# Everside Health Financial Model Technology-enabled primary care platform that partners with self-funded employer plan sponsors to deliver lower-cost, higher-quality healthcare for their employees. - Canonical: https://finamodel.com/startups/everside-health - Excel download: https://finamodel.com/startup-models/everside-health.xlsx - Category: Health-tech - Model type: SaaS ARR / Valuation - Funding round: Growth - Funding: $164M - Founded: 2022 - Geography: U.S. nationwide; HQ Denver, CO; 34 states / 140+ markets [DECK, slide 11]. - Customer: B2C ## About the company Everside Health is a technology-enabled primary-care platform partnering with self-funded employers to provide lower-cost, higher-quality care for employees. It operates onsite, nearsite, and virtual delivery models rather than simply licensing software. Employer plan sponsors sign recurring multi-year contracts, typically structured per employee per month or around dedicated health centres. The company had a substantial direct B2B client base, making contract retention and care utilisation central. The model should forecast employer clients, eligible employees, PEPM revenue, health-centre openings, utilisation, and renewals. Provider staffing, facility costs, virtual-care delivery, market launch cost, and client concentration should be included in the services forecast. ## What's included - 5-year monthly revenue build with stage-appropriate growth assumptions - Full P&L, headcount plan, and operating-expense schedule - Cash-flow statement, runway, and burn-rate tracking - Valuation via exit multiple with a DCF cross-check - Returns analysis with MOIC and IRR - Unit economics including CAC, LTV, payback, and cohort retention ## Product & value proposition Everside operates onsite, nearsite, and virtual primary care health centers for employers. Employers pay a fixed, recurring, multi-year contract fee (replacing utilization-driven fee-for-service). Employees receive free or low-copay access to: primary care, mental health services, chronic condition management, wellness coaching, onsite labs/testing, occupational health, referral management, and pharmacy. A proprietary rules engine ingests medical & Rx claims, clinical & lab data, wellness & risk data, and social determinants to generate a 360-degree patient view and produce actions for patients and providers. Key differentiators vs. industry: - Same/next-day appointments vs. 56-day average wait - 885 average patient panel size vs. 2,200 industry average - NPS +85 vs. industry average -1.7 - 1.1% medical cost trend vs. 6–7% industry inflation ## Market - 100M+ Americans covered by self-funded plan sponsors in 2021 - Plan sponsor health benefit costs averaged 7.8% of total compensation in 2021 - Average annual family coverage premium (2021): $22,221 total ($16,253 plan sponsor + $5,969 worker) - 87% of large employers believe health benefit costs will become unsustainable in the next 5–10 years - Only 10% of plan sponsors currently use value-based care (VBC) solutions; 87% have shown interest - 73% of plan sponsors plan to engage in VBC programs within the next 5 years (McKinsey survey) ## Revenue model - Fixed, recurring, multi-year contracts with employer plan sponsors - Fee structure: Per-employee-per-month (PEPM) or per-health-center contract - specific pricing not disclosed in deck - Channels: Direct B2B sales to self-funded employers (350+ clients as of deck date) - Delivery models: Onsite health centers (employer-dedicated), nearsite health centers (shared/multi-employer), and virtual care - Ancillary: Pharmacy, labs/testing embedded in health centers ## Traction & metrics All figures as of deck date (circa mid-2022 based on context): - 575K+ patients - 350+ employer clients - 375+ health centers - 400+ employed providers - 34 U.S. states / 140+ markets - 1,400+ employees - NPS +85 (as of July 2022) - 81% of patients report health improved after using services - 75% of patients viewed their employer more favorably due to Everside access - Clinical quality and outcomes metrics at 90th percentile or higher - 30%+ cost savings for employers - Best in KLAS: Employer Sponsored Healthcare Services 2022 ## Unit economics - Medical cost trend for employers: 1.1% vs. 6–7% industry average - Employer cost savings: 30%+ - Patient panel size: 885 per provider vs. 2,200 industry average ## Competition / moat Moat framing from deck: - Lower panel sizes enable high-touch, relationship-based care (vs. volume-driven FFS model) - Proprietary technology rules engine aggregating multi-source patient data (claims, clinical, labs, wellness, social determinants) - Fixed-contract model aligns incentives with employers to reduce total cost of care (vs. FFS which rewards utilization) - NPS +85 creates strong patient/employer retention - Scaled national footprint (375+ health centers, 34 states) is a hard-to-replicate physical asset base - Named competitors: Not explicitly named in deck ## Team & funding ask / use of funds Team: - Chris Miller, CEO - prior: Trumpet Behavioral Health, DaVita - Heather Dixon, CFO - prior: Walgreens Boots Alliance, Aetna - Adam Johnson, Chief Growth & Strategy Officer - prior: Compass, Alight - Tobias Barker MD, Chief Medical Officer - prior: Mass General Brigham, CVS Health - Courtney Harwood, CMO - prior: CLEAR, Xerox - Sampath Narayanan, CIO - prior: Concerto Health, Cognizant - Allison Velez, Chief People Officer - prior: Optum, DaVita - Michi Tsuda JD MBA, General Counsel - prior: Greenberg Traurig, Squire Patton Boggs - Mason Reiner, SVP Innovation & Value Based Care - prior: R Health --- ## Recommended financial model - **Archetype + why:** Employer-sponsored healthcare services revenue model - B2B contracted recurring revenue with a per-health-center / PEPM structure. Closest archetype is a **contracted services / recurring revenue 3-statement model** with client cohort tracking. Not a pure SaaS ARR model (physical health centers are the delivery unit and carry significant capex/opex), not a pure insurance GWP/loss-ratio model (Everside is not the risk-bearer - the employer is). The correct frame is a **health center P&L + employer contract revenue model**: revenue is contract fees per client (or per enrolled life), costs are driven by health center count × cost per center and provider headcount × fully loaded cost per provider. - **Forecast horizon & granularity:** 5-year annual model (2022–2027) with monthly build for Year 1; given physical build-out cycle, annual granularity is appropriate for Years 2–5. - **Key drivers & assumptions:** | Driver | Seed value | | -- | -- | | Employer clients (starting) | 350+ | | Net new clients per year | ~50–75 | | Health centers (starting) | 375+ | | Health centers per client (avg) | ~1.1 | | Patients per health center | ~1,533 (575K ÷ 375) | | Total enrolled lives (starting) | 575,000+ | | Enrolled lives growth (YoY) | ~15–20% | | Providers employed (starting) | 400+ | | Patient panel per provider | 885 | | Employee count (starting) | 1,400+ | | Employees per health center | ~3.7 (1,400 ÷ 375) | | Provider cost (fully loaded) | ~$250–$300K/yr per employed provider | | Non-provider opex per health center | ~$300–$400K/yr (rent, admin, supplies) | | Gross margin | 20–35% (employer-sponsored primary care benchmarks); target improving over time | | Employer medical cost savings delivered | 30%+ | | Client churn | <5%/yr; long-term contracts, high switching cost | | Contract length | 3–5 years; multi-year stated | - **Scenarios (Base / Bull / Bear - which variables flex):** - **Base:** 350 clients → 600 by Year 5; PEPM $100; gross margin 25% - **Bull:** Accelerated employer adoption (73% VBC intent in 5 years); PEPM $120; gross margin 30%; health center utilization improves - **Bear:** Employer budget pressure slows new wins; churn rises to 8%; PEPM held flat; new health center openings halved - **Required sheets / outputs:** 1. **Assumptions** - all drivers listed above with scenario toggle 2. **Client & Lives Build** - cohort-based: new clients × avg lives per client → total enrolled lives per year 3. **Revenue** - enrolled lives × PEPM × 12; break out onsite vs. nearsite vs. virtual if data becomes available 4. **Health Center P&L** - revenue per center, direct costs (providers, facility), contribution margin per center 5. **Headcount & Opex** - providers (panel-size-driven), non-clinical staff (center-count-driven), G&A, sales & marketing 6. **Income Statement** - revenue, COGS (provider + center costs), gross profit, opex, EBITDA 7. **Balance Sheet** - capex for health center build-out, working capital, debt (if applicable) 8. **Cash Flow Statement** - operating CF, capex (growth investment in new centers), free cash flow 9. **KPI Dashboard** - clients, enrolled lives, health centers, PEPM, revenue/center, gross margin %, EBITDA margin % ## Frequently asked questions ### Is the Everside Health financial model free? Yes. The Everside Health model is a free Excel download with live formulas. ### Can I change the assumptions? Yes. The workbook is editable and its live formulas recalculate when assumptions change.