Quality of Earnings Review
Financial clarity and risk insight to support confident healthcare transactions.
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A Quality of Earnings (QofE) review is one of the most critical components in evaluating the true financial performance of a healthcare organization during a transaction. Unlike a traditional financial audit, which examines historical accuracy, a QofE review assesses the sustainability, quality, and drivers of earnings — helping buyers, sellers, and investors understand the normalized financial picture before moving forward.
Coker’s healthcare-focused QofE team combines financial analysts, valuation experts, and operational specialists who understand how clinical operations, reimbursement models, and regulatory factors impact financial performance. We analyze not only the numbers, but the operational realities behind them — providing a more accurate, defensible foundation for valuation and deal structuring.
Our Approach
Coker’s QofE reviews are designed to deliver clarity, accuracy, and actionable insight. Our team:
- Evaluates revenue streams, expense drivers, and non-recurring adjustments
- Analyzes payer mix, reimbursement trends, and volume/acuity shifts
- Reviews revenue cycle performance and denials impact
- Identifies normalization adjustments and pro forma considerations
- Assesses working capital requirements and cash flow sustainability
- Highlights risks related to compliance, provider compensation, and operational dependencies
- Provides clear, data-supported reports for buyer and seller decision-making
Why It Matters
A thorough QofE review helps organizations:
- Understand normalized EBITDA and future-state earnings potential
- Identify financial and operational risks before closing
- Avoid overvaluation or unexpected post-close liabilities
- Strengthen negotiation position and deal structure
- Validate the investment thesis with healthcare-specific insight
Coker’s healthcare expertise ensures QofE findings are grounded in the realities of clinical operations, regulatory risk, and revenue cycle performance — not just financial statements. This gives investors and healthcare organizations the confidence needed to proceed with clarity.
Experts, focused on your needs.
Why Trust Coker
For more than three decades, Coker has been a trusted partner to healthcare leaders and investors, delivering clarity, compliance, and confidence through every stage of the transaction and beyond.
Positive outcomes are possible for you and your patients.
We approach every engagement with a results-driven mindset, leveraging our deep industry expertise and data-driven insights to develop strategies that drive meaningful, measurable improvements in performance.
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Solutions We Offer
We partner with clients to navigate the dynamic challenges of managing a high-performing physician enterprise.