Healthcare Accountants

Industries · Healthcare

Accountants who understand how a medical practice is owned and paid.

A medical or healthcare practice is a business built around its practitioners, where income, structure and payroll tax all hang together. Get the structure right and the practice runs cleanly. Get it wrong and a single payroll tax ruling can reshape the economics overnight. We work with the owners of established practices, on the structuring, tax and succession decisions that keep a practice sound and its practitioners properly looked after.

Talk to us→How we work→
In short

Prime Partners advises established medical and healthcare practices on the financial decisions that come with a business owned by its practitioners. That covers service entity structures, the payroll tax exposure on contractor practitioners, practitioner income and tax, structure as the practice grows, and succession when an owner steps back. We bring the technical depth of a specialist practice and the accessibility of a team that knows your practice by name.

We work with general practices, dental and specialist clinics, physiotherapy and allied health practices, psychology and mental health practices, optometrists, radiology and pathology providers, and veterinary practices.

The pressures you carryWhat we doHow we workMoments that matterCommon questions
The pressures you carry

The financial questions that sit underneath every practice.

A healthcare practice earns its income through its practitioners, which makes the structure and the payroll tax position matter as much as the clinical work. The decisions that count most are about how the practice is built and how its people are paid. These are the recurring pressures we help practices hold.

Payroll tax on practitioners
Recent state rulings have brought many contractor practitioners within payroll tax, even where they work independently. It is the single largest issue facing practices today, and how your agreements and structure are set up decides your exposure.
Service entity structures
The service entity is the backbone of most practices, providing the premises, staff and systems while practitioners keep their own billings. It has to be set up and priced correctly to work and to manage the risks that sit alongside it.
Practitioner income and tax
How income flows to each practitioner, and the tax that comes with it, depends on the structure of the practice and the entities behind each owner. It is rarely as simple as a salary, and it rewards careful planning.
Bringing practitioners in and out
Admitting a new partner or principal, or buying out a retiring one, means a valuation, terms and a tax position on both sides. Handled properly it strengthens the practice rather than unsettling it.
Structure and compliance
A practice carries tax, payroll tax, the obligations of employing staff and the regulatory expectations of healthcare all at once. Keeping that managed rather than reactive is what keeps the focus on patients.
What we do

The same journey we take every client on, told for a healthcare practice.

Most practices come to us for one thing and stay for the rest. The work tends to follow a natural order, from getting the structure and foundations right through to planning how the practice is eventually handed on. Each step below is a service in its own right, and each one links through to the full detail.

Accounting clean-up→
Where the books have fallen behind a busy practice, we bring them back to a standard you can rely on, so the numbers tell the truth before any decision is made on them.
Business accounting and tax→
Year-end accounts, tax and practitioner income, prepared with the structure of a practice owned by its practitioners properly understood. The foundation everything else sits on.
Business structure review→
The decision that matters most in healthcare. We review your service entity and practitioner arrangements against the current payroll tax rulings, so the structure protects the practice rather than exposing it.
External finance team→
The monthly reporting a practice actually needs, including income by practitioner, the service entity position and the picture across the group, run by a team alongside the practice rather than a once-a-year file.
Business growth→
The decisions that come with growing a practice, from adding practitioners and locations to funding fit-out and equipment, so growth strengthens the practice rather than straining it.
Business succession→
Planning the path for a principal stepping back, including the buy-in or buy-out of practitioners, so the practice and its patients carry on without disruption when ownership changes hands.
Private client advisory and SMSF→
The personal side of a practitioner’s wealth, including individual tax position, investment structures, self managed super and the planning that comes with a substantial professional income.
R&D tax incentive→
A specialised area in its own right. Where your practice or healthcare business develops genuinely new clinical methods, devices or technology, we assess eligibility and prepare the claim properly.
How we work

A senior-led relationship, not a once-a-year file.

Every engagement is led by a senior practitioner who knows the practice and stays close to it. The way we work follows the same shape, whatever the practice.

1
Understand the practice
We start with how the practice is owned, how practitioners are paid, how the service entity is set up, and what the owners are trying to build over the next few years.
2
Get the structure right
Your service entity and practitioner arrangements reviewed against the current payroll tax rulings, so the structure is sound and the exposure understood before it becomes a problem.
3
Advise on the decisions that count
Payroll tax, practitioner admissions, growth and tax addressed as they arise, with the analysis to support a real decision rather than a hunch.
4
Stay alongside the practice
A continuing relationship where you can pick up the phone before you bring in a practitioner or change an arrangement, rather than explain it after the fact.
5
Plan the handover
When the time comes to step back, we plan the succession well ahead of it, from the buy-out of a principal to the transfer of ownership, so the practice carries on and the owner who built it leaves on their own terms.
Moments that matter

The decisions that shape a practice deserve more than a once-a-year accountant.

Restructuring the practice when a payroll tax ruling changes the ground beneath it. Bringing in the practitioner who will help carry the practice forward. Opening a second location. Handing the practice to the next principal and stepping back well. These are the moments where good advice is worth far more than the work that surrounds it, and they are the moments Prime Partners exists for.

Common questions

Questions healthcare practices ask us.

What does an accountant for a medical or healthcare practice do?
An accountant for a medical or healthcare practice handles the financial work that comes with a business owned by practitioners and run around their income. That means structuring the practice and its service entity correctly, managing the payroll tax exposure on contractor practitioners, handling practitioner income and tax, and planning the structure and succession of the practice. At Prime Partners we cover the routine accounting as a matter of course and focus the relationship on the structuring, payroll tax and succession decisions that matter most to a practice and its owners.
How does payroll tax apply to contractor doctors in a medical practice?
Recent state rulings have treated many contractor practitioners as employees for payroll tax purposes, meaning the payments a practice makes to doctors or allied health practitioners can be caught by payroll tax even where they work as independent contractors. Whether it applies depends on how the practice is structured and how the agreements and payment flows are set up. It is one of the most significant issues facing medical practices, and we review your arrangements against the current rulings and advise on how to manage the exposure.
What is a service entity and why do medical practices use one?
A service entity is a separate business that provides the premises, staff, equipment and administration to the practitioners who run their own patient billings. Medical and dental practices use this structure so practitioners remain responsible for their own clinical income while sharing the cost and infrastructure of the practice. The arrangement has to be set up and priced correctly to be effective and to manage payroll tax and other risks, which is where careful structuring matters.
What is the best structure for a medical or dental practice?
The best structure for a medical or dental practice depends on how many practitioners own it, how income flows to each of them, and how you manage payroll tax, asset protection and succession. Many practices use a combination of a service entity and individual practitioner entities, with the right design depending on the practice’s size and ownership. Because payroll tax and practitioner agreements interact closely with the structure, the design needs to be reviewed as a whole rather than piece by piece.
Do you work with allied health and specialist practices as well as GPs?
Yes, we work across general practice, specialist medical, dental and allied health practices. While the clinical work differs, the financial questions are similar, covering practitioner income, service entity structures, payroll tax, and the tax and succession decisions that come with a practice owned by its practitioners. We tailor the advice to the size and ownership of each practice.
Where is Prime Partners located?
Prime Partners has offices in North Sydney and Orange, NSW. We work with medical and healthcare practices across both metropolitan and regional New South Wales, and nationally where the relationship calls for it.
Talk to us

Start a conversation about your practice.

If you are reviewing your payroll tax exposure, restructuring the practice, bringing in a practitioner, or planning your eventual exit, we would be glad to talk it through.

Get in touch→