Introduction: Why Vanity Metrics Don’t Survive the Boardroom
Most telehealth founders show up to board meetings with dashboards full of vanity metrics: clicks, impressions, downloads, or “visits booked.”
The problem? Boards and investors don’t buy vanity. They buy predictability.
When diligence starts, the only numbers that matter are the ones that prove your growth is defensible, scalable, and compliant. CAC is part of that story — but it’s not the whole story.
This guide unpacks the telehealth metrics that actually drive valuation. If you’re a CEO or investor, these are the numbers you should track, report, and optimize around.
Section 1: CAC (Customer Acquisition Cost) — Necessary but Not Sufficient
CAC will always be the first metric boards ask about. But too many CEOs treat CAC as the end of the story.
What Boards Want to See
- CAC segmented by channel (ads, SEO, employer contracts).
- CAC trend over time (stable or rising?).
- CAC in relation to LTV (payback period).
Red Flag: CAC rising faster than LTV.
Green Flag: CAC stable or declining because of owned channels and contracts.
Section 2: LTV (Lifetime Value) — The Real Growth Lever
If CAC is the cost, LTV is the engine. Strong LTV is what allows telehealth companies to scale and secure premium multiples.
Key Drivers of LTV
- Retention (patients staying subscribed or engaged).
- Expansion revenue (labs, pharmacy, coaching upsells).
- Employer/payer contracts (built-in retention).
Investor Lens: Boards want to see LTV at least 3x CAC.
Section 3: Churn — The Silent Killer of Telehealth
Most CEOs underestimate churn. Patients drop off after a single consult or a few months of therapy.
What to Track
- Monthly churn rate.
- Cohort retention curves (not just averages).
- Churn by channel (DTC vs employer).
Investor Lens: High churn = fragile business. Low churn = compounding growth.
Section 4: Payback Period — The Efficiency Test
How fast do you recover CAC?
- DTC telehealth: 12 months or less is healthy.
- Subscriptions: 6 months or less is better.
- Employer/payer: payback can be immediate.
Red Flag: 18+ month payback.
Green Flag: <12 months, improving over time.
Section 5: Revenue Mix — Predictability vs. Fragility
Boards care about where revenue comes from:
- DTC one-off visits: Fragile, churn-heavy.
- Subscriptions: Predictable, recurring.
- Employer contracts: Durable, defensible.
- Insurance reimbursement: Attractive but variable.
Investor Lens: Diversified mix = stronger story. Overreliance on one channel = risk.
Section 6: Compliance Metrics — The Hidden Valuation Driver
Most CEOs forget compliance shows up in numbers too.
- % of vendor contracts with signed BAAs.
- of compliance incidents reported (or avoided).
- % of marketing spend flowing through HIPAA-safe channels.
Investor Lens: Compliance maturity = valuation premium.
Section 7: Fragile vs. Defensible Metrics — Case Example
Company A (Fragile):
- CAC $200, LTV $220.
- Churn 70%.
- Payback 15 months.
- Revenue mix = 90% DTC ads.
- Compliance incidents flagged.
- Valuation multiple = 2x.
Company B (Defensible):
- CAC $180, LTV $1,200.
- Churn 25%.
- Payback 3 months (subscription + employer).
- Revenue mix = 40% DTC, 40% employer, 20% insurance.
- HIPAA/HITRUST certified.
- Valuation multiple = 8x.
Lesson: Metrics aren’t just numbers. They’re the boardroom story.
Section 8: The Telehealth Metrics Audit Checklist
- Is CAC segmented by channel and trending stable?
- Is LTV at least 3x CAC?
- Is churn tracked by cohort and improving?
- Is payback <12 months?
- Is revenue diversified (subscriptions, contracts, insurance)?
- Do you have compliance metrics to show investors?
If you answered “no” to more than two, your metrics are a valuation risk.
Why You Need Operator-Level Metrics Early
Most CEOs realize too late that the wrong metrics kill valuation. By the time diligence starts, it’s too late to fix the story.
The right time to architect boardroom-ready metrics is before investors ask.
That’s why I built the Growth Clarity Diagnostic™.
In one focused session, we’ll:
- Audit your telehealth metrics.
- Reframe your growth story for boards and investors.
- Build a roadmap that ties CAC, LTV, and compliance to defensible multiples.
👉 [Book your Growth Clarity Diagnostic™ here.]
Because in telehealth, metrics aren’t marketing KPIs. They’re valuation levers.
FAQ
What’s the #1 metric telehealth boards care about?
LTV/CAC ratio. It signals whether your growth is sustainable.
What’s a healthy payback period in telehealth?
<12 months for DTC, <6 months for subscription, immediate for employer contracts.
How do investors view churn?
As a leading indicator of fragility. High churn = weak LTV. Low churn = strong retention.
Do compliance metrics really affect valuation?
Yes. Investors see compliance maturity as risk reduction. Strong compliance raises multiples.
What revenue mix is most attractive?
A balance of subscription, employer, and payer revenue. Diversification signals stability.
