Tessic Health

BUILD VS BUY

What it costs to build your own telehealth stack

The worked example prices an in-house clinic line by line: the legal entities, provider licenses in all 50 states, the software team, audits and pharmacy contracts, then three years of running it. Tessic's published fees sit beside each line.

THE CALCULATOR

Change any number.

The page opens on a worked example. Edit any input and every figure, table and step updates as you type.

Tessic program to compare
Building it
Running it
The comparison

Worked example

Building your own costs $1,900,500 over 3 years. The same 3 years on Tessic Grow cost $87,000, and the clinic takes patients within days instead of 9 months.

Build it yourself, 3 years
$1,900,500
Tessic Grow, 3 years
$87,000
Time to first patient
9 months vs days
Profit missed while building
$90,000
9 months × $10,000; not in the totals
Line by line
Build it yourselfTessic Grow
Before the first patient (9 months to build)
Legal setup: MSO, professional corporation, management agreement$50,000Included
Provider licenses: 50 states × 2 providers × $1,500$150,000Included
Software: 2 engineers × 9 months × $15,000$270,000Included
Medical director during the build$45,000Included
Security program and first audit$60,000Included (HIPAA)
Pharmacy and lab contracts$25,000Included, 0% markup
Tessic setup fee—$15,000
Total before the first patient$600,000$15,000
Each year after launch
Engineers to run it: 2 × $15,000 a month$360,000Included
Software vendors: EHR, e-prescribing, video, hosting$48,000Included
Medical director$60,000Included
Compliance upkeep: audits and counsel$50,000Included
License renewals (40% of the license cost a year)$60,000Included
Tessic Grow platform fee—$24,000
Total per year$578,000$24,000
3-year total
All costs over 3 years$1,900,500$87,000

Visit fees and medication are left out of both columns: they grow with patients either way.

Year by year, running total
Build it yourselfTessic GrowDifference
End of year 1$744,500$39,000$705,500
End of year 2$1,322,500$63,000$1,259,500
End of year 3$1,900,500$87,000$1,813,500

How the numbers work

  1. Licenses: 50 states × 2 providers × $1,500 = $150,000.
  2. Software: 2 engineers × 9 months × $15,000 = $270,000.
  3. Add legal setup ($50,000), the medical director during the build ($45,000), the first security audit ($60,000) and pharmacy and lab contracts ($25,000): $600,000 before the first patient.
  4. Once live, running it costs $578,000 a year: engineers $360,000, vendors $48,000, medical director $60,000, compliance $50,000 and license renewals $60,000.
  5. Over 3 years the in-house clinic is live for 27 months: $600,000 + $578,000 × 27/12 = $1,900,500.
  6. Tessic Grow: $15,000 setup + $2,000 × 36 months = $87,000.

THE WORKED EXAMPLE

Where each default number comes from

Every input the worked example uses, and the reason for it. Tessic's own fees are published prices; everything else is an estimate to replace with your own.

Tessic program to compare
Grow: $2,000/mo + $15,000 setup
Grow includes the automation, integrations and analytics an in-house team would also have to build.
Legal setup
$50,000
Health-care counsel drafting the MSO (the management company that runs the business side), the professional corporation owned by a physician, and the agreement between them, plus a check of each state's telehealth rules. One to three months of hourly work.
States covered
50
A national brand needs a licensed provider in every state it sells into.
Providers licensed per state
2
Two providers per state keep a state open when one is out.
Cost per license, all-in
$1,500
An estimate covering board fees, fingerprints, verification, credentialing and a licensing service. State fees vary widely.
Engineers on the build
2
A small team building the storefront, intake, patient portal, subscriptions and the pharmacy connection on top of a licensed EHR.
Months to build
9 months
Legal comes first, and a new state license commonly takes 60 to 90 days from a complete application. Licensing, credentialing and pharmacy contracts depend on each other, so nine months is used here.
Cost per engineer per month
$15,000
Salary, payroll taxes, benefits and equipment for one US engineer.
Security program and first audit
$60,000
A HIPAA risk assessment and written policies, a penetration test and a first SOC 2 audit.
Pharmacy and lab contracts
$25,000
Counsel and engineering to contract a mail-order pharmacy licensed in every state it ships to, plus labs and cold-chain shipping for medications that must stay cold.
Engineers kept after launch
2
Two engineers keep a live medical platform patched, monitored and on call.
Software vendors per month
$4,000
EHR and e-prescribing licenses, including EPCS (electronic prescribing for controlled substances), video visits, HIPAA-grade hosting and text messages.
Medical director per month
$5,000
A physician who signs the clinical protocols and oversees providers, paid as a monthly stipend from the start of the build.
Compliance upkeep per year
$50,000
A yearly SOC 2 audit, HIPAA upkeep and counsel on retainer as state rules change.
Years to compare
3 years
Three years covers the build and more than two years of running the clinic.
Profit from one live month
$10,000
What the clinic would earn in a month once it is taking patients. Shown on its own and left out of the totals.

NOT COUNTED

What these numbers leave out

  • Visit fees and medication. Tessic charges $25 per completed visit and passes medication through at wholesale; an in-house clinic pays its own providers and pharmacy. Both grow with patients.
  • Recruiting providers, and the founder's own time managing the build.
  • Advertising, which costs the same either way.
  • Profit missed during the build. It is shown in its own tile and not added to the totals.

QUESTIONS

Questions founders ask

Why does building take so long?
Because the steps wait on each other. The legal entities have to exist before providers can be credentialed into them, a new state license commonly takes 60 to 90 days from a complete application, and pharmacies want to see a real clinical entity before they sign. The Tessic article "The real cost of launching a telehealth clinic" walks through the full ledger.
What does the Tessic setup fee cover?
Drafting the brand's MSO and friendly-PC structure, credentialing providers under the brand, contracting pharmacy and labs, and standing up the storefront and patient portal. Once the clinic is live, billing runs month to month.
Who owns the clinic on Tessic?
The brand. Patients, records and data belong to the brand by structure, and if it leaves, they leave with it. There is no long-term contract after setup.
What if the brand already runs its own EHR?
Tessic Prescribe plugs Tessic's licensed providers, pharmacy and prescribing into an existing EHR, live in under a week, at custom pricing.
Are these costs exact?
No. Every in-house number is an estimate, and the table above gives the reason for each one. Change any of them to match a real quote. The Tessic column uses published prices.

MORE CALCULATORS

Run the other numbers