Chronic Care Management Break-Even: About $93K Monthly Revenue

Fixed costs $9.5K/mo Recurring base

Contribution margin 93.5% After variable costs

Break-even revenue $230.1K/mo Monthly target

Break-even timing Month 30 Model break point

Break-even calculator

Test how monthly revenue, variable costs, and fixed costs interact to show break-even for a chronic care management service.

Lean Base Full

Monthly revenue Revenue sets how much margin is left to cover fixed overhead. $ Low revenue High revenue Variable expenses Include hosting, payment fees, and other costs tied to revenue. $ Low costs High costs

Money available to cover fixed costs $218,579 $230,083 revenue - $11,504 variable expenses

Margin ratio

95%

Covers fixed costs

Yes

Fixed monthly costs This is the monthly cost base profit must cover. $ Low fixed High fixed

Break-even chart Revenue Total costs

Which chronic care management expenses are fixed, and which move with patient revenue?

Cost classification

Break-even is only useful if recurring costs are sorted by behavior. In the first year, $596k of revenue still produces -$577k EBITDA, so mixing fixed rent, volume fees, hiring steps, and launch capex would overstate the path to Month 30 break-even.

Expense	Cost	Break-Even Treatment	Common Mistake
Office Rent	Fixed	Use $3,500/month as recurring overhead through Month 60. It sets the monthly floor before patient revenue covers usage-linked fees.	Flexing rent with patient volume.
Professional Liability Insurance	Fixed	Use $1,200/month in operating break-even. It stays stable across the relevant monthly planning range.	Treating required coverage as optional.
HIPAA Legal Retainer	Fixed	Use $1,800/month as recurring compliance support. Keep it in fixed overhead, not patient-level delivery expense.	Mixing legal setup work with monthly retainer spend.
Payment Processing Fees	Variable	Apply 2.5% of first-year revenue, about $14.9k on $596k. This moves directly with billed patient revenue.	Ignoring per-patient billing friction.
HIPAA-Compliant Platform Hosting	Variable	Apply 4.0% of first-year revenue, about $23.8k on $596k. It scales with platform usage and patient activity.	Modeling hosting as flat too early.
Care Coordinators	Semi-fixed	Model $82,000 salary across 2.0 full-time equivalents in the first year. Add staff in blocks as patient capacity fills.	Treating all staffing as fixed.
Marketing Budget	Semi-variable	Use the $300,000 first-year budget as managed acquisition spend tied to $450 customer acquisition cost, or CAC, which means cost to add one customer.	Locking spend even when enrollment goals change.
Custom Platform Development	Fixed	Exclude the one-time $200,000 build from recurring operating break-even. Track it separately as startup investment.	Mixing one-time platform development into monthly break-even.

How does break-even move from lean to base to full in a chronic care management service?

Scenario table

Lean still runs a monthly loss, base crosses into profit, and full builds a real cushion. The gap closes because revenue per patient rises and variable costs take a smaller share as the patient mix shifts.

Planning scenarios only; these figures are modeled assumptions, not guarantees.

Scenario	Monthly Revenue	Variable Costs	Fixed Costs	CM Ratio	Operating Profit	Break-Even Signal
Lean launch case	$49.7k	$3.2k	$94.5k	93.5%	-$48.1k	About 333 active patients still leaves a monthly gap.
Base scale case	$230.1k	$11.5k	$204.2k	95.0%	$14.3k	About 1,399 active patients reaches positive operating profit.
Full capacity case	$465.8k	$16.3k	$296.8k	96.5%	$152.8k	About 2,573 active patients creates a strong cushion.

What pushes this chronic care management plan past break-even?

Stress test

Break-even gets fragile if enrollment slows, care time per patient rises, or billing slips. A 10% revenue miss or a 10% overhead bump each adds about a $93k gap; together they turn into a much bigger cash drain.

Stress Case	Changed Assumption	Break-Even Revenue	Revenue Gap	Risk Signal
Current plan	No change from the base case.	$925,000	$0 cushion	Baseline reaches break-even near Month 30.
Revenue miss	Revenue lands 10% below the $925k target.	$925,000	$93,000 gap	Slower activation keeps fixed costs uncovered longer.
Overhead rise	Fixed overhead rises 10% from plan.	$1,018,000	$93,000 gap	Rent, software, and staffing creep delay payback.
Margin leak	Variable expense load climbs from 6.5% to 10.0%.	$961,000	$36,000 gap	Billing leakage and payer timing friction hit margin.
Combined stress	Revenue falls 10%, fixed overhead rises 10%, and margin weakens.	$1,035,000	$202,000 gap	Delays, longer care time, and missed docs can push cash past Month 29.

What should you verify before you commit to scaling this chronic care management service?

Founder checklist

Verify that referrals can fill the panel fast enough to support the $300K Year 1 marketing test and that a $450 CAC still pays back from a $149 blended monthly collection. If those two numbers miss, break-even slips and payroll becomes the trap.

1Referral flow667 enrollments

Confirm referral sources can produce about 667 Year 1 enrollments at the $300K marketing test, or the pipeline will not support the spend.

2CAC payback3.0 months

Test whether a $450 CAC earns back from a $149 blended monthly collection in about 3.0 months, because slower payback will squeeze cash.

3Fixed load$61.5K/mo

Add the base monthly overhead from rent, software, insurance, legal, accounting, and planned Year 1 salaries before more hiring, because that is the floor break-even must clear.

4Care capacity2.0 to 12.0 FTE

Verify the care team can absorb intake and documentation before you add customer success or IT support, since coordinator headcount rises from 2.0 FTE in Year 1 to 12.0 FTE in Year 5.

5Platform build$308K

Map CRM, care coordination, billing, and Health Insurance Portability and Accountability Act (HIPAA) workflow before buying software, and keep the $308K in custom platform, office fit-out, hardware, and EMR integration out of monthly break-even math.

6Cash cushionMonth 29

Hold enough reserve to cover the $552K cash trough in Month 29, because the model does not reach breakeven until Month 30.