Hemodialysis Center Break-Even Analysis: Month 25 Path

Fixed costs $25.5K/mo Base overhead

Contribution margin 82% After variable cost

Break-even revenue $31.1K/mo Monthly target

Break-even timing Month 25 Model breakeven

Break-even calculator

Test monthly revenue, variable expenses, and fixed costs to see where a hemodialysis center crosses break-even.

Lean Base Full

Monthly revenue Revenue is the cash coming in each month before direct costs and overhead. $ Low sales High sales Variable expenses These are direct costs that rise with patient volume, like supplies, billing, and software. $ Light costs Heavy costs

Money available to cover fixed costs $185,333 $222,222 revenue - $36,889 variable expenses

Margin ratio

83%

Covers fixed costs

Yes

Fixed monthly costs This is the monthly overhead the center must cover even when volume is flat. $ Low overhead High overhead

Break-even chart Revenue Total costs

Which hemodialysis center expenses are fixed and which move with treatment volume?

Cost classification

Break-even is reliable only when stable monthly overhead sits in the numerator and treatment-linked expenses reduce margin. Misclass payroll or utilities, and Month 25 break-even can look safer than it is.

Expense	Cost	Break-Even Treatment	Common Mistake
Facility lease payment	Fixed	Put the $15,000 monthly lease in fixed overhead for Months 1–60.	Tying rent to treatment volume when it does not move inside the lease period.
Clinical payroll	Semi-fixed	Model staff in FTE steps as capacity rises, including nurses, technicians, nephrologists, dietitians, and social workers.	Classing every payroll line as fully fixed instead of adding staff when volume grows.
Medical supplies	Variable	Reduce contribution margin by 7.0% of revenue in the first year, then use the forecast rate by year.	Putting supplies in fixed overhead and overstating per-treatment margin.
Pharmaceuticals	Variable	Reduce contribution margin by 6.0% of revenue in the first year, then use the forecast rate by year.	Ignoring drug usage changes as treatments increase.
Medical billing services	Variable	Treat billing services as a revenue-linked charge, starting at 3.0% in the first year.	Budgeting billing as a flat admin fee and missing collection-load pressure.
EHR software licenses	Variable	Use the forecast percentage of revenue, starting at 2.0% in the first year.	Treating all software as fixed when this license line scales with revenue.
Utilities	Semi-variable	Keep a base utility load, then let usage rise with water treatment and operating volume.	Treating all utilities as fixed even though dialysis volume drives water and power use.
Maintenance and repairs	Semi-fixed	Start with the $1,800 monthly baseline, then step it up as machines and treatment volume increase.	Leaving maintenance flat through scale-up while equipment wear rises.

How does break-even shift from a lean opening month to fuller utilization at this hemodialysis center?

Scenario table

At 18% variable cost and $964k of fixed monthly overhead, lean volume leaves a gap, the base case lands at break-even, and fuller use adds cushion. The key driver is how fast fixed lease and staffing are absorbed.

Planning figures only; actual results can move with payer mix, staffing, and utilization.

Scenario	Monthly Revenue	Variable Costs	Fixed Costs	CM Ratio	Operating Profit	Break-Even Signal
Lean opening case	$980k	$176k	$964k	82%	-$160k	Still short on fixed overhead.
Base break-even case	$1.18M	$212k	$964k	82%	$0	This is the break-even line.
Full stabilized case	$1.39M	$251k	$964k	82%	+$176k	Extra volume creates a cushion.

What breaks the break-even plan for a hemodialysis center?

Stress test

The base plan clears break-even, but the cushion is not wide. A 10% revenue drop still leaves room, yet slower referrals, payer delays, supply inflation, or another $10k in fixed overhead can push the clinic into a roughly $75k monthly gap.

Stress Case	Changed Assumption	Break-Even Revenue	Revenue Gap	Risk Signal
Current plan	No change.	$1,215k	$176k cushion	The base case clears break-even with room to spare.
Revenue shortfall	Cut revenue by 10%.	$1,190k	$62k cushion	Slow referrals or payer delays can erase most of the cushion.
Fixed-cost pressure	Raise fixed overhead by $10k per month.	$1,315k	$76k cushion	Overhead creep quickly tightens cash.
Margin pressure	Lift variable expense from 18% to 21% of revenue.	$1,256k	$135k cushion	Supply or billing pressure weakens the spread.
Combined pressure	Cut revenue by 10%, raise variable expense to 21%, and add $10k in fixed overhead.	$1,327k	$75k gap	These shocks together push the clinic below break-even.

What should a founder verify before signing the lease and buying dialysis equipment for a hemodialysis center?

Founder checklist

Before you sign the lease or buy the machines, test whether payer flow, staffing, and cash can carry the center to Month 25 breakeven. If opening utilization misses the 60.0% start, the model is too thin.

1Referral Flow60.0% start

Verify payer contracting, billing workflow, and referral flow can fill 60.0% of treatment capacity in Year 1 and move toward 85.0%, because empty chairs kill break-even.

2Fixed Burn$96.4K/mo

Verify the lease, utilities, malpractice insurance, and medical waste handling stay inside the monthly burn, because fixed overhead hits before revenue does.

3Capex Stack$975K

Verify six machines at $300K, water purification at $150K, six chairs at $30K, the generator at $60K, and build-out at $250K all fit the capex plan.

4Launch Team10 core staff

Verify opening staffing of 3 registered nurses, 4 dialysis technicians, 1 nephrologist, 1 dietitian, and 1 social worker is funded and scheduled before launch.

5Margin Check82% CM

Verify each treatment still carries about 82% contribution margin after 7.0% medical supplies, 6.0% pharmaceuticals, 3.0% billing, and 2.0% EHR licenses.

6Cash RunwayMonth 25

Verify cash can last to Month 25, since minimum cash is about -$589K and payback also lands there; shorter runway means the center stalls before breakeven.