Rivia Prepaid Provider Model Dashboard
Value-Based Care Economics - All financial figures in GHS
Model Parameters
Total Member Revenue
GHS 96,000.00
Gross Margin
GHS 46,000.00
Gross Margin %
47.92%
Avg Revenue Per Member
GHS 800.00
Health Credit Utilization
Source: CareHQ member utilization data
Cost Drivers Analysis
Source: Rivia claims analysis
Revenue Breakdown
Member Distribution by Plan
Profitability Analysis
Cost vs Revenue Per Member
Dynamic Insights
Virtual Care Opportunity
50% virtual visits will reduce total healthcare costs by 30% based on Rivia's pilot program data. This could save an estimated GHS 13,800 in the current model.
Source: Rivia Virtual Care Pilot (Q3 2025)
Medication Cost Management
Medication is the highest cost driver for 68% of members. Focusing on generic alternatives and therapeutic substitution could reduce pharmacy costs by 15-20%.
Source: Rivia Pharmacy Claims Analysis
Rivia's Value-Based Care Model
In this model, providers are not optimizing for billable hours and inflated costs but for "value-based care". Rivia amortizes the prepaid costs through large member signups - a fixed prepayment model guarantees access for members, caps costs, and enables sustainable growth.
Keep an eye on member utilization as it directly impacts provider economics and sustainability.
Financial Summary
| Metric | Value | Calculation |
|---|---|---|
| Provider Service Fee (Prepaid) | GHS 50,000.00 | Fixed Cost |
| Number of Members | 120 | Total Members |
| Average Cost Per Member | GHS 416.67 | Provider Fee / Number of Members |
| GHS 1,000 Plan Members | 72 | 60% of Total Members |
| GHS 500 Plan Members | 48 | 40% of Total Members |
| GHS 1,000 Plan Revenue | GHS 72,000.00 | 72 Members × GHS 1,000 |
| GHS 500 Plan Revenue | GHS 24,000.00 | 48 Members × GHS 500 |
| Total Member Revenue | GHS 96,000.00 | Sum of All Plan Revenues |
| Average Revenue Per Member | GHS 800.00 | Total Revenue / Number of Members |
| Gross Margin | GHS 46,000.00 | Total Revenue - Provider Fee |
| Gross Margin % | 47.92% | Gross Margin / Total Revenue |
| Health Credit - GHS 1,000 Plan | GHS 6,000.00 | Per Member Annual Credit |
| Health Credit - GHS 500 Plan | GHS 2,500.00 | Per Member Annual Credit |
| Members Using 100% Credit | 24 | 20% of Total Members |
| Members Using 50% Credit | 48 | 40% of Total Members |
| Members Using 0% Credit | 48 | 40% of Total Members |