Insights on Culture and Engagement (VOICE) assessment provides leaders with a research-backed, actionable framework for understanding and improving engagement. Unlike traditional surveys, VOICE translates insights into impact quickly, equipping organizations with tailored recommendations and tools that drive meaningful change within weeks.

The US Department of Health and Human Services (HHS) has revised its federal grant policy, introducing stricter oversight into budget adjustments. Effective October 1, 2025, the new rule lowers the allowable rebudgeting threshold from 25% to 10% and is expected to significantly reduce reallocation flexibility while increasing the administrative workload and compliance risks for health centers and other HHS grantees. 

In today's rapidly evolving business landscape, boards of directors are more than just stewards of governance—they are the strategic compass guiding an organization toward enduring success. For the latest installment of our corporate board leadership series, BerryDunn Director of Learning & Development, Shawn Tuttle, shares key insights on developing talent within an organization, including the importance of experiential learning, artificial intelligence, employee retention, and the role of managers. 

A financial institution’s core banking system, or core processing system, is an essential software that provides the backbone for day-to-day operations and transaction processing. Accounting for the costs of these systems can be tricky because of the complexities often involved in these contracts.

The Minimum Investment Return (MIR) is a critical component for all private foundations. It is a standardized calculation based primarily on the value of the foundation’s investment (i.e., non-charitable use) assets to ensure that endowments are put to charitable use rather than accumulating excessive wealth with little to no public benefit. By adhering to IRS guidelines and maintaining diligent records, foundations not only avoid costly penalties but also contribute meaningfully to the communities and causes they support. 

On March 25, 2025, President Trump issued an executive order regarding federal tax payments and refunds. Effective September 30, 2025, the US Secretary of the Treasury will discontinue the issuance of paper checks for tax refunds. Additionally, “as soon as practicable,” all payments to the federal government must be made electronically. This change could have a significant impact on taxpayers, especially those who do not have a US bank account. 

In today’s digital age, residents expect the same level of service from their local government as they do from private companies—fast, transparent, and personalized. For municipalities striving to meet these expectations, a constituent relationship management (CRM) system can be a game-changer. 

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. 

On July 18, 2025, the US took a historic step in digital finance when President Donald Trump signed the 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. 

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. 

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. 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. 

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.  

Artificial Intelligence (AI) is no longer a futuristic concept reserved for research labs or tech giants in Silicon Valley. Today, AI is becoming a practical and powerful tool for local governments across the country—helping to boost efficiency, reduce costs, and elevate the quality of public services. 

The National Recreation and Parks Association’s (NRPA) Conference is just around the corner, and the annual conference can really be overwhelming, especially for first-year attendees," shares Rich Neumann, manager with BerryDunn's Parks, Recreation, and Libraries team. "Here you have direct access to the brightest minds in our industry exploring the hottest trends in parks and recreation." With the conference approaching (September 16-19 in Orlando), our team of consultants and former practitioners shares their proven strategies for navigating this landmark event. 

Changes are brewing in the healthcare industry due to far-reaching federal reforms. With the One Big Beautiful Bill Act (OBBBA) now signed into law—alongside Executive Orders (EO), judicial rulings, and other federal actions—providers are facing a wave of new requirements and opportunities. This article highlights some of the changes affecting the industry and offers a comprehensive, downloadable summary for a closer look at key impacts.

The FDIC has proposed raising several key regulatory thresholds, including those that determine which institutions must comply with Part 363’s audit and internal control requirements. The primary driver behind these proposed changes is the growth experienced by institutions since the original thresholds were set decades ago. While the changes are designed to ease compliance burdens for smaller institutions, they also come with a cautionary tale—they would reduce regulatory requirements, but not the risk. 

In its newly released PIH Notice 2025-14, HUD lays out clear guidance for Public Housing Agencies on how to properly manage, report, and safeguard Operating Funds—especially when using centralized accounts like PayMaster or Revolving Fund Accounts. 

In today’s governmental accounting space, transparency isn’t just a best practice; it’s expected. Internal and external users rely on financial statements not just for numbers, but for a clear and concise picture of how a government is managing its assets and planning for the future. GASB 104 raises the bar on how governments disclose capital assets, and it warrants attention. 

Reflections from the MESC 2025 conference. 

A new Executive Order issued by President Donald Trump on August 7, 2025, brings major changes to how federal agencies handle discretionary grants. Titled "Improving Oversight of Federal Grantmaking," the changes in this Order introduce more political oversight, tighter controls on how funds are used, and new compliance rules that will directly affect organizations receiving federal funding. 

In today's rapidly evolving business landscape, boards of directors are more than just stewards of governance—they are the strategic compass guiding an organization toward enduring success. For the latest installment of our board leadership series, BerryDunn's Learning Consultant, Michelle Holloway, shares insights on learning and development, including designing effective training deliverables, aligning courses with an organization’s goals, and getting buy-in from leadership. 

The One Big Beautiful Bill Act (OBBBA) introduces sweeping reforms to federal student aid programs, reshaping the financial landscape for higher education institutions and their students. From changes in loan borrowing limits and repayment structures to Pell Grant eligibility and institutional accountability, the OBBBA signals a new era of fiscal discipline and transparency in postsecondary education.

One of the most overlooked yet critical aspects of a successful system replacement for justice and public safety information systems is the planning and documentation of interfaces and integrations.

For many hospitals and health systems implementing Electronic Health Record (EHR) systems, the "go-live" milestone is less of a celebration and more of a stumbling point—even when the implementation seemed like a triumph. Why does this happen? The truth is, go-live is just one of many milestones on the long ascent of your EHR journey.

The Public Company Accounting Oversight Board has released its 2024 Annual Report on the Interim Inspection Program for audits of broker-dealers, outlining persistent deficiencies in broker-dealer audits and attestation engagements. For management and audit committees, the report offers crucial insights into audit risks, regulatory expectations, and areas where stronger oversight is needed. 

The Centers for Medicare & Medicaid Services (CMS) issued the final rule for the PPS for SNFs for FY 2026 which was published in the Federal Register on August 4, 2025; the regulations in this rule are effective October 1, 2025. 

As financial institutions continue to navigate evolving regulatory landscapes, the recently enacted OBBBA legislation introduces a noteworthy incentive aimed at supporting rural and agricultural development. Effective July 4, 2025, the bill provides a 25% federal income tax exemption on interest income earned from qualifying rural or agricultural real estate loans.  

Executive Order (EO) 14221, released on February 25, 2025, directed the Secretaries of Labor, Health and Human Services (HHS), and the Treasury to implement changes to improve implementation and increase enforcement of the hospital price transparency (HPT) rule. Here we offer practical guidance for HPT compliance. 

The FDIC's Quarterly Banking Profile for quarter one 2025 reports the performance for the 4,022 community banks evaluated.

Capital campaigns can be game changers for nonprofits, enabling bold investments in infrastructure, programs, and long-term growth. Whether you're building a new facility, expanding services, or upgrading technology, a capital campaign aligns fundraising with your strategic vision. 

CMS recently extended the deadline for the mandatory SNF provider enrollment off-cycle revalidation to January 1, 2026.  

Healthcare organizations are currently facing growing financial challenges and experiencing high staff turnover. Recruiting a compliance officer may prove challenging due to the unavailability of experienced professionals or concerns about salary and fringe expenses. Depending on a healthcare organization’s fiscal health, consideration might be given to downsizing the compliance department. This article offers guidance to healthcare administrators as they ponder several compliance-related what-if scenarios.

July is National Parks and Recreation Month, and it’s the perfect time to celebrate the people who transform everyday spaces into places of joy, connection, and belonging. To highlight this year’s theme, ‘Build together, play together,’ members of BerryDunn’s Parks, Recreation, and Libraries team share stories of projects that helped communities thrive—and the personal ways they embrace play in their own lives. 

Signed into law by President Trump on July 4, 2025, the One Big Beautiful Bill Act (OBBBA) marks a significant step forward in addressing America’s growing need for affordable housing. With the demand for low-cost units far outpacing supply nationwide, the legislation offers targeted solutions aimed at making development more feasible and sustainable.

On July 4, 2025, the One Big Beautiful Bill Act (OBBBA) was signed into law. This article summarizes relevant key provisions that impact tax-exempt organizations. 

In today's rapidly evolving business landscape, boards of directors are more than just stewards of governance—they are the strategic compass guiding an organization toward enduring success. For the latest installment of our board leadership series, BerryDunn HR Generalist Maddie Stevens, shares insights on onboarding, engaging, and fostering connections for new employees, as well as leveraging generational gaps in the workforce.  

On July 1, 2025, Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) transitioned from cost report-based to claim-based Medicare reimbursement for influenza, pneumococcal, COVID-19, and Hepatitis B vaccines. This important policy change enables real-time payment, improving cash flow and making vaccine administration more financially viable for health centers and clinics. 

Tariffs remain a significant cost factor for US importers and exporters. Understanding and leveraging trade programs is more critical than ever. One underutilized but highly valuable strategic tool is duty drawback. 

Artificial intelligence applications in healthcare have become ubiquitous and pervasive, and their adoption is accelerating. A recent American Medical Association survey disclosed physicians’ confidence in AI’s advantage for patient care is on the rise and their enthusiasm for its use is increasing. 

The "Big Beautiful Bill" introduces a new savings vehicle for American families called the Trump Account. This novel provision has largely been overshadowed by other headline items including the SALT cap—and perhaps understandably so. This article will explain what these accounts are, how they would work, and their tax implications, so that if the legislation passes, you can be informed on whether they fit into your family's financial future.

BerryDunn's Valuable Organizational Insights on Culture and Engagement (VOICE) assessment offers an evidence-based approach to measuring and enhancing employee engagement, helping leaders identify ways to cultivate a motivated, committed, and high-performing workforce. 

The Medicare Payment Advisory Commission’s (MedPAC) June 2025 Report to Congress highlights critical developments in Medicare Advantage (MA). Several key insights emerged with important implications for home health and supplemental benefit policy. 

Newly appointed to lead BerryDunn’s Healthcare Practice Group, Lisa Trundy-Whitten is closely attuned to the healthcare industry. From challenges faced by healthcare organizations to the solutions BerryDunn’s experts can provide, Lisa shares her vision for the team as she takes the helm, as well as thoughtful insights for today’s healthcare leaders. 

As artificial intelligence (AI) becomes increasingly woven into nonprofit operations, boards are stepping into a new and critical role. Traditionally focused on mission oversight and fiscal responsibility, today's boards must also shape how AI is introduced, governed, and aligned with the organization’s values. Below are the seven most important actions a board can take to ensure responsible and strategic AI implementation. 

For healthcare finance professionals, Artificial Intelligence (AI) has become a strategic imperative. With a strong implementation strategy, AI can be implemented to prevent and manage denials, reducing the financial and administrative pressures on an organization. 

The debate and negotiations over tax reform are taking shape in the United States Congress. The United States Senate is reviewing the ‘One Big Beautiful Bill Act’ (OBBBA) passed by the US House of Representatives in late May. The House-passed legislation contains meaningful tax reforms with potentially significant impact to businesses and individuals.

Credit, purchase, and debit cards each offer convenience for small-dollar purchases, but carry varying levels of risk. Strong internal controls are essential to prevent fraud, misuse, and compliance violations.

In the complex world of international trade, businesses are constantly seeking ways to optimize their supply chains and reduce costs. One often-overlooked strategy that can yield significant savings is the use of first sale declarations.  

CAPRA accreditation is more than a “stamp of approval” for parks and recreation agencies. It is the foundation of a well-run parks and recreation department, offering proof that an agency is operating at the highest standards. In a competitive municipal environment where funding is tight and priorities shift, accreditation gives departments the credibility they need to advocate for resources and drive innovation. 

Nonprofit leaders must assess the risks and strategically position their organizations to adapt to changing funding landscapes. This article outlines key steps to help your organization proactively evaluate funding vulnerabilities, mitigate risks, and plan for sustainable operations. 

The proposed “One Big Beautiful Bill Act” includes several provisions that would directly impact tax-exempt organizations. BerryDunn’s experts provide a breakdown of how the bill could affect nonprofits.

Federally Qualified Health Centers (FQHCs) face a perfect storm—level grant funding, shrinking 340B drug pricing savings, and rising expenses. Staying sustainable requires identifying ways to maximize operations and revenue while controlling costs. That’s where site- and program-specific accounting become essential. 

The proposed $880 billion cuts to Medicaid, along with recently imposed tariffs and funding freezes, have placed healthcare organizations directly in the crosshairs of federal funding reductions. The result is an unprecedented threat that would profoundly affect the financial stability of organizations providing care.

The US Department of Health and Human Services Office of Inspector General has been actively enforcing healthcare compliance and fraud prevention in 2025. Are you ready? 

When it’s time to change auditors, it’s important to find a firm that feels like a long-term partner. Start by asking the right questions up front. 

With default federal student loan collections now resumed by the Department of Education, higher education institutions and other effected nonprofits need a strategy to ensure compliance. 

After an intense overnight session, the US House of Representatives narrowly passed the "One Big Beautiful Bill Act" with a 215-214 vote, marking a significant milestone in fiscal policy reform. The bill, which now heads to the Senate for further consideration, proposes extensive tax changes alongside broader regulatory shifts. While House Republicans and the current administration champion the bill as a legislative victory, Democratic opposition remains strong, and modifications are expected before it reaches the president’s desk.

Public health agencies have a powerful opportunity to inspire the next generation of professionals to join the governmental workforce. To build a pipeline of committed talent, agencies must take proactive steps—establishing dynamic mentorship programs, creating hands-on internship opportunities, and sharing compelling success stories that highlight the profound impact and fulfillment of serving in public health.

The Supporting Affordability and Fairness with Every Bet (SAFE) Act is a proposed federal legislation aimed at establishing minimum standards for sports betting across the United States. The SAFE Bet Act aims to help ensure minimum standards at in place throughout the United States for responsible gambling, protection of consumers, and maintaining the integrity of sports betting.

In today's globalized economy, businesses face an ever-changing landscape of tariffs, trade policies, and international supply chain challenges. For companies navigating these complexities, foreign trade zones (FTZs) present a strategic opportunity to reduce costs, improve logistical efficiency, and enhance overall competitiveness. 

As hospitals strive to balance their budgets and sustain primary care, there are options for hospitals to take that could ease financial burdens while preserving provider presence in the communities they serve. This article explores actionable models and strategies to reimagine primary care delivery in a way that benefits both patients and hospital systems.

In today's rapidly evolving business landscape, boards of directors are more than just stewards of governance—they are the strategic compass guiding an organization toward enduring success. As the challenges facing companies grow increasingly complex, from disruptive technological trends to shifting societal expectations, the board's role has never been more critical. 

Nonprofit audit committees play a pivotal role in maintaining transparency and accountability. Their responsibilities include financial oversight, compliance, reporting guidelines, risk management, external audits, internal audits, and ethical standards. Have you ever wondered what kinds of questions the audit committee should be asking of management and each other? Consider the following list of sample questions as a starting place.

How often does a new category of lending open up for the banking industry? This could happen if Congress ends federal tax exemptions for interest earned on municipal (“muni”) bonds. While a final decision has not yet been made, Congress is debating this option as they decide how to handle expiring provisions of the 2017 Tax Cuts and Jobs Act.

Employee retention is crucial in construction, where turnover can delay projects, increase training costs, and reduce efficiency. Statistics show that turnover in construction is approximately 21.4%, and with the industry facing an estimated labor shortage of 430,000 workers as of 2023, retaining skilled workers is vital. Here, we’ll look at proven strategies, backed by industry data and case studies, that small to medium-sized construction companies can use to reduce turnover and improve employee satisfaction.

Digital accessibility is more than a legal requirement—it’s about ensuring everyone can access public services, regardless of ability. As government agencies increasingly move services online, compliance with accessibility standards like the ADA’s Web Content Accessibility Guidelines (WCAG), EAA regulations, and Section 508 is essential. 

As new regulations take shape and tariff frameworks continue to change, importers must assess their compliance strategies with heightened scrutiny. One of the most critical components of this evaluation is transfer pricing. 

How does your nursing facility’s financial health stack up against industry peers? Benchmarking can provide you with the clear, relevant comparisons that are essential to measuring and optimizing your facility’s performance.

Last month, in honor of Women's History Month, we had the opportunity to speak with two women making waves in the parks and recreation industry—BerryDunn’s Becky Dunlap and Lakita Frazier. Both have built meaningful careers driven by a passion for community impact and the outdoors, forging paths that inspire others in the field. 

The construction industry presents some unique accounting and financial reporting requirements when it comes to construction work-in-progress (WIP) schedules. To keep a solid pulse on contract financial status and results, it is important that these schedules are accurate and up to date.

The FDIC's Quarterly Banking Profile for Q4 2024 reports positive performance for the 4,046 community banks evaluated.

On March 28, 2025, the FDIC issued a Financial Institution Letter (FIL), which rescinds its prior notification requirement for financial institutions engaging in crypto-related activities, as established in FIL-16-2022. 

In late 2024, the Centers for Medicare and Medicaid Services (CMS) launched a sweeping off-cycle mandate requiring all skilled nursing facilities (SNFs) in the United States to revalidate their Medicare provider enrollment record. Facilities of all types–including for-profit and not-for-profit–are affected.

To address evolving threats and regulatory challenges, OCR has issued proposed modifications to the Security Rule, introducing stricter security controls, mandatory encryption requirements, and a shift away from “addressable” implementation specifications. While these changes aim to improve data security, they also introduce new compliance burdens that could be challenging for many regulated entities. 

For foster teens, the path to adulthood is uniquely challenging. As thousands of young adults age out of the foster care system each year, many child welfare agencies are searching for ways to better support them through this transition. According to Dr. Elizabeth Wynter, child welfare advocate and author of Follow the Love: Permanent Connections Scaffolding, the key is to build strong youth-adult partnerships. In a recent episode of BerryDunn’s Fresh Perspectives in Social Work podcast, Dr. Wynter and I discussed the need for a “connection scaffold” and offered insights on improving outcomes for foster youth. Here are five take-aways from our conversation.

In today's data-driven world, the ability to share information between Medicaid and Public Health Agencies (PHAs) is crucial for efficiently using limited resources to serve both individual patient and population health goals and priorities. Often, states already have the needed technology, but they don’t have the partnerships or workforce infrastructure to leverage existing investments across different agencies.

Public health is at a crossroads. With the lessons learned from COVID-19 and a workforce on the brink of burnout, now is the time for transformative action. By reimagining operations, infrastructure, and health equity, we can shape a system that’s responsive to future challenges.

Most nonprofits rely on federal and state government funds to fulfill their missions. With a federal funding freeze in the headlines, many clients are asking us how they can best prepare for a freeze and protect their organizations if funding is cut. Here are three steps you can take today to stay ahead. 

If your organization is in the process of a large-scale project, such as replacing or implementing an electronic health record (EHR) system in the near future, success will depend on having a sound communication plan in effect before, during, and after the implementation. Fortunately, effective communication is not a difficult task to achieve. Based on our experience helping local governments implement EHR other systems nationwide, our team has developed five simple communication steps for successful implementations. 

The end of 4Q 2024 marks the start of a new year. In the Valuation Group, the end of the calendar year brings us to one of our busiest times of year: “ESOP season.” During the first few months of the year, we perform annual valuations for 30+ ESOP clients.

For manufacturers in New England, the global trade environment has always played a significant role in shaping supply chain strategies and cost structures. With the current tariff landscape marked by rapid changes and adjustments due to ongoing trade negotiations and economic strategies, businesses must be ready to quickly reevaluate their pricing models and material cost standards to maintain profitability. 

As the new year begins, your organization may be starting to plan for your next fundraising event. In addition to raising money for the organization, fundraising events are a wonderful way to build relationships within the community, raise awareness for a cause, and provide a meaningful experience to donors. Beyond the excitement and benefits of these events, there are important Form 990 reporting and compliance requirements that you must consider. Below are the most frequently asked questions we receive from our clients. We hope this helps you avoid some common pitfalls around fundraising events.

Rapid advancements in artificial intelligence (AI), robotics, quantum computing, and augmented reality will redefine how society functions by 2035

The market approach is one of three different ways to estimate the value of a company. In its simplest form, the market approach is fairly straightforward. Below is a very basic model for how a valuation could be applied:

Like many male-dominated industries, construction workplaces are often aligned with traditional masculine values such as self-reliance and stoicism, which can encourage resistance to traditional well-being approaches. 

The Financial Accounting Standards Board (FASB) has recently issued two significant Accounting Standards Updates (ASUs): ASU No. 2023-07 and ASU No. 2024-03. These updates aim to enhance the transparency and usefulness of financial disclosures for public business entities (PBEs) and are only applicable to PBEs.

Is your nonprofit using a break-even bottom line as your ultimate budget goal? If so, you may be missing out on opportunities to strategically further your mission. By looking at your budget using a statement of financial position perspective, rather than just a profit and loss perspective, you can gain a more complete financial picture of your organization.

As organizations navigate the complexities ahead in 2025, economic uncertainty presents both challenges and opportunities. Organizations must strategically address financial stability, donor engagement, federal compliance requirements, and workforce management to sustain their missions. This article dives into five critical finance trends and explores how nonprofits can effectively adapt.

The housing industry is subject to ongoing regulatory changes that are critical to their operations. Recently, we shared changes impacting compliance for multifamily housing, but that's just one example; all facets of the industry are subject to ongoing changes to compliance.

The FDIC's Quarterly Banking Profile for Q3 2024 reports positive performance for the 4,082 community banks evaluated.

Effective January 1, 2025, qualifying businesses in all Maine jurisdictions will be eligible for a generous, refundable credit while simultaneously investing in their business.

What Medicaid agencies and Medicaid-participating managed care organizations need to know about best practices for adhering to federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Requirements.

The Centers for Medicare & Medicaid Services (CMS) issued the final rule for the PPS for SNFs for FY 2025 which was published in the Federal Register on August 6, 2024, the regulations in this rule are effective October 1, 2024.

On November 6, 2024, members of the BerryDunn financial services team joined bankers and board members throughout the state of Maine at the annual Maine Bankers Association FDIC Directors’ College in Augusta, Maine. Here are our key takeaways from the event:

The election created a sense of anxiety and uncertainty among many people for a variety of reasons. One such concern was around how the election would affect business value.

The revenue cycle is an intricate system involving interdependent functions. Like an ecosystem, each component plays an important role. To optimize your revenue cycle, it helps to understand these four components of the ecosystem and the roles they play.

In this guide, we’ll explore the key benefits of the REAP Grant, explain who should consider applying, and highlight the important tax implications to help you make informed decisions about whether this program is right for your business.

This article explores the current trends in banking fraud, highlighting traditional schemes, emerging threats, and effective preventive measures.

These 7 success factors address the essential aspects of an economic development strategy––a roadmap for your community to encourage economic growth, create jobs, and improve the quality of life.

On July 25, 2024, the Public Company Accounting Oversight Board (PCAOB) issued its 2023 Annual Report on the Interim Inspection Program Related to Audits of Brokers and Dealers. The PCAOB can essentially be considered “the auditor of the auditor” and thus performs various inspections of audit firms that conduct broker-dealer audits on an annual basis.

The COVID-19 pandemic taught our public health systems a number of critical lessons about how we should engage, communicate, partner, and share data with other agencies and our communities. It also reinforced the importance of applying an intentional health equity lens to the system to better support vulnerable communities in times of crisis.  

The implementation of Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) 606, Revenue from Contracts with Customers, which has been in effect since 2018 for broker-dealers, has had a profound impact on financial reporting across various industries. For broker-dealers, the adoption of this standard has introduced new challenges and considerations in recognizing revenue accurately and in accordance with the principles outlined in ASC 606.  

Your parks and recreation master plan was created with the goals and values of your community at its core. It’s part of what makes your community a great place to live, work, and play. It’s also a living document, designed to meet both current and future community needs—and to evolve as those needs change.

We often see broker-dealers receive 12b-1 fees in the course of ordinary business. With these fees, we often see the broker-dealer acting as a pass-through, retaining these fees on its balance sheet until the ultimate payee requests such funds, typically for payment or reimbursement of expenses that are permissible to be paid from 12b-1 fees, as outlined in the distribution agreement. These fees can often be substantial and result in significant receivables on the broker-dealer’s balance sheet.

Enterprise Resource Planning (ERP) systems provide a shared platform for people in your organization to work together––and the benefits can be game-changing. 

The SECURE Acts made several changes to 401(k) and 403(b) plan requirements. Among those changes is a change to the permissible minimum service requirements.

One of the key strategies to making the patient check-in process a good experience for patients, while also gathering the most important information for billing, is to have clear scripts for your patient access staff. 

The BerryDunn Parks, Recreation, and Libraries team is thrilled to share our highlights from the 2024 NRPA Annual Conference in Atlanta, which showcased the vibrant future of parks and recreation through exciting sessions, meaningful connections, and moments of celebration.

In April 2024, the Governmental Accounting Standards Board (GASB) issued GASB Statement No. 103, Financial Reporting Model Improvements.

A more popular addition to Medicaid Enterprise System Conference (MESC) discussions this year was AI, and attendees expressed both fear and excitement over its potential to tactically support the enterprise.

If it’s been a while since your nonprofit organization last conducted a review of its governing documents and policies, worry not, you’re not alone! This article will highlight a few of the most critical documents applicable to nonprofits to ensure you remain in compliance and good standing.

How should a business owner, management team, or investor estimate the value of its company? There are a variety of methods available in the world of business valuation. Let’s discuss the pros and cons of using a common financial metric in the assessment of a business’s value: Earnings Before Interest, Taxes, Depreciation, and Amortization (EBITDA).

If there’s one thing that was clear at the recent Medicaid Enterprise Systems Conference (MESC) in Louisville, it is that CMS is focused on meaningful enterprise planning, meaningful outcome definitions, and meaningful data from State Medicaid Agencies (SMAs) to illustrate trends throughout every phase of the IT life cycle and the benefit to Medicaid beneficiaries.

Although summertime is a generally slower time for the valuation team, we’ve seen a notable increase in M&A activity. Transactional activity often follows interest rate trends. We’ve seen activity pick up significantly in the last nine months under the current stable interest rate environment. As rates drop, more deals are sure to follow.

Nursing facilities need to be aware of a wide range of potential data uses for payer-based reporting (PBR) data and have comprehensive internal data review procedures to help ensure the public use file reflects accurate reporting and facility is prepared for an audit.   

For larger educational institutions that can receive hundreds of such disclosable donations in a given year, the Schedule B reporting onus can become downright brutal. However, there is a special rule available for Schedule B reporting that could greatly reduce that requirement. Fundraising and Development departments rejoice!

To help public health state agencies target budget and fiscal management training needs for their workforce, a comprehensive assessment can be utilized to examine four domains of administrative management activities with a focus on financial management.

At first glance, the healthcare patient check-in process seems straightforward. But when examined through the lens of your revenue cycle and patient experience, it’s one of the most important interactions for your team to get right.

Non-profit financial statements include a wealth of important knowledge but can often be overwhelming. When sharing your financial statements with your board of directors or other stakeholders, it can be useful to simplify your statements so the key information stands out and unimportant information doesn’t cause confusion.

Parks and recreation agencies, like any public-serving organization, have an obligation to equally serve all members of their communities. But knowing that something must be done is not the same thing as knowing how to approach it. As heard in a recent episode of the “Let’s Talk Parks with BerryDunn” podcast, host Becky Dunlap spoke with Meredith Tekin, President of the International Board of Credentialing and Continuing Education Standards (IBCCES), and Lane Gram, Manager for Parks and Recreation in Gilbert, Arizona, about how the town is undertaking the endeavor of making their parks and facilities accessible and enjoyable for all.

In February 2024, the American Association of State Highway and Transportation Officials (AASHTO) released a 2024 Edition of the Uniform Audit & Accounting (A&A) Guide, which supersedes the 2016 edition. The guide is a tool for architectural and engineering (A/E) firms calculating and reporting overhead rates to state transportation departments (DOTs), and to guide state DOT auditors and public accounting firms in performing audits of A/E firms’ indirect cost schedules.  

The United States Department of Housing and Urban Development (HUD) signed the Housing Opportunity through Modernization Act (HOTMA) into law on July 29, 2016. For multifamily housing owners, HOTMA went into effect on January 1, 2024, and owners are expected to be fully compliant by January 1, 2025.

To stay competitive in the recruitment and retention of employees, employers need to stay abreast of the current well-being trends—the ones that have the potential to move the needle in creating a thriving, healthy workforce.

The Centers for Medicare and Medicaid Services (CMS) has temporarily paused the Program for Comparative Billing Reports (CBRs) and Evaluating Payment Patterns Electronic Report (PEPPERs). During this pause, which is expected to end in the fall of 2024, CMS will be improving and updating the program.

In November 2023, the US Department of Labor’s Employee Benefits Security Administration (EBSA) issued its fourth assessment of the quality of audit work performed by independent qualified public accountants. Here are our five key takeaways.

Did you receive an Employee Retention Credit (ERC) that you now believe you were ineligible for? Since the ERC was announced, many ineligible claims have been filed, due to a variety of reasons, including companies working with ERC vendors that either did not understand the complexities or were not providing the due diligence necessary to ensure that the applications were complete and accurate.

Early-stage startups must often contemplate the most practical way to raise capital for their business. If traditional debt and equity methods are not available, different avenues to raising capital must be considered. Here are four alternatives to traditional debt and equity transactions:

The Corporate Transparency Act (CTA) was enacted into law by Congress on January 1, 2021, as part of the National Defense Authorization Act. The CTA mandates that every foreign or domestic entity registered to do business in the United States disclose Beneficial Ownership Information (BOI) beginning in 2024.

On December 20, 2023, the National Credit Union Administration (NCUA) issued a technical correction with the calculation of the Current Expected Credit Loss (CECL) transition amount.

A SOC report can be an invaluable tool in helping you gain confidence about your service providers.

With the rapid growth of Medicare Advantage (MA) plans in the last several years, many hospitals are struggling to effectively manage the financial and operational challenges of these plans, including:

  • Increased denials of Medicare Advantage claims
  • Confusion between Medicare, supplemental Medicare plans, and Medicare Advantage (Part C) plans, and what each cover
  • Extra burden of “shadow billing” inpatient claims and leaving potential reimbursement off the table if not done correctly
  • Compliance risk, including the risk of Medicare fraud

Derivatives can be used to hedge against a company’s exposure to a particular risk, whether that be the purchase price of materials or equipment, the selling price of a product a company has already purchased the materials to produce, or a variable rate of interest on debt.   

Staff turnover can present a number of challenges for independent schools. When staff turnover in your business office occurs, there are serious matters related to financial risk that you should consider.  

Owners of rental property who receive assistance from the US Department of Housing and Urban Development (HUD) through debt financing or tenant rent subsidies for affordable housing are subject to specific reporting and compliance requirements. It’s important to know and understand these requirements in order to be ready for audits, maintain compliance, and continue to receive funding. Here are three of the most complex requirements that anyone receiving funding from HUD needs to be aware of and have a process in place to help ensure compliance.  

In the realm of gaming and sports betting, maintaining proper security, privacy, and operational integrity are crucial in providing assurance to all parties involved. In such a heavily regulated industry, it is essential that sportsbook providers have the resources and professional advice needed for obtaining and maintaining compliance.

As we put a bow on another Medicaid Enterprise Systems Conference (MESC), I want to express my thanks to the New England States Consortium Systems Organization (NESCSO), the State of Colorado, and the City of Denver for hosting a fantastic event.

We’ve all heard stories about organizations spending thousands on software projects that take longer than expected to implement and exceed original budgets. One of the reasons this occurs is that organizations often don’t realize that purchasing a large, commercial off-the-shelf (COTS) system is a significant undertaking.

The Centers for Medicare and Medicaid Services (CMS) issued the Final Rule for the PPS for SNFs for FY 2024, which was published in the Federal Register on August 7, 2023. The regulations in this rule are effective October 1, 2023, except certain amendments, which are effective January 1, 2024. 

There’s a good chance that your organization is being forced to do more with less under the strain of budget constraints and competing initiatives. It’s a matter of survival. 

Executive compensation, bonuses, and other cost structure items, such as rent, are often contentious issues in business valuations, as business valuations are often valued by reference to the income they produce. If the business being valued pays its employees an above-market rate, for example, its income will be depressed. Accordingly, if no adjustments are made, the value of the business will also be diminished.

Across all industries, organizations are struggling to attract and retain the employees needed to provide services to their communities. From local governments to retail outlets to…well, just about everyone.

In the latest episode of the Let’s Talk Parks with BerryDunn podcast, we discussed the topic of retaining all-star employees as it relates to Parks and Recreation Departments who are struggling to maintain community services due to staffing levels. The conversation with my colleagues Nikki Ginger and Barbara Heller and our guests Nicole Falceto and Fernando Avellanet from the Loudoun County (Virginia) Parks, Recreation and Community Services Department uncovered tangible and actionable strategies that any type of organization can use to start the process of improving their organizational culture to better retain staff.

Organizational change is hard. And necessary. And manageable.

You know your organization needs to change – to develop a better culture, to enhance efficiencies, or to improve outcomes. But where do you start?

In our most recent episodes of the Fresh Perspectives in Social Work Podcast, I had a conversation about this subject with organizational development experts Megan Clough, Manager with the State Government Practice Group at BerryDunn, and Jennifer Kerr, Director of Organizational Effectiveness at American Public Human Services Association (APHSA).

At BerryDunn, our healthcare consulting teams have worked with hundreds of organizations as they’ve transitioned to new enterprise systems such as Electronic Health Records (EHR) systems and Enterprise Resource Planning (ERP) systems. Based on our experience, there are 10 key areas to focus on in order to have a successful conversion.   

It can be challenging and stressful to plan for technology initiatives, especially those that involve and impact every area of your organization. 

Do you have a CEO succession plan? If not, you need to create one now.

This article is the first in a series to help employee benefit plan fiduciaries better understand their responsibilities and manage the risks of non-compliance with ERISA requirements.

Follow these six steps to help your senior living organization improve cash flow, decrease days in accounts receivable, and reduce write offs. 

As we find ourselves in a fast-moving, strong business growth environment, there is no better time to consider the controls needed to enhance your IT security as you implement new, high-demand technology and software to allow your organization to thrive and grow. Here are five risks you need to take care of if you want to build or maintain strong IT security.

In light of the recent cyberattacks in higher education across the US, more and more institutions are finding themselves no longer immune to these activities. Security by obscurity is no longer an effective approach—all institutions are potential targets. Colleges and universities must take action to ensure processes and documentation are in place to prepare for and respond appropriately to a potential cybersecurity incident.

This is the second blog post in the blog series: “Procuring Agile vs. Non-Agile Service”. Read the first blog. This blog post demonstrates the differences in Stage 1: Plan Project in the five stages of procuring agile vs. non-agile services.

Measuring performance of Medicaid Enterprise Systems (MES) is emerging as the next logical step in modularizing Medicaid programs. As CMS continues to refine and implement outcomes-based modular certification, it is critical that states adapt to this next step in order to continue to meet CMS funding requirements.

On June 18, 2019, the State of Maine enacted Legislative Document 1819, House Paper 1296, An Act to Harmonize State Income Tax Law and the Centralized Partnership Audit Rules of the Federal Internal Revenue Code of 1986

Planning and development service fees are, for many municipalities, often discussed but rarely changed. There are a number of reasons you might need to consider or defend your fee structure―complaints from developers, rising costs of operation, and changes in code or process are just a few.

Patient Driven Payment Model (PDPM) implementation is less than three months away. Is your facility ready for admissions under PDPM? The way you think about admissions and the admission process will change under PDPM.

In my last blog, I defined the what and the why of data governance, and outlined the value of data governance in higher education environments. I also asserted data isn’t the problem―the real culprit is our handling of the data (or rather, our deferral of data responsibility to others).

Proposed House bill brings state income tax standards to the digital age

On June 3, 2019, the US House of Representatives introduced H.R. 3063, also known as the Business Activity Tax Simplification Act of 2019, which seeks to modernize tax laws for the sale of personal property, and clarify physical presence standards for state income tax nexus as it applies to services and intangible goods. But before we can catch up on today, we need to go back in time—great Scott!

As the Project Management Body of Knowledge® (PMBOK®) explains, organizations fall along a structure and reporting spectrum. On one end of this spectrum are functional organizations, in which people report to their functional managers. (For example, Finance staff report to a Finance director.) On the other end of this spectrum are projectized organizations, in which people report to a project manager. Toward the middle of the spectrum lie hybrid—or matrix—organizations, in which reporting lines are fairly complex; e.g., people may report to both functional managers and project managers. 

As your organization works to modernize and improve your Medicaid Enterprise System (MES), are you using independent verification and validation (IV&V) to your advantage? Does your relationship with your IV&V provider help you identify high-risk project areas early, or provide you with an objective view of the progress and quality of your MES modernization initiative? Maybe your experience hasn’t shown you the benefits of IV&V. 

The IRS announced plans to conduct examinations of the universal availability requirements for 403(b) plans (Plans) this summer. Noncompliance with these requirements results in operational errors for Plans―ultimately requiring correction. Plan sponsors should review their Plans for proper inclusion and exclusion of employees. Such review can help you avoid costly penalties if the IRS does conduct an examination and uncovers an issue with the Plan’s implementation of universal availability.

Best practices for financial institution contracts with technology providers

As the financial services sector moves in an increasingly digital direction, you cannot overstate the need for robust and relevant information security programs. Financial institutions place more reliance than ever on third-party technology vendors to support core aspects of their business, and in turn place more reliance on those vendors to meet the industry’s high standards for information security. These include those in the Gramm-Leach-Bliley Act, Sarbanes Oxley 404, and regulations established by the Federal Financial Institutions Examination Council (FFIEC).

What is the difference in how government organizations procure agile vs. non-agile information technology (IT) services?

Focus on the people: How higher ed institutions can successfully make an ERP system change

The enterprise resource planning (ERP) system is the heart of an institution’s business, maintaining all aspects of day-to-day operations, from student registration to staff payroll. Many institutions have used the same ERP systems for decades and face challenges to meet the changing demands of staff and students. As new ERP vendors enter the marketplace with new features and functionality, institutions are considering a change. Some things to consider.

LIBOR is leaving—is your financial institution ready to make the most of it?

In July 2017, the UK’s Financial Conduct Authority announced the phasing out of the London Interbank Offered Rate, commonly known as LIBOR, by the end of 20211. With less than two years to go, US federal regulators are urging financial institutions to start assessing their LIBOR exposure and planning their transition. Here we offer some general impacts of the phasing out, specific actions your institution can take to prepare, and, finally, some background on how we got here (see Background at right).

Who has the time or resources to keep tabs on everything that everyone in an organization does? No one. Therefore, you naturally need to trust (at least on a certain level) the actions and motives of various personnel. At the top of your “trust level” are privileged users—such as system and network administrators and developers—who keep vital systems, applications, and hardware up and running.

Law enforcement, courts, prosecutors, and corrections personnel provide many complex, seemingly limitless services. Seemingly is the key word here, for in reality these personnel provide a set number of incredibly important services.

“The world is one big data problem,” says MIT scientist and visionary Andrew McAfee.

That’s a daunting (though hardly surprising) quote for many in data-rich sectors, including higher education. Yet blaming data is like blaming air for a malfunctioning wind turbine. Data is a valuable asset that can make your institution move.

Best Practices for Educating Your Financial Institution’s Board of Directors on Cybersecurity

According to Cybersecurity Ventures, cybercrime will account for $6 trillion annually by 2021—that’s more than the global trade of all major illegal drugs combined.  Data breaches and other information security events adversely impact organizations through significant losses in revenue, erosion of customer trust, substantial remediation costs, increased insurance premiums, and more.

Not-for-profit board members need to wear many hats for the organization they serve. Every board member begins their term with a different set of skills, often chosen specifically for those unique abilities. As board members, we often assist the organization in raising money and as such, it is important for all members of the board to be fluent in the language of fundraising. Here are some basic definitions you need to know, and the differences between them

Writing a Request for Proposal (RFP) for a new software system can be complex, time-consuming, and—let’s face it—frustrating, especially if you don’t often write RFPs. The process seems dogged by endless questions, such as:

On October 1, 2019, the Medicare Skilled Nursing Facility (SNF) payment system will transition from RUGS-IV to the Patient Driven Payment Model. This payment model is a major change from the way SNFs are currently reimbursed.

Of all the changes that came with the sweeping Tax Cuts and Jobs Act (TCJA) in late 2017, none has prompted as big a response from our clients as the changes TCJA makes to the qualified parking deduction.

In auditing, the concept of professional skepticism is ubiquitous. Just as a Jedi in Star Wars is constantly trying to hone his understanding of the “force”, an auditor is constantly crafting his or her ability to apply professional skepticism. 

As a new year is upon us, many people think about “out with the old and in with the new”. For those of us who think about technology, and in particular, blockchain technology, the new year brings with it the realization that blockchain is here to stay (at least in some form).

A capital campaign is a big undertaking. During the planning stage of a capital campaign you need to not only focus on your donor outreach strategy, but also on outreach materials. 

The existing case mix classification group, Resource Utilization Group IV (RUG- IV) will be replaced with a new case mix model, the Patient Driven Payment Model (PDPM). CMS has indicated factors leading to the change in the payment system include over utilization of therapy and incentives for longer lengths of stay.

Good fundraising and good accounting do not always seamlessly align. While they all feed the same mission, fundraisers work to meet revenue goals while accountants focus on recording transactions in compliance with accounting standards. 

Your government agency just signed the contract to purchase and implement a shiny new commercial off-the-shelf (COTS) software to replace your aging legacy software. The project plan and schedule are set; the vendor is ready to begin configuration and customization tasks; and your team is eager to start the implementation process.

A common pitfall for inbound sellers is applying the same concepts used to adopt “no tax” positions made for federal income tax purposes to determinations concerning sales and use tax compliance. Although similar conceptually, separate analyses are required for each determination.

All teams experience losing streaks, and all franchise dynasties lose some luster. Nevertheless, the game must go on. 

This October, my colleagues and I attended the National Association of Health Data Organizations (NAHDO) annual meeting in Park City, Utah. NAHDO is a national non-profit membership and educational association dedicated to improving healthcare data collection and use.

As 2018 is about to come to a close, organizations with fiscal year ends after December 15, 2018, are poised to start implementing the new not-for-profit reporting standard. Here are three areas to address before the close of the fiscal year to set your organization up for a smooth and successful transition, and keep in compliance:

It’s that time of year. Kids have gone back to school, the leaves are changing color, the air is getting crisp and… year-end tax planning strategies are front of mind! 

Reading through the 133-page exposure draft for the Proposed Statement on Auditing Standards (SAS) Forming an Opinion and Reporting on Financial Statements of Employee Benefit Plans Subject to ERISA, issued back in April 2017, and then comparing it to the final 100+ page standard approved in September 2018, may not sound like a fun way to spend a Sunday morning sipping a coffee (or three), but I disagree.

I leaned out of my expansive corner office (think: cubicle) and asked my coworker Andrew about an interesting topic I had been thinking about. “Hey Andrew, do you know what BATNA stands for?” I asked. 

State governments regularly negotiate contracts with vendors. Unfortunately, these negotiations are often prolonged, which can have major downstream effects on projects, procurements, and implementations—including skewed timelines, delayed milestones, and increased costs. 

With the wind down of the Federal Perkins Loan Program and announcement that the Federal Capital Contribution (FCC) (the federal funds contributed to the loan program over time) will begin to be repaid, higher education institutions must now decide how to handle these outstanding loans.

Reflecting on this year's National Academy for State Health Policy (NASHP) Conference in Jacksonville, Florida, I am amazed by all the recent healthcare innovations, which are resulting in policies with real and positive effects on health outcomes.

Modernization means different things to different people—especially in the context of state government. For some, it is the cause of a messy chain reaction that ends (at best) in frustration and inefficiency. For others, it is the beneficial effect of a thoughtful and well-planned series of steps. 

Truly effective preventive health interventions require starting early, as evidenced by the large body of research and the growing federal focus on the role of Medicaid in addressing Social Determinants of Health (SDoH) and Adverse Childhood Experiences (ACEs).

Do you want to receive top dollar for your business? Do you want to make your business irresistible to a potential buyer? Looking for a stress-free retirement? If you find yourself answering “yes” to these questions, it’s time to take steps to create a transferable business.

Last week, in addition to The Eagles Greatest Hits (1971-1975) album becoming the highest selling album of all time, overtaking Michael Jackson’s Thriller, the IRS issued Notice 2018-67—its first formal guidance on Internal Revenue Code Section 512(a)(6).

Artificial Intelligence, or AI, is no longer the exclusive tool of well-funded government entities and defense contractors, let alone a plot device in science fiction film and literature. Instead, AI is becoming as ubiquitous as the personal computer. 

The world of professional sports is rife with instability and insecurity. Star athletes leave or become injured; coaching staff make bad calls or public statements. The ultimate strength of a sports team is its ability to rebound. The same holds true for other groups and businesses.

As I head home from a fabulous week at the 2018 Medicaid Enterprise Systems Conference (MESC), I am reflecting on my biggest takeaways. Do we have the information we need to effectively move into the next 12 months of work in the Medicaid space? My initial reaction is YES!

Here we go again! With the 2018 Medicaid Enterprise System Conference (MESC) underway, we have another Medicaid Enterprise Certification Toolkit (MECT) Release. On July 31, 2018, the Centers for Medicare and Medicaid Services (CMS) issued the MECT Version 2.3.

Although there is no legal requirement to have a formal shareholder agreement, it’s a good idea for any company with more than one shareholder to have one, as it reduces the potential for conflict between shareholders, helping the company run smoothly and profitably. 

Is your state Medicaid agency considering a Centers for Medicare and Medicaid Services (CMS) Section 1115 Waiver to fight the opioid epidemic in your state? States want the waiver because it provides flexibility to test different approaches to finance and deliver Medicaid services.

All business owners need to consider a business valuation, ideally updated annually. A current business valuation is important for your company’s financial health as it can:

Are you struggling to improve business outcomes through modifications to your software solutions? If so, then you have no doubt tried — or are trying — traditional software implementation approaches. Yet, these methods can overwhelm staff, require strong project management, and consume countless hours (and dollars).

By now, you know all about the new corporate tax rate — a flat rate of 21% vs. the previous top tax rate of 35% — arguably the most publicized change of the recently passed Tax Cuts and Jobs Act (TCJA).

Any sports team can pull off a random great play. Only the best sports teams, though, can pull off great plays consistently — and over time. The secret to this lies in the ability of the coaching staff to manage the team on a day-to-day basis, while also continually selling their vision to the team’s ownership.

For over four years the business community has been discussing the impact Accounting Standards Codification (ASC) 606, Revenue from Contracts with Customers, will have on financial reporting. As you evaluate the impact this standard will have on a manufacturers’ financial reporting practices, there are certain provisions of ASC 606 you should consider.

The late science fiction writer (and college professor) Isaac Asimov once said: “I do not fear computers. I fear the lack of them.” Had Asimov worked in higher ed IT management, he might have added: “but above all else, I fear the lack of computer staff.”

When an organization wants to select and implement a new software solution, the following process typically occurs:

People are naturally resistant to change. Employees facing organizational change that will impact day-to-day operations are no exception, and they can feel threatened or fearful of what that change will bring. Even more challenging are multiyear initiatives where the project’s completion is years away.

Cost increases and labor issues have contributed to the rise of outsourcing as an option for senior living and health care providers.  While outsourcing of all types is a growing trend — from the C-suite to food service, it is a decision that should be considered carefully, as lack of planning could result in significant long-lasting financial, public relations and personnel losses. 

The day-to-day work of providing government services involves collecting, using, and storing large amounts of data. The data that government agencies accumulate is a critical asset — it holds answers about which programs perform best, which interventions are most effective, and how to improve service delivery. 

A professional sports team is an ever-changing entity. To have a general perspective on the team’s fluctuating strengths and weaknesses, a good coach needs to trust and empower their staff to discover the details. Chapter 5 in BerryDunn’s Cybersecurity Playbook for Management looks at how discovery can help managers understand their organization’s ever-changing IT environment. 

While new software applications help you speed up processes and operations, deciding which ones will work best for your organization can quickly evolve into analysis paralysis, as there are so many considerations.

Over the course of its day-to-day operations, every organization acquires, stores, and transmits Protected Health Information (PHI), including names, email addresses, phone numbers, account numbers, and social security numbers.

With the rise of artificial intelligence, most malware programs are starting to think together. Fortinet recently released a report that highlights some terms we need to start paying attention to:

Just as sports teams need to bring in outside resources — a new starting pitcher, for example, or a free agent QB — in order to get better and win more games, most organizations need to bring in outside resources to win the cybersecurity game.

The first time a student walks into a business class, they may expect to learn a lot about numbers. What they might not realize is they are walking into a foreign language class! 

As a leader in a higher education institution, you'll be familiar with this paradox: Every solution can lead to more problems, and every answer can lead to more questions. It’s like navigating an endless maze. When it comes to mobile apps, the same holds true. 

The recent Tax Cuts and Jobs Act includes many sweeping tax law changes, some of which left taxpayers scrambling at the end of 2017 to maximize tax saving opportunities. While the dust settles on tax reform at the federal level, the whirlwind at the state level is just beginning, with many unanswered questions.

Large-scale projects require extensive planning, quick decision-making, thoughtful problem-solving, and above all else, resourcefulness. One way to be resourceful? 

It may be hard to believe some seasons, but every professional sports team currently has the necessary resources — talent, plays, and equipment — to win. The challenge is to identify and leverage them for maximum benefit.

Did you know that there was more than a 40% increase (from $4.3 billion to $6.0 billion) in civil penalties assessed by the IRS regarding employment tax, for the 2016 fiscal year?

Texting has become a simple, convenient, and entrenched component of our everyday lives. We use it with family, friends, coworkers—and clients. My wife and I text to coordinate day care pickup and drop off of our kids every day.

We know, both from our experience as external auditors (all of us) and years of experience working in private sector firms (many of us), that changing audit firms can be a painful process. NOTE: if you’re a current BerryDunn client, feel free to stop reading here.

It’s one thing for coaching staff to see the need for a new quarterback or pitcher. Selecting and onboarding this talent is a whole new ballgame. Various questions have to be answered before moving forward: 

Private-sector pundits love to drone on about drones! Also known as Unmanned Aircraft Systems (UASs), drones are dramatically altering processes and increasing opportunities in the for-profit world. 

Success is slippery and can be evasive, even on the simplest of projects. Grasping it grows harder during lengthier and more complex undertakings, such as enterprise-wide technology projects—and requires incorporating a variety of short- and long-term strategies. 

When it comes to IT security, more than one CEO running a small organization has told me they have really good people taking care of “all that.” These CEOs choose to believe their people perform good practices. 

A penalty letter doesn’t mean the IRS is correct, but it’s important you know what to do to avoid paying an erroneous penalty. 

Most of us have been (or should have been) instructed to avoid using clichés in our writing. These overstated phrases and expressions add little value, and often only increase sentence length. We should also avoid clichés in our thinking, for what we think can often influence how we act.

In a previous blog post, “Six Steps to Gain Speed on Collections”, we discussed the importance of regular reviews of long-term care facility financial performance indicators and benchmarks, and suggestions to speed up collections. 

Is your organization a service provider that hosts or supports sensitive customer data, (e.g., personal health information (PHI), personally identifiable information (PII))? 

The relationship between people, processes, and technology is as elemental as earth—and older than civilization. From the first sharpened rock to the Internet of Things, the three have been crucially intertwined and interdependent. 

For professional baseball players who get paid millions to swing a bat, going through a slump is daunting. The mere thought of a slump conjures up frustration, anxiety and humiliation, and in extreme cases, the possibility of job loss.

After working with state health policy for seven years and Medicaid for 16, I had the opportunity for the first time to attend the 30th Annual National Association of State Health Policy (NASHP) Conference on October 23–25, 2017. Here are my top three takeaways.

Of course, we’re all suffering from “data breach fatigue.” But some breach announcements carry considerably more risk to the victim than others. For example, if I had received a letter saying a credit card of mine had been compromised, the end result would be simple:

The Merriam-Webster Dictionary defines leadership as having the capacity to lead. Though modest in theory, the concept of leadership permeates all industries and is a building block for every organization’s success. 

As more state and local government workers enter retirement, state and local agencies are becoming more dependent on millennial workers — the largest and most educated generation of workers in American history. But there is a serious gap between supply and demand.

Have you ever had a project derail at the last minute, or discovered that a project’s return on investment did not meet projections? These types of issues happen in the final stages of a project, often as a result of incorrect or incomplete stakeholder identification.

The MESC “B’more for healthcare innovation” is now behind us. This annual Medicaid conference is a great marker of time, and we remember each by location: St. Louis, Des Moines, Denver, Charleston… and now, Baltimore. 

Here’s a challenge for you: Can you identify the number one predictor of project success? According to Prosci, the leading change-management research organization, the answer is the project sponsor.

A year ago, CMS released the Medicaid Enterprise Certification Toolkit (MECT) 2.1: a new Medicaid Management Information Systems (MMIS) Certification approach that aligns milestone reviews with the systems development life cycle (SDLC) to provide feedback at key points throughout design, development, and implementation (DDI).

Today’s senior living providers must ensure that their mission and vision for the future are built on a healthy financial plan and structure. Here are some things you should know to build just that.

While GASB has been talking about split-interest agreements for a long time (the proposal first released in June of 2015, with GASB Statement No. 81, Irrevocable Split-Interest Agreements released in March of 2016), time is quickly running out for a well-planned implementation.

Because we’ve been through this process many times, we’ve learned a few lessons and determined some best practices. Here are some tips to help you promote a positive post go-live experience.

Some days, social media seems nothing more than a blur of easily forgettable memes. Yet certain memes keep reappearing to the point where we have no choice but to remember them. 

Four steps to take if you get an ACA Tax Penalty Notice from the IRS. It’s been almost a year since the IRS filing deadline for 2015 Forms 1094-C and 1095-C. Most expected the IRS to issue employer penalty notices related to the 2015 calendar year in late 2016.

We have talked about the two recent GAAP updates for years now: 1) changes to the lease accounting and 2) changes to revenue recognition standards. 

We all know them. In fact, you might be one of them — people who worry the words “go live” will lead to job loss (theirs). This feeling is not entirely irrational. 

Recently the Governmental Accounting Standards Board (GASB) finished its Governmental Accounting Research System (GARS), a full codification of governmental accounting standards.

We humans have a complex attitude toward change. In one sense, we like finding it. For instance: “Now I can buy something from the vending machine!” In reality, we try to avoid change as much as possible. Why? 

RANSOMWARE UPDATE: It happened again. Another ransomware attack hit very large corporations around the globe. Much like WannaCry, a worm spread through entire networks, and locked out encryption data and systems.

On June 16th the FASB issued the final standard for credit losses. We’ve analyzed the new standard and pulled together some key items you’ll need to know:

As the technology we use for work and at home becomes increasingly intertwined, security issues that affect one also affect the other and we must address security risks at both levels.

In July 2016, we wrote about how the booming microbrewery scene in Maine is shaking up the three-tier system of alcohol distribution, which dates back to the 1930s.

As we begin the second year of Uniform Guidance, here’s what we’ve learned from year one, and some strategies you can use to approach various challenges, all told from a runner's point of view.

During my lunch in sunny Florida while traveling for business, enjoying a nice reprieve from another cold Maine winter, I checked my social media account.

When last we blogged about the Financial Accounting Standards Board’s (FASB) new “current expected credit losses” (CECL) model for estimating an allowance for loan and lease losses (ALLL), we reviewed the process for developing reasonable and supportable forecasts for use in establishing the ALLL. 

Government projects conducted in challenging conditions require trust, collaboration, communication, and project management acumen to succeed. Here are five recommendations for project success.

Recently, federal banking regulators released an interagency financial institution letter on CECL, in the form of a Q&A. Read it here

NEW IRS proposed guidance is welcome news and provides not-for-profit employers with more flexibility than originally expected.

Electronic accessibility in every aspect of modern life has increased ten-fold, but government — and courts in particular — has been slow to follow.

When it comes to offering non-qualified deferred compensation to executives of not-for-profit organizations, there aren’t many options.

People love the idea of being able to conveniently charge their phones without a cable or having to hunt for a plug. Free charging stations are popping up everywhere.

By now, pretty much everyone in the banking industry has heard plenty of talk about CECL – the forthcoming “Current Expected Credit Loss” model of accounting for an institution’s allowance for loan losses (ALL).

Financial fraud by the numbers. In a June 2016 Gallup poll, 72 percent of respondents said they had “very little” or only “some” confidence in banks.

By now you have heard that the Financial Accounting Standards Board’s (FASB) answer to the criticism the incurred-loss model for accounting for the allowance for loan and lease losses faced during the financial crisis has been released in its final form. 

Many of my hospital clients have an increased incidence of providing temporary housing for locums, temps and some employees and, as a result, have questions regarding the proper tax reporting to these individuals.   

With the implementation of GASB 72 now in full force, GASB organizations are hard at work drafting their new fair value disclosures. The addition of a fair value hierarchy table in the footnotes will add a bit more thickness to a likely already hefty financial package. 

There is plenty of media coverage of Maine’s, and specifically Portland’s, burgeoning microbrew scene. It’s good economic development and complements the already established “foodie” scene Portland is renowned for.

Online banking? Check. Online shopping? You bet. Online permit application submittal? What? Actually, yes. As Americans are becoming more and more accustomed to performing everyday functions online, local governments are evolving and keeping up with the times. This online evolution is coming in the form of implementing modern enterprise applications with electronic workflow and a public-facing portal that allows residents to apply for permits, submit documentation, pay for, and collaborate with local government staff to perform a variety of processes.

Why it can happen to you and how to protect yourself. We’ve all seen the headlines. Stories about not-for-profit fraud have been popping up in the news, and the statistics confirm what you might have suspected: fraud in the not-for-profit sector is on the rise.

With the most recent overhaul to the Form 990, Return of Organization Exempt From Income Tax, the IRS has made clear its intention to increase the transparency of a not-for-profit organization’s mission and activities and to promote active governance. To point, the IRS asks whether a copy has been provided to an organization’s board prior to filing and requires organizations to describe the process, if any, its board undertakes to review the 990.

Remember the old adage about pornography? “I know it when I see it,” said the Supreme Court Justice Potter Stewart. 

H.R. 1, previously titled the “One Big Beautiful Bill Act”, represents one of the most comprehensive federal policy changes in recent decades. It touches healthcare, taxes, and social programs, and shifts financing and implementation responsibilities across federal, state, and local governments. The Congressional Budget Office (CBO) estimates it will reduce federal Medicaid spending by about $1.04 trillion over ten years and lead to around 16 million fewer people with coverage, split between Medicaid (about 7.8 million) and the Affordable Care Act (ACA) Marketplaces (about 8.2 million). This overview explains H.R. 1’s major provisions and what they could mean for states, consumers, providers, and payers.

Medicaid: Financing and administrative changes

Work requirements. Most adults ages 19–64 must now document at least 80 hours per month of work or a qualifying activity to maintain Medicaid coverage. Individuals who do not verify compliance lose eligibility for both Medicaid and ACA Marketplace premium tax credits. Exemptions apply for pregnant people, caregivers, and those recently released from incarceration, among others. Research shows most adults on Medicaid already work or qualify for an exemption; KFF estimates that in 2023, 64% were employed and over 90% were either working or exempt.

Faster renewals and more verification. Expansion adults must now renew eligibility every six months, and states are required to conduct additional verification and interstate data-matching. These steps are intended to strengthen program integrity by improving the accuracy of eligibility determinations and reducing improper payments. They may also add administrative complexity and raise the risk of coverage loss for eligible individuals—particularly those with unstable housing, limited internet access, or language barriers.

Provider taxes. The federal “safe harbor” cap on provider taxes will decrease from 6% to 3.5%. States have historically relied on these taxes to generate federal matching funds—accounting for about 17% of non-federal Medicaid financing in 2018, or 28% when including local contributions (MACPAC). The lower cap may prompt states to reassess Medicaid financing strategies and weigh trade-offs in how programs are structured.

State Directed Payments (SDPs) and rural care. Beginning in FY 2028, SDP limits will be tied to Medicare rates, reducing states’ flexibility to supplement managed care payments. With roughly $110 billion in annual SDP spending, largely financed through provider taxes and intergovernmental transfers, this change could constrain a key tool states use to support provider networks in underserved areas. Federal Medicaid spending in rural communities is projected to decline by $155 billion over ten years. A new $50 billion Rural Health Transformation Program aims to offset some of these reductions, with impacts dependent upon state capacity and program decisions.

ACA Marketplaces: Subsidies and enrollment

Stricter verification. Consumers must now fully verify income, immigration status, residency, and family size before receiving premium tax credits (PTCs) or cost-sharing reductions (CSRs). Roughly one in five HealthCare.gov enrollments occur through “passive” renewal; ending automatic re-enrollment for individuals with incomplete verification may increase the risk of coverage disruptions.

Full repayment of excess subsidies. Consumers will no longer have caps on how much excess premium tax credit (PTC) they must repay at tax filing. Some immigration categories will lose eligibility for subsidies, and people enrolling outside a qualifying life event will not qualify for financial assistance. Together, these changes may reduce enrollment continuity and raise financial exposure for households with variable income.

Enhanced subsidies expire. The enhanced premium tax credits (PTCs) introduced under the American Rescue Plan Act and extended through 2025 by the Inflation Reduction Act will expire. Beginning in 2026, subsidies will revert to pre-2021 levels, increasing required premium contributions across income groups. These enhancements had boosted Marketplace enrollment by lowering premiums and eliminating the “subsidy cliff” for many middle-income and older adults.

Analyses by KFF and the Urban Institute project that, without an extension, average consumer-paid premiums could more than double in 2026 and coverage could decline by approximately 4.8 million people. Their expiration has become a central issue in ongoing Congressional negotiations during the federal government shutdown. If no deal is reached, higher premiums and reduced enrollment are likely outcomes.

Ending “silver loading.” Insurers have historically increased silver-tier premiums to offset the cost of providing cost-sharing reductions (CSRs), which raised the benchmark used to calculate premium tax credits (PTCs). H.R. 1 ends this practice. Silver premiums would likely decline along with the benchmark—reducing subsidies across all plan tiers. Brookings estimates that current silver benchmarks are about 28% higher because of silver loading; removing it could lower subsidies by a similar amount. While unsubsidized silver-plan enrollees may see lower gross premiums, many subsidized consumers—particularly those in bronze, gold, or platinum plans—could face higher net premiums and greater sensitivity to income fluctuations.

Coordination gets harder. Medicaid and the ACA marketplaces act as complementary coverage systems, with many individuals moving between them as incomes change. Tighter Medicaid eligibility rules and shorter redetermination cycles may increase these transitions. At the same time, reduced Marketplace subsidies and stricter enrollment criteria may limit affordable coverage options for those losing Medicaid—leading to higher churn, uncompensated care, and pressure on risk pools. These dynamics could create coordination challenges for states and insurers as they manage eligibility transitions and enrollment stability.

Medicare: Payments and innovation models

Eligibility and payments. H.R. 1 narrows Medicare eligibility rules, delays implementation of the 2023 Medicare Savings Program enrollment rule until 2034, and links physician payment updates to the Medicare Economic Index, slowing projected growth after 2027. The law also ends enhanced payments for Advanced Alternative Payment Models (APMs), extends orphan-drug exemptions from federal price negotiation, and postpones new federal nursing home staffing standards until 2034. Changes may affect payment stability and innovation pathways—potentially increasing attribution volatility, complicating risk adjustment, and adding operational and financial complexity for organizations participating in value-based or alternative payment models.

Outlook and implications

H.R. 1 marks a broad realignment of federal health policy, tightening eligibility standards, expanding verification and reporting requirements, and revising financing structures across Medicaid, the ACA Marketplaces, and Medicare. Overall, the legislation redistributes financial responsibilities among federal, state, and local entities and is expected to reshape healthcare coverage, financing, and innovation over the next decade.

Better policy through better information

BerryDunn’s healthcare policy and economics team provides the insights government agencies, healthcare policy research groups, and other organizations need to improve healthcare accessibility and affordability. We have the expertise to inform intelligent, impactful decisions related to healthcare payment reform and cost transparency, to the effect of government mandates on population health and insurance costs, and to market competition. We also have a comprehensive understanding of economic and quality issues in behavioral healthcare—including substance abuse disorder treatment—and of mental health coverage parity. Learn more about our team and services. 

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H.R. 1: What state agencies, providers, and payers need to know

Read this article to get a physician's perspective on onboarding from Alan Weintraub, MD.

For a physician beginning a new clinical role, the onboarding process is more than a formality—it lays the foundation for safe, efficient, and high-quality care delivery. Onboarding, particularly surrounding credentialing, clinical privileging, and provider enrollment, is the bridge between a clinician’s availability and their ability to practice. When this process is fragmented or delayed, it doesn’t just frustrate the provider—it impacts patient access, revenue cycles, compliance, and team morale. A seamless onboarding experience signals to clinicians that the organization values their time, expertise, and contribution to the care continuum. In today’s environment, where every dollar and every patient interaction count, the financial impact of a well-executed onboarding strategy is considerable. 

Creating a strategy for clinician onboarding 

Healthcare organization leaders must recognize onboarding as a strategic lever—not a back-office task. A well-planned onboarding journey, from aligning payer contracting timelines to ensuring organizational and NCQA-compliant credentialing workflows, directly impacts patient care. A streamlined onboarding experience reflects an organization’s commitment to operational excellence and clinician support. 

Onboarding is a continuum of processes and procedures that begin from the time a clinician agrees to join the practice or organization and extends through the first six months to a year after hiring. The continuum consists of credentialing, clinical privileging, payer enrollment, and a set of activities and informational components that equip clinicians with the tools to practice effectively with a goal of establishing a long-term relationship. 

The extensive volume of information that clinicians are often asked to submit during onboarding can be overwhelming, especially when it must be provided separately to different offices, organizations, or locations. This “hassle factor” can result in missing data or documents, errors, delayed start dates, or dissuading clinicians from fulfilling their commitment to join. 

What does streamlined onboarding look like? 

A tight onboarding process should: 

  • Accelerate ramp-up time for new providers 

  • Reduce burnout by minimizing administrative friction 

  • Boost retention by making clinicians feel supported from day one 

  • Improve patient access and revenue cycle efficiency 

  • Support compliance and revenue integrity 

To create a clinician-focused and efficient onboarding experience, be sure to: 

  • Coordinate closely with the hiring team: Provide clear, consistent information about what to expect and plan all aspects of onboarding. Include a checklist of all required information and documents. 

  • Provide an onboarding contact: Have a single (ideally) or consistent, identified point of contact for the clinician. 

  • Centralize processes and communication: Request documents once and then distribute appropriately. 

  • Set a timeline: Goals should be realistic and achievable to help with effective planning and ensure clear expectations. 

  • Be consistent with feedback: Provide and request transparent and regular feedback on credentialing, privileging, and the enrollment progress. 

Providers aren’t asking for perfection—they’re asking for clarity, consistency, and connection. An efficient onboarding experience shows that the organization values their time and expertise. It sets the tone for collaboration and trust. With thought, intention, and appropriate resources, you can make onboarding the portal to a thriving clinical workforce. 

BerryDunn’s healthcare compliance team incorporates deep, hands-on knowledge with industry best practices to help ensure your operation is compliant and efficient. Our credentialing team is adept at navigating the challenges providers face. As an NCQA-certified Credentials Verification Organization (CVO), we help clients streamline processes with strict adherence to compliance policies and regulatory standards. Reach out for information about our physician consulting services

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Why clinician onboarding matters: A physician's perspective

In today's rapidly changing job market, the importance of workforce development cannot be overstated. As public health evolves and new challenges emerge, both new and seasoned professionals need guidance to navigate their careers effectively. The 2021 Public Health Workforce Interests and Needs Survey found that 16–18% of the workforce considers programmatic expertise highly important to their day-to-day work, yet reports low proficiency in this area. Whether guiding fresh graduates or supporting experienced employees, mentoring is a vital step in the workforce lifecycle. It bridges the gaps from academic learning and onboarding through career transitions to professional growth and expertise, helping individuals move from passion to practice and thrive in their respective areas. 

Workforce Lifecycle Model 

At its core, mentoring is a relationship where a more experienced individual—often referred to as the mentor—offers guidance and support to someone with less experience, the mentee. This relationship can be incredibly impactful, offering insights and advice beyond what is taught in classrooms or learned through hands-on experience alone.

Mentoring facilitates knowledge transfer, allowing mentors to share practical experiences and industry-specific knowledge that help mentees avoid common mistakes and navigate their careers with confidence. Mentors also introduce mentees to professional networks, creating valuable connections that can lead to new opportunities and career advancement. 

Principles of mentoring 

A successful mentoring relationship is built upon several guiding principles: 

Mutual respect: A successful mentoring relationship is built on mutual respect between mentor and mentee. 

  • Commitment to growth: Both mentor and mentee should be committed to the personal and professional growth of the mentee. 
  • Active listening: Mentors must listen attentively to understand the needs, aspirations, and challenges of their mentees. 
  • Empathy and patience: Understanding the mentee's unique situation and providing guidance without judgment. 

Effective mentoring practices for the public health workforce

Effective mentoring is more than just sharing advice. The relationship creates a bond that enables the mentor and the mentee to engage freely, setting the stage for continuous feedback and reflection. Mentors help mentees assess their progress, identify improvement areas, and set achievable career goals. Through regular meetings, mentees can refine their skills, enhance performance, build programmatic expertise, and take meaningful steps toward reaching their professional aspirations. Mentors also foster critical soft skills such as communication, leadership, and adaptability—qualities essential for success in today’s dynamic work environment. 

  • Relationship building: Developing trust and open communication is foundational for a successful mentoring relationship. 
  • Feedback and reflection: A continuous process of constructive feedback helps the mentee assess progress and areas for improvement. 
  • Goal setting: Mentors assist mentees in setting clear career goals, providing a roadmap for professional development. 
  • Support for soft skills: Mentors help mentees hone crucial soft skills such as communication, leadership, and adaptability. 

Mentorship benefits all employees 

For those early in their careers, the transition into the workforce can feel overwhelming. Mentorship eases this transition by providing real-world perspective and experience. Internships, projects, and entry-level roles offer opportunities for new graduates to gain practical exposure, and mentors guide them on how to make the most of these experiences. Mentors encourage continuous learning, helping mentees understand that education doesn’t stop after formal schooling. Staying current on industry trends and acquiring new skills are imperative for career advancement. 

Mentoring also helps new professionals establish networks and build relationships that can lead to new opportunities. As mentees build their networks, they develop a clearer sense of their career aspirations. A mentor can help define their path, set clear goals, and take effective steps toward achieving them. For example, one early-career mentee emphasized the importance of a mentor being honest and relatable, preferring face-to-face feedback to foster a personal connection. This mentee shared that their BerryDunn mentor was invaluable in identifying relevant training and certifications that contributed to career progression and personal growth. 

Mentoring also holds great value for experienced professionals. For tenured employees, mentoring offers an opportunity to give back and enhance leadership skills. By guiding younger employees, mentors support growth while strengthening their own leadership development. When experienced employees take on the mentee role, they continue to develop skills key to their current position or future goals. In either case, mentorship benefits both individuals and fosters a more engaged and capable workforce. 

Invest in mentorship: We can help 

Investing in mentorship prepares agencies for the big changes happening in public health. It supports transitions from academia to the workforce, encourages continuous learning, eases career changes, and builds confidence in professionals at all levels. Mentors provide valuable insights, foster career growth, and help develop essential skills needed to navigate workplace complexities. For public health agencies looking to strengthen their workforce, structured mentoring programs offer long-term benefits, improve employee satisfaction, and support ongoing professional development. 

At BerryDunn, we practice what we preach by offering a robust mentorship program accessible to all employee levels. As a testament to its success, the program was recently featured in BerryDunn’s “In the Spotlight” podcast, where an employee shared how mentoring played a key role in their career growth. If your agency is looking to establish a formal mentoring program, BerryDunn can assist by identifying the right approach, implementing effective matching and evaluation strategies, and applying best practices to ensure success. Learn more about our services and team.

Read other articles in the public health workforce series:

Securing the future of public health: Confronting the workforce shortage

Supporting mental wellness in the public health workforce

Public health transformation: Addressing workforce challenges

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Mentoring in public health: A key strategy for workforce development

Starting January 1, 2025, a new individual tax benefit allows taxpayers to deduct certain interest paid on loans for qualified passenger vehicle purchases. This deduction is available through the end of 2028 and presents both opportunities and compliance responsibilities for lenders. 

Eligibility criteria for the deduction 

To qualify, the vehicle must: 

  • Weigh less than 14,000 pounds 

  • Have its final assembly point in the United States 

  • Be purchased after December 31, 2024 

  • Be new with its original use beginning with the taxpayer 

Required reporting by lenders 

Lenders must provide borrowers with specific information to support their deduction claims. The required data includes: 

  • Total amount of interest received during the calendar year 

  • Origination date of the loan 

  • Principal balance at the beginning of the year 

  • Confirmation that the vehicle meets the eligibility criteria 

If Vehicle Identification Number (VIN) data is not currently captured or is stored in a separate system, lenders should begin exploring ways to access and integrate this information to ensure accurate reporting. 

Transitional relief for 2025 

On October 21, 2025, the IRS announced transitional relief for lenders for the 2025 tax year. Lenders will not be subject to informational reporting penalties as long as they provide the total amount of interest received on qualified auto loans to customers via online banking platforms, regular account statements, or other reliable methods. 

The IRS has not yet issued a specific form or instructions for this reporting and it is not expected to do so for the 2025 tax year. The IRS has indicated that a standardized form (like Form 1098) is expected for 2026 and beyond. 

Reporting deadline 

The deadline for lenders to provide the required information to customers is January 31, 2026

Phase-out of the deduction 

The deduction begins to phase out for taxpayers with modified adjusted gross income (MAGI) above $100,000 for single filers and $200,000 for joint filers. Taxpayers above these thresholds will see a gradual reduction in the allowable deduction amount. The deduction is reduced by $200 for every $1,000 of MAGI above these thresholds and is fully phased out at $150,000 for single filers and $250,000 for joint filers.  

What lenders should do now 

  • Determine how required information will be reported to borrowers for 2025. 

  • Review systems to ensure VIN and vehicle eligibility data can be accessed. 

  • Prepare to track and report interest and loan details on an informational tax form starting in 2026. 

  • Communicate with borrowers about the upcoming deduction and reporting timeline. 

This new deduction offers a valuable benefit to consumers and a chance for lenders to support tax compliance while enhancing customer service. 

BerryDunn can help 

Our dedicated audit, tax, and consulting professionals understand the financial services industry and its challenges, and are committed to helping you meet and exceed regulatory requirements. We partner with you to bring tailored approaches to fit your needs and operations and provide guidance on best practices and recommendations that make sense for you. Learn more about our services and team. 

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New tax break on vehicle loan interest: What lenders need to know

Read this if you are a CFO, director of HR, or a retirement plan sponsor. 

Beginning January 1, 2026, significant changes will affect catch-up contributions to retirement plans for high-earning individuals, sometimes referred to as ‘highly paid participants.’ This group of high-earning individuals will be more inclusive than the current definition of a Highly Compensated Employee. The new rules, enacted as part of recent legislative updates, specifically target plan participants whose prior-year compensation exceeds a set threshold and require that their catch-up contributions to 401(k), 403(b), and governmental 457(b) plans be made on a Roth (after-tax) basis. 

This article provides an overview of these new requirements, focusing on the affected plan participants, and discusses the pros and cons as well as key considerations for employers and affected individuals in advance of the transition deadline on December 31, 2025. Importantly, plan sponsors will need to coordinate compliance with their payroll provider and retirement plan recordkeeper. Plan sponsors will also need to communicate the new rules to the affected plan participants. 

Overview of 2026 Roth catch-up contribution changes 
 

Under current law, individuals age 50 and older can make catch-up contributions to employer-sponsored retirement plans, such as 401(k), 403(b), and eligible governmental 457(b) plans. Historically, these catch-up contributions could be made on either a pre-tax or Roth basis, depending on plan provisions and the participant’s salary deferral election. Starting January 1, 2026, however, plan participants whose prior-year Social Security wages with the employer equal at least $145,000 (indexed annually beginning in 2026) will be required to make all catch-up contributions as Roth contributions. This means these contributions will be made with after-tax dollars and will not be tax-deductible, but qualified withdrawals in retirement generally will be tax-free. 

Significantly, any Roth salary deferral contributions made by a high earner (e.g., a regular deferral contribution or a catch-up contribution) count towards satisfying the Roth catch-up requirement. This means that if a high earner is already making regular Roth deferrals, they would not be required to make Roth catch-up contributions after the normal salary deferral limit (i.e., $23,500 for 2025) is reached as long as the Roth contributions exceed the catch-up limit (i.e., $7,500 for 2025). The plan sponsor may default those contributions that are over the normal salary deferral limit to Roth treatment, but the plan must allow the high earner to choose to make catch-up contributions on a pre-tax basis (assuming they have already made the required amount of Roth contributions). Essentially, this means a plan sponsor can only mandate Roth treatment for contributions up to the dollar amount of that year’s catch-up limit (i.e., $7,500 for 2025). 

New 2026 Roth rules for partners, other self-employed individuals, and owners 
 

The relevant guidance clarifies that a participant who does not have Social Security wages, such as a partner with self-employment income, will not be subject to the Roth catch-up requirement. This group would also include sole proprietors and members of an LLC taxed as a partnership. 

However, the Roth catch-up requirement will apply to owners of a C-Corp or S-Corp who have Social Security wages equal to at least $145,000 (indexed) reported on Form W-2, Box 3. 

Other pertinent Roth 2026 rule changes to consider 

Wage limit is not pro-rated: The relevant guidance states the Social Security wage amount (i.e., $145,000, indexed) is not pro-rated for an employee’s partial year of employment. For example, an employee who is hired on September 1, 2025, at a $200,000 salary will not be subject to the Roth catch-up requirement in the 2026 plan year because the employee’s Social Security wages would only be approximately $66,600 for the 2025 calendar year. 

Employer definition: The relevant employer is the common law employer of the plan participant. The final regulations allow a plan to aggregate the Social Security wages a participant receives from all employers in a controlled group and/or where a common paymaster is used. If a plan sponsor wants to take advantage of this permissible aggregation, however, it must specify in the plan which aggregation method it is using and what groups are being aggregated. 

Deemed elections: A plan may provide that an election by a participant subject to the Roth catch-up contribution requirement to make salary deferral contributions on a pre-tax basis will be treated as a deemed election to make catch-up contributions as designated Roth catch-up contributions. If a plan will apply deemed elections, the plan document must provide for them and must permit participants to change their deemed elections. Alternatively, a plan sponsor could require the affected plan participant to make a separate election for Roth catch-up contributions.  

Super catch-up contributions: Made by participants who attain age 60 to 63 during a calendar year, these contributions are subject to the Roth catch-up contribution requirement. 

Employers will need to track compensation across all relevant categories to ensure compliance and retirement plan administrators will need to update procedures to enforce the Roth catch-up rule for affected participants. 

Pros and cons of the 2026 Roth catch-up requirement 

Pros

  • Tax-free growth: Roth contributions grow tax-free and qualified withdrawals in retirement are not subject to federal income tax, potentially providing greater after-tax retirement income. 

  • No Required Minimum Distributions (RMDs): Roth 401(k) and Roth IRA accounts are not subject to RMDs during the account holder's lifetime, offering more flexibility in retirement planning. 

  • Estate planning benefits: Roth accounts can be advantageous for heirs due to tax-free distributions. 

Cons

  • No immediate tax deduction: Roth contributions are made with after-tax dollars, so high earners lose the immediate tax deduction that pre-tax catch-up contributions previously provided. 

  • Higher current tax liability: Switching to Roth catch-up contributions may increase current-year taxable income, possibly moving participants into a higher tax bracket. 

  • Complexity for employers: Employers and plan sponsors must implement new administrative procedures to track compensation and enforce Roth-only catch-up contributions for eligible participants. 

Actions for employers and high earners before December 31, 2025 

With the new Roth catch-up requirement taking effect on January 1, 2026, employers and affected high earners should take proactive steps in 2025 to prepare for the transition: 

  1. Review plan documents: Employers should ensure that their retirement plan documents support Roth catch-up contributions, updating them if necessary. 

  1. Assess payroll and administrative systems: Ensure systems can accurately track compensation and enforce the Roth catch-up requirement for high earners. 

  1. Communicate with participants: Provide clear information to employees about the upcoming changes, how compensation is calculated, and the implications for their retirement savings. 

  1. Tax planning: The affected plan participants should consult with tax advisors to assess the impact of losing the pre-tax catch-up option and to explore strategies for minimizing overall tax liability. 

  1. Maximize pre-tax catch-up contributions in 2025: Eligible individuals may wish to maximize their pre-tax catch-up contributions before the new requirement takes effect. 

  1. Evaluate Roth vs. pre-tax savings: Consider the long-term benefits of Roth savings, including tax-free withdrawals and estate planning advantages, versus the short-term impact on taxable income. 

Start planning now for 2026 Roth changes 

The new Roth catch-up contribution requirement for certain plan participants marks a significant shift in retirement plan rules. While the change offers potential long-term tax benefits, it also increases current tax liability and administrative complexity. Employers and affected individuals should use the time before December 31, 2025, to review plan provisions, communicate with participants, and engage in strategic tax planning to ensure a smooth transition and take full advantage of available retirement savings opportunities. 

BerryDunn is one of only a few firms that specializes in all aspects of retirement plan design, optimization, and management. We understand the importance of a sound retirement plan strategy and its impact on business operations. And, we’ll help you stay abreast of new regulations, investment options, and contribution limits and present you with opportunities to realize more value as they arise. Learn more about our services and team.  

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Understanding the 2026 Roth catch-up changes for high earners