Founder pitch cheat sheet

1The wedge — primary care, on purpose

Say

"We start where the work is most repeatable: primary care. Established-patient visits — 99213 and 99214 — are ~84% of the volume, and that's a narrow, automatable coding distribution."

Decision

PCP-first beachhead — not all specialties on day one.

Why

A narrow, routine visit mix is exactly what makes a 78% gross margin and ~98.5% first-pass clean claims credible — and it's a focused, winnable first market.

If pushed

"Why not bigger?" → "Specialty expansion is upside we haven't modeled. The entire plan closes on PCP alone."

2The product — AI-native end to end, not bolted on

Say

"The schedule is solved to the minute, eligibility fires at booking, the note is written by an ambient scribe and coded in the room, and denials are prevented before the patient is even seen."

Decision

One integrated record with AI in the core — not modules stitched together with AI bolted on the side.

Why

Shifting the work left → ~98.5% first-pass clean claims → cost-to-serve toward ~1.3% of collections, vs a labor-heavy billing shop.

If pushed

"Everyone says AI." → "Theirs is a rules engine with AI stapled on; ours generates the code from the encounter. Let me show you the live walk-through."

3The revenue — two engines per provider

Say

"Every provider pays us twice: $595 a month for the platform, plus 4.9% of what we collect for them — and 90% take the RCM."

Decision

Bundle SaaS + a variable RCM fee. We never put a fixed price on a variable cost.

Why

~$59K revenue/provider/yr, ~$147K per practice — and real pricing power: we can move to $995 / 6.9% later, which is pure upside not in the base case.

If pushed

"Is an RCM % sustainable?" → "It's below market and it scales with the value we create. The more we collect for them, the more they want it."

4The margin — 78%, and earned

Say

"That gives us a 78% gross margin — with full cloud and AI cost in COGS, not labor-only math."

Decision

Fold real cloud/AI COGS into cost-to-serve and book 78% (the modeled figure at exit — the same number everywhere).

Why

athenahealth, the category benchmark, runs ~54% as a labor-heavy multi-specialty shop. AI-native + PCP-first is structurally higher.

If pushed

"78% is high for healthcare." → "It's a primary-care, at-scale figure off a narrow visit mix — and it's lower than pure SaaS because we earn the RCM%. The margin-defense page walks the ramp."

5The growth — acquire networks, not one doctor at a time

Say

"We don't sell one physician at a time. 85% of our growth is captive — Empower feeds us acquired networks and we onboard them at ~$0 CAC; our lean external sales team only has to win the ~15% we don't already own."

Decision

Captive-acquisition GTM, with only ~15% from external sales reps.

Why

A predictable, compounding ramp to 346 practices / 866 providers — not a leaky one-by-one sales funnel.

If pushed

"Acquisition is capital-intensive." → "It's structured so the seed funds it — and cash never goes negative in the model."

6The structure — airtight, and self-funded to exit

Say

"This one $4M seed funds the entire plan to exit. No Series A, no Series B. Cash never goes negative."

Decision

Self-fund to exit, with conservative reality baked in: 5% churn, 40-day A/R, real taxes (NOL + Texas franchise), bottom-up hiring.

Why

No future dilution — the seed owns the outcome. The downside is already in the numbers, not hand-waved away.

If pushed

"Really no more rounds?" → "Trough cash is +$911K on the base case. We'd raise more only to go faster, never to survive — and you can stress it yourself in the playground."

7The moat — the incumbents have a ceiling

Say

"Legacy systems are labor-heavy rules engines. eClinicalWorks paid $150M+ to the DOJ; their AI failed live in our diligence; and their all-in cost to a practice is higher than ours."

Decision

Compete on structural margin and true AI — not on a feature checklist.

Why

They can't reach our cost-to-serve without rebuilding on AI, and their installed base is the anchor that stops them.

If pushed

"Incumbents are entrenched." → "Entrenched on old economics. We're cheaper all-in and we keep more of every dollar."

Reminder: add ?realnames only when it's appropriate — the default investor view is anonymized.

8The market — we need a sliver

Say

"There are ~280K primary-care physicians in ~136K groups in the U.S. We need a sliver of it."

Decision

Size the market on PCPs and groups — not a hand-wavy trillion-dollar healthcare number.

Why

346 practices / 866 providers is a rounding error of the TAM — the plan does not depend on heroic penetration.

9The exit — back to where we started

Say

"A 78%-margin, AI-native asset growing this fast trades at a premium. Comps put 6× ARR as conservative and 8–10× as earned."

Decision

Headline the high case, defend the low one.

Why

6× → 15.3× your money; 10× → 25.4× — about $101.8M back on a $4M seed.