Employers and

COVID-

19

Read this if your organization is considering replacing or implementing a new EHR system. 

Have you ever been on a vacation with a group of friends or relatives, whether it was a camp outing at the nearest lake, a trip to an amusement park, or a visit to another country? There's one thing that can make or break a trip: communication. If you had good sound communication with your travel companions, it probably enhanced the enjoyment of the vacation. Nonexistent, poor communication more than likely contributed to an experience you won't want to repeat. The same dynamic is present in any workplace project involving other humans.  

According to research by Salesforce, which included employees, corporate executives, and educators, 86% felt that ineffective communication was the underlying reason for workplace failure. A study performed by the Economist Intelligence Unit identified that poor communication results in 25% of missed goals and 44% of failure to complete projects. By contrast a poll by Expert Market showed that when employees are offered better communication, productivity can increase by up to 30%.  

If your organization is in the process of a large-scale project, such as replacing or implementing an electronic health record (EHR) system in the near future, success will depend on having a sound communication plan in effect before, during, and after the implementation. Fortunately, effective communication is not a difficult task to achieve. Based on our experience helping organizations implement EHR systems nationwide, our team has developed five simple communication steps for successful implementations. 

 1. Reach the right audience 

Determine who will be affected by an EHR system. Remember, it is not just providers and caregivers. Make certain that all affected staff (e.g., IT, schedulers, administrative) and providers are discovered, and determine how the daily workflow will be changed.  

2. Develop a thoughtful communication plan

A communication plan is essentially a well-thought-out guidebook for the implementation team to follow, to spread the message of change. A proper communication plan sets forth the process of updating and educating on the coming changes, requests for needs, reporting of issues, training, and delivering the right messages to the masses that change is happening. (e.g., A provider would not need to know the billing and accounts receivable data, nor would a scheduler need to know the nursing data). 

3. Have a dedicated resource for communication

It is essential to know who will be communicating the change and how that communication should be spread throughout your organization. An organization may have a dedicated change manager who orchestrates the progression of all communications, or this task could be dedicated to a group with shared duties. Regardless, the task remains the same: effectively communicate the changes coming.  

4. Frequently re-evaluate and restructure the communications 

Not all communications work the same. Know your staff and their preferences for receiving their communications. Providers may need a messaging system of notification, nurses may prefer an email, but finance may need a memo. It is also important to re-evaluate frequently how well the communications are getting to the target audience. What may have worked before may not be working now, and the organization needs to consistently re-invent their communications to make sure the message of change is being heard and understood.  

5. Hold periodic implementation discussions 

The dedicated change manager(s) should be given an opportunity to briefly discuss changes coming with members of the organization who may be impacted by the change. This may mean one-on-one discussions, group meetings, or during an operations or full staff meeting. A two-way approach to communication will help to disseminate important information and ensure transparency by inviting feedback and questions.  

BerryDunn’s team of consultants is happy to assist you with creating a Request for Proposal, selecting the right EHR vendor for your organization, and developing communication, change management, and project management for system implementation projects. Learn more about our team and services.  

Most nonprofits rely on federal and state government funds to fulfill their missions. With a federal funding freeze in the headlines, many clients are asking us how they can best prepare for a freeze and protect their organizations if funding is cut. Here are three steps you can take today to stay ahead. 

Analyze cash flow and reserves 

The first step an organization should do is understand their cash flow situation and how dependent the organization is on its funding streams. Consider upcoming planned expenditures that could strain cash flow and be sure to track key metrics such as days cash on hand, current ratio, and accounts payable turnover.  

Understand your grant agreements 

Review your organization’s existing grant agreements. Consider whether there are any stop-work clauses and stay in close contact with the grant officers who handle the funds. These factors may give you advanced notice of a possible shutdown, giving your organization more time to plan.  

Develop contingency plans 

Having a contingency plan to implement quickly after a funding freeze is announced is crucial. Maintaining sufficient short-term cash reserves in the face of a funding freeze will allow your organization to adopt a long-term plan. Understand your options to cover short-term cash needs, such as lines of credit and private foundations. Also, prioritize essential services and temporarily scale back the non-essential services as needed. Analyze your variable costs associated with the services and be ready to discontinue them if they are no longer necessary. Lastly, understand the workforce implications that a funding freeze would have. Funding freezes may result in hiring freezes or temporary furloughs. 

Being prepared and staying prepared is step one. If you do lose access to your federal funding, stay calm and implement your contingency plan. If you continue to run a program through alternative funding sources or utilize your cash reserves, make sure that you are maintaining the level of compliance necessary so there will not be issues when funding is restored. If your control structure changes due to a funding freeze, make sure you are adjusting it appropriately to maintain compliance and proper segregation of duties. Continue to stay in contact with your granting agencies so you can stay abreast of the changing landscape of federal and state funding.  

BerryDunn’s nonprofit team brings a clear understanding of nonprofit funding, in-depth knowledge of complex compliance requirements, and the industry-specific knowledge necessary for accurate, complete financial reporting. That knowledge informs our work—and enhances your performance by addressing your most important operational challenges. Learn more about our team and services. 

Public health is at a crossroads. With the lessons learned from COVID-19 and a workforce on the brink of burnout, now is the time for transformative action. By reimagining operations, infrastructure, and health equity, we can shape a system that’s responsive to future challenges.

Applying lessons learned during the COVID-19 response, our post-pandemic world requires public health to embrace a culture of change and discover new ways to offer services and improve health outcomes. Fostering an educated and resilient workforce, operationalizing health equity, strengthening partnerships and funding, enhancing organizational change management, and improving data collection and sharing efforts are key considerations for public health leaders navigating the transformation process. 

Through transformation, public health agencies can build a system that is more engaged with partners and responsive to future community health challenges. When agencies are more capable of meeting the needs of communities, they essentially increase their abilities to enhance health outcomes across the country. 

Since 2014, the Public Health Workforce Interest and Needs Survey (PH WINS) has assessed the governmental public health workforce in the United States. The survey, conducted by the de Beaumont Foundation and the Association of State and Territorial Health Officials (ASTHO), identifies the public health workforce’s opportunities and challenges including demographics, job characteristics, employee engagement, and training needs within public health agencies. The 2021 survey was conducted during the COVID-19 response and provided meaningful insights that public health leaders could use to make decisions about the current workforce and set priorities for the future workforce with the goals of improving the employee experience and increasing the effectiveness of public health efforts across communities.  

Key survey findings 

The 2021 PH WINS identified a diverse public health workforce in terms of age, educational background, and experience but also recognized challenges posed by an aging workforce. The survey found a significant proportion of public health professionals nearing retirement, which presents a potential problem for sustainability and a critical need for succession planning within public health agencies. 

Taking a deeper look into the demographic gaps identified by survey respondents, most public health professionals identified as white (54%), female (79%), and aged 40 or older (63%). Nearly half of the nation’s public health workforce reported being between the ages of 31 and 50 years, and nearly half of the professionals had served in public health agencies for five years or less while 13% had served for 21 or more years.  

To safeguard communities, promote health equity, and prevent disease, public health professionals are essential. Understanding the workforce’s reasons for leaving the field is crucial for succession planning, recruitment, and retention. The top reasons identified by survey respondents for leaving include work overload, burnout, and stress. More than 25% of public health staff stated they are considering leaving their organization within the next year, and 24% reported that the COVID-19 pandemic had an impact on the decision.  

According to the survey, job satisfaction and morale should be areas of concern for public health leaders even though many public health professionals reported they are dedicated to their work. Over 50% of the respondents reported feeling burnt out, with the COVID-19 pandemic increasing these feelings. The results also acknowledge the importance of addressing and offering mental health services for public health professionals to work toward improving employee morale. 

The PH WINS highlights several important opportunities and challenges required to strengthen the public health workforce. Public health agencies must begin addressing burnout, offering mental health support, and guaranteeing access to professional development opportunities. The survey revealed a substantial proportion of the workforce identified gaps in professional growth and training with public health professionals saying they need more training in areas such as leadership, health equity, and data analysis.  

According to the 2021 survey, the top five areas for training identified nationally by public health professionals across all supervisory levels include: 

• Budget and financial management   
• Systems and strategic thinking   
• Community engagement   
• Change management   
• Policy engagement  

Opportunities for improvement through public health transformation

By addressing and closing gaps, the public health system will be more responsive, skilled, and versatile. Opportunities for improvement through public health transformation include identifying and addressing concerns within communities served by infusing a health equity lens throughout all areas of public health programs and implementing a data modernization strategy. The results of the PH WINS emphasize how important it is to plan and invest in the public health workforce to achieve goals to help ensure the safety and well-being of communities across the country.  

The 2024 PH WINS, set to be released this summer, will give us a timelier temperature check on how the public health workforce is faring and if the opportunities and challenges identified in 2021 remain relevant, have changed, or have been adequately addressed. As the public health landscape evolves, leaders must act decisively to strengthen the workforce, embed health equity into programs, and modernize data systems. By doing so, we can safeguard communities and ensure lasting positive health outcomes. 

This is the first in a series of articles delving into opportunities for public health transformation. Learn more about our public health team and services. 

The end of 4Q 2024 marks the start of a new year. In the Valuation Group, the end of the calendar year brings us to one of our busiest times of year: “ESOP season.” During the first few months of the year, we perform annual valuations for 30+ ESOP clients.

Meanwhile, other members of the valuation team have been focusing on assisting business owners with exit planning through our value acceleration service. The value acceleration exit planning framework is designed to help business owners identify and address value constraints and transferability limitations, but like turning a ship, it takes time. We recommend that business owners understand their strengths, limitations, and value at least five years before planning to exit. This proactive approach allows for a smoother transition and maximizes the business’ value.

Often, business owners like to wait until year-end results come out to make decisions. That way, they can compare performance year-over-year to aid in decision-making. Now that 2024 has concluded, we can assist business owners with decision-making by determining the value of the business based on year-end results. The end of the year is a busy time, with fiscal years wrapping up and holidays in full swing. As we move into 2025, it's an opportune moment to make strategic decisions for the future.

Speaking of busy, M&A activity often peaks in the fourth quarter. In 2024, this trend was again observable. After a strong year in 2024, our transaction advisory team is looking to help more clients sell or buy companies in 2025.

Another exciting opportunity for BerryDunn’s valuations team is the merger of BerryDunn and Burzenski & Company on December 1, 2024. Burzenski is well known for its work with veterinary practices and the construction industry. The merger will enable BerryDunn to expand into the veterinary practice market and add to its existing construction practice.

We track trends in several databases of private company transactions, among them GF Data, Capital IQ, DealStats, and BIZCOMPS. As presented below, we saw a slight downturn in multiples in the third quarter of 2024. We also saw the number of transactions increase in the fourth quarter compared to the third quarter of 2024 and in line with the first and second quarter.

Don’t get too fixated on the multiples in this chart as an indicator of value for your company. Look at the trends. Multiples vary dramatically from industry to industry and business to business. If you are interested in exploring value drivers for your company, read this recent article.  

The value of privately held companies often isn’t as volatile as share prices for public companies. However, activity in the stock market provides general guidance that is often much more timely than data available for private companies.

There are a few indexes we keep an eye on. The S&P 500 is generally considered the go-to benchmark for stock market performance, although it is dominated by a handful of large tech stocks. The Russell Midcap Index cuts out the largest 200 companies in the Russell 1000 Index, keeping 800 US companies with market capitalizations between $2 billion and $10 billion. The Dow Jones Industrial Average is comprised of 30 “blue chip” US stocks that may be similar to many private companies.

Stock prices have followed a generally upward trend throughout 2024 but have started to trend downward toward the end of Q4.

Many drivers of business value can be influenced or controlled by the decisions of the business’s management team, including product diversification, brand recognition, and employee retention. Other drivers are outside of management’s control, such as inflation and unemployment rates. As summarized below, key drivers of the US economy generally remained near similar levels in 4Q as in 3Q.¹

¹ Source: Federal Reserve Economic Data, available at https://fred.stlouisfed.org/.

² Indicates the likely effect on business value for most businesses. Depending on the business model, certain businesses may demonstrate an inverse relationship to economic variables compared to the market as a whole.

As many of our clients are located in New England, we’ve included a summary below of some of the key economic drivers that affect businesses in the Northeast³. If your business is headquartered outside of New England, reach out to us for an economic analysis specific to your market area. 

Economic activity  

Economic activity increased slightly overall. Prices and employment levels were roughly unchanged, and wages rose at a modest pace. Air travel was a relative bright spot, as domestic air passenger traffic through Boston finally surpassed 2019 levels, and passenger traffic through the Worcester airport increased substantially in the past year. Tourism activity overall increased only modestly, however, and restaurants in some areas reported softer-than-expected sales. Retail revenues rose slightly, and consumers remained highly price-conscious. Manufacturing sales were mixed, while software and IT services firms experienced stable and healthy demand. Residential real estate sales increased modestly, helped by improved inventories in some areas, while commercial real estate activity was flat. The outlook was modestly optimistic on balance, although some contacts had concerns for 2025 related to how national economic policies might change and where long-term interest rates would land.

Labor markets  

Employment was roughly steady, and wages increased modestly on average. Contacts in the retail, tourism, and software and IT services sectors all reported stable headcounts. Among manufacturing contacts, headcounts increased slightly at selected firms, decreased modestly at one in response to slower sales, and were reportedly unchanged otherwise. Labor supply to retail and tourism jobs improved modestly, with contacts noting greater ease of hiring and reduced attrition. Wages increased modestly on average, and contacts reported no elevated wage pressures. However, one manufacturing contact experienced a significant increase in health insurance costs that they partly passed on to employees, while offering a slight wage increase as an incomplete offset. No contacts mentioned plans for major changes in hiring or wages in 2025. Cape Cod contacts, whose businesses rely heavily on seasonal worker visas, expressed concerns that potential changes to visa programs could restrict their labor supply in 2025 or beyond.

Prices 

Prices were about flat on balance. An online retailer reported only modest pricing pressures and remained keenly aware of consumers’ heightened price sensitivity. The same contact was cautiously optimistic that any tariffs would not have a major impact on their prices, owing to changes made to their supply chain in recent years. Hotel room rates in the Greater Boston area decreased modestly on a year-over-year basis, but contacts pointed out that the change was in relation to the record-high room prices of November 2023. Manufacturers held output prices steady, even though most experienced slight to modest increases in input prices. Software and IT services firms posted modest price increases on average. Contacts did not foresee major changes in pricing pressures for their businesses moving forward.

Retail and tourism 

First District⁴ retail contacts reported slight increases in revenues in recent months, while tourism activity experienced modest growth on average. An online retailer described fourth-quarter revenues as stable overall but said that promotions had been critical to those results and that demand for lower-end goods remained weak. On Cape Cod in the fourth quarter, hotel occupancy rates and retail sales met expectations and were roughly on par with the fourth quarter of 2023, but restaurants experienced weaker-than-expected sales. Airline passenger traffic through Boston increased moderately in the fourth quarter from one year earlier, with domestic travel finally surpassing 2019 levels. Worcester air passenger counts grew 18 percent from the previous year. Like the change in hotel room prices, hotel occupancy rates in greater Boston were down slightly in November from one year earlier, when occupancy rates had been at all-time highs. Contacts expected robust tourism and convention activity for Boston for 2025. The outlook for retail and restaurant activity was more cautious, as contacts in those businesses expected roughly flat activity going forward.

Manufacturing and related services 

Manufacturing sales were flat on average since the last report. Most firms reported no change in revenues in the fourth quarter from the third, but sales were unexpectedly soft for one manufacturer and unexpectedly strong for another. The strong sales pertained to a frozen fish producer who speculated that retailers were accumulating inventories in anticipation of tariffs. A semiconductor maker with flat sales said that demand for their products was softening and that they would adjust employment downward moving forward. Capital expenditures largely stayed within forecast ranges. The outlook for 2025 was modestly positive on balance, as most firms expected sales to increase at least slightly in the new year, but one semiconductor manufacturer expected moderate declines in sales relative to 2024.

IT and software services 

First District IT and software services contacts described demand as stable at healthy levels, and one firm’s total revenues for 2024 exceeded expectations. Capital spending was constant, and physical investments were described as minimal given firms’ reliance on cloud computing services. Contacts expected revenues to increase strongly in the first quarter of 2025, based on a combination of organic growth in demand and, in one case, the recent acquisition of another company. Considering the longer-term outlook, most contacts expressed confidence that demand for their products would continue to rise, even in an environment of heightened political and macroeconomic uncertainty. Nonetheless, one firm said that increased competition from China affecting its clients could either boost its business, as client firms invested in new technologies to keep up, or hurt demand if clients were pushed out of the market altogether by such competition.

Commercial real estate 

Commercial real estate activity was mostly flat in the First District. Contacts reported uniformly that elevated long-term interest rates continued to limit transactions. One contact said that borrowers, hoping that long-term rates would decline, continued to favor extensions for maturing loans. However, several contacts downgraded the chances of significant rate declines in 2025. Office leasing activity remained slow, but prime Boston properties continued to experience relatively healthy activity. Contacts described industrial and retail leasing activity as stable. Rents and occupancy rates were unchanged across all asset classes. One contact said that a recent Massachusetts law intended to promote multifamily construction was yielding tangible results in some areas of the state. Around half of contacts were cautiously optimistic that the first quarter of 2025 would bring more robust commercial real estate activity, while others expected current activity levels to persist or, more pessimistically, that interest rates would stay higher for longer than previously expected and exert negative impacts on the market.

Residential real estate 

Home sales in the First District rose modestly on a year-over-year basis in November 2024, the most recent month for which data was available. Supporting the increase in sales, home inventories were up moderately from a year ago overall, with very large increases in Maine and Vermont, although inventories declined moderately in Massachusetts from a year earlier. However, the typical number of days homes spent on the market increased, as multiple contacts mentioned that some buyers were waiting until after the presidential election to make purchasing decisions. Considering changes since November 2023, prices of single-family homes increased at a brisk pace, while condo prices increased moderately on average in Massachusetts and Rhode Island but decreased modestly in the northern New England states. Multiple contacts expressed optimism that more sellers would put their homes on the market in early 2025 and that this would lead to increased sales activity.

³ Quoted from the Beige Book – January 2025 from the Board of Governors of the Federal Reserve System.

⁴ The Federal Reserve System’s First District includes Connecticut (excluding Fairfield County), Massachusetts, Maine, New Hampshire, Rhode Island, and Vermont.

• To learn more about ESOPs, here is a brief overview of ESOPs we put together. 
• Interested in learning more about business valuations? Read more here or pick up a copy of our book, A Field Guide to Business Valuation.
• MaineBiz recently featured an article about exit planning for business owners.

Where to find us

Casey Karlsen and Seth Webber are leading a four-part workshop series for business owners about increasing business value and liquidity. We previously summarized this content in a couple of blog posts (Session 1, Session 2, Session 3). Take a look if you missed us! 

Interested in meeting the team? Please reach out to us. We would love to connect. 

For manufacturers in New England, the global trade environment has always played a significant role in shaping supply chain strategies and cost structures. With the current tariff landscape marked by rapid changes and adjustments due to ongoing trade negotiations and economic strategies, businesses must be ready to quickly reevaluate their pricing models and material cost standards to maintain profitability. 

Tariffs and the rising cost of materials for manufacturers 

Tariffs on imported raw materials—especially steel, aluminum, and electronic components—have significantly impacted manufacturing costs for many New England manufacturers. Impacts include:  

• Higher material costs: Price increases in metals and components force businesses to either absorb higher costs or pass them along to customers, potentially affecting competitiveness. 
• Supply chain disruptions: Many businesses that previously relied on international suppliers must reconsider domestic sourcing, which may not be as cost-effective. 
• Increased production costs: With raw materials costing more, the overall cost of goods sold increases, tightening profit margins. 

What manufacturers can do now to be ready for tariffs 

For CFOs, controllers, cost accountants, and business owners, it is imperative to assess how these tariffs affect cost margins and whether existing standard costs remain valid. Key considerations include: 

• Reassessing bill of materials pricing: Companies should review and update material costs in their enterprise resource planning (ERP) systems to reflect current market prices. 
• Revising standard costs: Many manufacturers set cost standards based on historical pricing. With tariffs inflating costs, businesses should update these figures to avoid inaccurate pricing models and profitability projections. 
• Scenario planning for future tariffs: The tariff landscape remains uncertain. Running cost simulations under different tariff conditions can help businesses prepare for potential future changes. 
• Vendor and supply chain analysis: Evaluating domestic versus international sourcing and considering supplier renegotiations could mitigate tariff impacts. 

How BerryDunn can help 

Navigating the complexities of tariff-induced cost increases requires a strategic approach. At BerryDunn, we assist manufacturers with: 

• Costing analysis and standard updates: We help businesses reassess standard costs and implement updated costing models to maintain accuracy in financial reporting. 
• Profit margin impact assessments: Our team can analyze the direct and indirect effects of tariffs on your bottom line, identifying opportunities for cost recovery. 
• Supply chain cost modeling: We provide financial modeling to compare sourcing alternatives and develop cost-efficient strategies. 
• Budgeting and forecasting support: Our expertise in financial planning ensures your business remains resilient despite tariff fluctuations. 

The tariff landscape continues to evolve, and manufacturers must remain proactive. By reassessing costs and adapting pricing strategies, businesses can sustain profitability and competitive positioning. If you need assistance understanding how tariffs impact your financials, BerryDunn is here to help. Reach out to our team today to help your business stay ahead of the curve.