July 24th, 2010 | Posted by Mark Dietrich in - (Comments Off on MedicalPracticeValue.Com)

Welcome to the Internet’s richest source of information about medical practice valuation, sponsored by Mark O. Dietrich, CPA P.C.. You can visit our website and explore the wealth of data on valuation as well as managed care by clicking on our name, or follow the links to the left directly to specific pages on the topics of interest to you. For information on the just re-released 2001/2002 Adobe pdf edition of The Medical Practice Valuation Guidebook, click here.

For inquiry’s on the firm’s services, call Mark Dietrich at (508) 877-1999.

BVR's Guide to Physician Practice Valuation

July 10th, 2010 | Posted by Mark Dietrich in - (Comments Off on BVR's Guide to Physician Practice Valuation)
BRV's Guide to Healthcare Valuation

The new edition of BVR’s Guide to Physician Practice Valuation available in June is the essential resource for understanding the complexities inherent in physician practice valuation, whether for sale to a hospital, private equity firm or to another physician.  The Second Edition contains nine additional chapters and revisions to six existing chapters?  Among the new chapters is one addressing traditional practice buy-ins and buyouts as well as how the presence of noncompete agreements affects value.  Another deals with the actual valuation of noncompete agreements and personal goodwill, the key to many litigation engagements as well as tax planning associated with conversion of C Corporations to S Corporations or to tax-exempt status.

Mark Dietrich and other top healthcare appraisal experts deliver current and comprehensive “how-to” guidance on valuation approaches.  Learn how the Anti-Kickback Statute and Stark Law impact your valuation in a completely updated chapter.  A related new chapter devoted to the Bradford Regional case analyzes the risks of being unfamiliar with the regulatory construct as does another new chapter on measuring intangible value in physician practices co-authored by the industry’s most experienced healthcare valuation experts.  Various chapters explore the not so subtle nuances of valuing a physician practice, including coding analysis, ancillary technical component revenue, “incident to” billing for midlevel providers, valuing accounts receivable and benchmarking and normalization of expense.

Practical guidance coupled with adherence to professional and regulatory standards define the 2012 Guide to Physician Practice Valuation.

Medical Practice Valuation Guidebook

July 5th, 2010 | Posted by Mark Dietrich in - (Comments Off on Medical Practice Valuation Guidebook)

Sorry, the paper edition (published in 2001) is SOLD OUT, but the entire book has been scanned into Adobe pdf – see below for ordering details. We do, however, recommend purchasing the BVR 2012 Guide to Physician Practice Valuation instead because it is more current. The following quote is from the author’s introduction to the Second Edition (2001/2002), which has more than 30% new material and an Attorney’s Guide! More recent books are available elsewhere on the website.

Table of Contents is Here!
Description of New Features is Here!

“I am very excited about the second edition of the Medical Practice Valuation Guidebook, Including Comprehensive Financial Analysis and the Influence of Managed Care. The overriding goal of the second edition is to provide in-depth analysis and related problem solving tools to the financial and valuation issues confronting the medical profession now. Readers of the first edition will note the addition of extensive new material covering such diverse areas as dental practices, ambulatory surgery centers and litigation. As many who followed the PPMC industry expected, a host of lawsuits has sprung from the near collapse of that industry, and this book addresses many of the related valuation issues, such as valuing the noncompetition agreements typically included in such a transaction. Valuators engaged in Expert Witness and Divorce work will find a wealth of new information, including a point by point approach to isolating enterprise (practice) goodwill from personal (professional) goodwill, including a spreadsheet model. The Tax Planning chapter includes detailed analysis on the impact of recent tax cases such as Davis and Gross. It also includes a comprehensive description of the issues and approach to valuing a medical practice for donation to a tax-exempt entity, a surprisingly common occurrence. Valuators and physician-advisors will find a solution to the most common of all small medical practice dilemmas, solving the two-person practice buy-out. In addition, there is a complete Attorney’s Guide to the book as well as a Checklist to be used by attorneys in evaluating experts and their reports. That checklist should be invaluable to expert witnesses and valuators as well. There are numerous other additions and updates. I am certain you will find the second edition the most valuable asset in your medical practice library, whether you are a valuation expert, a consultant, industry executive, or attorney.”

Author’s Note: The print edition is sold out, BUT we have recently (July 2009) re-scanned the entire book into a single, searchable, Adobe pdf file! We are offering the scanned book along with the updated Chapter 5 on valuation methods (in searchable .pdf format with expanded coverage of valuation methods) for the price of $125 with the most recent edition of my Report on the Healthcare Economy. For prior purchasers of updated Chapter 5, a special discount is available – e-mail for details. New Chapter 5 includes critical analysis of why the market approach for valuing medical practice DOES NOT WORK due to lack of sources of comparable data. The Chapter is consistent with my peer-reviewed article appearing in the November 2005 edition of the Journal of Accountancy.In addition, to make sure purchasers have current information, the latest Report on the Healthcare Economy with more than 80 pages of detailed information industry – specific inflation, growth, reimbursement and regulatory topics – is e-mailed with your paid order. Chapter 12 of the book contains a Sample Report, which was written based upon market conditions in 1996. I still structure my reports in the same fashion, but readers should not believe that market conditions in 2009 are remotely similar to 1996 – that is why I offer the Report on the Healthcare Economy! In particular, market “data” is known to be less relevant simply because insufficient comparable data is available. I am amused when asked in cross-exam (as happened this past May, 2007) about values today based upon a report written nearly a decade ago. I have been influenced by the excellent work on the limitations of market data done by Nancy Fannon, CPA/ABV, ASA and Heidi Walker, CPA/ABV as well as my own extensive analysis. Of particular importance for medical practices is the insufficiency of Goodwill Registry data for use in the direct market method of valuation.Finally, given the importance of Revenue Ruling 59-60 in valuation, I offer the following quote from new Chapter 5: “The IRS Exempt Organizations Continuing Professional Education Technical Instruction Program Textbook for 1995 states the following in a section entitled Establishing Comparability under the Market Approach: “Factors affecting comparability include markets served; practice and specialty type; competitive position; profitability; growth prospects; risk perceptions; financial composition (capital structure); physician compensation; physician age, health and reputation; physician productivity; average revenues per physician; cost structure; and average revenue per visit or covered life to revenue to revenue mix (capitated versus fee for service): with a reference to Financial Valuation: Businesses and Business Interests. I know of no database with such information!”

Mark combines more than 20 years of experience as a medical practice consultant and tax partner with his skills as a valuation consultant accredited by the AICPA, to produce the first and only comprehensive guide applying the art and science of valuation specifically to medical practices. Templates and spreadsheets on disk are included, with a valuation model. To order the searchable .pdf version of the Book along with updated Chapter 5 in searchable .pdf format with expanded coverage of valuation methods, call (508) 877-1999.

Look for first edition reviews in:

Business Valuation Review, March, 1999

Business Valuation Update, June 1999

CPA Expert, Special Edition, Spring, 1999

Accounting Today, August/September, 1999

Health Niche Advisor, June 1999

Valuation Examiner, August, 1999


Reviewer quotes for the 1999/2000 Medical Practice Valuation Guidebook – Including the Influence of Managed Care, first edition

“This book is a real contribution that I recommend to anyone involved in a medical practice valuation. This is a very comprehensive and useful book with a lot of information packed into every page in an easy-to-read style. Besides the basic information, the frequent “Author’s Insights and Analysis” paragraphs translate the author’s own experiences into useful guidelines for readers. He also succinctly differentiates characteristics and appropriate valuation methodologies among different types of practices.”

Shannon P. Pratt, CFA, FASA

Managing Director, Willamette Management Associates

“At last, a single source that explains all issues and details required to analyze a health care practice! This book takes the time to explain the health care analysis factors that should be considered as well as the implications of the analysis results. Should be required reading and library reference for every valuation and health care professional.”

Jim Rigby, CPA-ABV, ASA

Co-Managing Director, The Financial Valuation Group

“You can’t value what you don’t understand. Mark Dietrich offers the valuation expert – who is not already versed in the intricacies of physician practice management, the knowledge and insight in how to correctly value a medical practice. This books is three books in one: a detailed review of medical practice operations, an excellent review of valuation theory, and a nearly unlimited supply of practical “author’s insights” based on his extensive experience. If you value medical practices, you will value this book.” (Sadly, Jim passed away in January of 2009)

John Mayerhofer, FACHE, FHFMA, CPA

Mayerhofer & Associates

“Needless to say, the information in this [book] is invaluable to appraisers attempting to value a physicians’ practice or the (likely) restricted stock of a PPM company. Chapter 10, Wall Street Meets Medicine, is must-reading for any physician who is considering participating in a roll-up with a PPM. Dietrich captures the essence of the economics of PPMs both from the perspective of the physician and the PPM, as well as providing insights into the very nature of roll-ups.”

Z. Christopher Mercer, ASA, CFA

President, Mercer Capital

The Table of Contents is available (just click). The book leads the reader through the analysis and valuation of the practice. Special chapters on special valuation circumstances, regulatory concerns, physician practice management companies, common mistakes and a sample valuation report with commentary round out this complete guide to valuing a medical practice. In addition to the text, the book will include a CD-Rom with valuation spreadsheets in Lotus and Excel format, reports, correspondence and other material necessary to permit the reader to value a medical practice.

To order the revised version of Chapter 5 in searchable .pdf format with expanded coverage of valuation methods, call (508) 877-1999.

Welcome to CPA.NET!

July 5th, 2010 | Posted by Mark Dietrich in - (Comments Off on Welcome to CPA.NET!)

Welcome to our home page on the Internet. As our URL – – would suggest, our early web presence (pre-1996!)  makes the firm one of the Internet “pioneers” in the accounting and appraisal profession. Our current practice is limited solely to the healthcare industry and includes business and intangible asset valuation, fair market value compensation opinions, managed care and network development consulting, litigation support, taxation and regulatory matters.

Mark Dietrich is one of the appraisal profession’s most prolific and accomplished authors (with four books published in 2012!) and lecturers and many of his articles and upcoming seminar appearances can be found by visiting his BLOG – under Categories above right, select Seminars and Publications. If you are interested in purchasing one of his books, visit the Publications page. Specific categories of services can be found by visiting our Services page. Mark is also available as a widely recognized and accomplished speaker on healthcare valuation and healthcare Reform.

We have endeavored to keep our Home page and Website simple, fast-loading and with a minimum of annoying distractions. In the hectic post-Reform era, busy professionals do not need to watch flash videos! For inquiries on the firm’s services, call Mark Dietrich directly at 508 877-1999.

The information contained in this web site is not legal or professional advice; it is for educational purposes only.


July 2nd, 2010 | Posted by Mark Dietrich in - (Comments Off on Slides)

This page contains links to all slideshows from seminars Mark has taught and has chosen to post.

Fundamentals Of Health Insurance And HealthCare Reform

A Guide to Hospital-Physician Transactions

AICPA 2007 BV Conference – The Grand Illusion: Market Data Post-Caracci and Issues from Delaware Open MRI

Current Events In the Dynamic World of Healthcare Valuations: 2008 AICPA/ASA Business Valuation Conference, Don Barbo, Mark Dietrich

Physician Hospital Joint Ventures & Local Market Factors: 2008 AICPA Healthcare Conference, Carol Carden, Mark Dietrich


July 1st, 2010 | Posted by Mark Dietrich in - (Comments Off on Services)

Information about the services that Mark Dietrich provides:

Roast on the Runway

June 15th, 2010 | Posted by Mark Dietrich in Sports - (0 Comments)

I ran the PTI Airport 5K last Saturday AM. It was quite an experience riding a bus from the parking lot while escorted by TSA personnel in a pickup truck to join the 1000+ others who showed up for the event! Although my warmup run at 6:45AM around the hotel was spot-on, by Race Time it was in the mid-80s, little breeze and, of course, no shade on the runway. Went out way too fast at around a 6 minute mile pace and did not find a rhythm until a half mile into it. Comically (in hindsight), I saw the ultimate winner of the race run by me in the opposite direction at around the 1.25 mile mark. Settled in briefly after turning the corner to head back, but ultimately the heat ate me up. My goal was 7'50" and, at least according to my GPS, I hit 7'58", and that was a real struggle. Official time was 8'02" and lots of folks were 'complaining' that their official times were long in the tooth.

No more racing until the weather cools off. C'Ville Chocolate Chase in October is a must.

Owl’s Roost: Redemption

April 30th, 2010 | Posted by Mark Dietrich in Sports - (0 Comments)

Well! All good things come to those who wait; or go back and check the official results! For no particular reason – actually, to see if the photo-finish picture was up yet – I just checked the official race results and see that I am once again in third place in the over-50! On Race Day, I figured that two errors in age were unlikely and thus my 5th place could not move forward two into a podium position. I still show as 29th overall even though I should be 28th, but I am likely the only one counting.

A truly crazed 55 year old outsprints two 32 year olds

Apologies to Dickens. I ran to defend last year’s third place finish in the old guy division this morning; rain stopped about the time we got to the park; it was windy, a tad cool, … and they started the 3.5 miler nearly 30 minutes late. I ran with the lead group for .25 mile before noticing my GPS indicated a pace of 6.5 minutes … my target being 7.5 at the open. I decided to slow down.
Fast forward to the last climb on the tortuous last mile. Flashing back to losing second place by a second due to folding on this climb, I sucked it up and passed a guy I had followed the entire race. Still in possession of my wits, if not my lungs, I expected a challenge in the last 40 yards. Where last year it was a 9 year old trying to spoil my finish, this year he was 32. I fought this one off, beating him by a foot – in his good natured estimate – and after 4 minutes of attempting to catch my breath, retired to await the times, confident of a podium finish.
Alas, Dickens had it right; despite finishing nearly 3 minutes faster than last year at what I would say was a blistering pace of 8’30” per mile, I found myself in 5th place in the over 50 and 28th overall vs last year’s 27th overall. If memory serves, the 50 year old who placed first ran at a 7’05” pace – about as fast as I can run downhill!