Revenue trajectory by engine
Customers & members
Logo count and total covered lives on the platform.
Y5 revenue mix
How the four revenue lines split at steady state.
5-year revenue build
| Line | Y1 | Y2 | Y3 | Y4 | Y5 |
|---|
Market sizing · TAM / SAM / SOM
TAM
Total Addressable
245M lives + $74B loan ceiling
$0B
SAM
Serviceable
~100M lives (95M ESI + 5M uninsured-employed)
$0B
— % of TAM · broker-reachable channel
SOM
5-Year Capture
— lives by Y5
$0M
— % of SAM · — % of TAM
Penetration Sensitivity · What-if reference
Capture % of TAM
Implied revenue: $0
Capture % of SAM
Implied revenue: $0
Method: TAM: Subscription + Success TAM use 245M lives at full Octi-eligible OOP rate. Financing TAM anchors to $74B annual US medical borrowing × Y3+ take rate (channel-agnostic). SAM: 100M lives (95M ESI at broker-reachable employers + 5M uninsured-employed at the same employers) × current scenario's slider values. SOM: Y5 ARR from the active scenario's broker funnel. Each customer's workforce includes ~5% uninsured members, representing a 1% total revenue uplift.
Base vs Aggressive · Side-by-side
Static comparison at default scenario values. Move sliders to see live SOM in the headline KPIs above.
| Metric | Base | Aggressive | Multiple |
|---|
How to read this model
Plan A - Flat PMPM bills employers a fixed monthly fee per member (employee + dependents). Predictable revenue, no risk-sharing, easier broker sell.
Plan B - Hybrid is a lower base PMPM plus a success fee on the dollars Octi saves the patient. Eligible bills/member × avg OOP × reduction % × success fee % drives this line.
Patient Financing rolls out in phases: Y1 not active, Y2 referral, Y3+ balance-sheet lender. The take rate that year flows through the financing revenue line.
The warning banner appears if you stack 4+ aggressive sliders simultaneously.
Plan B - Hybrid is a lower base PMPM plus a success fee on the dollars Octi saves the patient. Eligible bills/member × avg OOP × reduction % × success fee % drives this line.
Patient Financing rolls out in phases: Y1 not active, Y2 referral, Y3+ balance-sheet lender. The take rate that year flows through the financing revenue line.
The warning banner appears if you stack 4+ aggressive sliders simultaneously.
Sources
- LoansWest Health–Gallup (Mar 2025): 12% of US adults (~31M) borrowed $74B for healthcare in 2024.
- LoansWest Health press release — $74B borrowed across age and income groups.
- LoansIBISWorld — US Medical Patient Financing industry ~$18.2B (2025), 4.1% CAGR.
- CompPayZen — $32M Series B + $200M debt facility; ~6× YoY growth (2024).
- CompPhreesia–AccessOne acquisition — ~$35M annualized revenue, $160M deal (Nov 2025).
- MarketKFF 2025 Employer Health Benefits Survey — 154M on ESI, 67% self-funded ≈ 103M lives.
- MarketKFF — ~$220B total US medical debt; ~100M adults affected.
- ErrorsHealthSureHub — 49–80% of medical bills contain errors; avg overcharge ~$1,300 on bills >$10k.
- ErrorsCFPB-aligned reporting — $88B of medical debt on US credit reports.
- CompShortlister — full benefits-navigation vendor list (Quantum, Accolade, Rightway, HealthJoy) Q2 2025.