DI

DispatchHealth Financial Model

Five care tiers delivered in the home:

1. Clinic Without Walls - virtual visit augmentation; extends provider reach to home/senior communities for lower-complexity complaints.
2. Acute Care (ER Alternative) - on-demand high-acuity care; on-site diagnostics, CLIA-certified lab, procedures, medications, PCP integration.
3. Advanced Care (Hospital Alternative) - conditions: HF, COPD, pneumonia, complex UTI, metabolic disorders; Milliman admission criteria; up to 30-day post-acute management; payer bundle payment.
4. Extended Care (Nursing Facility Alternative) - complex medical/post-surgical patients post-discharge; 24/7 skilled care incl. PT/OT; payer bundle payment.
5. Bridge Care (Hospital-to-Home) - 24–72 hr post-discharge intervention; medication reconciliation; targets reduced hospital recidivism.

Value prop quantified: in-home hospitalizations save $5,000–$7,000 per episode vs. facility; 20% mortality reduction cited.

• Total US healthcare system: $4T.
• Facility-based spend (TAM proxy): $1.3T.
• Addressable in-home market (SAM): $140B.
• DispatchHealth current market (SOM): $85B - described as "Dispatch Market Today" (likely the acute/advanced care segments currently served or actively targeted).
• Growth tailwinds: virtual care utilization +4x during COVID; +70% of users expecting to continue using more convenient care.

Payment mechanisms implied by the service tiers:

• Acute Care: fee-for-service or per-visit reimbursement via payer contracts (insurance, Medicare/Medicaid likely, though not stated explicitly).
• Advanced Care + Extended Care: contractual bundle payments with payers.
• Bridge Care + Clinic Without Walls: payer/provider contracts implied; mechanism not detailed.
• Customer savings metric: +$1,200 average savings per acute care visit generated for customers (payers/health systems) - suggests shared-savings or value-based contract structures possible.
• No explicit pricing per visit, episode rate, or contract value disclosed in this deck.

All from:

• 31 markets live at time of deck.
• 174% YE Run-Rate Revenue CAGR since 2017.
• Net Promoter Score: 96 (healthcare average <30).
• +$350M total savings generated for customers to date.
• Average savings of +$1,200 per acute care visit.

No absolute revenue figure, visit volume, patient count, or specific year of deck disclosed.

• Savings per acute care visit: +$1,200 for payer/health system customers.
• Episode savings vs. facility: $5,000–$7,000 per in-home hospitalization.

Not explicitly addressed in the 5-slide deck. Implied moats:

• Clinical breadth (5 care tiers from acute to post-acute is a meaningful scope vs. point-solution competitors).
• NPS of 96 vs. healthcare average <30 - strong retention signal.
• Purpose-built platform enabling "rapid scaling".
• No competitor names, market-share data, or explicit differentiation section in this deck.

Archetype + why: Multi-revenue-stream healthcare services P&L with visit/episode volume as the primary driver. The business is fundamentally a volume × reimbursement-rate model across service lines, with a cost structure that is largely variable (clinical staffing, dispatch, supplies) plus market-expansion fixed costs. Closest archetypes: healthcare services 3-statement model with a visit-volume revenue build, layered across markets (geo × service-tier matrix). Value-based bundle contracts add an episode-cost layer. Not SaaS, not marketplace - this is a clinical services business.

Forecast horizon & granularity:

• 5-year annual model (Year 1–5), monthly in Year 1 given growth-stage volatility.
• Market-by-market ramp (cohort logic: markets open in different quarters, each with an S-curve ramp to maturity).

Key drivers & assumptions:

*Revenue:*

• Number of markets: 31; +8–12 new markets/year based on 174% CAGR and stated scaling ambition.
• Visits per market per month: ~500–1,500 acute care visits/month at maturity; new markets ramp over 12–18 months.
• Blended reimbursement per acute care visit: ~$400–$700 based on ER-alternative positioning (Medicare/Medicaid + commercial payer mix); deck states $1,200 savings per visit for customer, so reimbursement likely a fraction of that delta.
• Bundle revenue per advanced/extended care episode: ~$3,000–$8,000/episode; deck cites $5,000–$7,000 facility savings as benchmark.
• Service-line mix: Acute Care majority (~60–70%), Advanced Care growing, Bridge/Extended/Virtual smaller; adjust as data available.

*Costs:*

• Clinical staffing (clinicians, nurses, EMTs per team): primary COGS driver; ~50–65% of revenue.
• Dispatch/logistics (vehicles, supplies, dispatch ops): ~10–15% of revenue.
• Market G&A overhead: fixed cost per market of ~$200–500K/year for non-clinical ops.
• Corporate overhead (tech platform, G&A, S&M): leverage over time as markets scale.

*Operational:*

• Market maturation timeline: 18–24 months to breakeven at market level.
• Revenue CAGR: 174% historical; decelerates to 80–100% near-term as base grows, then 40–60% mid-period.

Scenarios (Base / Bull / Bear):

• Base: 31 → ~55 markets in 3 years; acute care volume grows at ~80% p.a.; bundle contracts ramp.
• Bull: faster payer contract wins; hospital-at-home tailwinds (CMS Acute Hospital Care at Home waiver) drive Advanced Care volume 2×; market ramp to maturity in 12 months.
• Bear: payer reimbursement compression; slower market expansion (regulatory, clinical hiring); acute care volume stays flat in early markets.
• Flex variables: new markets opened per year, visits/market/month at maturity, blended reimbursement rate, clinical staff cost per visit.

Required sheets / outputs:

1. Market cohort build - markets opened by quarter × monthly visit ramp curve → visit volume per market.
2. Revenue build - visit volume × reimbursement by service line (Acute, Advanced, Extended, Bridge, Virtual).
3. COGS / contribution margin - clinical labor + dispatch/supplies per visit; gross profit by service line.
4. Market P&L - contribution margin minus market-level fixed costs → market-level EBITDA; breakeven month per cohort.
5. Corporate P&L - S&M, tech/platform, G&A, R&D over the forecast period.
6. Consolidated 3-statement - IS, BS, CF; cash runway if raise amount known.
7. KPI dashboard - total markets, total visits/month, revenue/visit, NPS (static), savings generated (for customer storytelling).
8. Assumptions sheet - all inputs clearly flagged; scenario toggle.