Why continuity planning for a family business should include health 

Family business owners plan carefully. Diversification, tax efficiency, liquidity, succession, all of it gets real attention. Yet the single asset most likely to derail every projection in that plan often receives the least strategic thought: the owner’s health. 

Health outcomes are not separate from business outcomes. They are an input. 

Why this matters here 

Greater Cincinnati was built by entrepreneurs and still holds one of the strongest privately held business communities in the country. This city built its fortunes through family enterprises, many still passing from one generation to the next. Nationally, an estimated $124 trillion is projected to transfer between generations by 2048 (Cerulli Associates, December 2024), and our region’s families will carry their share. 

In a closely held company, one person’s health is rarely one person’s concern. It is a company’s continuity, a family’s stability, and a transition’s timing. 

The gap in conventional care 

The average primary care visit lasts about 18 minutes (Medical Care, January 2021). For an owner carrying responsibility across a business, an estate, and multiple generations, that model can be mismatched to the stakes. A missed diagnosis or a delayed intervention doesn’t only cost quality of life. It can trigger succession disruption, forced liquidity events, and unplanned transitions of control at the worst possible time. 

Three questions worth asking 

The question is not “do you have a doctor.” The better questions: 

• If something happened tomorrow, who is coordinating your care, and does that person have the time and access to do it well? 

• If you could not make decisions for yourself, do the right people hold the right authority through current healthcare proxies and powers of attorney? Does the business have parallel documents naming who can act on its behalf? 

• Has your family talked about this, so a health event becomes a plan in motion rather than a crisis in the dark? 

For many owners, the honest answers reveal a gap. Closing it isn’t about extravagance. It’s about applying the same rigor to health continuity that you already apply to every other form of risk. 

Some families address the access problem by changing their care model. Concierge and direct primary care practices, for example, typically limit panels to 400 to 600 patients rather than thousands (The American Journal of Medicine, 2017), which creates time for prevention and gives one physician the job of coordinating specialists and second opinions. (Full disclosure: my wife practices concierge medicine.) The model matters less than the planning question behind it: whether your care arrangement, your healthcare proxies, your powers of attorney, and your long-term care funding actually work together. 

Bring it to the table 

Holiday gatherings will bring your family to one table this fall. For many family businesses, that is the most practical moment to hold a first family meeting, and these questions belong on the agenda. 

The owners who plan best are the ones who recognize that their greatest asset isn’t on any balance sheet. Wealth is the vehicle, not the point. The point is your health, your family, and the business you’re building together, now and for generations to come. 

Brian Van Jura, CFA, is Vice President and Senior Wealth Advisor at HORAN Wealth. 

Investment advisory services offered by HORAN Wealth, LLC, registered with the U.S. Securities and Exchange Commission. Not FDIC Insured | No Bank Guarantee | May Lose Value 

The information herein has been obtained from sources believed to be reliable, but we cannot assure its accuracy or completeness. Neither the information nor any opinion expressed constitutes a solicitation for the purchase or sale of any security. Any reference to past performance is not to be implied or construed as a guarantee of future results. HORAN Wealth does not provide tax, legal, accounting, or medical advice. This material has been prepared for informational purposes only. You should consult your own tax, legal, accounting, and medical professionals before making decisions in these areas.