Fractional CFO for EHR & practice management companies
EHR and practice management is vertical SaaS layered on a healthcare billing engine. Epic and Cerner own the hospital tier; the venture-backed opportunity sits in specialty ambulatory, behavioural health, dental, optometry, PT and long-term care, with RCM increasingly bundled in so a meaningful slice of revenue is collections-linked.
Finance work splits cleanly into three streams reconciled monthly: subscription revenue tied to provider counts that drift with hiring and attrition, transactional revenue from clearinghouse and claims volume, and RCM revenue net of a 90-plus-day payment lag. NRR is per-provider, gross margin is split by stream because services drag the blend, and implementation backlog is a working-capital line in its own right.
Flow provides financial modelling, FP&A and fractional CFO advisory to EHR and practice management companies across specialty ambulatory EHRs, behavioural and dental practice platforms, post-acute and long-term care systems, RCM-led businesses and clearinghouse infrastructure. Our startup CFO team handles the per-provider FP&A and RCM accounting that vertical SaaS investors expect.
KPIs to track for "EHR & practice management" startups
We're very 'KPI-driven' fractional CFOs, and we make sure to monitor the right metrics for your startup.
Active providers
Practices live
Net revenue per provider
Encounters processed
Claims processed
RCM attach rate
Net retention
Gross retention
Days in AR
Gross margin
Financial modelling for "EHR & practice management" startups
As fractional CFOs, we build KPI-driven financial models that are insightful and easy to maintain.
Financial modelling is both art and science - models must be robust, but also understandable, and useful for both internal planning and VC fundraising purposes. Hire a fractional CFO who knows how to handle both sides of the equation.
Per-provider ARR waterfall
ARR built up at provider count rather than practice count, with new providers, hiring and attrition inside existing practices, expansion modules and churn separated. The metric per-provider acquirers actually look at.
Subscription, transactional and RCM split
Three revenue streams reported separately each period, with their own recognition pattern, gross margin and cash conversion. Bundling them into one ARR line hides that RCM lags collections by 90-plus days while subscription is prepaid.
RCM and claims volume model
Claims processed, clean-claim rate, payer-mix-weighted collection rate and contingency or per-claim revenue layered against the 90-to-180-day collection cycle. The line that breaks the cash forecast when payer mix or denial rate moves.
Implementation backlog as working capital
Signed contracts not yet live tracked as backlog with the implementation services revenue, go-live timing and the working-capital cost of carrying the build. Surfaces whether implementation capacity is the actual growth constraint.
Gross margin by stream
Subscription margin held up against transactional margin and services-heavy RCM margin, with the blend explained. Avoids the common error of reporting an aggregate gross margin that looks weaker than the platform margin alone.
Days in AR and collection cycle
Practice-level AR aged by payer and procedure category, against the platform's own AR for subscription and services revenue. Two collection cycles run in parallel inside one P&L and each has to be planned for.
Founders and investors we've worked with
We've supported winning builders across EHR & practice management and beyond.
Cannadorf
As a fractional CFO we helped Cannadorf, an Israel-based pharma-grade medical cannabis leader applying tissue culture technologies, build out its financial plan ahead of scaling production.
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Cannabis Innovation Center
We acted as fractional CFO to Cannabis Innovation Center, a Tel Aviv-based medical cannabis group developing multiple cannabis-based therapies, providing internal valuation guidance.
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BiomX
As a fractional CFO we performed a confidential valuation of BiomX, a Tel Aviv-based clinical-stage microbiome therapeutics company, supporting Elevator Fund's portfolio management.
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TBô
We acted as fractional CFO to TBô, a Zurich-based tech-enabled DTC male underwear brand, building a bottom-up financial / operating model with cohort-level KPIs and positioning the company for its next venture round.
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Onlogist
We acted as fractional CFO to Onlogist, a Hamburg-based online marketplace for last-mile vehicle transfer, providing confidential valuation guidance and operating model support.
See moreRecent fractional CFO track record
See our fractional CFO and financial modelling experience across EHR & practice management and beyond.
Simple pricing
No hidden costs, no complicated long-term contracts. We understand how important flexibility is for EHR & practice management startups.
Per month
- Accounting / FP&A tech stack implementation
- Monthly financial statements and reporting pack
- Quarterly board pack with detailed financial analysis (with variance analysis vs. budget, relevant KPI observations etc.)
- Investor-friendly output
Per month
- Everything in Core, plus
- Operating model (via an online platform like Runway or Excel-based)
- Ongoing model maintenance, refining projections, burn/runway management
- Customer cohorts modelling, churn and retention analysis
- LTV / CAC, unit economics analysis
- Cap table management
Per month
- Everything in Grow, plus
- M&A / fundraising support; review of business plan
- Pitch deck preparation
- Investor approach strategy / list building
- Due diligence support and deal negotiation
- Valuation as required and free access to Multiples Pro
Packages shown are illustrative, final pricing is tailored to client requirements.
Explore our fractional CFO offering for similar verticals
We're a specialized fractional CFO to digital health companies.
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We provide fractional CFO services to companies operating across the entire tech.
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We help you scale by providing fractional CFO advice, through fundraising and a successful M&A exit.
VC fundraising for EHR & practice management companies
We help you prepare materials, reach out to investors in our extensive network, negotiate fair term sheets and structure the VC round.
Learn moreM&A for EHR & practice management companies
We advise winning tech companies on M&A exits, and over the years successfully executed numerous transactions with both financial and strategic buyers.
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