Where SGA East and SGA West Diverge Today
The May 2026 analysis revealed that the reporting infrastructure itself makes the problem harder to manage. SGA West already solved most of these gaps. The table below shows what that means in practice.
Velixo is already deployed in the SGA West environment. Power BI is already in use. GL sub-accounts are a finance configuration change, not a software build. The recommendations below are configuration tasks and process changes — not net-new technology investments.
GL Structure — Split GL 74000 into Three Sub-Accounts
The most fundamental reporting problem is that GL 74000 (Advertising & Marketing) currently captures three things that have completely different owners, different budget owners, and different approval processes. Lumping them creates every month's "overspend" conversation — because no single team controls the full number.
In May 2026, the "marketing overspend" of +$36,206 vs. budget included $20,411 in corporate GL rows (74000-02 future) and doctor-authorized chronic accounts (74000-03 future). Marketing's actual discretionary overage — 74000-01 only — was much smaller. The sub-account structure makes this defensible in any budget review.
Owner: CFO + Controller. Chart of accounts change in Sage Intacct. No software purchase required.
Effort: 1–2 weeks to configure + recode historical spend for YTD comparability. A clean GL structure also makes the Velixo extension (Section 3) more valuable — variance rolls up by sub-account, not just by the blended 74000 total.
Velixo Extension — Close the 30–45 Day Reporting Lag
SGA West PGPs can see budget vs. actual vs. variance per practice as charges post throughout the month. SGA East PGPs see the same data 30–45 days after the month closes — after all the charges are final and nothing can be reversed. The tool to fix this is already in the organization.
Velixo is an Excel/reporting add-in that connects directly to Sage Intacct. On the SGA West / Gen4 side, it pulls budget, actual, and prior-year data per practice and presents it in a consistent format PGPs receive mid-month — not after close. The data refreshes as AP entries post.
If SGA East operates in the same Sage Intacct environment as SGA West (or a connected environment), extending Velixo is a configuration task: map the SGA East entity, replicate the existing budget/actual template, and assign PGP access. No new licensing is required if the SGA West license already covers the entity count.
- Month closes → AP runs → P&L generated → 30–45 days
- PGP receives data; overage is already final
- No ability to intervene; escalation is retroactive
- Myles conversation happens weeks after the fact
- Charges post → Velixo reflects variance within days
- PGP flags overage mid-month while spend is live
- Escalation happens before charges are final
- Monthly close becomes a confirmation, not a surprise
Owner: IT + Finance Controller. Configuration task using existing SGA West infrastructure.
Effort: 30–60 days depending on Sage Intacct environment alignment. Prerequisite: confirm SGA East is in the same Sage Intacct instance or a connected one. If separate, assess data bridge options with IT before committing timeline.
Dependency: GL sub-account split (Section 2) should be done first — Velixo is more actionable when the 74000 line is already separated into three sub-accounts. Without it, near-real-time data still shows one blended number with no structural insight.
Power BI Changes — Unlock Existing Data
Two changes to Power BI would immediately improve what marketing can see and say in a reporting conversation. Neither requires new data — both unlock data that already exists.
The Power BI Decomposition Tree already separates vendor spend into "Declared" (vendors with contracts on file) and "Undeclared" (vendors without). Sharley currently cannot expand the Undeclared column — she sees the total but not the vendor breakdown within it. This means she cannot speak to a material portion of the Advertising & Marketing total when presenting to Myles.
The most likely cause is Row-Level Security (RLS) in Power BI — Sharley's role is restricted from the Undeclared dimension, either intentionally or by omission when the role was set up. Granting access requires an IT admin to update the RLS role assignment in the Power BI workspace. Estimated: 30 minutes.
When the Dallas and Nathan situations were addressed previously, the Decomp Tree vendor drill-down was what produced cuts Myles saw and approved. It works. The only gap is that Sharley can't currently use the full version. This is the highest-leverage 30 minutes of IT time in this list.
Cost per new patient (CPP) is the most actionable metric in a marketing spend conversation. The May 2026 analysis revealed a network average of $48/patient — with a range from $1/patient (specialty referral practices) to $6,559/patient (Brentwood). That range cannot be seen in the current Power BI Marketing page because CPP requires joining spend data from the Marketing page with new patient counts from a separate page.
A calculated column in Power BI (Spend ÷ New Patients, where New Patients > 0) would make CPP visible at a glance for every practice, every month. It would also make the outlier identification in reports like this one automatic rather than a manual join exercise.
What the Standard Monthly Report Should Look Like
Once the infrastructure changes above are in place, a monthly marketing spend report can be produced consistently and quickly — rather than as a one-time analysis triggered by a budget question. Below is the recommended template structure.
- Account-Level Summary: Advertising & Marketing / Practice Promotion / Total — showing Actual, Budget, Variance, SPLY, and YoY Change for each. Keep the two "overage" framings (budget variance vs. YoY increase) separate and clearly labeled.
- Sub-Account Breakout (once GL split is live): 74000-01 (Marketing-Directed), 74000-02 (Corporate/Ops), 74000-03 (Doctor-Authorized) — each with its own budget and variance column. This separates what marketing owns from what it does not.
- Practice-Level Table: All active locations sorted by spend, including columns for Promo Spend, % of NPR, New Patients, and Cost Per New Patient. Flag any practice above $500 CPP or above 15% of NPR for review. Include a network average row at the bottom.
- Bright Spots: Top 5 practices by CPP efficiency (below $100/patient with meaningful volume). Reference point for the network — what good looks like at scale.
- Escalation Queue: Any practice on a 3-month trend of increasing CPP or spend above its individual budget threshold (once per-location budgets are in place). Each entry includes last month, current month, and recommended owner (Ops vs. Marketing vs. COO).
Monthly delivery, ideally within 5 business days of month close (matching or improving on the current P&L lag). Recipients: Sharley (Marketing), Sarah (PGP Lead), relevant PGPs for flagged practices, COO for any Escalation Queue items above a threshold (e.g., $10K+ overage or >$1,000 CPP). The Velixo integration makes a mid-month preview possible as an add-on — same template, flagged in-progress numbers.
Implementation Roadmap
Immediate (this week, no infrastructure required): Power BI RLS fix for Sharley's Undeclared access · CPP column added to existing report · Decomp Tree pulls for Brentwood and Ressler before the Myles meeting · CFO budget reset for Practice Promotion / Giveaway line.
30–60 days (finance and IT configuration): GL 74000 sub-account split · Albany HQ / OpCo cost center reclassification · Velixo feasibility assessment · Per-location budget setup.
Ongoing (once infrastructure is in place): Monthly report using the Section 5 template · Mid-month Velixo preview for PGPs · Escalation queue for COO items.