Telehealth Econ
🛡️ Public data only — no PHI permitted on this instance.
Telehealth Economics Analyzer
Visit-level P&L · provider productivity · state parity · tech stack · PHE cliff exposure · DTC comparables — 1,630 corpus deals
Annual Visits
876,000
Annual Revenue
$75.8M
Blended GM
65.6%
Provider FTE
579
States Operating
48
Visit Types
8
Reg Cliffs
5
Corpus Deals
1,630
Visit-Type Economics (P&L by Visit Category)
| Visit Type | Reimbursement | Direct Cost | Gross Margin | GM % | Duration (min) | Annual Volume | Annual Revenue ($M) |
|---|---|---|---|---|---|---|---|
| Urgent Care (Acute Low) | $68.00 | $22.00 | $46.00 | 67.6% | 15 | 180,000 | $12.24 |
| Primary Care Async | $48.00 | $16.50 | $31.50 | 65.6% | 12 | 240,000 | $11.52 |
| Primary Care Sync | $118.00 | $42.00 | $76.00 | 64.4% | 18 | 95,000 | $11.21 |
| Behavioral Health (45-min) | $165.00 | $58.00 | $107.00 | 64.8% | 45 | 125,000 | $20.62 |
| Psychiatry Med Management | $95.00 | $34.00 | $61.00 | 64.2% | 25 | 85,000 | $8.07 |
| Dermatology Async Photo | $58.00 | $14.50 | $43.50 | 75.0% | 8 | 48,000 | $2.78 |
| Chronic Care Management | $42.00 | $12.00 | $30.00 | 71.4% | 20 | 68,000 | $2.86 |
| Specialty Consult (Endo, Cardio) | $185.00 | $72.00 | $113.00 | 61.1% | 30 | 35,000 | $6.47 |
Provider Productivity by Specialty
| Specialty | FTE | Visits/Provider/Day | Utilization | Avg Rev/Provider ($k) | Attrition |
|---|---|---|---|---|---|
| Primary Care | 128 | 22 | 78.0% | $685 | 18.0% |
| Urgent Care (PA/NP) | 185 | 28 | 82.0% | $465 | 22.0% |
| Psychiatry | 62 | 12 | 88.0% | $1,085 | 14.0% |
| Behavioral Health Therapy | 142 | 8 | 85.0% | $525 | 24.0% |
| Dermatology Teledermatology | 38 | 45 | 72.0% | $825 | 12.0% |
| Specialty Consult | 24 | 10 | 68.0% | $1,285 | 15.0% |
State-Level Payer Parity Status
| State | Parity | Medicaid | Medicare | Commercial | Sunset Risk |
|---|---|---|---|---|---|
| California | full parity | permanent | temp extension | full | low |
| New York | full parity | permanent | temp extension | full | low |
| Texas | service parity | permanent | temp extension | limited | medium |
| Florida | service parity | permanent | temp extension | limited | medium |
| Illinois | full parity | permanent | temp extension | full | low |
| Pennsylvania | full parity | permanent | temp extension | full | low |
| Ohio | service parity | permanent | temp extension | limited | medium |
| North Carolina | service parity | permanent | temp extension | limited | medium |
| Georgia | no parity | permanent | temp extension | limited | high |
| Virginia | full parity | permanent | temp extension | full | low |
Technology Stack Cost Structure
| Component | Annual Cost ($M) | % of Revenue | Vendor | Renewal |
|---|---|---|---|---|
| Video Platform (Zoom Enterprise / Twilio Live) | $2.40 | 1.40% | Twilio Live | auto-renew 2027 |
| EHR/Practice Management | $4.20 | 2.50% | athenahealth | 3-yr through 2028 |
| Patient Portal + Scheduling | $1.80 | 1.10% | Epic MyChart OEM | annual |
| eRx + DEA EPCS | $0.90 | 0.50% | Dr First | annual |
| Billing / RCM Technology | $2.80 | 1.70% | Waystar | 3-yr through 2027 |
| AI Scribe / Ambient | $1.20 | 0.70% | DAX Copilot | annual pilot |
| Security / Compliance / HIPAA | $1.60 | 1.00% | Drata + Vanta | annual |
| Telephony / Call Center | $2.10 | 1.30% | Five9 | 3-yr through 2028 |
Regulatory Cliff Exposure (PHE / Ryan Haight / Home Originating)
| Policy | Status | Expiration | Revenue at Risk ($M) | Mitigation |
|---|---|---|---|---|
| Medicare Telehealth Expansion (PHE-era flexibilities) | extended through 2025 | 2025-12-31 | $28.50 | Advocate for permanent codification via TCEA / bipartisan legislation |
| DEA Special Registration (Ryan Haight) | extended through 2025 | 2025-12-31 | $12.00 | Implement in-person touchpoint model; DEA special registration application |
| Home as Originating Site | PHE-era extension | 2025-12-31 | $18.50 | Rural site-of-service enablement; telehealth-first strategy |
| Interstate Licensure Compacts (IMLC) | state-by-state | varies | $8.20 | Enroll providers in IMLC; licensure automation tooling |
| Audio-Only Coverage | PHE extension | 2025-12-31 | $4.50 | Shift to video-first where feasible; grandfathered by some MA plans |
| Behavioral Health Telehealth Parity (CMS 2023 rule) | permanent | n/a | $0.00 | No action needed |
Comparable DTC / Telehealth Platforms
| Company | Visit Type | Price/Visit | Subscription/mo | Status |
|---|---|---|---|---|
| Teladoc Health | Primary Care + BH | $0.00 | $0.00 | public, enterprise B2B2C |
| Hims & Hers | DTC Men's/Women's Health | $85.00 | $45.00 | public, subscription-led |
| Ro (Roman) | DTC Telehealth + Pharmacy | $95.00 | $15.00 | private, hybrid |
| Lifestance Health | Behavioral Health (in-net) | $0.00 | $0.00 | public, payer-network |
| Included Health (VC) | Enterprise Concierge | $0.00 | $0.00 | private, B2B |
| Galileo Health | Primary Care + Behavioral | $0.00 | $0.00 | VC, employer-paid |
| 98point6 | Primary Care (exited DTC) | $0.00 | $0.00 | pivot to enterprise |
| MDLIVE (Evernorth acq) | Primary Care / Urgent | $0.00 | $0.00 | payer-owned |
Telehealth Thesis: 876,000 annual visits produce $75.8M at 65.6% gross margin.
Behavioral health and specialty consult are highest-margin visit types; async primary care has highest volume.
579 provider FTE across 48 states with IMLC coverage. Cumulative regulatory cliff exposure $71.7M
concentrated in PHE-era Medicare flexibilities and DEA Ryan Haight telecontrolled-substance prescribing. Mitigation via bipartisan TCEA legislative push
and in-person touchpoint model for DEA compliance. Behavioral-health telehealth parity is now permanent — the safest revenue stream post-PHE.