Telehealth Company Financial Model
20-Year Financial Model for A Telehealth Company
This very extensive 20 Year Telehealth (Telemedicine) Model involves detailed revenue projections, cost structures, capital expenditures, and financing needs. This model provides a thorough understanding of the financial viability, profitability, and cash flow position of your company. Includes: 20x Income Statements, Cash Flow Statements, Balance Sheets, CAPEX sheets, OPEX Sheets, Statement Summary Sheets, and Revenue Forecasting Charts with the revenue streams, BEA charts, sales summary charts, employee salary tabs and expenses sheets. Over 130 Spreadsheets in 1 Excel Workbook.
Income Statement (Profit & Loss)
3.1 Revenue
Sum of all six streams described above.
Total Revenue = Σ (All Revenue Streams)
3.2 Cost of Goods Sold (COGS)
Direct costs associated with delivering telehealth services:
Clinician compensation (if company-employed).
Platform hosting and data usage costs.
Device costs for RPM.
Payment processing fees.
Customer support related to service delivery.
3.3 Gross Profit
Gross Profit = Total Revenue – COGS
3.4 Operating Expenses
Broken into categories:
Sales & Marketing: Advertising, affiliate fees, lead generation, CRM tools, marketing staff.
Research & Development: Software engineering, product management, design, QA.
General & Administrative: Salaries (executive, HR, finance), rent, legal, accounting, insurance.
Customer Success & Operations: Account management, onboarding, technical support.
3.5 EBITDA
EBITDA = Gross Profit – Operating Expenses
3.6 Depreciation & Amortization
Software amortization, capitalized development costs, and equipment depreciation.
3.7 Interest Expense & Income
Debt interest and any interest earned on cash reserves.
3.8 Taxes
Modeled as a percentage of pre-tax income.
3.9 Net Income
Net Income = EBITDA - D&A - Interest - Taxes
Telehealth Cash Flow Statement
4.1 Operating Cash Flow
Derived from net income adjusted for non-cash items and changes in working capital.
Adjustments: Depreciation & amortization added back.
Working Capital Changes:
Accounts receivable from B2B clients and insurers.
Deferred revenue (for prepaid subscriptions).
Accounts payable and accrued expenses.
Operating Cash Flow = Net Income + Non-Cash Adjustments ± Working Capital
4.2 Investing Cash Flow
Capital expenditures (e.g., servers, IT infrastructure).
Software development capitalization.
Purchase or sale of investments.
Acquisition of smaller digital health startups (if applicable).
Investing Cash Flow = -CapEx – Capitalized Dev + Proceeds from Sales
4.3 Financing Cash Flow
Equity raises (venture capital, Series A/B/C).
Debt issuance or repayment.
Dividend payments (if any).
Share buybacks (rare for startups).
Financing Cash Flow = +Equity + Debt – Repayments – Dividends
4.4 Net Change in Cash
Net Cash Flow = Operating + Investing + Financing
Ending cash balance updates monthly/annually.
Telehealth Balance Sheet
5.1 Assets
Current Assets:
Cash and cash equivalents.
Accounts receivable (from B2B contracts, insurers).
Prepaid expenses.
Inventory (RPM devices).
Non-Current Assets:
Capitalized software development.
Property and equipment.
Intangible assets (licenses, patents).
Goodwill (if acquisitions made).
5.2 Liabilities
Current Liabilities:
Accounts payable.
Accrued expenses (salaries, marketing).
Deferred revenue (subscriptions prepaid).
Current portion of long-term debt.
Non-Current Liabilities:
Long-term loans or convertible notes.
Lease obligations.
5.3 Shareholders’ Equity
Paid-in capital (from investors).
Retained earnings (cumulative net income).
Other reserves (share-based compensation).
Assets = Liabilities + Shareholders’ Equity
Key Metrics and KPIs For A Telehealth (Telemedicine) Company
To complement the three statements, the model should track:
MRR / ARR (for subscription-based revenue).
Churn Rate / Retention Rate.
Customer Acquisition Cost (CAC).
Lifetime Value (LTV).
LTV:CAC Ratio.
Gross Margin %.
Burn Rate and Runway.
EBITDA Margin.
Free Cash Flow.
Revenue Model
The company has six primary revenue streams. Each stream is modeled with its own drivers and assumptions:
2.1 Six-Tier Subscription (B2C Model)
Structure: Monthly or annual recurring revenue (MRR/ARR) across six tiers (e.g., Basic, Plus, Premium, Family, Specialist Access, and Concierge).
Key Assumptions:
Number of subscribers per tier.
Monthly subscription fee per tier.
Customer acquisition rate, churn rate, and upgrade/downgrade rates.
Revenue Formula:
Revenue = (Subscribers_tier × Price_tier × (1 - Churn Rate))Notes: This stream drives predictable recurring revenue and high lifetime value if churn is controlled.
Fee-for-Service (PAYG)
Structure: Pay-as-you-go consultations or specialist visits paid per session.
Key Assumptions:
Number of consultations per month.
Average fee per consultation.
Commission or platform fee retained by company if clinicians are contractors.
Revenue Formula:
Revenue = Consultations × Average Fee × Platform Retention %Notes: Offers flexible, transactional income and complements subscription-based plans.
Enterprise Licensing (B2B SaaS Model)
Structure: White-labeled telehealth platform licensed to hospitals, clinics, or health systems.
Key Assumptions:
Number of enterprise clients.
Average annual license fee.
Implementation and support fees.
Revenue Formula:
Revenue = Clients × (License Fee + Setup Fee + Support Fee)Notes: High-margin revenue source with strong scalability once core tech is built.
Corporate / Employer Contracts
Structure: Employers pay per covered employee (PEPM) or annual contract for telehealth access as part of employee wellness programs.
Key Assumptions:
Number of corporate clients.
Average number of employees per client.
Average contract value or PEPM fee.
Revenue Formula:
Revenue = (Clients × Employees per client × PEPM × 12 months)Notes: Long-term contracts that improve revenue stability and forecast accuracy.
Marketplace Commissions
Structure: Commission on services provided by third-party health professionals (e.g., nutritionists, therapists, labs) via the platform.
Key Assumptions:
Gross transaction volume (GTV).
Commission rate.
Revenue Formula:
Revenue = GTV × Commission %Notes: Expands ecosystem value; contributes to gross margin depending on revenue share terms.
Remote Patient Monitoring (RPM)
Structure: Recurring revenue from device-enabled chronic care management (subscription-based) plus reimbursement from insurers (CPT codes in the U.S.).
Key Assumptions:
Number of enrolled patients.
Monthly monitoring fee or reimbursement per patient.
Device cost and service costs per patient.
Revenue Formula:
Revenue = Patients × Monthly RPM Fee × 12 monthsNotes: Fast-growing segment in telehealth; contributes to both B2B and B2C channels.
Scenario and Sensitivity Analysis
Growth Scenarios: Conservative, Base, and Aggressive growth projections.
Pricing Scenarios: Testing impact of subscription tier adjustments.
Cost Scenarios: Impact of scaling engineering or support costs.
Funding Scenarios: Required capital for growth milestones or profitability breakeven.
6-Tier Telehealth Subscription Model Outline
The suggested tiers are structured to build upon one another, with the higher tiers offering greater access, specialized services, and cost savings on advanced care.
Tier 1: Basic Access (Free/Trial Tier)
This tier serves as a lead generator and a basic patient entry point, proving value before requiring a commitment.
Monthly Price: (low or a very low administrative fee).
Target User: New users, individuals testing the service, or those needing only occasional, non-medical support.
Core Features:
Health Library Access: Full access to articles, guides, and educational content.
Symptom Checker: AI-driven tool for pre-screening and recommending next steps.
Messaging Support: Unlimited asynchronous messaging with a Health Coach or Navigator (non-clinical, for help scheduling/navigating benefits).
Visit Co-Pay: All virtual visits (PCP/Urgent Care) are billed at a standard, non-discounted rate (e.g., $75 per visit).
Tier 2: Quick Care (Essential Access)
The foundational paid tier, focused on primary and urgent virtual care accessibility.
Target User: Individuals who use virtual care regularly for common ailments (e.g., cold, flu, refills).
Core Features (Includes Tier 1, plus):
Unlimited Virtual Primary Care: Access to General Practitioners/PCPs for routine care.
Discounted Urgent Care: Virtual Urgent Care visits (e.g., for non-emergent issues) at a reduced co-pay (e.g., $15 per visit).
Basic Prescription Refills: Covered for common, non-controlled maintenance medications (service fee may apply).
Basic Behavioral Health: Access to group therapy sessions or guided meditation content.
Tier 3: Complete Health (Enhanced Mental Wellness)
Adding focused mental health and expanded primary care benefits.
Target User: Users seeking integrated physical and mental wellness, and families who need broader coverage.
Core Features (Includes Tier 2, plus):
Individual Behavioral Health: Two (2) free individual therapy sessions per month with a licensed therapist or counselor.
Preventive Screenings: Access to virtual preventive health check-ins and screening assessments.
Specialist Discount (Tier 1): 10% discount on all specialized care visits (e.g., Dermatology, Cardiology).
Family Inclusion: Ability to add one (1) additional family member at a 50% discount on the monthly fee.
Tier 4: Chronic Care Pro (Specialized & RPM Integration)
Focusing on complex, ongoing conditions and incorporating technology.
Target User: Patients with chronic conditions (e.g., Diabetes, Hypertension) requiring continuous management and monitoring.
Core Features (Includes Tier 3, plus):
Free Remote Patient Monitoring (RPM): Provision of one (1) connected monitoring device (e.g., blood pressure cuff, glucose meter) with professional review of data.
Chronic Care Management (CCM): Dedicated virtual case manager/RN check-ins for complex condition management.
Specialist Discount (Tier 2): 25% discount on all specialized care visits and consultations.
Dietitian/Nutritionist Access: Unlimited virtual appointments with a registered dietitian.
Tier 5: Platinum Concierge (VIP Access & Priority)
Premium service offering priority access and white-glove service.
Target User: High-earning individuals or busy professionals who prioritize speed, convenience, and direct access.
Core Features (Includes Tier 4, plus):
Priority Booking: Guaranteed virtual appointments with PCPs or Urgent Care within two (2) hours.
Direct Provider Line: A dedicated phone line for fast, non-emergency communication with a care team.
Care Coordination: Full coordination of in-person specialist referrals and scheduling (e.g., setting up imaging or lab work).
Travel Health: Virtual consultation and preparation for international travel (vaccine recommendations, prophylactic prescriptions).
Home/Lab Services Discount: 15% discount on optional at-home lab draws or mobile diagnostic services (if offered).
Tier 6: Executive Health (Ultimate Family & Wellness)
The top-tier, comprehensive plan offering the most freedom and family coverage.
Target User: Affluent individuals or families who desire all-inclusive care and maximum cost predictability.
Core Features (Includes Tier 5, plus):
All-Inclusive Visits: Zero co-pay for all virtual visits (PCP, Urgent Care, and Specialist visits).
Family Plan: Coverage for up to four (4) family members on the single monthly fee.
Wearable Integration: Advanced integration and clinical review of data from personal wearables (Apple Watch, Fitbit, etc.).
Genetic Health Assessment: One (1) free advanced virtual genetic health risk consultation per year.
Wellness Stipend: A quarterly $50 credit for wellness services (e.g., fitness classes, healthy food delivery, or supplements).
Final Notes on the Financial Model
This 20 Year Telehealth Company Financial Model focuses on balancing capital expenditures with steady revenue growth from a diversified product line. By optimizing service costs, consultancy efficiency, and maximizing high-margin services, the model ensures sustainable profitability and cash flow stability.
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