Behind the model
How the clinic ROI model works
Every number in the model is worked out from your inputs; nothing is hidden. Below is each formula, paired with a worked example from the default 80 visits/day build (₹1.2 Cr total CapEx, 70% debt over a 7-yr tenor). Change any input in the model and the same formulas apply.
Capacity & utilisation ramp
Annual capacity is daily throughput × operating days; volume is that capacity scaled by a utilisation that ramps linearly from a soft-launch level to a stabilised plateau.
Annual capacity
daily capacity × operating days / year
80 × 312 = 24,960 visits/yr
Utilisation ramp (linear)
start + (stabilised − start) × (year−1) ÷ (ramp yrs − 1)
40% → 70% over 3 yrs
Visits in a year
annual capacity × utilisation(year)
year 1: 9,984 · stabilised: 17,472
Throughput / operating day
annual visits ÷ operating days
56 a day once settled
CapEx: build cost
Equipment + fit-out + licence lines (AERB/PC-PNDT, NABL/NABH, Clinical Establishments + BMW + fire NOC), then contingency, then interest-during-construction (IDC). India note: GST on the build (5% on most devices post Sep-2025, 18% on fit-out services) is a sunk cost, healthcare output is GST-exempt, so there is no input credit. CapEx per annual visit is an output, never an assumption.
Base CapEx
equipment + fit-out + Σ line items
₹80 L + ₹24 L + ₹5 L = ₹1.09 Cr
Contingency
base × 8%
₹8.72 L
Sub-total
base + contingency
₹1.18 Cr
Interest during construction (IDC)
total × debt% × interest% × (months ÷ 12) × ½
6 mo → ₹2.16 L
Total project cost
sub-total + IDC
₹1.2 Cr
CapEx per annual visit (derived)
total project cost ÷ annual capacity
₹480 / visit
OpEx: annual running cost
Two costs scale with activity, consumables (per visit) and the doctor share (% of revenue). Staff, rent and other fixed lines plus a maintenance % of CapEx escalate each year. India note: healthcare output is GST-exempt, so the 18% GST on rent and AMC is a sunk cost with no input credit, enter GST-inclusive amounts.
Doctor / consultant share
revenue × 25% (tracks revenue, not the opex escalator)
stabilised: ₹33.7 L/yr
Consumables (variable cost)
visits × consumables/visit × (1 + opex esc)^(yr−1)
stabilised: ₹13.7 L/yr
Rent (Indian convention)
₹/sqft/month × carpet sqft × 12 = 60 × 2,000 × 12
₹14.4 L/yr (base)
Staff / rent / other (escalated)
base × (1 + 6%)^(yr−1)
₹20 L staff · ₹14.4 L rent · ₹9 L other
Maintenance
CapEx (excl. IDC) × 4% × (1 + esc)^(yr−1)
stabilised: ₹5.29 L/yr
Total OpEx
doctor share + consumables + staff + rent + other + maintenance
stabilised: ₹1.02 Cr/yr
Revenue
Revenue is visits × billing per visit, with prices escalating each year. Volume follows the utilisation ramp (and per-phase ramps for a staged build). Healthcare services are GST-exempt, billings carry no GST.
Revenue
visits × price/visit × (1 + price esc)^(yr−1)
year 1: ₹69.9 L · stabilised: ₹1.35 Cr
Price escalation
price × (1 + 5%)^(yr−1)
5%/yr
EBITDA
revenue − total OpEx
stabilised: ₹33.3 L (25% margin)
Phased build (vintages)
each phase commissions in its year, then ramps from scratch on its own clock
default: all at once
Financing: debt, moratorium, tax & depreciation
Debt with an interest-only moratorium during the utilisation ramp, then principal amortises over the remaining tenor. Depreciation follows the Income-tax Act's 40% written-down-value rate for life-saving medical equipment by default (straight-line optional), and tax carries losses forward.
Debt / equity split
debt = total cost × debt% ; equity = remainder
₹83.9 L debt · ₹36 L equity
Principal moratorium
interest-only for the first N years from opening, then amortise
2 yr grace, 7 yr tenor
Equal-principal repayment
debt ÷ (tenor − moratorium) each amortising year
₹16.8 L / yr over 5 yrs
Annuity (EMI) option
debt × r ÷ (1 − (1+r)^−(tenor−moratorium))
level-payment alternative
Interest
outstanding balance × interest rate
year 1: ₹8.81 L
Depreciation: WDV 40% (default)
dep(yr) = CapEx × 40% × 60%^(yr−1), declining balance, front-loaded
yr 1: ₹48 L · yr 3: ₹17.3 L
Depreciation: straight-line option
total CapEx (incl. IDC) ÷ 7 yrs
₹17.1 L/yr for 7 yrs
Tax (with loss carryforward)
max(0, PBT − losses) × 25% ; losses carry forward
WDV's big early write-offs + ramp losses shelter the first profitable years
Returns & coverage
The unlevered cash flows give the project view; the equity cash flows give the geared view. Project IRR excludes the interest shield so it is financing-independent. A longer build window defers first revenue.
Unlevered (project) FCF
EBITDA − project tax − CapEx (project tax excludes interest)
Project IRR 14.2%
Equity FCF
PAT + depreciation − principal − equity-funded CapEx
Equity IRR 19.7%
NPV
Σ unlevered FCF ÷ (1 + discount)^t
@ 13% = ₹7.3 L
Construction lead
ceil(months ÷ 12) − 1 zero-revenue years inserted after t=0
0 (≤12-mo build)
Payback
year cumulative unlevered cash flow first turns positive
5.2 yr
DSCR
CFADS ÷ debt service ; CFADS = EBITDA − tax (amortising years only)
min 1.30× · avg 1.55×
LLCR
PV(CFADS over loan life) ÷ debt
1.35×
Equity multiple (MOIC)
Σ equity cash returned ÷ equity invested
3.97×
Break-even utilisation
stabilised utilisation at which NPV = 0
68%
Per-visit unit economics
The stabilised year reduced to a single visit, the numbers that tell you whether the clinic works at the margin. Contribution nets BOTH per-visit costs: consumables and the doctor's share of the fee.
Revenue / visit
stabilised revenue ÷ stabilised visits
₹772
Doctor share / visit
revenue/visit × 25%
₹193
Consumables / visit
stabilised consumables ÷ stabilised visits
₹79
Contribution / visit
revenue/visit − consumables/visit − doctor share/visit
₹500
OpEx / visit
stabilised total OpEx ÷ stabilised visits
₹581
EBITDA margin
stabilised EBITDA ÷ stabilised revenue
25%
These are planning estimates you can check line by line, not a quote. The typical Indian figures are assumptions from public sources, not ClarWorks data, and every one can be changed in the model. Open the model →
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