Multi-clinic groups · Healthcare
Clinic-level contribution for multi-clinic groups, from opening day to break-even
A multi-clinic group grows by opening the next clinic, often before the last one has proved itself. We report each clinic's ramp-up, contribution and share of central cost from the day it opens. The decision to open another then rests on what earlier clinics actually took to break even.
In one paragraph
Primary-care, family-medicine, paediatric, physiotherapy, women's health and polyclinic groups usually run five to sixty clinics at ₹5–150 crore turnover. Each site is small, staffed by a few doctors and support staff. It earns from consultations, procedures, pharmacy and diagnostics, while the brand, technology and management sit centrally. Founders and chief executives, often with the head of operations, need to know what each site really adds.
Founder or chief executive, often with the head of operations
The economics
How the money moves in this trade
A clinic's revenue builds slowly as patients find it, while rent, staff and fit-out cost begin on opening day. The months to break-even and the cash consumed on the way are the central economics of the business. They vary widely by location, specialty and doctor. A group that opens clinics faster than it measures them can find its cash consumed by sites that will never pay back.
Revenue is a mix of consultation fees, procedures, in-clinic pharmacy and sample collection. Memberships, subscription plans and corporate contracts paid in advance are a growing share. Doctors may be salaried, paid per consultation or paid a share. Central costs — brand, technology, call centre, management — grow with the network, and the clinics have to bear them if the group is to make money.
The problem
Where the numbers usually break down
Ramp-up is not tracked by clinic
Each clinic's monthly result is reported, but not against a ramp-up path, so nobody can tell whether a new clinic is ahead or behind where earlier ones were at the same age.
Central cost is not allocated
Brand, technology and management cost sit at head office, so clinics look profitable while the group as a whole loses money.
Membership revenue is booked when sold
Annual memberships and subscription plans are recognised when paid, overstating revenue in the month of sale and hiding the service still owed.
Cash handling varies by clinic
Cash and card collections at the front desk are reconciled differently at each site, and small differences go unexplained.
Doctor payouts follow local arrangements
Each clinic has negotiated its own doctor terms, often recorded informally, and payouts are not reconciled to consultations billed.
What we do
The work, and the result each part produces
Clinic ramp-up reporting
Each clinic's revenue, contribution and cash consumed reported by month since opening and compared with earlier clinics.
New clinics are judged against the group's own experience.
Central cost allocation
Head-office cost allocated to clinics on a stated basis, with contribution shown before and after.
Clinic profitability reflects the cost of running the network.
Membership and contract revenue tracking
Memberships, subscriptions and corporate contracts recorded by member and recognised over the period of cover.
Revenue and the service still owed are stated correctly.
Front-desk cash controls
A standard daily collection reconciliation across all clinics, with differences investigated and reported.
Collections are complete and consistent at every site.
Doctor payout standardisation
Payout arrangements documented on a common basis and reconciled to consultations and procedures billed before release.
Payouts are checkable and comparable across clinics.
New clinic appraisal
Expected ramp-up, fit-out, rent and staffing for a proposed clinic modelled from the group's own clinic history.
The next clinic is opened with a realistic break-even date.
Where we start
The first steps of an engagement
Clinic ledgers and opening dates
We ask for clinic-wise billing and ledgers since each clinic opened, the head-office cost ledger, membership and corporate contract records, daily collection reports and each doctor's payout terms.
Ramp-up by opening cohort
Each clinic's revenue, contribution and cash consumed is laid out by month since opening. Newer clinics can then be compared with earlier ones at the same age.
One daily collection reconciliation
A single standard reconciliation of cash, card and UPI collections is put in place at every front desk, with differences investigated and reported.
Clinic contribution and ramp-up report
The first report shows contribution by clinic before and after central cost, months to break-even by opening cohort, and membership revenue still owed as service.
How it is measured
The reports the work is judged on
Each is recorded as a baseline before the work starts, so later reports have an honest comparison.
- Months to break-even, by clinic and opening cohort
- Clinic contribution before and after central cost
- Deferred membership and contract revenue
- Daily collections reconciled, by clinic
- Doctor payouts reconciled to billing
- Cash consumed by clinics still ramping up
Who it suits
Written for, and not the right fit for
- You need help with clinic registration, pharmacy licences or clinical protocols; those sit with your clinicians and the relevant authorities.
- You need the group's statutory audit or tax-audit report signed — that is the work of an independently engaged CA.
- Primary-care, paediatric, physiotherapy and specialty clinic groups with several sites.
- Groups selling memberships, health plans or corporate contracts.
- Founder-led groups planning a faster rollout or raising investment.
Services
Services this work draws on
MIS and financial planning
Reporting built around the questions you actually need answered.
Explore service ↗Outsourced accounting
Your books kept current and reconciled, closed to a published calendar.
Explore service ↗Internal controls and risk
Controls sized to your business, documented and actually tested.
Explore service ↗Fractional CFO services
Senior financial leadership on the days you need it, not a full-time hire.
Explore service ↗Every other service, also available in this trade
Common questions
Questions owners in this trade ask
How should central costs be allocated to clinics?
On a basis that reflects what drives them — revenue, visits or simply an equal share, depending on the cost. The basis matters less than using one consistently and showing contribution both before and after it.
When does a new clinic count as a failure?
When it's well behind the ramp-up path your earlier clinics followed, with no clear reason it will catch up. The report gives you that comparison; the decision stays with you.
Can you handle accounting for all our clinics?
Yes. A single chart of accounts and close process across every clinic is usually what makes clinic-level reporting possible in the first place.
5th Quadrant performs accounting, reporting, reconciliation and control work. Clinical establishment registration, pharmacy licences and clinical protocols are the group's own responsibility with its clinicians and the relevant authorities. Statutory audit and tax-audit reports are performed by independently engaged licensed professionals. Full detail is on our Professional Scope page.
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