Enterprise-grade finance for organizations without an enterprise finance team.
Ledger & Oak builds the financial clarity that hospitals, private businesses and community institutions need to lead with confidence. We recover what reimbursement owes, rebuild the systems your reporting depends on and give leadership numbers it can defend to a board or a bank. For the banks, brokers and lenders we work alongside, that means clients arrive ready to close.
INDUSTRIES
Start with who you are.
Hospitals & Healthcare
Rural, critical access, community and privately run hospitals and clinics, as well as behavioral health providers, that need Decision Support without an in-house team.
Learn more →Private Businesses
For owner-led and growing companies, we fill whatever gap your finance function has, from controller-level close and reporting to CFO-level strategy to rebuilding your financial infrastructure from the ground up.
Learn more →Nonprofits & Community Institutions
Nonprofits, foundations and community venues whose boards need budgets, program costs and reviews they can defend.
Learn more →Banks, Brokers & Lenders
We work alongside banks, brokers and lenders to help their clients present clear, lender-ready financials, so promising deals move to close with confidence.
Learn more →WHAT YOU NEED
Or start with what is on your desk.
Reimbursement and cost reports
Cost report review, Texas uncompensated care and DSH timing, bad debt and the funding applications small hospitals rarely have time to write.
See the work →Decision Support and cost accounting
True cost of care by service line, delivered monthly. We pull the data, host the platform and do the analysis your team does not have hours for.
See the work →Financial systems and chart of accounts
Chart of accounts and department redesign, ERP readiness and an embedded implementation lead so a vendor go-live does not land on a two-person office.
See the work →Finance leadership and board reporting
Operating and capital budgets, monthly cash and operating reviews and board briefs that let a committee decide in one meeting.
See the work →Capital, lending and bankability
Credit packages, lender liaison and controlled closings for owners who need the bank story to match every schedule.
See the work →Getting a startup off the ground
Financial infrastructure built right from day one: a chart of accounts and general ledger designed to scale, the right accounting systems and an investor-ready model.
See the work →Preparing for a sale or succession
Organized, documented financials and a clear earnings story so owners can approach a buyer, successor or lender from a position of strength.
See the work →Monthly close and reporting
A dependable monthly close, reconciled accounts and audit-ready schedules, so leadership reviews current numbers every month and year-end runs smoothly.
See the work →Automation behind the work
Our in-house development team builds proprietary platforms that turn weeks of cost report assembly into a reviewed, repeatable process.
See the technology →THE DECISION SUPPORT DISCIPLINE
One discipline, applied to every sector.
Decision Support began in hospital finance, but its core methods are not specific to healthcare. Cost accounting, forecasting, net revenue modeling and benchmarking answer the same questions in a hospital, a manufacturer, a nonprofit or a borrower preparing for a loan: what things truly cost, where margin comes from and what happens next. We apply one disciplined toolkit across every sector we serve.
Cost accounting
The true cost of a service, product, job or program, built from direct and indirect costs.
Data analytics
Clean, reconciled data turned into answers leadership can act on.
Forecasting
Cash, revenue and volume projections that are updated as conditions change.
Net revenue modeling
Expected collections modeled from contracts, payer mix, pricing and volume.
Contract negotiations
The cost and margin analysis that supports a stronger position at the table.
Benchmarking
Performance compared with peers and with your own history to find efficiencies.
Budgeting
Operating, capital and flexible budgets with variance analysis that explains the why.
KPI dashboards
A small set of measures leadership reviews every month, delivered on time.
WHY IT WORKS
The data problem is bigger than the software problem.
Most small organizations have already bought modern software. What flows into it is the problem - years of old structures, old habits and vendor onboarding that never finished. New systems end up producing the same broken outputs as the ones they replaced.
We work underneath the software. We fix the accounting infrastructure, from the chart of accounts to the general ledger structure, build the reports on top of it and automate the tedious parts so they keep working after we leave.
OUR TECHNOLOGY
Automation for the work that eats finance teams' weeks.
Cost reports, data mapping and monthly reporting follow rules. Rules can be automated. Our reporting platform ingests general ledger, payroll and clinical service data, suggests how accounts and positions should map and produces the report for your team to review and submit.
CAM - LIVEREPORT III - LIVEMEI - IN DEVELOPMENT
WHY CHOOSE US
Senior judgment, built to last.
- CFO-level expertise without the overhead, backed by more than ten years of financial and data analysis.
- Deep experience in hospital and healthcare finance, from cost reports and reimbursement to Decision Support.
- Senior attention on every engagement, from the first conversation through delivery.
- Insight from custom tools built on our proprietary reporting platform and financial blueprints tailored to your goals.
- Veteran-owned values of discipline, trust and integrity in everything we deliver.
THE FOUNDER
An operator, not a salesperson.
Jason Cannaday helped build what is now the Decision Support team at University Medical Center in Lubbock, then served as CFO of StarCare Specialty Health System for nearly nine years. He is a service-disabled U.S. Army veteran of Operation Iraqi Freedom and holds a BBA and an MS in Finance from Texas Tech.
He founded Ledger & Oak in 2025 to bring the managerial finance and Decision Support that large systems take for granted to organizations that will never staff an enterprise team.
FROM THE DESK OF OUR FOUNDER
Read the thinking behind the work.
Rural hospital data is worse than you think
What we learned building a Decision Support model for facilities the industry has overlooked.
Read on LinkedIn →The CHC CFO playbook
Turning the $50 billion Rural Health Transformation Program into real-time financial intelligence.
Read on Blackbaud →Solving the quiet problem
Turning your new financial infrastructure into true cost intelligence.
Read on Blackbaud →