What this tool does
Drive the model by hand. Set how long you’re in development before go-live, dial EMR price, collections and the RCM percentage, then tune headcount and costs — and watch physicians, EMR vs RCM revenue, and total cost play out month by month.
Assumptions — drag to explore
Each slider's thickness = how much that lever moves the KPIs (cash trough + exit EBITDA). Thick levers (pricing, collections, staffing) swing the model; hairline levers (software / platform cost) are nearly noise. Drag the scenario dial above to sweep the whole model from downside to upside.
Cost to serve — bottoms-up COGS
Per-encounter (AI-scribe + clearinghouse + eRx), payment processing on collections, per-physician/yr licensing, and a company-wide platform flat — added to the labor cost-to-serve and flowing into the cost line, EBITDA and cash. Click ⓘ on a derived input to see its math.
Staffing plan — driver-based, Sr / Mid / Jr
Revenue, cost & physicians by month
How the model works (methodology & the year-1 ramp)
Data flow
Assumptions → per-physician Revenue (EMR + RCM) and Cost-to-Serve (per-encounter COGS + serve-team labor). The serve-team labor is driven by the RCM / serve-team FTE ratios (physicians-per-FTE). Physician growth comes from the funded growth curve for the chosen raise tier; everything downstream is computed from there into the monthly proforma, the exit return, and the export.
The year-1 ramp
Both price and the serve/RCM FTE ratios ramp during operating year 1. Price starts at the year-1 ramp (— of full) and the serve ratios are less efficient by the same factor — you staff a minimum team before patient volume arrives — then reach their mature values from operating year 2.
Ramp effect at low scale (important)
You hire whole people. In the first operating months physician counts are small, so each serve role rounds up to its minimum (one person) regardless of the ratio — the ramp is mostly absorbed by whole-person rounding early on and only bites visibly once you scale (by which point you are in year 2 at the mature ratio). The hiring plan and the chart use actual whole-person headcount; the per-physician cost-to-serve figure is the smooth, at-scale value. The two converge at scale and differ slightly early — that gap is whole-person rounding, not an error. The exported spreadsheet spells this out on its Notes tab and shows the ratio build on the RCM-Staffing tab.
Exit
Exit value = revenue run-rate (final month × 12) × the multiple, taken at seed ownership pre-dilution. EBITDA excludes financing and taxes.