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Run the Payroll Fee Auditor →Blog · Payroll Management · Healthcare
Healthcare Practices: Managed Payroll for Small Businesses (Under 25 Employees) (2026)
Managed payroll at $25-$45 PEPM all-inclusive makes economic sense at nearly every size for healthcare practices, but the specific value drivers differ depending on headcount.
Payroll at Different Sizes for Healthcare Practices
| Healthcare Practices Size | Monthly Cost | vs. In-House Hire |
|---|---|---|
| 10-person clinic | $250-$450/mo | Save $62K-$92K/yr |
| 25-person practice | $625-$1,125/mo | Save $58K-$88K/yr |
| 50-person medical group | $1,250-$2,250/mo | Save $50K-$80K/yr |
The comparison is against an in-house hire at $65,000-$95,000 fully loaded to $67K-$98K per year.
Under 25 Employees: The Clearest ROI
For healthcare practices under 25 employees, in-house payroll cannot be justified. A payroll coordinator costs $65,000-$95,000 fully loaded -- compared to $625-$1,125/month for managed payroll. The savings pay for a year of managed payroll in the first 2-3 months.
25-75 Employees: Complexity Drives the Case
In the 25-75 employee range, healthcare practices are dealing with more shift differentials, on-call pay, credentialing-based pay tiers, multi-location clinic payroll. An in-house generalist is less likely to have the depth needed in these areas. Managed payroll provides specialist coverage that reduces exposure.
75-200 Employees: Hybrid Approaches Emerge
At 75+ employees, healthcare practices often consider a hybrid approach: an HR generalist handles employee relations and benefits while a managed payroll provider handles the compliance-heavy payroll function. This keeps an internal HR presence while outsourcing the most technically complex piece.
How to Get a Quote for Your Healthcare Practices
BEG quotes managed payroll based on your actual headcount and pay frequency. For most healthcare practices, the first discovery call includes a custom cost comparison against your current setup.
Managed Payroll, Handled.
BEG manages payroll at $25-$45 per employee per month, all-inclusive. Get an instant cost comparison for your business.
Frequently Asked Questions
Can you handle shift differentials for nurses?
Yes. Shift differentials are set up as pay rate modifiers. Night shift, weekend, and on-call differentials apply automatically based on hours worked, producing the correct blended rate and overtime calculation.
How do you handle ACA reporting?
For practices with 50 or more full-time equivalent employees, we handle Form 1094-C and 1095-C preparation and filing. We track hours to determine ACA full-time status and flag coverage gaps.
Can you process payroll for multiple clinic locations?
Yes. Multi-location practices run on a single payroll system with consolidated reporting and per-location cost center codes.
How do you handle credentialing-based pay tiers?
Credentialing-based tiers are configured as pay grade structures. When a provider advances, the pay tier updates on the date you specify.
What does BEG charge for healthcare payroll?
Healthcare payroll runs at $25-$45 per employee per month, all-inclusive. For a 25-person practice, that is $625-$1,125 per month.
Related Resources
Anthony leads payroll solutions at Business Executive Group, a national managed payroll firm serving businesses across industries including Healthcare Practices. BEG manages payroll at $25-$45 PEPM, all-inclusive, with deep expertise in compliance, multi-state filing, and industry-specific payroll requirements. Get instant pricing at beghr.com.
Authoritative source: U.S. Department of Labor: Wage and Hour Division
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