How Pilot Helped Commons Clinic Develop a Sustainable Business Model

With Nick Aubin, Co-Founder and CEO of Commons Clinic

Nick Aubin is on a mission to change healthcare as we know it.

It’s a journey that started when Nick led the growth team at Heal, a value-based, in-home primary care service provider, and became even more resolute after a childhood friend passed away from glioblastoma, an aggressive type of brain cancer. 

After launching Ora Oncology, a startup that supports community oncology providers to thrive in value-based arrangements with health plans for cancer patients at predictable price points, Nick used the lessons learned from running that company and scaling operations at Heal to create the framework for what would become Commons Clinic in 2021.

In an effort to meet the modern-day needs of patients with musculoskeletal issues or conditions, Commons Clinic offers surgical services and end-to-end care for a single, transparent price. This business model is intended to prevent sticker shock and ultimately save patients and health plans some money in the process. 

Nick is also working diligently to consistently provide high-quality care and generate high margins — a balance that is oftentimes difficult to achieve for many healthcare providers. 


Once he was ready to launch Commons Clinic, Nick wanted to nail down prices for all the company’s services, figure out what its margins were going to be, and convey the startup’s compelling value to medical professionals, patients, and investors.

“Financial models, even in healthcare, can be very opaque,” Nick explained. “A lot of the venture-backed healthcare businesses out there don't know their margins. They're really banking on this kind of pot of gold at the end of the yellow brick road by theoretically saving a health plan money, and you end up building a lot of businesses that are underwater and don't really know what their commercial model is.”

After scaling and running two previous healthcare startups, Nick knew that he needed to have clear visibility and control over the financial operations at Commons Clinic from the start. He also wanted to bring in the right finance partner who would be in it for the long haul and know the business inside and out.

In the end, Nick opted to seek out an outsource partner who could meet Commons Clinic’s growing needs over time. 

“I feel like you need a breadth of resources that a single person's not going to solve,” Nick explained. “There's a lot of key person risk there, and then you obviously want to work with someone who’s tech forward, affordable, and so forth.” 


From the get-go, it was clear to Nick that Pilot’s bookkeeping and controller services could meet the Commons Clinic’s complex finance needs. But what ended up being equally or even more valuable to Commons Clinic is Pilot’s CFO services for growing startups.

Before bringing Pilot into the fold, Nick was focused on executing tactical initiatives in addition to developing higher-level go-to-market strategies. It was a workload that would be difficult to balance as the business developed. 

Commons Clinic, for instance, didn’t have a tech stack that could effectively scale with the company as its needs grew over time. Instead, Nick wired money from a bank account to pay vendors and used an employee management platform to pay himself and Commons Clinic co-founder Paulo da Costa. 

To automate this process, Pilot’s cross-functional team helped Commons Clinic find and implement a vendor that made it easy to pay employees. With more time on his hands, Nick could step back and focus more on strategic endeavors.

“We included Pilot essentially from day one so I don’t need to think as much about our books and can focus more on the key milestones that need to happen,” Nick said.

The real challenge, however, came when Nick needed to develop a novel way to price Commons Clinic services like a consumer product. 

“Just because it’s healthcare, it doesn’t mean you can’t run it like a consumer business,” Nick said. 


Pilot’s CFO Services team worked closely with Nick to turn his innovative idea for Commons Clinic’s financial model into a reality. 

“The CFO services have proven to be the absolute best part about what we’re doing,” Nick said. “From the start, they felt engaged and like they were always going to go the extra mile.”

In the end, the CFO Services team helped Nick create an ecommerce-like finance model that enables Commons Clinic to price their services like a consumer product and offer a long-needed layer of transparency for patients.

“Pilot has helped us set up our financial infrastructure and grow really fast with a consumer lens,” Nick said.

This financial model will likely serve as a critical piece of leverage when it’s time for Nick to raise more money for Commons Clinic and ultimately build a sustainable business. Although he created financial models for his two previous private equity-funded healthcare startups, Nick is quick to admit that Pilot’s model for Commons Clinic is polished and generally better than anything that he could have produced on his own.

“Pilot built our Series A model—that’s a pretty big undertaking and very important to us strategically,” Nick said. “They took it on and delivered such a high-quality product.” 

Even if he eventually hires more employees who can take care of administrative tasks and duties, such as revenue cycle management, Pilot will continue to serve as a strategic partner for Commons Clinic, Nick said.

“I would much rather invest my time in resources, into our revenue cycle team, rather than a controller team,” he explained. “Pilot is going to be a core piece of our stack for years to come. I’m excited to see how they evolve with us as we become less of a startup and more of an enterprise.”

Why Pilot Is the Right Fit for Early-Stage Startups

When founders are running early-stage startups, time is extremely valuable and they simply don’t have a whole lot of it to be doing administrative tasks or figuring out their books, so having a partner they can trust to do these essential obligations is key. 

In Pilot’s case, however, the CFO Services team provided additional value to Commons Clinic by helping Nick get more clarity on the company’s margins and develop an innovative financial model for a healthcare startup. With high-quality financials from Pilot in hand, Nick could dedicate more time to running Commons Clinic and raising more capital from investors. 

“The CFO team has added a level of polish and third-party validation that brings a lot of credibility to an early-stage business,” Nick said. “It felt like I could actually delay hiring a CFO for several years, and that’s pretty critical to what has us locked in.”

Along with ensuring that Commons Clinic is recognizing revenue, Pilot’s bookkeeping and controller services enable Nick to get the data that he needs to share with potential investors.  

“All of our books have been super clean and easy—it has been a two-second process for me every month,” Nick said. “I just don’t think about it that much so it’s running pretty well.”

And, if Nick were to start another business, he wouldn’t think twice about bringing Pilot on board. 

“When you start a new business, you end up creating a little tribe of resources you bring from business to business,” Nick said. “These are third parties I trust, so I’ve curated that list over time, and I think it’s clear that Pilot has gone into that sphere for me.”

Commons Clinic is a specialty healthcare provider that offers all-inclusive surgical and ongoing care services at a single, transparent price that’s designed to ultimately save customers and health plans money.

Life before pilot
  • No automated and organized way to pay employees and vendors
  • Financial models built in house for the business
  • Needed to accurately set prices for the company’s services and determine what its margins needed to be
  • Hours spent on bookkeeping and administrative tasks
Life with pilot
  • Newly organized workflows that take no time at all to pay employees and vendors 
  • A game-changing ecommerce-like finance model for a healthcare provider that offers price predictability to patients 
  • Strategic outsourced CFO partners at Pilot who help Commons Clinic raise additional capital
  • A trusted team of finance experts at Pilot who ensure the books for Commons Clinic are done right and in good shape

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