Medical practice financing

Maik Sammer

Medical practice financing

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    More information about Medical practice financing

    Start-ups and practice owners have different forms of financing and concepts open to them.

    Whether building your own or taking over an existing practice – who wants to be self-employed, needs competent support right from the start.

    An overview of a possible structure and possible funding we like to give them in an individual conversation.

    Freedom of design, self-fulfillment and independence play a central role for many academic health professions in the leap into self-employment. At the same time, self-employment is characterized by financial and economic responsibility. The doctor becomes an entrepreneur. In this capacity, physicians have to take care of the financing and profitability of their practice.

    The step into self-employment requires extensive investments. Finally, the expenses for medical equipment, practice equipment, modernization, reconstruction or construction measures must be financed. The total financing volume – including working capital loan – for this depends on the type of the chosen form of formation.

    There are good reasons to make these investments with individually planned financing and explore alternatives. Who finances is more independent in the choice of practice or the practice equipment. At the same time, financing offers a firm basis for calculation; the financial situation remains plannable. The financing concept is based on the occupational and private situation of the borrower. Term, debit interest and repayment shares are agreed individually and take into account the personal needs.

    Tailored financing concepts

    Start-ups have different forms of financing and concepts open to them:

    Investment loans. Amongst other things, interest payment loans (term loans) are suitable for start-up founders. In this case, the loan is repaid in full at the end of the term. The burden during the term is limited to the payment of debit interest. As a repayment, the claims from endowment policies, private pension insurance, home savings or investment funds or real estate, … are ceded as collateral. Savings plans are reserved separately and used at the end of the term to repay the loan.

    For the borrower this results in advantages:

    Thus, the interest on loans for real estate loans or loans for rented real estate is tax deductible as operating expenses or income-related expenses. Because these are higher due to the unchanged loan value compared to other forms of financing, tax benefits arise. If the savings paid are invested in an investment (for example, mutual funds) whose expected return is above the interest rate of the loan, this may also be beneficial. The construction of the interest payment loan also means that the sum of payments in the repayment instrument can be lower than the loan amount to be repaid. This results from the possible increases in the value of the fund assets over the entire term.

    This variant is only recommended if you are offered so-called “net contracts”. We are happy to provide you with relevant information.

    Other types of financing are repayment and annuity loans. With repayment loans repayments remain constant over the entire loan period – with the result that the financial freedom increases over time, because the calculated interest on the remaining term interest rate component decreases over time. Annuity loans are suitable for financing, where you want to achieve a constant installment. This is usually the case in the private sector, such as mortgage lending.

    In addition to lending by the bank, it is also advisable to resort to public support program loans, such as those from the Kreditanstalt für Wiederaufbau (KfW).

    Operating loan. The working capital loan is a current account credit, which among other things serves to pre-finance the costs in the start-up phase of the practice. In its peculiarity as a current account credit, only the amount actually used – ie the utilization of the credit limit – must be paid interest. Although the borrowing rates are often higher than those of an investment loan, the working capital loan is often more cost-effective due to its high flexibility and should therefore be planned in addition to an investment loan.

    Zeichenbeschränkung: 5000
    • Holistic practice concept. In the life planning of many physicians in addition to their own existence and an adequate provision for the future and a property play an important role. It therefore makes sense to embed practice funding into a holistic pension and investment concept as part of a “practice concept”. This is a combination of practice financing, real estate financing and old-age provision, in which interest-rate effects and tax effects are optimally utilized. So it may be advantageous to repay an interest payment loan on a (unit-linked) pension insurance. The repayment takes place via the expiry performance or a repurchase value of this parallel hedging. In the savings phase, the investor benefits from the regular contributions from the compound interest effect. Because the sooner the deposits start and the longer the money “works”, the more the capital grows due to compound interest. Often it is therefore advantageous not to pay for the practice loan, but to extend. Because the credit interest is in this concept, well above the net debt – with a very good cash investment management. There is a significant capital advantage. This amount can be used to finance your own property and / or retirement. Therefore, in such projects on a bank and financial market neutral advice should be placed in order to achieve this goal in practice! Feel free to use the contact button to experience this added value!
    Plan maintenance investments exactly
    In order to compete, older medical practices have to invest. Over the years, the wear and / or aging of medical devices and equipment is increasing. Such investments are important to be able to offer innovative treatment options and to secure the practice value. However, the purchase of new equipment is associated with high expenses.
    Before acquiring medical devices, it should be planned beforehand: How many exams are required annually to cover the fixed costs of the device? What profit can be achieved by using the device? And how profitable is the purchase of the device? ”
    Apart from the profitability, we also carry out a liquidity planning for a financing. It is examined whether and how the necessary financing for the investment can be realized. If the new equipment is financed by credit, it will affect income and liquidity. The latter is important for the existence of the practice and must not be endangered by the financing. Based on the liquidity planning, the loan amount to be financed, the optimal term of the fixed interest rate and other conditions are determined. In addition, public promotional loans – such as the KfW Entrepreneur Loan – can also be used for investments. This promotes investments that become necessary in the course of a practice modernization.
    Public lenders such as KfW-Mittelstandsbank offer attractive financing alternatives to bank or savings bank loans.
    The financial and banking crisis has also led to a rethinking of physicians: So far, often only the house bank has been used as a lender for practical investments, now the spectrum seems to be widening. Public lenders such as KfW-Mittelstandsbank offer attractive financing alternatives to bank or savings bank loans.
    Public subsidy programs with extremely low borrowing costs of around one to two percent per annum, depending on the creditworthiness of the respective practice owner, can financially secure and support investment measures for virtually any purpose. For this purpose, the respective house banks, which are to be included regularly in the application for these funds (“house bank principle”), in the form of an appropriate advice to make their share. In still difficult times, physicians should not give up these public financing components as part of financially sustainable overall financing.
    One of the largest lenders of public funds is KfW-Mittelstandsbank, whose product diversity makes it possible to support almost every economically viable investment measure by medical practices of varying financial size. It is both about practice foundations and practice consolidations as well as practical extensions:
    • The ERP Start-up Credit Start-up Fund provides funds of up to € 100,000 for corresponding investments with terms of up to ten years (with up to two grace-free start-up years) and fixed interest rates. In addition to practice founders and practice successors, the funding also includes young practices up to three years after starting work.
    • Practices in structurally weak regions can also use funds from the ERP regional funding program for medium and long-term investment financing. Maturities of up to 20 years with up to five redemption-free start-up years characterize this program variant. Here also practice foundations and practice consolidations are possible.
    • The ERP Innovation Program will, above all, accommodate physicians who are considering new products, processes or services, for example, seeking funding for related research and development activities. Attractive interest rates (depending on creditworthiness), grace periods and easier access to capital in the event of a lack of collateral also show a program flexibility that benefits the doctor as a borrower.
    Of course, other development banks, which specialize in stabilizing regional credit markets, also offer interesting credit products. Doctors should ask their independent contact persons for careful advice, as with the financing programs of KfW-Mittelstandsbank.
    We are happy to assist you with words and deeds.