Primary Care Clinic Break-Even Analysis: $54K Monthly Revenue

Fixed costs $45.3K/mo Year 1 base

Contribution margin 84% After variable costs

Break-even revenue $53.9K/mo Revenue floor

Break-even timing Month 13 Launch-year close

Break-even calculator

Test how monthly revenue, variable expenses, and fixed costs move the clinic to break-even.

Lean Base Full

Monthly revenue Monthly revenue is the cash coming in before costs. $ Lower run Busy month Variable expenses These are direct costs that move with patient volume. $ Lower cost Higher cost

Money available to cover fixed costs $75,799 $89,175 revenue - $13,376 variable expenses

Margin ratio

85%

Covers fixed costs

Yes

Fixed monthly costs This is the monthly cost base break-even must cover. $ Light overhead Heavy overhead

Break-even chart Revenue Total costs

Which primary care clinic expenses are fixed and which move with patient volume?

Cost classification

Break-even depends on putting each expense in the right bucket. If billing fees, supplies, or stepped staffing are treated as flat overhead, the model can overstate margin before Month 13.

Expense	Cost	Break-Even Treatment	Common Mistake
Clinic Rent	Fixed	Use $12,000 per month from Month 1 through Month 60.	Spreading rent across visits and hiding the true monthly hurdle.
Insurance Premiums	Fixed	Use $2,500 per month as stable overhead in the planning range.	Treating premiums as if they fall when patient volume is low.
Electronic Health Record Software Fees	Fixed	Use $1,800 per month unless the software contract changes with scale.	Rolling software into variable visit expense and overstating contribution margin.
Medical Supplies	Variable	Apply the revenue rate, starting at 3.5% in the first year and falling to 2.5% by the fifth year.	Modeling supplies as fixed overhead instead of visit-linked usage.
Lab & Diagnostic Fees	Variable	Apply the revenue rate, starting at 4.5% in the first year and falling to 3.5% by the fifth year.	Leaving lab fees below gross margin and overstating each visit’s profit.
Billing & Collections Fees	Semi-variable	Start with 5.0% of revenue in the first year, then reduce to 4.5% in the later years.	Treating billing as general overhead even though collections volume drives fees.
Patient Acquisition Marketing	Semi-variable	Use 3.0% of revenue in the first year, tapering to 2.0% as retention improves.	Assuming every new patient is free after opening month.
Medical Assistant Payroll	Semi-fixed	Add staff in steps, from 2.0 full-time equivalents in the first year to 6.0 by the fifth year.	Treating all staffing as fixed, even when capacity requires new hires.

How does break-even shift from a lean clinic to a base case and a full clinic build?

Scenario table

The model reaches break-even in Month 13, but the lean case still carries a small monthly gap. The base and full cases add more cushion because revenue grows faster than fixed overhead.

Planning assumptions only; actual reimbursement, staffing, and patient flow can shift results.

Scenario	Monthly Revenue	Variable Costs	Fixed Costs	CM Ratio	Operating Profit	Break-Even Signal
Lean primary care build	$526K	$84K	$453K	84%	-$12K	This case still runs about $12K short each month.
Base primary care build	$988K	$148K	$499K	85%	$341K	This case is past break-even and builds a strong cushion.
Full primary care build	$1,697K	$239K	$593K	86%	$865K	This case has a large cushion, so break-even risk is low.

What breaks the clinic’s break-even plan first?

Stress test

Year 1 is only slightly above break-even, so a small miss in revenue or a small rise in costs turns into a real loss fast. A 10% revenue drop or a 5-point margin hit pushes the annual gap into the mid-$30Ks to mid-$50Ks.

Stress Case	Changed Assumption	Break-Even Revenue	Revenue Gap	Risk Signal
Current plan	Year 1 revenue stays at $526K, variable expenses stay at 16%, and fixed costs stay at $453K.	$539K	$13K gap	Thin cushion; a small miss flips the plan red.
Revenue shortfall	Year 1 revenue falls 10% to about $473K.	$539K	$56K gap	Volume softness quickly wipes out the margin cushion.
Fixed-cost increase	Fixed costs rise 10% to about $498K.	$593K	$56K gap	Higher overhead needs more patient revenue just to hold even.
Margin pressure	Variable expenses rise 5 points, cutting contribution margin to 79%.	$573K	$38K gap	Billing, supply, or lab cost creep erodes break-even fast.
Combined pressure	Revenue falls 10%, fixed costs rise 10%, and margin drops to 79%.	$630K	$125K gap	Small misses across all three levers create a cash burn problem.

Can this primary care clinic clear break-even before you sign the lease and hire the team?

Founder checklist

Don't sign the lease until the clinic can fund the $345K build, carry the $558K cash trough, and support 390 monthly visits. The model does not reach break-even until Month 13, so fixed rent and payroll need to be safe before the first patient walks in.

1Lease Rent$12K/mo

Verify the lease stays at $12K a month, because that fixed bill starts on day one and does not wait for patient volume.

2Startup Capex$345K

Confirm renovation, equipment, furnishings, IT setup, inventory, security, and signage total $345K before you commit any upfront spend.

3Cash Cushion$558K

Keep at least the modeled $558K minimum cash, because the trough hits in Month 13 before the clinic turns stable.

4Visit Plan390/mo

With 2 GPs, 1 NP, and 1 PA in Year 1, capacity is about 680 visits a month, so the 390-visit plan only works if scheduled demand is real.

5Staff Ramp$302.5K/yr

Year 1 wages total about $302.5K a year at the modeled FTE mix, so test front-desk, billing, and medical assistant coverage before adding more fixed payroll.

6Launch StackPre-open

Finish credentialing and EHR setup before opening, and keep the $2.5K monthly insurance premium funded, because paid visits can't ramp until the stack is live.