Medical Decision Support Software Break-Even: Month 11 Coverage

Fixed costs $98.8K/mo Core overhead base

Contribution margin 81% After variable costs

Break-even revenue $122K/mo Monthly target

Break-even timing Month 11 Launch-year timing

Break-even calculator

Use this calculator to test whether monthly revenue clears variable costs and the fixed cost base; the model reaches break-even around Month 11.

Lean Base Full

Monthly revenue Revenue is the pool that pays direct costs and then the fixed base. $ Lower revenue Higher revenue Variable expenses These are direct costs that rise with sales and usage. $ Lower direct costs Higher direct costs

Money available to cover fixed costs $372,614 $446,750 revenue - $74,136 variable expenses

Margin ratio

83%

Covers fixed costs

Yes

Fixed monthly costs This is the monthly overhead the margin has to cover. $ Lower overhead Higher overhead

Break-even chart Revenue Total costs

Which expenses stay fixed and which move with sales in a medical decision support software break-even model?

Cost classification

Break-even is only reliable if payroll and overhead stay above the contribution line, while revenue-linked items reduce margin. In the first year, variable platform costs total 19% of revenue before fixed overhead.

Expense	Cost	Break-Even Treatment	Common Mistake
Core payroll: CEO, data science, engineering, sales, and clinical implementation	Fixed	Use annual salaries divided by 12; first-year payroll is about $70,833 per month.	Tying the core team to monthly sales volume.
HIPAA Compliance and Security Audits	Fixed	Include $4,500 per month in overhead from Month 1 through Month 60.	Burying recurring compliance work in launch spend.
Office Lease and Utilities	Fixed	Include $12,000 per month from the launch month, regardless of early sales volume.	Waiting for a full sales ramp before adding rent.
Cloud Infrastructure and HIPAA Hosting	Variable	Reduce contribution margin by 8.0% of revenue in the first year.	Treating hosting as flat forever.
EHR API and Integration Maintenance	Variable	Reduce contribution margin by 4.0% of revenue in the first year.	Ignoring provider-specific integration workload.
Sales Commissions	Variable	Reduce contribution margin by 5.0% of revenue across all forecast years.	Including commissions only inside fixed sales payroll.
Payment Processing and Billing	Variable	Reduce contribution margin by 2.0% of revenue in the first year.	Overlooking invoice, billing, and collection fees.
Annual Marketing Budget	Semi-fixed	Spread the first-year $150,000 budget at about $12,500 per month for planning.	Assuming spend stops when sales slow.

How does break-even change from a lean pilot to a full-scale rollout for clinical decision support software?

Scenario table

Lean is close to break-even because its 81.0% contribution margin barely clears about $98.8k of fixed costs. By Year 3 and Year 5, margins rise to 83.4% and 85.8%, so the cushion widens fast.

Planning cases only, not guaranteed demand.

Scenario	Monthly Revenue	Variable Costs	Fixed Costs	CM Ratio	Operating Profit	Break-Even Signal
Lean pilot rollout	$119.9k	$22.8k	$98.8k	81.0%	-$1.7k	Thin cushion; month 11 break-even is tight.
Base provider adoption	$446.8k	$74.2k	$163.0k	83.4%	$209.6k	Positive monthly profit gives room above break-even.
Full-scale clinical expansion	$1,093.5k	$155.3k	$236.8k	85.8%	$701.5k	Strong cushion if rollout and adoption hold.

What pushes this plan past break-even?

Stress test

Year 1 revenue is only about $65,000 above break-even, so the cushion is thin. Slower provider contracts, longer onboarding, heavier integration work, or a $10,000 monthly overhead bump can push Month 11 break-even into the next period.

Stress Case	Changed Assumption	Break-Even Revenue	Revenue Gap	Risk Signal
Current plan	No change.	$1,374,000	$65,000 cushion	Small slack, so timing matters.
Revenue shortfall	Year 1 revenue falls 15% as provider contracts close slower.	$1,374,000	$151,000 gap	Slower adoption pushes break-even out.
Fixed-cost pressure	Monthly overhead rises by $10,000.	$1,522,000	$83,000 gap	Fixed-cost creep can erase the Month 11 cushion.
Margin pressure	Variable expenses rise from 19% to 24% on heavier onboarding and integration work.	$1,465,000	$26,000 gap	Lower contribution margin pushes break-even higher.
Combined pressure	Revenue falls 15%, monthly overhead rises by $10,000, and variable expenses rise to 24%.	$1,622,000	$399,000 gap	Break-even slips fast if sales and implementation both slow.

What should you verify before scaling clinical decision support software?

Founder checklist

Before you add sales headcount or platform spend, prove buyers will pay the tiered prices, onboarding work matches the one-time fees, and cash stays above the $446k floor. Break-even lands in Month 11, but the cash low point is Month 13.

1Tier demand$15k/$35k/$75k

Talk to providers and prove they will pay these monthly tiers before you add sales headcount, then compare paid conversion to the Year 1 $2,500 CAC.

2Onboarding fees$5k/$12k/$25k

Test each one-time fee against real setup work so the charge covers implementation time instead of hiding it inside the subscription price.

3EHR scopeMonth 11

Freeze electronic health record integration scope before you promise go-live timing, because the Month 11 break-even line only works if delivery stays on schedule.

4Base burn$28k/mo

Map the HIPAA audit and security workflow before launch, because rent, counsel, tools, audits, and insurance create a fixed monthly load from day one.

5Pilot capacity1 FTE

Check whether one clinical implementation specialist can support early pilots, because onboarding load decides how fast you can grow without adding more staff.

6Cash runway$446k

Keep cash above the Month 13 pressure point and hold Year 3 hiring until Month 11 break-even is repeatable, or the model runs out of room fast.