How to make a yearly plan for your therapy practice

Decide what you want the year to improve

Write down what should be different a year from now. You might want existing clinicians to have steadier caseloads, a new specialty to become viable, more time for supervision or less owner involvement in routine billing. Growth in headcount is one possible means, not a complete plan.

State what you intend to protect: the clinical model, sustainable workloads, supervision time and the owner’s role. A plan that produces more sessions by consuming all of those can miss the reason you built the practice.

Limit the major priorities to the work the practice can support. An owner trying to change the EHR, hire several clinicians, open a location and rebuild intake at once needs to understand how those projects compete for the same attention.

Start with a realistic picture of the practice

Begin with recent appointments, clinician openings, inquiries, payments and costs. Note anything unusual, such as leave, a clinician joining or leaving, changed fees or a large payment for old work. A single strong month may not be a realistic starting point for the year.

Separate recurring conditions from one-time events. A payment from an old claim improves cash in the current month but is not evidence that every future month will collect that much. A temporary leave reduces capacity but may not describe next year’s staffing.

The SBA’s planning guidance connects the business model, operating structure, revenue and costs. Apply that discipline to the practice: every target needs an operating assumption and a financial consequence.

Work out how many appointments you can complete

Start with appointment slots the practice can offer. Then estimate how many will book and how many booked appointments will happen. Keeping these steps separate shows where the plan depends on finding clients or improving attendance.

Illustrative annual model: six clinicians each offer 20 bookable sessions per week across 50 working weeks. That is 6 × 20 × 50 = 6,000 available session slots. At an assumed 80% booking rate and 90% completion rate among booked sessions, expected completed sessions are 6,000 × 0.80 × 0.90 = 4,320.

These figures show how the plan works; they are not recommended workloads or industry averages. Use separate rows when clinicians have different schedules or working weeks. For a new hire, start from their joining date and allow time for appointments to fill.

Use the weekly booking-goal calculator and capacity calculator to check whether the annual goal fits the actual calendar.

Compare the money in a normal and a slower year

Next, check what those completed sessions would leave after costs. Continue the example with $120 received and $72 of session-related costs for each appointment. Each session leaves $48 toward the other bills. At 4,320 sessions, that is $207,360. If other yearly costs are $144,000, the plan leaves $63,360. The table shows what happens if fewer slots book.

Check money available and owner time too

Check money month by month too. A year can look profitable while a particular month is short of cash. Put expected payments and bills on a timeline, especially when hiring or paying setup costs. Test what happens if money arrives later or a new clinician starts later.

Give owner time a budget too. If the plan depends on the owner doing more clinical work while also managing recruiting, intake and billing, show where those hours come from. Assign the administrative responsibilities before counting the time as available.

Use profitability planning for the cost model and the owner admin-time guide for the handoff. These are different constraints and both can stop a financially attractive plan.

Turn priorities into the next few actions

Give each priority a starting point, a next action, a person responsible and a time to check progress. Write down what result would make you continue, change direction or stop. That turns a yearly aim into something the team can act on now.

An intake priority might begin with a measured gap between suitable inquiries and completed first appointments. Its first project is to identify stalled stages and clarify availability. The next decision is whether the revised workflow improved completion for a comparable group of inquiries. “Do marketing” does not provide that sequence.

A hiring priority might depend on sustained inquiries that fit the role, available supervision and cash for a slower ramp. Until those conditions are met, work on the condition rather than treating the hire date as fixed. The hiring guide provides a role-specific model.

Update the plan when the facts change

At a regular review, compare the assumptions with what happened: available slots, booking, attendance, collection per session, costs and owner time. Identify which assumption explains the gap. That tells you whether to change the work or change the plan.

Keep a dated decision record when a priority moves. If a clinician start is delayed, update capacity and cash together. If a referral source grows, check whether intake and scheduling can support it. An annual plan should make these choices easier rather than become a document the owner feels obliged to defend.

Use Cortexa to support the everyday work

Cortexa Analytics supports the ongoing view of revenue, sessions, clients and clinician capacity. It helps the owner compare the practice’s activity with the assumptions in the plan. Costs, cash commitments and clinical priorities still need their own deliberate review.

Full Service Partner provides front-office, intake, scheduling and billing support, with payroll and marketing defined in the membership agreement. That lets the operating plan identify which work Cortexa supports and which decisions stay with the practice. The purpose is to help the independent practice execute its own direction.