Clinic-Level Profitability

This use case explains how to model and analyse clinic level profitability for healthcare, clinics and allied health practices using Model Reef.

You will:

  • Represent each clinic as a branch in the model.

  • Attach practitioner utilisation, revenue and staffing cost to each clinic.

  • Add rent, utilities, admin staff and other clinic overheads.

  • Produce P&L and cash views per clinic and in total.

The objective is to understand which clinics are strong, which need improvement, and how changes in staffing, hours or pricing will affect clinic performance.


When to use this pattern

Use this pattern when:

  • You operate one or more clinics or practices.

  • You want clear P&L and cash views per clinic.

  • You need to assess new clinic openings, closures or relocations.

  • You want practitioner and clinic performance aligned in one model.

It is usually combined with:

  • Practitioner Utilisation Model

  • Medicare or Private Billing Forecast

  • Multi Clinic Consolidation


Architecture overview

Clinic level profitability uses:

  • Branch structure

    • One branch per clinic.

    • Optional group and regional branches above.

  • Clinic level revenue

    • Practitioner revenue per clinic.

    • Medicare or insurer rebates and patient gap payments.

    • Other income such as room hire or diagnostics.

  • Clinic level cost

    • Practitioner staffing cost.

    • Non clinical staff and admin.

    • Rent, utilities, consumables and other overheads.

  • Outputs

    • P&L per clinic.

    • Cashflow and Cash Waterfall per clinic and for the group.

    • Margin comparison across clinics.


1

Step 1: Build a branch tree with one branch per clinic

In the branch tree, create a structure such as:

  • Group

    • Clinic - City A

    • Clinic - City B

    • Clinic - Suburb C

    • Central Overheads

If you have regions, insert regional branches between the group and clinics.

Each clinic branch will hold its own revenue and cost variables. The group and any regional branches simply aggregate outputs and can hold central costs.

2

Step 2: Attach practitioner utilisation and revenue per clinic

Using the Practitioner Utilisation Model, ensure each clinic branch has:

  • FTE or practitioner count drivers per discipline.

  • Capacity and utilisation drivers per clinic.

  • Revenue variables per practitioner type and payer type.

Examples of clinic level revenue variables:

  • Revenue - GP - Clinic City A.

  • Revenue - Physio - Clinic City A.

  • Revenue - Psychology - Clinic City A.

  • Revenue - Other Services - Clinic City A.

All of these should be of type Revenue so they flow into P&L and downstream statements automatically.

3

Step 3: Add clinic level staffing and overhead cost

Within each clinic branch, create Staff and Opex variables such as:

  • Staff - GP Salaries - Clinic City A.

  • Staff - Nurses - Clinic City A.

  • Staff - Admin Team - Clinic City A.

  • Opex - Rent - Clinic City A.

  • Opex - Utilities - Clinic City A.

  • Opex - Medical Consumables - Clinic City A.

  • Opex - Cleaning and Security - Clinic City A.

Use drivers such as:

  • FTE and salary per FTE.

  • Rent per month or per square metre.

  • Consumables cost per visit or as a percentage of revenue.

Make sure payment timing reflects actual behaviour:

  • Staff paid weekly, fortnightly or monthly.

  • Rent and utilities on monthly or quarterly cycles.

  • Consumables on supplier terms.

4

Step 4: Add clinic level capex where relevant

If clinics have significant assets such as:

  • Fit outs and refurbishments.

  • Diagnostic equipment.

  • IT and medical devices.

Create Asset variables per clinic, for example:

  • Assets - Fit Out - Clinic City A.

  • Assets - Equipment - Clinic City A.

Set useful life and depreciation assumptions, and link capex and financing using standard Asset and Liability variables where required.

This ensures that each clinic bears its share of depreciation and financing costs in P&L and cashflow.

5

Step 5: Represent central overheads separately

Create a Central Overheads branch for costs that should not sit with any single clinic, for example:

  • Group leadership and administration.

  • Central marketing and branding.

  • Corporate systems, HR and finance.

  • Group debt and equity.

You can later allocate some or all of these overheads to clinics when reporting if desired, but keeping them in a separate branch maintains transparency.

6

Step 6: Build clinic level and group dashboards

Create dashboards that show, for each clinic:

  • Revenue by practitioner type or service line.

  • Staff cost and overheads by category.

  • Clinic level EBITDA and margin percentage.

  • Contribution after central overheads, if you choose to allocate them.

At group level, display:

  • Total revenue and EBITDA across all clinics.

  • Clinic comparison charts ranked by revenue, EBITDA or margin.

  • Simple traffic light or threshold views for underperforming clinics.

These dashboards support operational reviews and strategy discussions.

7

Step 7: Use scenarios for clinic openings, closures and turnarounds

Clone the base model into scenario models to test situations such as:

  • Opening a new clinic in a new location.

  • Closing or consolidating underperforming clinics.

  • Turning around a clinic with new staff, hours or services.

  • Changing central overhead allocation policies.

In each scenario, adjust:

  • Branch structure (adding or removing clinics).

  • Practitioner and revenue assumptions per clinic.

  • Cost, staffing and capex per clinic.

  • Central overhead assumptions and allocations if used.

Compare scenarios based on:

  • Clinic level and group level profit and cash.

  • Payback for new clinics and refurbishments.

  • Valuation effects for the group.


Check your work

circle-info
  • Clinics in the model align with how the organisation reports and manages performance.

  • Revenue, staff and overhead cost per clinic reflect recent actuals when calibrated.

  • Central overheads are clearly separated and not double counted in clinic branches.

  • Scenario results make sense to both finance and operational leaders.


Troubleshooting

chevron-rightSome clinics appear implausibly profitable or loss makinghashtag

Reconcile model revenue and cost assumptions for those clinics to actuals and check that central overheads are not misallocated or omitted.

chevron-rightIt is difficult to see the impact of central functions on clinicshashtag

Use reports that show both clinic level profit before allocations and profit after allocations, with a clear explanation of allocation drivers.

chevron-rightThe model feels too detailedhashtag

Group smaller clinics into a combined branch where appropriate and maintain detail for only the largest or most important sites.


Last updated