EBITDA Impact Battle Group

How benefits and PBM flow through to enterprise value.

This view translates GLP-1, PBM economics, and benefits strategy into something boards actually trade on: EBITDA, valuation, and exit timing. No abstract trend charts — a concrete EBITDA bridge and playbook.

What this battle group answers

• How much of EBITDA drag is coming from benefits and PBM?
• What is realistically recoverable in 12–24 months?
• How does GLP-1 strategy change exit readiness?
• What does a de-risked benefits stack look like on a deal model?

Benefits drag on EBITDA

3.8%

of total EBITDA

Modeled recoverable lift

+0.8–1.2 pts

12–24 month window

GLP-1 headwind

0.9 pts

embedded in benefits trend

Confidence band

High

contracts + claims + benchmarks

EBITDA Bridge (Illustrative)

How Kincaid IQ reframes benefits from "cost center" to a lever on earnings and valuation.

Board-facing view

Illustrative for a 3,500-life employerBased on contracts + claims, not vendor marketing.

$38M

Current EBITDA

- PBM / GLP-1 drag

$42M

Modeled after PBM cleanup

+ Benefits structure

$45M

After full benefits playbook

Exact numbers will differ, but the pattern doesn't: we disentangle PBM spread, GLP-1 policy, and plan design into a bridge that finance leadership can plug directly into their models.

How Kincaid IQ models EBITDA impact

• Ingests PBM contracts, GLP-1 cohorts, and claims to quantify true spread, rebate retention, and high-cost drug drag.
• Links benefits spend to revenue and operating income to calculate benefits-as-%-of-EBITDA and headwind over time.
• Runs scenarios: PBM restructuring, GLP-1 guardrails, and plan redesign — expressed as basis points of EBITDA, not just PMPM.

Where this shows up in board conversations

• Quarterly: "Why is EBITDA under plan?" – Kincaid IQ isolates the portion driven by benefits, PBM, and GLP-1 trend.
• Deals: "What happens to this company's earnings if we fix the benefits stack?" – we show before/after bridges.
• Exit: "Is there a credible story for the next owner to expand margin?" – we quantify remaining upside and de-risk the narrative.

What you get in the EBITDA Impact view

EBITDA Bridge

Visual breakdown: current → PBM cleanup → benefits optimization

Scenario Models

3–5 modeled paths with timeline, confidence, and cash impact

Exit Readiness Score

How defensible is your benefits narrative for the next buyer?

Illustrative case

3,500-life Indiana employer — EBITDA lens, not just trend lines.

De-identified; pattern is typical, numbers are illustrative.

Inputs

• PBM contract and rebate schedule
• 24 months of Rx & medical claims
• GLP-1 cohort and utilization patterns
• Revenue and EBITDA baseline

Findings

• ~0.9 pts of EBITDA drag tied to GLP-1 policy alone
• Spread and retained rebates equivalent to ~0.5 pts
• Benefits structure driving above-peer cost for risk profile

Modeled outcome

• 0.8–1.2 pts EBITDA improvement in 18–24 months
• Cleaner story for lenders and buyers
• Clear handoff: remaining upside the next owner can take

Run an EBITDA Impact scan on your plan.

We'll map PBM, GLP-1, and benefits structure into an EBITDA bridge your finance team can drop straight into the model.

Request EBITDA Impact scan Back to all battle groups