The arc, in one paragraph
Maywell today is a ~$2.4–2.7M run-rate interventional pain practice that is Brian-gated on procedures, leaking a quarter of booked capacity, converting 61% of referrals, and sitting on ~$972K of expected net already in process. The two-year move: stop the leaks with capacity that already exists (call center, Ops Board, recall queues) → add the second engine (12F routed per-payer, second interventionalist, recurring chassis) → convert the operating system itself into the asset (outcomes dataset, compliance file, productized IP), so that by month 24 there are three live options — sell into Total Ortho, compound standalone, or license the platform — and none of them is forced.
Days 91–180 · Nov 14, 2026 – Feb 11, 2027
12F live. Recurring proven.
- Suite operational — Quad A passed, anesthesia class decided; cases follow the per-payer routing table (Medicare/commercial in-house; NF/WC/lien stays at the ASC).
- NDC margin capture live — bupivacaine + contrast billed in-office for drug-paying carriers, reconciled monthly against supply cost.
- Membership 25–40 · RTM ≥100 enrolled · RFA recall at steady state on the board.
- Attrition program v1 — true-loss 24% → under 20%.
- TO decision forced by ~day 150 — LOI terms on the disciplined math, or a formal walk and the second-interventionalist search opens the same week. The deal may not drift.
- Quantum on measured footing — three monthly sent-list reconciliations done; rent executed with the FMV file.
Day-180 gate: 12F utilization ≥60% · members ≥25 · RTM ≥100 · true-loss <20% · TO decision memo dated · first arbitration awards logged · booking ≥68%.
Days 181–360 · Feb 12 – Aug 15, 2027
The second engine.
- Break the Brian-gate — second interventionalist producing; success is structural: procedures/wk no longer capped by Brian's calendar.
- Recurring becomes a P&L line — membership 75–100 ($250–450K prepaid); recurring ≥15% of collections.
- Booking ≥75%, true-loss <15% — the call center's two numbers, a year in.
- Outcomes dataset v1 published — the year-2 option maker. It cannot slip.
- Compliance file diligence-ready; accrual model becomes empirical from measured awards; AR normalized and books audit-ready even if no one audits.
Day-360 gate: not-Brian interventional ≥25% · recurring ≥15% of collections · members 75–100 · outcomes report v1 published · measured arbitration curve live · normalized run-rate ≥$3.5M.
Year 2 · Aug 2027 – Aug 2028
Platform optionality — three live options, none forced.
- Option A — the TO division deal: division P&L with settlement-timing curve, audited-quality financials, measured capture rate, outcomes data → a disciplined multiple on real EBITDA.
- Option B — standalone compounding: $4M+ normalized; membership 100+ with proven renewal; recurring ≥20%; the empty quadrant occupied in public.
- Option C — the platform: IP licensed never assigned (WC Note Writer, CDS, RSS router, the ops-board OS). Prices the system, not Brian's hands.
- Fixed regardless: Rida NIW filing (late 2027, carried by the published outcomes work) · second clean fiscal year · quarterly governance cadence.
Year-2 gate: three managed numbers healthy · two clean fiscal years · outcomes dataset at 4+ quarterly reports · no compliance item older than a quarter unresolved · Brian's calendar is a choice, not the constraint.
Kill criteria & standing refusals
- Any new line without a named non-Deb owner: doesn't launch.
- Membership <15 at day 180: re-price / re-anchor before any scale spend.
- TO deal undecided at day 150: it decides itself — walk and hire.
- CPA >$254 sustained after the attribution fix: kill the campaign, not the yardstick.
- Measured arbitration win rate materially below scenarios: re-price every pending ledger that week, Sara's included.
- No RED-tier peptides through the deal window · no PI/MVA while ATIC is live · no patient data to ad platforms, ever · no %-of-revenue MSO fees · no deal numbers on staff surfaces · no referral-pattern changes for legal optics.
Source of truth for this board: 70_PLANS/MAYWELL_30_60_90_2026-08-16.md and 70_PLANS/MAYWELL_HORIZON_PLAN_2026-08-16.md. Ticks here are progress tracking; the documents govern.
What would change the plan: the arbitration curve landing far from scenarios · the TO decision · the UTOX audit result · a rent outcome far from FMV · membership traction (the empty-quadrant thesis's live test).
What would change the plan: the arbitration curve landing far from scenarios · the TO decision · the UTOX audit result · a rent outcome far from FMV · membership traction (the empty-quadrant thesis's live test).