ClarWorks

Behind the model

How the clinic ROI model works

Every number in the calculator is derived bottom-up from your inputs — no black box. 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 tool and these relationships hold.

Capacity & utilization ramp

Annual capacity is daily throughput × operating days; volume is that capacity scaled by a utilization that ramps linearly from a soft-launch level to a stabilized plateau.

Annual capacity

daily capacity × operating days / year

80 × 312 = 24,960 visits/yr

Utilization ramp (linear)

start + (stabilized − start) × (year−1) ÷ (ramp yrs − 1)

40% → 70% over 3 yrs

Visits in a year

annual capacity × utilization(year)

year 1: 9,984 · stabilized: 17,472

Throughput / operating day

annual visits ÷ operating days

56 / day at stabilized

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)

stabilized: ₹33.7 L/yr

Consumables (variable cost)

visits × consumables/visit × (1 + opex esc)^(yr−1)

stabilized: ₹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)

stabilized: ₹5.29 L/yr

Total OpEx

doctor share + consumables + staff + rent + other + maintenance

stabilized: ₹1.02 Cr/yr

Revenue

Revenue is visits × billing per visit, with prices escalating each year. Volume follows the utilization 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 · stabilized: ₹1.35 Cr

Price escalation

price × (1 + 5%)^(yr−1)

5%/yr

EBITDA

revenue − total OpEx

stabilized: ₹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 utilization ramp, then principal amortizes 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 amortize

2 yr grace, 7 yr tenor

Equal-principal repayment

debt ÷ (tenor − moratorium) each amortizing 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 (amortizing 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

stabilized utilisation at which NPV = 0

68%

Per-visit unit economics

The stabilized 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

stabilized revenue ÷ stabilized visits

₹772

Doctor share / visit

revenue/visit × 25%

₹193

Consumables / visit

stabilized consumables ÷ stabilized visits

₹79

Contribution / visit

revenue/visit − consumables/visit − doctor share/visit

₹500

OpEx / visit

stabilized total OpEx ÷ stabilized visits

₹581

EBITDA margin

stabilized EBITDA ÷ stabilized revenue

25%

These are transparent planning estimates, not a quote. A real clinic or diagnostic centre needs a proper feasibility study and DPR — that’s where we help. Open the calculator →