Healthcare Demo Model

TDABC Profitability Model
FY 2025 - Restricted Access

Incorrect password. Try again.
Demo access please contact:
miguel.guimaraes@costctrl.com

P&L Overview

Full Year 2025 - HealthClinics

FY 2025
Total Revenue
€4.56M
45,600 consultations
Direct Service Costs
-€1.82M
39.9% of revenue
Gross Margin
€2.74M
60.1%
Net Profit
€114K
2.5%
Clinical Staff Costs
-€2.12M
46.5% of revenue
Operating Margin
€620K
13.6%
Support Departments
-€506K
11.1% of revenue
Clinics
8
30 doctors · 115 staff
Waterfall P&L
P&L Detail
Monthly Revenue & Cost Trend (FY 2025)

Whale Curve

Cumulative Profitability Distribution - 4 P&L Layers

PARETO
Dimension
By Doctor
By Service
By Patient
By Treatment
By Consultation
P&L Layer
Revenue
Gross Margin
Operating Margin
Net Profit
Whale Curve

Multi-Dimensional P&L

Clinic x Doctor x Service Type

TDABC
By Clinic
By Doctor
By Service
P&L by Clinic
Treemap - Revenue by Clinic (size) & Operating Margin (color)
P&L by Doctor
P&L by Service Type

Profitability Heatmap

Clinic x Service Type - Operating Margin %

HEAT
Heatmap - Clinic x Service Type (Operating Margin %)
Treemap - All Doctors (Revenue size, Margin color)

Service Analysis

16 Service Types - Performance & Profitability

16 SERVICES
Revenue by Service Type (€)
Operating Margin by Service Type (%)
Service Detail Table

Functional Profile

Staff Profiles with Cost Allocation

STAFF
Total Staff
115
30 doctors, 24 nurses, 61 support
Best Doctor Margin
Dr. R. Carvalho
43.8% op. margin
Total Clinical FTEs
70
30 doctors + 24 nurses + 16 auxiliares
Worst Doctor Margin
Dr. P. Mendes
-26.7% op. margin
Staff Cost Allocation by Role
Cost per Consultation by Clinic

Clinic Analysis

8 Clinics across Portugal

8 CLINICS
Revenue by Clinic
Operating Margin by Clinic (%)
Clinic Detail Table

Cost Drivers TDABC

Cost Pool Breakdown & Allocation

TDABC
Clinical Staff
-€2.12M
46.5% of revenue
Direct Service
-€1.82M
39.9% of revenue
Support Depts
-€506K
11.1% of revenue
Total Costs
-€4.45M
97.5% of revenue
Cost Distribution (Donut)
Costs as % of Revenue
TDABC Cost Pool Detail

Doctor Detail

30 Doctors - Individual Profitability Ranking

30 DOCTORS
Profitable Doctors
20 / 30
66.7% profitable
Loss-Making Doctors
10 / 30
destroying €168K profit
Best Doctor
Dr. R. Carvalho
43.8% op. margin
Worst Doctor
Dr. P. Mendes
-26.7% op. margin
Doctors - Operating Margin Ranking (%)
Revenue vs Operating Profit (€)
Full Doctor P&L Table

TDABC Capacity

Time Capacity Utilization by Doctor & Nurse

CAPACITY
Average Utilization
67.8%
54 clinical pools
Excess Capacity Cost
-€683K
32.2% of staff costs
Pools >80% Util.
6 pools
Overloaded risk
Total FTEs
54 FTE
30D + 24N
Capacity Utilization by Doctor (%)
Efficient (50-80%)Low Util. (<50%)Overload (>80%)
Capacity Detail Table

AI Insights

Recommendations by Decision-Maker Profile

AI
CostCtrl TDABC - Automated Analysis

Profitability Insights - HealthClinics

TDABC analysis of 45,600 consultations across 8 multi-specialty clinics in FY 2025. Net margin of 2.5% is thin. The whale curve reveals massive cross-subsidization between doctors and clinics.

Clinical Director
Operations Director
CFO
CEO
1

10 Doctors with Negative Operating Margin

URGENT
Ten doctors are operating at a loss after TDABC allocation. Dr. P. Mendes is the worst at -26.7% operating margin, followed by Dr. L. Neves (-21.8%), Dr. H. Pinto (-20.0%), and others. Combined, they destroy ~€168K of operating profit annually. Their consultation volumes are low relative to their allocated costs.
Potential Impact
+€168K/yr
Correcting loss-making doctors
Action: Immediate review of workload allocation and consultation scheduling for loss-making doctors. Consider volume targets or contract restructuring.
2

Fisioterapia & Analises Clinicas Under-Priced

PRICING
Fisioterapia (€40/session) and Analises Clinicas (€35/test) have operating margins below 6% despite high volumes. The time required per session combined with specialist costs makes these near break-even. Market pricing suggests a 15-20% uplift is achievable on both service lines.
Revenue Uplift
+€95K/yr
15% price increase on low-margin services
Action: Benchmark pricing against 3 comparable multi-specialty providers. Propose price adjustment in next contract cycle for Fisioterapia and Analises.
3

Porto Centro & Lisboa PN Top Performers

BEST PRACTICE
Porto Centro (27.2% op. margin) and Lisboa Parque das Nacoes (22.0%) significantly outperform the group average (13.5%). Key drivers: higher consultation volume per doctor, efficient scheduling, and strong service mix weighted toward Cardiologia, Imagiologia, and Pequena Cirurgia. Their practices should be replicated across the group.
Benchmark Target
20%+ margin
If all clinics match top 2
Action: Document operational practices at Porto Centro and Lisboa PN. Create standardization playbook for underperforming clinics.
1

Faro & Funchal Below Break-Even

CAPACITY
Faro (-6.3% op. margin) and Funchal (-12.8%) are struggling. Both are loss-making after TDABC staff allocation. Both clinics have 3 doctors each but only ~4,200 consultations/year vs the group average of 5,700. Fixed staff costs and island overhead (Funchal) crush margins. Capacity utilization is below 55%.
Optimization
+€140K/yr
If volume reaches group average
Action: Launch commercial push for new patient acquisition in Faro and Funchal. Consider reducing Funchal to 2 doctors until volume justifies 3.
2

Seasonal Margin Compression

OPERATIONS
July-August peak months (emigrant returns + summer injuries) show revenue up 30% but operating margin drops 3-4pp due to overtime costs. Staff overtime in peak months costs an additional €110K that could be avoided with better scheduling or temporary staff. Winter peaks (Jan-Feb) also compress margins.
Savings
€110K/yr
Overtime cost reduction
Action: Implement flexible staffing model with part-time contracts for peak seasons. Spread appointment scheduling more evenly across the year.
3

Pequena Cirurgia High-Margin Opportunity

GROWTH
Pequena Cirurgia (Minor Surgery) has the highest operating margin at 28.5% but only 1,100 consultations (2.4% of volume). This service requires specialist skills but commands premium pricing at €150/session. Growing this service by 50% would add €70K in operating profit.
Growth +50%
+€70K/yr
Minor Surgery expansion
Action: Create dedicated marketing for Minor Surgery services. Train 2 additional doctors for this service line. Equip Braga and Coimbra clinics.
1

2.5% Net Margin is Unsustainable

CRITICAL
At €114K net profit on €4.56M revenue, the business has minimal buffer against any revenue drop. A 3% revenue decline would push the business into loss. The TDABC model reveals that support department costs of €506K are the final straw - without them, operating margin is a healthier 13.6%. The question is whether support costs can be reduced or if revenue growth can absorb them.
Break-Even Buffer
2.5% only
€114K before loss
Action: Review support department costs for optimization. Target 10% reduction (€50K) in FY2026. Simultaneously push revenue growth to €5M.
2

Cross-Subsidization Between Clinics

ANALYSIS
Porto Centro and Lisboa PN generate €374K of operating profit combined, which subsidizes the thin margins at Faro, Funchal, and Setubal. Without the top 2 clinics, the remaining 6 would barely break even. This creates concentration risk - any disruption at Porto Centro would significantly impact the group.
Concentration
61%
Op. profit from 2 of 8 clinics
Action: Set clinic-level P&L targets. Each clinic should achieve minimum 10% operating margin. Create incentive structure tied to clinic profitability.
3

TDABC Reveals True Cost Per Consultation

VISIBILITY
Average revenue per consultation is €100 but true fully-loaded cost is €97.50, leaving only €2.50 net profit per consultation. However, the range is massive: best doctor generates €25/consultation profit, worst loses €22/consultation. This granular visibility was invisible before TDABC.
Visibility
€2.50
Net profit per consultation
Action: Embed TDABC cost-per-consultation metrics into monthly management reporting. Set minimum profitability threshold at €8/consultation.
1

3 Levers to Triple Net Profit

STRATEGY
The TDABC model identifies 3 clear levers: (1) Fix loss-making doctors (+€168K), (2) Grow underperforming clinics to average volume (+€140K), (3) Optimize support costs (-€50K). Combined, these would take net profit from €114K to €472K - a 4x improvement. The path is clear, the execution requires discipline.
Target Net Profit
€472K
4x current, achievable in 12-18 months
Action: Board presentation with 18-month transformation plan. Quarterly review of TDABC dashboard metrics. Tie management incentives to operating margin improvement.
2

Revenue is Vanity - Margin is Sanity

CULTURE
The organization has been managing by revenue - every clinic shows positive revenue, every doctor "contributes." The TDABC whale curve proves this is an illusion. The shift from revenue-focused to margin-focused management is the single most important cultural change needed.
Culture Shift
Revenue → Margin
Management paradigm
Action: Introduce monthly TDABC review meetings. Share whale curve with all clinic directors. Make operating margin the primary KPI in scorecards.
3

Scale to €5.5M Revenue with Current Structure

GROWTH
With 68% average capacity utilization, there is room to grow revenue to €5.5M without adding doctors. Each incremental consultation has very low marginal cost. Growing from €4.56M to €5.5M would take operating margin from 13.6% to ~20% and net profit from €114K to ~€600K due to operating leverage.
€5.5M Revenue Target
€600K+ NP
Operating leverage effect
Action: Develop commercial strategy to capture 20% more market share. Focus on specialties with highest margins (Pequena Cirurgia, Imagiologia, Cardiologia). Expand dental and physiotherapy offerings.

Statistics

Summary Metrics & Benchmarks - FY 2025

KPIs

Financial Summary

Total Revenue
€4.56M
FY 2025
Gross Margin
60.1%
€2.74M
Operating Margin
13.6%
€620K
Net Margin
2.5%
€114K
Revenue/Consultation
€100.00
45,600 total
Cost/Consultation
€97.50
Fully loaded TDABC
Net Profit/Consult.
€2.50
Range: -€22 to +€25
Break-Even Buffer
2.5%
Revenue decline to loss

Operational Metrics

Total Clinics
8
Across Portugal
Total Doctors
30
20 profitable, 10 loss
Total Staff
115
Multi-specialty
Avg Utilization
67.8%
Clinical staff
Avg Consult Time
22 min
Doctor + Nurse combined
Monthly Avg Rev.
€380K
Range: €320K-€450K
Best Clinic Margin
Porto Centro
27.2% operating margin
Worst Clinic Margin
Funchal
-12.8% operating margin
Top Doctors by Operating Margin
Clinics by Operating Margin

Model Architecture

TDABC Model - HealthClinics

MODEL

Time-Driven Activity-Based Costing - HealthClinics

The TDABC model allocates all operating costs to individual consultations based on time consumed by each resource pool. 8 multi-specialty clinics, 30 doctors, 24 nurses, 16 service types, ~45,600 annual consultations.

Revenue Layer

Consultation Revenue - €4.56M

16 service types ranging from €25 (vaccination) to €150 (minor surgery). Average €100/consultation. Volume-weighted by service mix per clinic across multi-specialty services.

Multi-Specialty Clinics

General practice, Paediatrics, Cardiology, Orthopaedics, Dermatology, OB/GYN, Ophthalmology, ENT, Psychiatry, Lab, Imaging, Physiotherapy, Minor Surgery, Nursing, Dental, Vaccination.

Direct Service Costs - €1.82M (39.9%)

Materials & Lab Costs

Consumables, lab analysis, reagents, imaging materials. Allocated per service type based on actual consumption. Range: €8-€60 per consultation depending on service complexity.

Clinical Consumables

Gloves, disposables, equipment depreciation. Fixed per consultation at €12 average. Reviewed quarterly.

Clinical Staff Costs - €2.12M (46.5%)

Doctors (30 pools) - €1.20M

TDABC: Cost per minute x actual consultation time. Individual rates calculated per doctor. Range: €0.85-€2.40/min based on specialty and seniority.

Nurses (24 pools) - €600K

TDABC: Cost per minute for triage, assessments, diagnostic support. Average rate €0.55/min. Support all 16 service types.

Auxiliares de Accao Medica (16) - €320K

Support clinical operations, patient flow, room preparation. Allocated by clinic headcount and volume.

Support Departments - €506K (11.1%)

Assistentes Tecnicos (reception) - €280K

12 receptionists + 6 customer service. Scheduling, billing, patient reception. Allocated by consultation volume.

Directors & Management - €180K

4 clinic directors. Strategic oversight, quality assurance. Allocated by clinic.

Facilities, IT, HR, Finance, Marketing - €526K

Cleaning €96K, HR €105K, IT €120K, Finance €100K, Logistics €60K, Marketing €45K. Allocated by headcount and area.

TDABC Rates

Cost per Minute by Doctor & Nurse

RATES

TDABC Cost Rates - FY 2025

Cost per minute calculated for each doctor and nurse based on total allocated salary divided by practical available capacity. Practical capacity = 80% of theoretical (384 min/day productive, 22 days/month).

Doctor Cost Rates (Top 15 by Volume)
Other Cost Pools - Fixed per Consultation
PoolTypeAnnual CostVolumeRate/Consult.Driver
Materials & LabDirect Service€1,824,00045,600€40.00Per service type
Assistentes TecnicosSupport€280,00045,600€6.14Volume proportional
DirectorsSupport€180,00045,600€3.95Per clinic
Facilities & Other SupportSupport€526,00045,600€11.54Area + headcount
Total€4,446,00045,600€97.50

Clinical Team

115 Staff across 8 Clinics

ORG

HealthClinics - Clinical Team

115 professionals distributed across 8 multi-specialty clinics in Portugal. 30 doctors, 24 nurses, 16 auxiliares, 12 assistentes tecnicos, 6 atendimento cliente, 4 directors, 8 cleaning, 3 HR, 3 IT, 4 finance, 3 logistics, 2 marketing.

Doctors (30) - by Clinic
Support Staff Summary
RoleCountDistributionAnnual CostTDABC Driver
Enfermeiros (Nurses)24~3 per clinic€600,000Time per consultation (min)
Auxiliares de Accao Medica16~2 per clinic€320,000Time per consultation
Assistentes Tecnicos (reception)121-2 per clinic€216,000Fixed per consultation
Atendimento ao Cliente6Central + large clinics€64,000Fixed per consultation
Directores41 per 2 clinics€180,000Per clinic
Limpeza (Cleaning)81 per clinic€96,000Area proportional
HR3Central€105,000Headcount proportional
IT3Central€120,000Headcount proportional
Finance/Contabilidade4Central€100,000Revenue proportional
Logistica/Compras3Central€60,000Volume proportional
Marketing2Central€45,000Revenue proportional
Total Non-Doctor Staff85€1,906,000

Assumptions

Model Methodology & Data Sources

METHODOLOGY

Model Assumptions - HealthClinics

The TDABC profitability model uses time-driven cost allocation with 54 clinical cost pools and 16 service types. FY 2025 data across 8 multi-specialty clinics. All values in euros, annual basis.

1. Revenue - Service Pricing

16 multi-specialty service types with prices ranging from €25 (vaccination) to €150 (minor surgery). Pricing based on market rates and agreement tables. Average revenue per consultation: €100.

2. Doctor Costs - TDABC by Time

30 doctors with individual cost/min rates calculated from (annual salary + benefits) / (practical capacity in minutes). Practical capacity = 80% of theoretical 480 min/day x 22 days/month x 12 months. Range: €0.85-€2.40/min.

3. Nurse & Auxiliar Costs

24 nurses with average rate €0.55/min. 16 auxiliares at €0.35/min. Includes triage, clinical assessments, patient preparation, post-procedure care. Total: €920K (20.2% of revenue).

4. Direct Service Costs

Materials, lab costs, imaging materials, consumables allocated per service type. Range: €8-€60/consultation. Imagiologia and Analises Clinicas are the highest direct cost services. Total: €1.82M (39.9% of revenue).

5. Support Departments

Admin/Reception (€280K), Directors (€180K), Facilities & shared services (€526K) allocated proportionally to consultation volume, clinic area, and headcount. Total: €506K (11.1%). This compresses net margin to 2.5%.

6. Capacity Calculation

Theoretical capacity: 480 min/day x 22 days/month x 12 months = 126,720 min/year per FTE. Practical capacity: 80% = 101,376 min/year. Capacity cost rate = Annual cost / Practical capacity. Unused capacity = (1 - utilization%) x cost.

7. Data Sources

CostCtrl platform with FY 2025 data. Clinical scheduling system (consultation times). HR system (salaries, headcount). Accounting (SAF-T PT integration). Validated by Clinical Director and CFO.

8. TDABC Methodology

Time-Driven Activity-Based Costing per Kaplan & Anderson. Cost pools defined by individual clinician. Time drivers measured from scheduling system. Monthly recalculation cycle. Full reconciliation with financial statements.

Project

CostCtrl Platform & Offering

CTA

CostCtrl - Healthcare Profitability Platform

This demo dashboard showcases the CostCtrl TDABC methodology applied to multi-specialty healthcare clinics. The platform transforms raw operational data into actionable profitability insights at the consultation level.

1. Data Integration

Automated ingestion from clinical scheduling systems, HR/payroll, accounting (SAF-T PT), and facility management. Minimal manual effort after initial setup.

2. TDABC Engine

Proprietary cost allocation engine. Handles unlimited cost pools and activity drivers. Monthly recalculation with full reconciliation to financial statements.

3. Whale Curve Analysis

Multi-layer profitability analysis from Revenue through to Net Profit. Identifies cross-subsidization patterns invisible in traditional P&L reporting.

4. Interactive Dashboard

17-page interactive dashboard with drill-down by clinic, doctor, service type, and time period. Heatmaps, treemaps, and scatter analysis.

5. AI Insights

Role-specific recommendations for Clinical Director, Operations, CFO, and CEO. Quantified impact estimates for each recommendation.

6. Advisory + SaaS

Initial advisory engagement (model design, data mapping, validation) followed by monthly SaaS subscription for automated updates and ongoing insights.

Next Step
See what CostCtrl reveals about YOUR organization

This demo uses fictional data for HealthClinics. The CostCtrl platform works with any healthcare group, clinic network, or service organization. We integrate with your existing systems and deliver actionable profitability insights within 4-6 weeks.

Contact CostCtrl miguel.guimaraes@costctrl.com
Healthcare Switch model