How Multi-Location Health Systems Get Consolidated Financials Without the Spreadsheet Marathon
Ask your Controller when the CFO last had a current consolidated financial picture on a random weekday in the middle of the month. At most multi-entity health systems, the honest answer is: not since the last close.
The consolidated view exists once per period. It arrives after the manual process runs its course — after every entity closes, after spreadsheets are collected, after intercompany balances are reconciled by hand, after the elimination entries are posted. By the time leadership has the consolidated financials, they are already looking at last month. This is accepted as normal. It should not be.
How Traditional Consolidation Actually Works
Financial consolidation in a multi-entity health system typically follows four steps. Understanding them makes the problem concrete.
Entity close, then wait. Each business unit follows its own close calendar. A hospital or a practice group may need a week or more to close its books. The corporate accounting team cannot begin consolidation until every entity is done. The consolidated view is the last thing completed, not a running total.
Results arrive by spreadsheet or email. Corporate accounting collects entity financials through indirect channels: file shares, email attachments, or manual exports from entity systems. This data must be manually reformatted to match the consolidated chart of accounts. The process creates version control issues that are common and time-consuming: which file is current, which one was revised after the initial submission?
Intercompany elimination is a manual project. Intercompany transactions, charges between the hospital and the medical group, shared services allocations, internal loans, must be identified and eliminated from the consolidated view. This is done through journal entries in the financial system or directly in the consolidation spreadsheet. Missing an elimination entry on one side creates a discrepancy that requires another round of research.
Last-mile reporting is where most time goes. After the consolidated numbers are assembled, someone formats them into the reports that leadership, the board, and external parties actually need. This last mile often takes as long as the consolidation itself.
Research from the Financial Executives Research Foundation and Robert Half found that 58% of companies manually reconcile accounts, with only 22% using software for this purpose. While that data dates to 2017, the pattern is consistent with what DSD consultants observe across mid-market health systems today: for most organizations at this size, manual consolidation is still the default approach.
How Sage Intacct Handles Consolidation Differently
Manual consolidation is manageable when you have two or three entities, a small volume of intercompany transactions, and a team that has run the same process for years. It breaks under three conditions that are common in growing health systems.
Growth. Each new entity adds another close calendar, another file to collect, another set of intercompany eliminations to track. What took two people two days for three entities takes those same two people four days for six entities. Hiring more people does not fix a process problem; it just distributes the manual work.
The cost of that accumulated manual work — and why it compounds — is explored in [The True Cost of ‘If It Ain’t Broke’ ERP Thinking in Healthcare]
Speed requirements. Leadership needs financial results faster than they have historically been delivered. Board packages, lender covenant reporting, and operational decisions all depend on current financial information. A consolidated view that takes two weeks to produce after period end is not useful for decisions that need to be made in the first week of the following month.
Late entries and adjustments. When a late entry comes in from one entity after consolidation is complete, the process has to be re-run, at least partially. In a manual system, that means revisiting the spreadsheet, re-running the elimination entries, and regenerating the reports. Every restatement adds time and introduces the risk of a new error in the revision.
What Automated Consolidation Actually Looks Like
Sage Intacct treats consolidation as a function of the system rather than a separate manual project. Because all entities operate within the same multi-entity GL, the data is always current — and when you’re ready to consolidate, you run the process in Intacct rather than assembling it by hand in a spreadsheet.
| Manual Consolidation | Sage Intacct Multi-Entity | |
|---|---|---|
|
When consolidated view is available
|
After all entities close, 2+ days later
|
Same day entities close; on-demand consolidation job replaces manual spreadsheet process
|
|
How entity data is collected
|
Spreadsheets, email, file shares
|
All entities in one system
|
|
Intercompany elimination
|
Manual journal entries, monthly
|
Automated: system reconciles intercompany balances
|
|
Chart of accounts harmonization
|
Manual reformatting each period
|
Standardized in a single GL
|
|
Late entries
|
Require re-running consolidation
|
Post to entity ledger immediately; reflected in next consolidation run
|
|
New entity onboarding
|
New spreadsheet, new process
|
New entity added to existing system
|
|
Drill-down from consolidated view
|
Not available: aggregated numbers only
|
Entity-level detail in one click
|
The eliminations are the most operationally significant difference. In Sage Intacct, intercompany relationships are configured once. When a transaction posts in one entity that involves another entity, Intacct tracks both sides simultaneously. At consolidation, intercompany balances are reconciled and elimination entries are posted automatically. There is no manual step to identify which transactions are intercompany and eliminate them from both sides. The system already knows, and it is already done.
The result: the consolidated financial view is available on demand, not at the end of a two-day manual process.
The Close With and Without Automation
Consider a health system with a hospital, a medical group, an ambulatory surgery center, and a hospital foundation: four entities with different close calendars, active intercompany transactions, and a CFO who needs a consolidated view within three days of period end.
Under the manual process, the accounting team starts consolidation after the last entity closes, often day seven or eight of the month. It takes two more days to collect the files, reconcile the intercompany balances, post the elimination entries, and generate the reports. The CFO gets the consolidated financials on day ten or eleven. Any board reporting or leadership analysis that depends on those financials cannot start until then. A late entry from the foundation pushes the delivery to day thirteen.
With Sage Intacct’s multi-entity consolidation, all four entities run their close within the same system. As each entity posts transactions across company lines, the intercompany journal entries are created automatically. Rather than manually building elimination entries in a spreadsheet, the consolidation process in Intacct generates them automatically — you run the consolidation job, and the system handles the entries. On the day the last entity closes, consolidation can be run and results are available the same day.
The CFO can drill down from the consolidated income statement to any entity’s results in one click. A variance in the hospital’s supply costs compared to budget is visible from the consolidated view without requesting a separate entity report. A late entry from the foundation posts to the entity ledger immediately and is reflected the next time the consolidation job is run.
One Sage Intacct Customer manages a single multi-dimensional GL across 14 entities with automated global consolidations. When leadership needs to evaluate whether to proceed with an acquisition, that decision is made using current financial data, not last month’s spreadsheet.
When Manual Consolidation Is Holding Leadership Back
These are the signals that manual consolidation is already limiting your organization:
- Consolidated financial statements are not available until more than five business days after period end
A late entry from one entity requires re-running part or all of the consolidation
Intercompany balances do not agree on the first pass and require manual reconciliation to resolve
Adding a new entity to the consolidated view requires building new spreadsheet infrastructure
The CFO or leadership cannot get a current consolidated view between close cycles
Your accounting team spends more time assembling the consolidated view than analyzing it
If any of these are true, the problem is not execution. Adding people or shortening deadlines will not close the gap. The process itself is the constraint, and the only way to resolve it is to change what the process runs on.
Frequently Asked Questions
How does Sage Intacct handle intercompany eliminations automatically? Intercompany relationships are configured once at setup. When a transaction posts in one entity that involves another entity, Intacct tracks both sides simultaneously. For organizations subscribed to Domestic Consolidations or Advanced Consolidations, elimination entries are generated automatically as part of the consolidation process — no manual step required to identify or build those entries.
What does “real-time consolidated view” mean in practice? It depends on how your reporting is structured. Combined reports — which pull financial data across all entities — are available at any time without running a separate process. For organizations running true consolidations with elimination entries, a consolidation job is run in Intacct to generate those financials. Either way, the underlying data is current and the process takes minutes rather than days.
Does Sage Intacct handle multi-currency consolidation? Yes, though most U.S.-based health systems at this size operate in a single currency and will not need this feature. For organizations that manage joint ventures or affiliates reporting in a different currency, Intacct handles translation automatically. Note that adding a foreign currency entity to a consolidation structure requires some additional configuration beyond standard combined reporting setup — DSD consultants manage that process as part of implementation.
How quickly can a newly acquired entity be added to the consolidated view? New entities can be added to Sage Intacct in less than a minute and immediately appear in the combined view. The entity inherits the parent’s chart of accounts framework and is visible across consolidated reporting right away. DSD consultants manage the full onboarding as part of implementation to ensure the new entity is properly configured before its first close cycle.
Talk to a DSD Consultant
Leadership decisions made from last month’s spreadsheet are decisions made with incomplete information. DSD Business Systems implements Sage Intacct’s multi-entity consolidation at health systems where the close cycle delay has become a leadership visibility problem.
If your CFO is waiting a week or more for consolidated results every period, that is a solvable problem.
Douglas Luchansky
Director, Client Transformation
