Telehealth has been through a full cycle in five years - order-of-magnitude visit growth through 2020-21, then a higher-but-narrower baseline as in-person care returned and reimbursement parity was rolled back in several states. The businesses still scaling carry fee-for-service per-visit revenue, payer capitation, employer contracts and DTC subscriptions inside the same P&L, with cross-state provider licensure as the binding constraint as often as patient demand.

Finance work centres on the provider supply equation. Modelling visits requires modelling clinicians available to deliver them - by state, specialty, W-2 versus 1099, salary versus per-visit - reconciled against payer mix, no-shows and denial patterns. Payer AR runs 60 to 120 days and has to be aged at the payer level, while DTC subscription revenue tracks alongside with a different recognition pattern. Most operators also have a prescribing line where controlled-substance policy can move utilisation overnight.

Flow provides financial modelling, FP&A and fractional CFO advisory to telemedicine and telehealth companies across DTC virtual care brands, employer and payer-contracted virtual primary care, condition-specific specialty clinics, hybrid networks and asynchronous prescribing platforms. Our startup CFO team builds the segmented FP&A and financial modelling that separates contracted revenue from DTC.