Kaia Health Financial Model

• Mobile app delivering 3 digital therapies for MSK conditions: back pain, knee, and COPD/respiratory (implied by "3 digital therapies").
• Three pillars: (1) daily therapeutic exercise programs, (2) mindfulness/education content, (3) AI Motion Coach™ - camera-based real-time exercise tracking via smartphone, no hardware required.
• Health coaches (certified, NBC-HWC accredited, RN or 4-yr health degree) provide ongoing adherence support and care navigation.
• "Care Compass" triage layer routes members to specialty care, telemedicine, or digital programs as needed.
• 4 patents pending on motion-tracking technology.
• 400,000+ users referenced in marketing copy.
• 6 peer-reviewed clinical studies published (Nature Digital Medicine, JMIR, Journal of Pain Research, DovePress).

• MSK direct medical spend: $300–500 PMPY per major diagnostic area; up to 16% of total medical spend for payors.
• MSK indirect costs: 11.4 average workdays lost per person per year; largest driver of short- and long-term disability claims.
• MSK spending breakdown by category: Surgery 48%, Rx incl. opioids 13%, Evaluation & mgmt. 9%, PT/OT 7%, HCPCS II 5%, Other 18%.

• Primary channel: B2B - sold to self-insured employers and health plans (50 B2B customers).
• Pricing: Monthly active user (MAU) charge only; employers not charged for inactive users.
• Comparison table positions pricing as "monthly active user charge only" vs. competitors' "flat up-front fees + telehealth fees".
• The ROI slide (slide 32) shows a representative client example: Investment $1,634,574 / Year 1 savings $3,621,837 → net savings $1,987,263 → ROI 2.2x. This is a customer ROI illustration, not Kaia's own revenue figure.
• Secondary revenue: "Kaia Care Compass" premium partner referral model (specialty care, telemedicine, digital programs) referenced but monetization details not disclosed.

• 100 employees ("Kaianeers")
• 3 digital therapies in market
• 50 B2B customers
• $50m total raised
• 400,000+ users (referenced in engagement marketing copy)
• Customer logo / name examples: Harvard Pilgrim Health Care, BCBS (implied)

Engagement / utilization metrics (B2B employer program):

• Account creation rate: 7% of eligible population
• Acceptance rate (post-screening): 90%
• Utilization per week: 3.2x sessions/week per active user
• Therapy success / retention: 80%
• User satisfaction (CSAT): 93%

Clinical outcomes (proxy for LTV/retention quality):

• Pain reduction vs. standard care: -33% pain change vs. control at 3-month follow-up
• High-risk patient pain change: -43%
• RCT (Nature Digital Medicine): Kaia NRS 2.7 vs. control 3.4 at 12 weeks (0–10 scale)
• Employee productivity impact: -54% pain hampering productivity; -62% likelihood to seek PT
• Mental wellbeing improvement: +13%

Customer ROI (representative client, Year 1):

• Client investment: -$1,634,574
• Client MSK savings: $3,621,837
• Net savings: $1,987,263
• ROI multiple: 2.2x
• Savings breakdown: Surgery 30–40%, Rx/injections 20–25%, PT/OT/chiro 15–25%, Radiology 10–15%, Other 3–5%

• Competitors use additional hardware + flat up-front fees + telehealth fees with their own remote PTs.
• Kaia differentiation: (1) BYOD (no hardware), (2) MAU-only pricing, (3) network non-redundancy (no financial conflict of interest with PT networks), (4) proprietary AI Motion Coach™ (4 patents pending), (5) 6 published RCTs, (6) integrated care navigation (not fragmented).
• Named competitor(s): Not explicitly named in deck (referred to generically as "Competitors").
• Notable: Hinge Health is the obvious comparable but not named.

• Team: Not detailed in deck (no team slide identified in 32 slides).
• Total raised to date: $50m.

Archetype + why: B2B digital health PMPM / MAU-based revenue model. Revenue is driven by number of employer/plan customers × eligible covered lives × activation rate × PMPM charge. This is closest to a B2B SaaS cohort model but with healthcare-specific engagement funnel (eligible → activated → accepted → active). Not a pure ARR SaaS because billing is tied to monthly active users, not seats.

Forecast horizon & granularity:

• 3 years, monthly granularity (Years 1–3). Monthly needed to model activation cohorts and MAU churn.
• Year 1 should reflect current state (~50 B2B customers as baseline).

Key drivers & assumptions:

*Customer acquisition:*

• B2B customers (employers/plans) at period start: 50
• New B2B customers added per quarter: 8–12 in Year 1, scaling to 15–20 in Year 2; rationale: early-stage, sales cycles in employer health are 6–12 months
• Average covered lives per employer contract: 5,000–15,000; rationale: mix of mid-market and regional health plans; no deck data

*Engagement funnel (per employer cohort):*

• % eligible lives that create account: 7%
• % of accounts accepted into program: 90%
• Net activation rate (enrolled / eligible): ~6.3% (7% × 90%)
• Active users per week (utilization): 3.2x sessions
• Therapy success / graduation rate: 80%; implies average program duration 12–16 weeks before graduation/churn

*Pricing:*

• PMPM charge per active user: $35–$65/month; rationale: digital MSK market benchmarks (Hinge Health publicly disclosed ~$50–70/member); Kaia's deck does not disclose price
• Health coaching add-on: included in base PMPM (no separate line shown)

*Costs:*

• Health coach headcount per active user ratio: 1 coach per 150–200 active users; rationale: intensive 30-day onboarding + monthly check-ins described in deck
• Coach fully-loaded cost: $80–100k/year; rationale: RN + certification requirement
• Gross margin: 55–70%; rationale: digital health services with significant coach labor; no deck data
• R&D / motion tracking infra: 15–20% of revenue in early years, declining to 10% by Year 3
• S&M: 25–35% of revenue (B2B enterprise sales team + employer marketing kits)
• G&A: 10–15% of revenue

*Customer ROI / retention:*

• Net revenue retention per employer: 110–120%; rationale: 2.2x client ROI supports strong renewal + upsell to additional covered populations
• Logo churn: 5–10% annually

Scenarios (Base / Bull / Bear - which variables flex):

• Base: 7% activation, $50 PMPM, 10 new B2B customers/quarter by Year 2, 65% gross margin
• Bull: 10% activation (better employer comms), $65 PMPM, 15 new customers/quarter, 72% gross margin (coach leverage)
• Bear: 5% activation, $38 PMPM (price pressure from incumbents), 6 new customers/quarter, 55% gross margin (higher coach costs)

Required sheets / outputs:

1. Assumptions - all drivers in one place
2. B2B Customer Cohort Model - monthly, tracks each employer cohort through activation funnel
3. MAU Bridge - eligible → activated → accepted → active per month
4. Income Statement (P&L) - revenue, COGS (coach labor, infra), gross profit, opex by function, EBITDA
5. Headcount Plan - coaches (demand-driven), sales, R&D, G&A
6. Cash & Runway - burn rate, cash on hand, months of runway (given $50m raised, unknown spend rate)
7. Customer ROI Model - replicates slide 32 logic; used for sales tool validation
8. Scenario toggle - Base / Bull / Bear via dropdown