# Ryse Health Financial Model

Tech-enabled, office-based + virtual endocrinology practice focused on type 2 diabetes management.

- Canonical: https://finamodel.com/startups/ryse-health
- Excel download: https://finamodel.com/startup-models/ryse-health.xlsx
- Category: Fintech
- Model type: SaaS ARR / Valuation
- Funding round: Seed
- Funding: $34M
- Founded: 2022
- Geography: DC & Baltimore metro areas (proof-of-concept); national expansion long-term. [DECK slide 6]
- Customer: B2B2C

## About the company

Ryse Health is a tech-enabled endocrinology practice focused on type 2 diabetes, combining physical clinics with virtual care. Its model aims to deliver specialist treatment more accessibly while using technology to support ongoing patient management.

The company initially resembles a fee-for-service physician practice, but its longer-term opportunity is value-based care with risk-sharing or per-member payments. Clinical capacity, patient outcomes, payer contracts, and care-delivery cost all shape the commercial outcome.

The model should forecast patient acquisition, active patient panels, visits, reimbursement per encounter, provider capacity, and clinic utilisation. Value-based contracts need a separate PMPM, quality-bonus, medical-cost, and risk-sharing schedule, allowing the transition from visit revenue to population-health economics to be tested.

## 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

- Comprehensive, multidisciplinary care team: endocrinologists, NPs/PAs, registered dieticians (RDs), certified diabetes care & education specialists (CDCESs), licensed clinical social workers (LCSWs), and health coaches.
- Technology layer: continuous glucose monitor (CGM) integration, custom patient app for data synthesis, self-management support, and care team communication.
- Structured care protocol: 2-hour onboarding visit → 60-day intensive launch phase (frequent virtual contact, data review) → maintenance phase (quarterly A1c reviews, periodic visits) → tune-up periods as needed.
- Differentiator vs. traditional endocrinology: outcomes-focused (not CPT-code / visit-volume focused); vs. virtual-only vendors: physical presence + deeper clinical team; vs. PCP: specialist depth.

## Market

- US chronic disease total economic cost: $3.7T/year; causes 1.7M deaths/year; responsible for 7 out of 10 US deaths.
- Chronic disease annual economic cost breakdown (USA, $T): Cardiovascular $1.5T, Diabetes $0.5T, Arthritis/Back Pain $0.9T, Alzheimer's $0.3T, Cancer $0.3T, Other $0.2T.
  - Diabetes direct costs: $0.2T; productivity costs: $0.3T.
- US type 2 diabetes population: ~30M total.
  - By responsible provider: Primary Care Physician ~20M; No Provider ~6M; Endocrinologist ~3M; Virtual-only Vendors ~1M.

## Revenue model

- Primary channel: Direct patient care delivered via office-based + virtual hybrid model.
- Near-term: Implied fee-for-service / specialist practice billing (endocrinology CPT codes, though deck explicitly critiques this model as a legacy constraint for competitors).
- Long-term target: Value-based payment model (risk-sharing / outcomes-based contracts with payers).

## Traction & metrics

- Glycemic control - average % time out of range (all patients): 42% at baseline → 27% at Days 47–60 (−36% relative reduction).
- Average A1c for patients with initial A1c >8: 10 at baseline → 8 post-launch (−2.0 points).
- Patient satisfaction (Day 60–90): 4.96 / 5 stars average; based on 32 total reviews (31 at 5 stars, 1 at 4 stars).
- No revenue, patient count, or growth rate numbers disclosed.

## Competition / moat

- Competitive landscape framed around four provider categories, all with key limitations:
  - No Provider (~6M patients): no health improvement mechanism.
  - Virtual-only Vendors (~1M): low engagement sustainability, disconnected from PCPs.
  - Endocrinologist (~3M): visit-volume economic model, not outcomes-oriented.
  - Primary Care Physician (~20M): insufficient clinical depth.
- Ryse's moat: multidisciplinary in-person + virtual model optimized for outcomes, proprietary tech layer (CGM + app), and eventual value-based contracts that lock in payer relationships.
- No mention of specific named competitors (e.g., Virta Health, Cecelia Health).

## Team & funding ask / use of funds

- Richard Gurley, MBA - Co-founder & CEO: VP Payer Partnerships at Evolent Health; advisor to Doctor on Demand, Modern Fertility, Vera Whole Health; McKinsey health payer/provider practice; Tennessee government.
- Erin Kane, MD - Co-founder & CMO: Harvard and Hopkins-trained physician; led Hopkins capacity command center and GW COVID-19 remote monitoring; McKinsey management consultant.
- Antares Meketa - CTO/CPO: departing Head of Product Operations at Commure; prior CPO/CTO at Karuna Health and MeYou Health.

## Recommended financial model

- Archetype + why: **Tech-enabled specialty practice P&L with value-based overlay** - hybrid of a physician practice revenue model (visit/encounter-based) transitioning to per-member-per-month (PMPM) value-based contracts. Similar to Evolent Health / Oak Street model at early stage. A standard 3-statement model is appropriate, with a patient cohort waterfall driving revenue.
- Forecast horizon & granularity: 5 years; monthly for Years 1–2 (practice ramp), quarterly for Years 3–5.
- Key drivers & assumptions:
  - **Active patient panel size**: Starting cohort; begin with ~50 patients (proof-of-concept DC/Baltimore launch); ramp ~20–30 new patients/month in Year 1 based on single-practice capacity.
  - **Care phases & visit cadence**: Launch phase = 60 days intensive (higher cost); maintenance = ongoing lighter touch.
  - **Revenue per patient (fee-for-service phase)**: ~$3,000–$5,000/year per patient in Year 1–2, blended across endocrinologist visits, RD/CDCES touchpoints, CGM interpretation, and telehealth. Needs payer contract validation.
  - **PMPM value-based revenue (Year 3+)**: target payer contracts at $150–$250 PMPM (~$1,800–$3,000/patient/year); reflects outcomes savings on diabetes-related hospitalizations.
  - **Care team staffing cost**: 1 endocrinologist + 1 NP/PA + 2 health coaches + 1 RD/CDCES + 1 LCSW per ~100–150 patients; salary benchmarks from healthcare staffing norms.
  - **Technology / CGM cost per patient**: ~$150–$300/patient/month for CGM supplies + app infrastructure; decreases at scale.
  - **Patient acquisition / CAC**: primarily PCP referral-based; low paid CAC initially (~$200–$500/patient) given B2B2C referral model.
  - **Attrition / churn**: 10–15%/year for maintenance-phase patients; clinical outcomes support low churn thesis.
  - **Gross margin**: 40–55% at steady state (labor-heavy model typical of care delivery); negative in Year 1 as team pre-hired for capacity.
  - **A1c improvement rate**: 2.0 points average reduction - key value-based contract negotiating lever, model as clinical outcome tracker.
  - **Patient satisfaction (NPS proxy)**: 4.96/5 - supports referral flywheel assumption.
- Scenarios (Base / Bull / Bear - which variables flex):
  - **Base**: Single DC/Baltimore market, 150 patients by end Year 1, fee-for-service with 1 value-based pilot contract Year 3.
  - **Bull**: Second market (new city) Year 2; payer adoption of value-based contracts Year 2; 300+ patients Year 2.
  - **Bear**: Slow PCP referral ramp; fee-for-service only through Year 3; patients per clinician below capacity.
- Required sheets / outputs:
  1. Assumptions sheet (all drivers above)
  2. Patient cohort waterfall (new patients, active patients, attrition by month)
  3. Revenue build (FFS revenue + PMPM value-based revenue by contract)
  4. Clinical staffing model (headcount plan + payroll)
  5. Operating expense model (tech/CGM, G&A, facilities)
  6. P&L (IS)
  7. Cash runway / burn (simplified CF - no balance sheet needed at this stage unless fundraising round modelled)
  8. KPI dashboard (active patients, revenue per patient, A1c outcomes, gross margin)

## Frequently asked questions

### Is the Ryse Health financial model free?

Yes. The Ryse 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.