Rheumatoid Arthritis Clinic Break-Even Revenue: Month 1 Plan

Fixed costs $76.6K Monthly base

Contribution margin 79% After variable costs

Break-even revenue $96.9K Monthly target

Break-even timing Month 1 Launch month

Break-even calculator

Test monthly revenue, variable expenses, and fixed costs against break-even for a rheumatoid arthritis treatment clinic.

Lean Base Full

Monthly revenue Revenue from visits and treatments is the cash pool that covers direct costs and overhead. $ Lower volume Higher volume Variable expenses These are the direct costs that rise with patient volume, supplies, drug use, and claims work. $ Lower costs Higher costs

Money available to cover fixed costs $411,213 $506,417 revenue - $95,204 variable expenses

Margin ratio

81%

Covers fixed costs

Yes

Fixed monthly costs This is the monthly cost base the clinic must cover before profit starts. $ Lower base Higher base

Break-even chart Revenue Total costs

Which rheumatoid arthritis clinic expenses are fixed, and which move with treatment volume?

Cost classification

Break-even is only useful if fixed overhead, visit-driven costs, and staffing steps are separated cleanly. Here’s the quick math logic: revenue-linked items reduce contribution margin, while fixed and semi-fixed items set the monthly hurdle.

Expense	Cost	Break-Even Treatment	Common Mistake
Medical Facility Lease	Fixed	Include $12,000 per month from Month 1 through Month 60 as baseline overhead.	Lowering rent per visit as volume rises instead of keeping the monthly cash hurdle intact.
Malpractice Insurance Premium	Fixed	Include $6,500 per month as required coverage that does not move with monthly visits in this model.	Treating insurance as a per-treatment charge and overstating margin pressure at higher volume.
Medical Consumables and Lab Supplies	Variable	Model at 4.5% of first-year revenue, then adjust by the annual percentages shown in the forecast.	Calling supplies fixed overhead, which makes each added visit look more profitable than it is.
Specialty Biologic Drug Inventory	Variable	Model at 8.5% of first-year revenue, tied directly to treatment mix and infusion activity.	Treating biologic inventory as fixed, which hides the cash drag from higher infusion volume.
Patient Marketing and Digital Ads	Variable	Use 5.0% of first-year revenue, then step down by forecast year as the clinic gains volume.	Locking marketing into fixed overhead and missing how patient growth usually requires spend.
Billing and Claims Processing Fees	Variable	Use 3.0% of first-year revenue because claims work rises with billed treatments and collections activity.	Treating billing fees as fixed and overstating contribution margin when revenue scales.
Utilities and Facility Maintenance	Semi-variable	Start with $1,800 per month, but allow usage to rise as infusion rooms and therapy areas run longer.	Keeping the full amount fixed even when higher patient flow drives more facility use.
Medical Receptionist payroll	Semi-fixed	Model in staffing steps: 2.0 FTE in the first year, 3.0 FTE in Year 3, and 4.0 FTE in Year 5.	Spreading payroll smoothly across visits instead of adding headcount when the front desk hits capacity.

How does break-even shift from launch to steady state to full scale in a rheumatoid arthritis clinic?

Scenario table

Break-even gets easier as the clinic moves from launch staffing to steadier use of rheumatologists, infusion nurses, physical therapists, occupational therapists, and clinical assistants. The Year 1 case is already above break-even, and Year 5 has the widest cushion.

Planning assumptions only; actual reimbursement, visit mix, and staffing can move these figures.

Scenario	Monthly Revenue	Variable Costs	Fixed Costs	CM Ratio	Operating Profit	Break-Even Signal
Launch case, Year 1	$2.32M	$487k	$766k	79.0%	$1.07M	Above break-even from Month 1, but the cushion is still tightest here.
Operating case, Year 3	$6.08M	$1.14M	$857k	81.2%	$4.08M	Core plan case; fixed overhead is spread well, so break-even risk is lower.
Scale case, Year 5	$12.33M	$2.03M	$895k	83.5%	$9.40M	Widest cushion; full-capacity planning matters more than break-even risk.

What pressures can break the break-even plan for this rheumatoid arthritis clinic?

Stress test

The base case clears break-even, but the plan is most exposed to referral delays, denied claims, biologic waste, and hiring ahead of patient flow. A 25% revenue drop or a 15% fixed-cost jump still leaves cushion, but it shrinks fast.

Stress Case	Changed Assumption	Break-Even Revenue	Revenue Gap	Risk Signal
Current plan	No change.	$0.76M	$1.18M cushion	Base case clears break-even in the opening month.
Revenue shortfall	Revenue is 25% lower than plan.	$0.76M	$0.69M cushion	Referral delays or denied claims cut the cushion sharply.
Fixed-cost pressure	Fixed overhead and admin payroll rise 15%.	$0.90M	$1.03M cushion	Rent overbuild or hiring too early pushes break-even up.
Margin pressure	Variable costs rise from 21% to 26% of revenue.	$0.81M	$1.13M cushion	Biologic waste, supply inflation, and claims friction hit profit fast.
Combined pressure	Revenue is 25% lower, fixed overhead rises 15%, and variable costs rise to 26% of revenue.	$0.96M	$0.49M cushion	Still above break-even, but one more miss can erase the buffer.

Can you prove referrals, staffing, and cash before you sign the lease?

Founder checklist

Don’t sign the lease until referrals, payer credentialing, staffing, and cash all match the Year 1 plan. The model shows Month 1 break-even, but the Month 2 cash trough still needs $846K, so the real test is whether the clinic can carry the buildout and ramp.

1Referral flow160 / 80

Verify referral flow can support at least 160 rheumatology visits and 80 infusions a month, or the lease and staff will outrun demand.

2Fixed load$76.6K/mo

Check that lease, insurance, IT, utilities, admin, and salaries total about $76.6K a month, since that is the burn the clinic starts with.

3Margin buffer79% CM

Check that Year 1 costs stay at 13.0% COGS and 8.0% variable spend, which leaves a 79.0% contribution margin before fixed overhead.

4Staffing ramp65% / 50%

Match the first-year schedule to 65% rheumatologist use and 50% infusion nurse use, then add FTE only when bookings stay dense.

5Cash trough$846K min

Hold this cash through the Month 2 trough before you sign the lease and fund buildout, because the project still needs runway while rooms and schedules fill.

6Launch setupPre-launch

Finish EHR, billing, and biologic inventory controls before opening, because Year 1 drug inventory is 8.5% of revenue and claims fees are 3.0%.